Inspection on 28/10/08 for Harpwood

This inspection was carried out on 28th October 2008.

CSCI found this care home to be providing an Good service.

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 20/11/06

Harpwood 02/08/06

Harpwood 25/10/05

Harpwood 12/04/05

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 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Harpwood Harpwood Seven Mile Lane Wrotham Heath Sevenoaks Kent TN15 7RY     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Wendy Mills     Date: 2 8 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Harpwood Seven Mile Lane Harpwood Wrotham Heath Sevenoaks Kent TN15 7RY 01732882282 01732886833 admin@harpwood.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Anna Christine Budd Type of registration: Number of places registered: Marcford Limited care home 50 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Harpwood has forty-two single and four shared bedrooms on the ground and first floors. The homes policy is to offer single bedroom occupancy with the capability of providing residence to a couple wishing to have a shared room. Twenty-nine bedrooms have an en-suite facility. Residents have the benefit of a passenger lift. The home is approached by a long, uphill drive from the main road. There are extensive grounds surrounding the premises with two good-sized parking areas, one close to the home and one approximnately half way up the main drive. Bus services are nearby and the home is close to major road networks. Twenty-four hour support for residents is provided. This includes three members of staff on duty every night. All bedrooms and communal areas have call bells that enable residents to summon immediate Care Homes for Older People Page 4 of 25 Over 65 50 0 Brief description of the care home assistance. The weekly fees range from £350 to £440. Additional charges are made for items such as private phone bills, newspapaers, hairdressing and chiropody. Further information about the fees and facilities that this home offers can be obtained by contacting the service directly. Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This visit was unannounced and formed part of the inspection process under the Care Standards Act 2000. This report is compiled using evidence gathered during the visit and information that we have received about the service since the last inspection. This includes information that the home has sent us, such as their Annual Quality Assurance Assessment (AQAA) and notifications about significant events that have occurred in the home, that are required under the Act, as well as comments from the residents, relatives and health and social care professionals. The findings of this inspection will result in the home being given a star rating. During this visit five residents, two relatives and three members of staff were spoken to in private to seek their views about the home. Other residents and staff were spoken Care Homes for Older People Page 6 of 25 to during a tour of the home. Documentation, including care plans and staff files, was examined and a tour of the home made. case tracking, based on three care plans was carried out. This means that the care given to three residents was followed in detail. Their care plans were checked against medication records, the daily records and their own views. Direct and indirect observations were made throughout the visit and detailed discussion was held with the registered person. Throughout this report the people who use this service will be referred to as residents as this is their preferred term. The quality rating for this home is 2 Stars. This means that the home is judged to be good. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home gives prospective service users and their supporters good information about the home. This means that they can make an informed decision about moving into the home. Appropriate pre admission assessments are made. This means that only those people whose needs can be met and who are suited to the home are offered a place at the home. Evidence: The home gives the people who use the service plenty of information about what is going on in the home. The statement of purpose and the service users guide have recently been updated. Three care plans of people who had recently come to live in the home were examined. Care Homes for Older People Page 10 of 25 Evidence: These showed that appropriate pre admission assessments had been made. The information gained at these assessments is used to draw up service user plans so that staff are clear about the needs and wishes of individual residents. Care Homes for Older People Page 11 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home promotes the health and well being of the residents. This means that they can enjoy their life in the home in as good health as possible. Evidence: There is a written plan of support for each service user. These are important documents. This is because they form one of the means by which the service users and their supporters can be tell that they will be supported in the manner of their choice. Also, the plans are a source of reference information for the care workers who need to ensure that they assist people in a consistent and appropriate manner. The care plans are up to date and in order. The care needs and wishes of the residents are noted. However, these could be improved if more detail about the cultural background of each resident were to be included. There is good evidence that the home seeks appropriate medial advice on behalf of the residents. Local GPs make calls to the home and there are regular visits from district nurses and other health care professionals such as chiropodists. Relatives said that Care Homes for Older People Page 12 of 25 Evidence: they are very pleased with the care at the home and that there is good communication about progress and concerns. residents said that they are very well cared for and that the staff are kind. There are sound policies and procedures for the management and administration of medicines in the home. Medicines are stored safely and securely and records are well maintained. The local pharmacist has recently carried out an audit of the management and administration of medicines in the home and was satisfied with procedures. Care Homes for Older People Page 13 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There has been an improvement in activities in the home but the appointment of an activities co-ordinator would further improve activities in the home. Evidence: The home has a post for an activities co-ordinator but this is vacant at present. The registered manager said that the post had been advertised but they had not been successful in recruiting a suitable person as yet. There is a spacious lounge with views over the grounds. Residents said that they really enjoy watching the wildlife and the changing seasons. In a corner of the lounge there is an area with plenty of board games, arts and crafts materials and books. Staff said that they try to encourage the residents to take part in activities but not all of them are keen to join in. Residents spoke to said that they had plenty to keep them occupied and that they can choose how they spend their time. Several said that they enjoyed the privacy of their own rooms where they could choose to spend time watching television, reading, listening to music or reading their newspapers. Care Homes for Older People Page 14 of 25 