Inspection on 21/08/07 for Harrison House

This inspection was carried out on 21st August 2007.

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

Harrison House 07/03/07

Harrison House 26/07/06

Harrison House 16/12/05

Harrison House 24/08/05

Harrison House 10/12/04

Harrison House 01/07/04

Harrison House 12/02/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Harrison House Liverpool Road South Maghull Liverpool Merseyside L31 8BS Lead Inspector Mrs Trish Thomas Key Unannounced Inspection 21st August 2007 11:00 X10015.doc Version 1.40 Page 1 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 Harrison House DS0000005407.V346291.R01.S.doc Version 5.2 Page 2 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. Harrison House DS0000005407.V346291.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Harrison House Address Liverpool Road South Maghull Liverpool Merseyside L31 8BS 0151 526 0564 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) hhmanager@parkhaven.org.uk Parkhaven Trust Mrs Claire Louise Burgess Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places Harrison House DS0000005407.V346291.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users to include up to 24 OP. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 7th March 2007 Date of last inspection Brief Description of the Service: Harrison House is a care home for 24 older people, which is surrounded by extensive and well-maintained gardens. Harrison House is owned by Parkhaven Trust and the registered manager is Mrs. Claire Burgess. The service provides seven placements for respite care, contracted by Sefton Social Services and the remainder of places are for permanent residency. Harrison House is situated in a residential area, close to bus routes and with shops and restaurants in the general area. All residents who live permanently in Harrison House are registered with a local G.P., (and those receiving respite care have temporary access to doctors during residency). There are arrangements for referrals to be made to district nurses and paramedical services as needed. There are three ground floor bedrooms with a passenger lift to upper floors, where the remainder of bedrooms are situated. The weekly charge for this service is £370 :00p. Harrison House DS0000005407.V346291.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The visit was un announced and the methods used to assess the service in Harrison House were, discussion with the senior person in charge, Sue Riding (in the manager’ absence). Discussion also took place with residents and the staff on duty. Records compiled in Harrison House, regarding staffing, quality assurance and health & safety were read. The care of two residents was tracked through checking action plans against assessments and assessing the systems in place for risk management and care reviews. What the service does well: What has improved since the last inspection? Requirements from the last inspection have been met regarding a hospitalization plan for one resident and improvements to the medication administration recording system. In response to an individual resident’s personal circumstances, in consultation with interested parties, a written procedure has been produced. This is the Harrison House DS0000005407.V346291.R01.S.doc Version 5.2 Page 6 guidance to be followed by care staff, in any instance where hospital admission may be needed for this resident. To ensure the safe recording, administration and audit of medicines, codes are inserted in the medication administration records for any medication not administered to the resident. The conservatory and outside decking and ramp have been completed and provide enhanced communal spaces for residents with beautiful views of the grounds. There is an ongoing decoration and replacement programme in Harrison House, and improvements to the décor and facilities are continual. Staff have taken action to arrange placements for three residents whose placements for respite in Harrison House, proved to be inappropriate. It was not possible to read the pre-admission assessments for these people during this visit because, as part of the single assessment documentation, they had been transferred as each individual was discharged. What they could do better: 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. The summary of this inspection report can be made available in other formats on request. Harrison House DS0000005407.V346291.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Harrison House DS0000005407.V346291.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. To ensure that Harrison House can meet their assessed needs, prospective residents have had their needs assessed before moving in. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Standard 3. Harrison House provides respite and permanent places for elderly residents subject to individual assessment. The system in place for admitting people to the respite service is as follows : Prospective residents have their needs assessed by social workers and the information is faxed to Harrison House from social services before each person moves in. This is to ensure that the services and facilities in Harrison House will meet the person’s needs. For prospective residents referred for permanent placement, in addition to social work assessments, staff from Harrison House carry out an assessment using a standardised format. Prospective residents are invited to visit the home to meet staff and residents before moving in, to ensure they feel relaxed and Harrison House DS0000005407.V346291.R01.S.doc Version 5.2 Page 9 comfortable in Harrison House. A resident of the respite service was spoken with during the visit and said, “I like it so much here that this is my second stay. I have had only good experiences here.” Copies of needs assessments were seen in residents’ care files. Harrison House DS0000005407.V346291.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Care plans address residents’ health and personal care needs and there are satisfactory systems for managing prescribed medication. