Inspection on 12/04/05 for Harpwood

This inspection was carried out on 12th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Harpwood 28/10/08

Harpwood 20/11/06

Harpwood 02/08/06

Harpwood 25/10/05

Harpwood 12/11/04

Harpwood 15/06/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Harpwood Seven Mile Lane Wrotham Heath Sevenoaks, Kent TN15 7RY Lead Inspector Jo Griffiths Unannounced 12 April 2005 10:30 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Harpwood H56-H06 S23952 Harpwood V217673 120405 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Harpwood Address Seven Mile Lane, Wrotham Heath, Sevenoaks, Kent, TN15 7RY Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01732 882282 01732 886833 Marcford Limited Anna Budd CRH Care Home 50 Category(ies) of OP Old Age (50) registration, with number of places Harpwood H56-H06 S23952 Harpwood V217673 120405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 12/11/04 Brief Description of the Service: Harpwood is a large care home that provides personal care and support to up to 50 adults aged 65 and over. The home is not registered to provide a service to people with Dementia. The home is able to accomodate people using wheelchairs and a lift is available to reach the first floor. The majority of bedrooms are single and have ensuite facilities. Those bedrooms without ensuite facilities have access to a nearby bathroom. The home can provide double accomodation subject to availability. The home is set within extensive grounds just off of the A20 at Wrotham Heath. The towns of Sevenoaks, West Malling and Maidstone are easily accessible by car or public transport. The M20 Motorway can be accessed approximately 2 miles away. The home benefits from being situated in a peaceful location and the grounds are home to a range of small wildlife. Harpwood H56-H06 S23952 Harpwood V217673 120405 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced Inspection was carried out by Inspectors Jo Griffiths and Harbinder Ghir between 10.30am and 2.30pm. During the Inspection the views of 9 service users and 1 relative were sought. The Manager, Anna Budd, was present throughout the Inspection. A number of staff were spoken and some records were inspected. A tour of the home took place. There have been no complaints received about this home. What the service does well: What has improved since the last inspection? Since the last Inspection Anna has applied to become the Registered Manager and is waiting for her certificate to arrive. Service users have been issued with an updated Statement of Purpose for the home, which tells them about the facilities and services offered. To make Harpwood H56-H06 S23952 Harpwood V217673 120405 Stage 4.doc Version 1.20 Page 6 medication procedures safer Anna has obtained some new information on safe handling of medicines for all the senior staff to follow. The downstairs toilet door lock has now been changed to a safer style that service users find easier to use. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Harpwood H56-H06 S23952 Harpwood V217673 120405 Stage 4.doc Version 1.20 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Harpwood H56-H06 S23952 Harpwood V217673 120405 Stage 4.doc Version 1.20 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 3, 4 and 5 Prospective service users are given the information they need to make an informed decision about moving into the home. EVIDENCE: The Statement of Purpose and Service User Guide were seen and these contain all the information needed by service users about the services offered. Both these documents have been presented in a clear format that the people living at Harpwood can read and understand. Service users are fully assessed prior to being offered a place at the home so that they know their needs will be met. Service users said that they had been able to visit for a trial period before making their final decision about moving to the home. It was confirmed by the Manager that these visits are used as an opportunity for the service user and their family to see if they like the home as well as provide an opportunity for the Manager to assess the service users needs. Harpwood H56-H06 S23952 Harpwood V217673 120405 Stage 4.doc Version 1.20 Page 9 Four care plan files were inspected and these contain full and detailed assessments of individuals needs. Service users said that all their care needs are being met and they know what services they are entitled to receive. Harpwood H56-H06 S23952 Harpwood V217673 120405 Stage 4.doc Version 1.20 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 10 and 11 Service users have a clear plan of care that meets their individual care and health needs. They feel they are treated with respect and their rights are upheld. EVIDENCE: Four care plans were examined and these contain clear and directive information for staff to ensure the support needs of the service user are met, including personal care, mobility, social and health needs. Each service user has had an assessment of their needs that has been used to formulate the plan. Service users said they had been involved in developing their plan and the plans had been signed by them. Risk assessments have been completed as part of the plan of care so that service users safety is maintained during everyday activities. All the care plans have been reviewed within the last 8 months and the manager has begun planning a new system for reviewing care plans more frequently so that service users changing needs are met. It was agreed this would be examined further at the next inspection. Harpwood H56-H06 S23952 Harpwood V217673 120405 Stage 4.doc Version 1.20 Page 11 Care plans evidenced service users health needs are met by the multi disciplinary team with regular contact with the GP, optician, district nurse, dentist and chiropodist. Service users can have visits at home if they prefer or need this. There are no service users with pressure sores in the home and the Manager described a range of preventative equipment in use for prevention. Service users gave positive feedback during the inspection about the approach of the staff team, comments included “nothing is too much trouble for