Evidence: Relatives said they thought that there was enough for the residents to do. They said they are always made welcome and can visit at any reasonable time. The home has a hairdressing room and some residents said that they enjoyed their visits to the hairdresser. On the day of this visit there was plenty of fresh and nutritious produce in the home. Residents said that the enjoy their meals and always have plenty to eat. They said that there is always a choice and that they can ask for something different if they wish. There is a large dining room and residents can choose to eat here or in their rooms. Care Homes for Older People Page 15 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has sound policies for the handling of concerns, complaints and safeguarding. Staff understand these and are prepared to put them into practice if necessary. This means that the home works to protect the residents from all forms of abuse. Better recording of day to day concerns would make it easier to audit these issues. Evidence: There are clear policies and procedures for the handling of concerns and complaints and for the safeguarding of vulnerable people. There have been no formal complaints recorded since the last inspection. The registered manager said that day to day concerns are dealt with as they arise. These concerns are recorded in the care plan of the individual. This way of recording means that it is difficult to review the number and type of these concerns. The home should consider recoding these issues in a separate place as well. This would mean that closer watch could be kept on the frequency and type of day to day concerns. Should one particular issue, for example, the loss of items of personal clothing then measures can be taken to address the root cause. Staff all receive instruction in safeguarding vulnerable people both during the induction period and as on going training. Training records and certificates on staff files show that appropriate training is provided. Staff spoken to confirmed that they had received Care Homes for Older People Page 16 of 25 Evidence: this training and that they clearly understand their duty to report any concerns. They said that they would always be prepared to report concerns and that they understand the reporting mechanisms. They said that they would be prepared to go directly to the homes owner if necessary. Care Homes for Older People Page 17 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The environment is spacious, clean and well maintained. This gives the residents a pleasant and homely place in which to live. Evidence: The home is spacious and well maintained. There is plenty of communal space with two lounges, a dining room and a hairdressing room. There is a large lounge with lovely views over the gardens. Residents said that they really enjoy this room as they can watch the wild life and flowers outside. The furniture in the lounge is arranged in small groups and this gives a homely feel even though the lounge is large. There is a smaller lounge and a light and airy dining room. All areas were seen to be clean and well maintained on the day of this visit. Outside there are large and well stocked gardens. The home is approached by a long drive. There is ample parking space with two parking areas. The home has a redecorating and refurbishment programme and rooms are decorated as they become vacant. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing levels and staff training are sufficient to meet the needs of the residents. However, the home must ensure that staff do not work very long hours as this may effect their ability to give good care. Staff morale is good and there is a cheerful and committed staff team. There are sound recruitment policies and procedures. This means that all staff are properly vetted before being offered employment in the home. Evidence: The registered manager told us that they had experienced a higher staff turnover that expected over the past year and that recruitment had initially been slow. This is now improving and there are sufficient staff rostered for each shift to meet the needs of the residents. However, more staff are needed to ensure that there is always cover should there be a period of staff sickness as was the case during the two weeks previous to this visit. We were told that gaps in staff rosters are usually filled by existing staff taking on extra hours. This is good because it means that the residents receive care by staff who know them but it is essential that the registered persons ensure staff are not exceeding the conditions of their work permits or the Working Times Directives. it is essential that permanent staff are not working such long hours that their ability to give Care Homes for Older People Page 19 of 25 Evidence: good care is lessened by tiredness. Three members of staff were interviewed in private. They said that the home is a very nice place to work and that they get sufficient training to help them do their jobs. The training matrix showed that statutory training has been undertaken and that there is an ongoing programme. There are regular staff meetings and staff said that they feel able to express their views at these meetings. They said that their views are listened to and that, where practical, their ideas are put into practice. A sample of staff files was examined. There was good evidence that all appropriate checks had been made before an applicant had been offered employment at the home. CRB checks are on file, POVA first has been obtained and written references are in place. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and the views of residents, relatives and staff are listened to and acted upon. This means that the home is run in the best interests of the residents. Evidence: The registered providers take an active interest in the running of the home. The registered manager has resigned since the last inspection and a new manager has been appointed. She is in the process of preparing her application for registration with the Commission. The is also a deputy manager who has worked at the home for a number of years and is very familiar with the needs of the residents and the running of the home. Staff said that they can talk to the manager and that there is an open door policy. There are good organisational structures with good reporting mechanisms so staff are clear about their roles and responsibilities. Care Homes for Older People Page 21 of 25 Evidence: There are sound quality assurance processes. Relatives are encouraged to have their say, there are regular quality assurance visits by the registered provider and residents and there is a comments book. Relatives say that they can easily talk to the manager and that any concerns are dealt with quickly. The home is well maintained and there is a continuous improvement programme. Staff supervision is in place and staff say that they are properly supervised. There were some minor health and safety concerns noted during a tour of the home. For example some storage baskets were place on high shelves. It appeared that they might tumble down at any moment. These, and some other minor hazards, were removed immediately when pointed out. More diligent daily checks of the home would help to make sure that such hazards are not ignored. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 24 of 25 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 25 - 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!