CARE HOMES FOR OLDER PEOPLE
Harpwood Seven Mile Lane Wrotham Heath Sevenoaks Kent TN15 7RY Lead Inspector
Jo Griffiths Announced 25 October 2005 09:30 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 V247055 251005 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Harpwood Address Seven Mile Lane Wrotham Heath Sevenoaks Kent TN15 7RY 01732 882282 o1732 886833 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) Marcford Limited Mrs Anna Christine Budd CRH 50 Category(ies) of OP Old age (50) registration, with number of places Harpwood H56-H06 S23952 Harpwood V247055 251005 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 12/04/05 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 some have ensuite facilities. Those bedrooms without en-suite facilities have access to a nearby bathroom. 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 V247055 251005 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was announced. Time was spent talking with service users and their relatives and a number of feedback cards were received. The Manager provided feedback on the progress made at the home since the last inspection. What the service does well: What has improved since the last inspection? What they could do better:
The temperature of the medication room needs to be monitored to ensure it does not get too warm and spoil medicines. Any controlled medicines need to be recorded in a bound book. Some service users would like a review of the activities that are available and more opportunities to go out. The application form that new employees complete needs updating to ensure safe recruitment of carers. Service users would benefit from all staff completing Adult Protection training, core safety training and more staff undertaking the NVQ award. The induction for new staff should meet the standards set by the National Training Organisation. Staff should be formally supervised 6 times a year to help them develop in their role. All areas of the home need to be kept free from unpleasant odours. Service users would benefit from a clearer fire procedure for them to read and the complaints procedure needs to be updated to tell service users they can contact CSCI at any time.
Harpwood H56-H06 S23952 Harpwood V247055 251005 Stage 4.doc Version 1.40 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Harpwood H56-H06 S23952 Harpwood V247055 251005 Stage 4.doc Version 1.40 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 V247055 251005 Stage 4.doc Version 1.40 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) 2, 3, 4, 6 Service users have their needs fully assessed before being offered a place at the home and they know the home will be able to meet these needs. Service users have a contract with the home. EVIDENCE: Before moving into the home prospective service users have a full assessment of their needs. This assessment is very detailed and covers all areas of physical, social, emotional and personal needs. The Manager confirms with the service user, after the assessment, whether the home can meet their needs. Service users have a signed contract with the home that specifies the terms and conditions. The home can offer short term stays to service users but does not offer intermediate or rehabilitative care. Harpwood H56-H06 S23952 Harpwood V247055 251005 Stage 4.doc Version 1.40 Page 9 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, 9, 10 Service users have a care plan that meets their needs including good provision for their health needs. They are protected by safe procedures for administering their medication. Service users feel they are treated with respect. EVIDENCE: Service users have a plan of care that meets their assessed needs. Since the last inspection care plans are now reviewed more frequently. Evidence was seen where a need had changed and this had been clearly reflected in the reviewed care plan. The care plans are well written and easy for staff to follow. Service users health needs are met by various health professionals who can visit the home if required. Service users said that their health needs are met promptly and they gave examples of this. Service users medication is stored and administered safely. The medication room was warm and it is recommended the temperature of this be monitored. A bound book is needed to safely record controlled medicines. Service users said that they felt the staff treat them with care and respect. Staff were seen to interact positively with service users during the inspection. Harpwood H56-H06 S23952 Harpwood V247055 251005 Stage 4.doc Version 1.40 Page 10 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, 14, 15 Service users enjoy the activities but would like more opportunities to get out of the home for activities of their choice. They can maintain contact with relatives and friends and are supported to make as many choices about their lives as possible. Service users enjoy a balanced and varied diet. EVIDENCE: Records show that a range of activities are provided within the home. These include entertainers, games and puzzles, pets, music and bingo. Feedback from service users indicated that some would prefer some more stimulating activities and some service users said that they do not have the opportunity to go out very often. Whilst the majority of the service users are satisfied with the activities provided it is recommended that the Manager review the programme with the service users group and ensure their interests are reflected. Service users said they can receive visitors when they wish and a number of relatives were at the home during the inspection and spoke with the inspector. There are sufficient private spaces for service users to see their guests. Service users said that they have lots of choice about their daily routine and can choose when to get up and go to bed. Service users choose where they would like to eat their meals. Service users said they were generally happy with the meals provided and the choice available. Homemade cakes and tea and coffee are available throughout the day. Since the last inspection the meals service users actually eat are being accurately recorded.