the carers” and “ The staff are very caring” Appropriate locks have been fitted to all bathrooms since the last inspection that are safer and easier for service users to use and staff were seen to knock on service users doors before entering, maintaining their privacy. The staff on duty were observed indirectly throughout the inspection to interact in a positive manner with service users, demonstrating respect for them. Service users have their mail delivered to their rooms to open in private. Service users are treated with respect and dignity by the staff team and are enabled to be as self-managing as possible in their own care. Assessments within the care plans showed that service users have been asked about their wishes and preferences surrounding the end of their life. These have been recorded sensitively in the plan of care to ensure these wishes are respected. Harpwood H56-H06 S23952 Harpwood V217673 120405 Stage 4.doc Version 1.20 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 and 15 Service users have access to a range of activities, can make choices about all aspects of their daily routine and are supported to maintain contact with family, friends and the wider community. They receive a wholesome and appealing diet. EVIDENCE: Service users said that the home provides a range of activities including musicians, bingo, sing-along and religious ceremonies. Visitors arrived at the home during the inspection and were welcomed and invited to stay for lunch. Service users and relatives said that links have been formed with voluntary organisations in the community who arrange activities such as social lunches. One service user has a particular interest in gardening and the Manager has arranged for them to manage their own area of the homes garden. Risk assessments have been completed for this to ensure their safety at all times. The service user was enjoying working in the garden during the inspection. Service users have a choice of meals that are served at appropriate times in pleasant surroundings. The chef described how the 4-week menu is planned and reviewed taking into account service users wishes, dietary needs and seasonal availability. A special menu was seen for a service user who requires Harpwood H56-H06 S23952 Harpwood V217673 120405 Stage 4.doc Version 1.20 Page 13 a gluten free diet. The main menu for the home was examined and this provides a varied and balanced diet. A choice of two hot meals is available at lunchtime or an alternative cold dish and service users are asked to choose what they would like for breakfast, lunch, dinner and supper for the following day. Home cooked desserts are included on the menu and snacks and drinks are available throughout the day. It is recommended that the home maintains a record of the foods and amounts service users are actually eating to monitor nutritional intake and likes and dislikes. Service users said they are happy with the choices and the quality of the food and the meal that was served during the inspection was nicely presented. Some service users eat in the main dining room and others in their rooms, they said they are able to choose and can vary where they eat from day to day. For one group of 4 individuals arrangements have been made for them to eat together in a smaller dining room upstairs in the home as they have expressed to the Manager that they did not always wish to use the main dining room, but that they also did not wish to eat in their own rooms. This event is seen as a weekly opportunity for a social gathering for friends. Harpwood H56-H06 S23952 Harpwood V217673 120405 Stage 4.doc Version 1.20 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 Service users and their relatives are aware of how to make a complaint and are confident that their concerns will be acted upon. EVIDENCE: Service users have access to a clear complaints procedure that gives information about who they can direct complaints to and the timescales for response. The complaints procedure is displayed within the home and included in the Statement of Purpose and Service User Guide. Service users and relatives said they are aware of how to complain and were confident that the Manager would resolve any issues quickly. The home has not received any complaints but has received a number of letters of compliment from service users and relatives and these were viewed during the inspection. Harpwood H56-H06 S23952 Harpwood V217673 120405 Stage 4.doc Version 1.20 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 23, 24, 25, 26 Service users live in a safe, well-maintained and clean environment that has a high standard of décor, furnishing and fittings and is homely and pleasant. EVIDENCE: Service users occupy spacious single bedrooms. These are personalised and service users spoken with expressed their satisfaction with their rooms, one said, “it is just right for what I need and lovely and clean”. The majority of rooms have ensuite facilities and where these are not included a suitable bathroom is located nearby. The home has sufficient toilet and bathroom facilities for the number of service users. The home has a number of communal lounge and dining areas that are all fully furnished including radio and television. Service users are able to access the large garden and patio areas and said they enjoy doing this in the summer. Harpwood H56-H06 S23952 Harpwood V217673 120405 Stage 4.doc Version 1.20 Page 16 The home is warm and lighting is appropriate for the service users needs whilst maintaining a domestic style. The lounge and dining areas benefit from large windows giving the home a light and airy feel. Some equipment and aids were seen in the home to assist service users who have limited mobility and these have been well maintained and serviced. Call bells are fitted in all areas of the home and when tested the response by the staff was fast. Service users commented that generally staff responded very quickly to the call bells. The home is kept extremely clean throughout and some service users and relatives have sent letters to the home commenting on the high standard of maintenance and cleanliness. These letters have been kept by the Manager as part of the