Harpwood H56-H06 S23952 Harpwood V247055 251005 Stage 4.doc Version 1.40 Page 11 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, 17, 18 Service users know that their concerns will be taken seriously and responded to. They are supported to maintain their legal rights and are protected from abuse. EVIDENCE: The home responds well to any complaints and a clear record is kept. There has been 2 minor complaints made to the home since the last inspection and these have been dealt with effectively. It is recommended that the home’s complaints procedure advises service users that they can contact CSCI at any time. Service users said that they knew who to talk to if they had any concerns. Service users are supported to maintain their legal rights. The home has contacts with an advocacy service that specialises in legal matters that they can contact for support. An adult protection policy is in place. Some staff have received training in this area and it is recommended that this be provided for all staff. CRB disclosures have been received for all employees. Harpwood H56-H06 S23952 Harpwood V247055 251005 Stage 4.doc Version 1.40 Page 12 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, 23, 24, 25, 26 Service users live in a comfortable and safe home. They have access to plenty of communal and personal space and bathroom facilities. The home is well furnished and clean. EVIDENCE: The home continues to be well maintained, decorated and furnished to a high standard. Service users and their relatives said the home is always clean, warm and comfortable. Service users have access to a number of large communal area and personal space. All areas of the home are fully furnished and well lit. Bedrooms have been personalised by the service users with their own belongings. The home has large garden areas for service users to use. Service users have plenty of toilet and bathroom facilities to use, some bedrooms have en suite facilities. Service users are happy with the laundry services at the home. An unpleasant odour was detected in one bedroom and the Manager provided evidence of how this was being addressed. Harpwood H56-H06 S23952 Harpwood V247055 251005 Stage 4.doc Version 1.40 Page 13 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, 28, 29, 30 Service users are supported by sufficient numbers of competent staff. They would benefit from staff undertaking further training and qualifications. Service users are protected by safe recruitment procedures. EVIDENCE: Service users and relatives said that they felt that most of the time there were sufficient staff on duty. They felt the staff were always busy but said staff always come quickly when they are called. The service users spoke highly of the staff and said they are all very caring. 3 of the care staff have completed their NVQ award and 4 more are registered to start. It was acknowledged that this has reduced since the last inspection because some trained staff had left the home. Staff have completed training in COSHH and fire safety since the last inspection. Training is planned for Manual Handling, 1st AID and Health and Safety. All staff undertake an induction when they join the home. The Manager intends to review this to ensure it meets the TOPSS standards. The recruitment procedures for the home are robust and all checks are made before an employee can start work. The Manager was advised that the application form requires a small amendment to meet the reviewed regulations. Harpwood H56-H06 S23952 Harpwood V247055 251005 Stage 4.doc Version 1.40 Page 14 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, 33, 35, 36, 38 Service users live in a home that is run by a competent Manager. They are consulted on their views and their health, welfare and financial interests are safeguarded. EVIDENCE: The Manager of the home is now registered and holds the RMA Award. The manager carries out surveys for service users twice a year. The results of the recent survey were seen and were positive. Service users meetings are occasionally held to discuss the running of the home. The minutes showed action had been taken in response to service users’ requests. Money is held securely on behalf of some service users. Staff have supervision sessions with their manager, but it is recommended that these sessions take place at least 6 times a year. Service users are protected by safe procedures in the home and a well maintained environment. It is recommended that the fire procedure be displayed in a format service users can easily read. Risks are appropriately assessed.
Harpwood H56-H06 S23952 Harpwood V247055 251005 Stage 4.doc Version 1.40 Page 15 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. 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 x 3 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 3 15 3
COMPLAINTS AND PROTECTION 4 3 3 x 3 3 3 2 STAFFING Standard No Score 27 3 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 3 2 3 x 3 x 3 2 x 2 Harpwood H56-H06 S23952 Harpwood V247055 251005 Stage 4.doc Version 1.40 Page 16 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 OP9 Regulation 13(2) Requirement The registered person shall make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. In that, The temperature of the medication storage room must be kept below 25c A bound and numbered book must be used to record controlled drugs. 2. OP26 16(2)(k) The registered person shall, having regard to the size of the care home and the numbers and needs of the service users keep the care home free from offensive odours. The registered person shall not employ a person to work at the care home unless he has obtained in respect of that person the information and documents specified in schedule 2. In that,
Harpwood H56-H06 S23952 Harpwood V247055 251005 Stage 4.doc Version 1.40 Page 17 Timescale for action 21/11/05 31/10/05 3. OP29 19(1)(b) Schedule 2 31/10/05 In addition to details of criminal convictions, cautions must also be disclosed by the applicant. A full employment history must be reuested rather than just the past 10 years of employment. 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. Refer to Standard OP12 Good Practice Recommendations It is recommended that a review of the activity timetable take place to ensure all service users interests and needs are reflected. It is also recommended that this be clearly displayed so that service users can see the planned activities for the week. It is strongly recommended that service users be given the opportunity to go out more frequently. It is recommended that all staff complete training in adult protection. It is recommended that at least 50 of the care staff achieve the NVQ award at level 2 or above. It is recommended that the Manager continue plans to provide training for staff in Manual Handling, 1st Aid and Health and Safety before Dec 2006. It is also recommended that the induction programme for new staff covers all areas identified in the TOPSS standards. 6. 7. 8. OP36 OP38 OP16 It is recommended that the frequency of formal care staff supervision increase to at least 6 times per year. It is recommended that the Fire Procedure be displayed in a format all service users can easily understand. It is recommended that the complaint procedure be
H56-H06 S23952 Harpwood V247055 251005 Stage 4.doc Version 1.40 Page 18 2. 3. 4. 5. OP13 OP18 OP27 OP30 Harpwood reviewed to ensure it advises the reader that they can contact CSCI at any stage of their complaint. Harpwood H56-H06 S23952 Harpwood V247055 251005 Stage 4.doc Version 1.40 Page 19 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 V247055 251005 Stage 4.doc Version 1.40 Page 20 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