ongoing quality assurance process. A team of domestic workers are employed and the Manager is looking to replace the laundry assistant that has recently left. Harpwood employs a maintenance person and a rolling programme of decoration is in place. The reception area of the home has recently been decorated and service users were happy with the style and colour. The home has a separate laundry room with sufficient equipment and it is clean and hygienic. Service users said that their clothing is well looked after and is always returned from the laundry quickly. The kitchen was viewed and this is kept clean and hygienic. The chef talked about the last environmental health inspection at which there had been no requirements. The one recommendation made was in hand with the chef. Service users can receive visitors in private, although there is not a room specifically allocated for this purpose a small lounge is currently used and the Manager is looking to adapt a vacant bedroom to a visitor’s room. Harpwood H56-H06 S23952 Harpwood V217673 120405 Stage 4.doc Version 1.20 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 30 Service users are supported by an enthusiastic workforce that strives to continually improve the quality of life for them. The numbers of staff employed are sufficient to provide the level of care required. EVIDENCE: Staff rotas were examined and evidenced effective planning to ensure full and consistent cover. Harpwood does not use agency staff, providing consistent support by a team that are familiar to the service users. Service users and relatives spoken with stated they felt sufficient staff were on duty at all times to meet the needs of all service users. They praised the approach and manner of the staff. The staff spoken with demonstrated commitment to their role and a good understanding of service users individual needs. Good practice was seen throughout the day in relation to the way that support was given to service users. The staff are enthusiastic about training and development and have undertaken a range of courses between them. The records of training courses completed by staff were seen and this showed that most of the team have completed the mandatory training including first aid, adult protection, health and safety, fire and manual handling. Those staff who have not yet completed these courses will be doing so within the next 6 months. The plans for this Harpwood H56-H06 S23952 Harpwood V217673 120405 Stage 4.doc Version 1.20 Page 18 were seen on the training matrix. Senior staff administer medication, they have received training in this subject and the Manager has recently obtained information from the Royal Pharmaceutical Society on the safe handling of medicines for staff to follow. Harpwood H56-H06 S23952 Harpwood V217673 120405 Stage 4.doc Version 1.20 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 38 The Manager and the senior team provide clear and open leadership throughout the home. The health and safety of service users is maintained whilst promoting their choices and independence. EVIDENCE: The Manager is suitably qualified and has a clear vision for the home, which she has effectively communicated to service users, relatives and staff. The Manager has worked with older service users with a range of needs for many years and has recently completed the Registered Managers Award, this is awaiting certification. She has been employed at Harpwood for some time and has built good relationships with staff, service users and relatives. Staff and service users spoke with high regard for the Managers approach. Staff said they feel well supported and have daily contact with the Manager and the senior team. They said they are involved in the running of them home Harpwood H56-H06 S23952 Harpwood V217673 120405 Stage 4.doc Version 1.20 Page 20 and this makes them feel valued. Service users said the Manager is approachable and always around if you need to speak to her. They said they are not afraid to say when they are unhappy and are often asked for their views. The Manager demonstrated through discussion, a clear understanding of the philosophy of the home and the needs of the service users and any current issues. The Manager monitors health and safety within the home and regularly walks around all areas to check for safety issues. Evidence was seen that fire safety equipment has been recently serviced and a fire risk assessment has been completed and agreed with the fire officer, this has been recently updated. Risk assessments have been completed for individual service user activities and all areas of the environment to ensure the safety of service users, staff and visitors. The environmental health officer carried out an inspection of the kitchen last year and there were no requirements made. The recommendation of fixing fly screens to the kitchen windows is being investigated by the chef. Staff have been trained in most areas of health and safety and they are able to demonstrate a good understanding of risk assessment and the need to follow procedure. Harpwood H56-H06 S23952 Harpwood V217673 120405 Stage 4.doc Version 1.20 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 4 3 3 3 3 3 3 4 STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 3 x x x x x 3 Harpwood H56-H06 S23952 Harpwood V217673 120405 Stage 4.doc Version 1.20 Page 22 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP 15 OP7 OP30 Good Practice Recommendations It is recommended that the home records and monitors the actual nutritional intake of service users. It is recommended that the Manager implement the planned system for reviewing care plans at least monthly. It is recommended that all staff complete core training and updates in line with the National Occupational Standards. Harpwood H56-H06 S23952 Harpwood V217673 120405 Stage 4.doc Version 1.20 Page 23 Commission for Social Care Inspection The Oast, Hermitage Court Hermitage Lane Maidstone Kent, ME16 9NT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Harpwood H56-H06 S23952 Harpwood V217673 120405 Stage 4.doc Version 1.20 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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