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Standards 7.8.9.10. All residents have a care plan, which is based on the outcomes of their individual assessments. Residents’ health and social care needs were addressed in their care plans and there were records of reviews and risk assessments. Residents’ diversity is supported in care plans through regular review and risk management to ensure that their independence is maintained. All permanent residents are registered with local doctors and there are arrangements for short-stay residents who do not live permanently in the area, to have access to a G.P. There was evidence in care plans that residents have Harrison House DS0000005407.V346291.R01.S.doc Version 5.2 Page 11 access to local clinics, district nursing services and paramedical services such as chiropody. There is a procedure for managing residents’ prescribed medication and staff on duty said they have received the relevant training and updates. Medication is locked in a cabinet and there are arrangements in place for securing the keys. Medication for two residents was checked and was satisfactory. There were stocks of each drug prescribed as recorded on the medication administration record and the audit trail was in order. Residents said they get their medication daily at the same time, and have trust in staff to manage this for them. For staff guidance, Harrison House has polices on confidentiality, privacy and dignity. Residents looked well cared for and appeared relaxed. They expressed no concerns about the way in which care and support is given in Harrison House. A resident said, “The staff are very considerate, everything is fine, I trust the staff here, they get everything right. Harrison House DS0000005407.V346291.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. The lifestyle in Harrison House meets residents’ expectations and preferences and their meals are wholesome and nutritious. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Standards 12,13,14.15. A part time activities co-ordinator is employed and an activities diary is posted on the residents’ notice board. Residents said the lifestyle suits them, one said she likes to go out on the train. She said she likes her musical DVDs and has many friends in the area. Residents who were spoken with appeared relaxed, reading newspapers in the lounge. A resident was walking in the gardens and said, “I have been here a few months now and things are going well”. Some of the residents prefer to remain in their bedrooms during the day. A couple was visited on the first floor and they said they were comfortable and had no complaints. Harrison House DS0000005407.V346291.R01.S.doc Version 5.2 Page 13 Residents said that there are no undue restrictions on visiting times, their visitors are made welcome by staff and their privacy is respected when friends and family visit. The service principles of Harrison House promote community contact through provision of a respite service. People receive short-term residential care when recovering from illness, or in crisis situations, with a view to returning to the community. One resident who was due to be discharged said, “I have enjoyed staying here and the care is great, I am ready to go home.” Residents’ diversity is respected through recording their beliefs and making arrangements for visits from local clergy, which are advertised on the residents’ notice board. There is a non- denominational service once a month in Harrison House and Holy Communion administered once a week. Also on the notice board are details of local advocacy services for residents who have no family and may need representation. Residents made very favourable comments about their meals, one resident said, “I wouldn’t swap the place and the food is so very good.” Another comment made was, “It is great here, the food is fabulous and I am very comfortable.” The menus were seen and these are seasonally adjusted with choices and alternatives on offer and provision for special diets. The dining room is very well presented with beautiful views of the grounds. At the time of the visit, tables were laid with clean cloths and cutlery and there was enough seating and places for all the residents. The kitchen is adjacent to the dining room and residents said that food is always nice and hot as it is served and that drinks are served with each meal and at regular intervals. The kitchen was clean and well equipped and catering records had been satisfactorily maintained. There were substantial stocks of fresh, frozen, chilled and dry foods in stock. and storage and labelling of food were satisfactory. Harrison House DS0000005407.V346291.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Residents’ complaints are listened to and they are protected through the training and procedures in place. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Standards 16 and 18. Harrison House has a complaints procedure, which has recently been reviewed. The procedure is given to residents (and their representatives), at the time of moving in and is available to them throughout their stay. According to records in the home, the complaints procedure was discussed at a recent residents’ meeting. A resident who was spoken with during the visit said, “I haven’t had reason to complain, but I would tell the manager if anything was wrong. I would not have a problem doing that as they are there to listen.” There have been no complaints to CSCI about Harrison House since the last visit. A record of internal complaints is maintained on the premises. The last recorded complaint to management was on 11/5/07 regarding bath water being too cold. The matter was resolved through advice from maintenance staff. The water needs to run for 3 minutes due to the length of the pipe-work in Harrison House, before warm water reaches the tap. Harrison House DS0000005407.V346291.R01.S.doc Version 5.2 Page 15 Harrison House has procedures for Protection of Vulnerable Adults and staff have received relevant training. Those on duty were aware of the indicators of abuse and the reporting procedures to be followed if abuse of a resident is suspected. There have been no POVA referrals from Harrison House since the last visit. Harrison House DS0000005407.V346291.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. The building is clean, comfortable and well maintained and is suitable for residents’ who are frail and have poor mobility. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Standards 19 and 26. The building is well maintained and is furnished and decorated in a homely and domestic style. A large conservatory and a decked terrace have been built off the main lounge, which has increased and enhanced communal areas available to residents. The grounds are very well maintained providing a beautiful setting for Harrison House. There is a car park and planted areas at the front of the building and large secluded gardens at the back. Residents said they are very comfortable in Harrison House and were satisfied with their bedrooms, Harrison House DS0000005407.V346291.R01.S.doc Version 5.2 Page 17 which are personalised with good views of the grounds. There are toilets and bathrooms throughout the building for residents’ convenience. Moving equipment, assisted baths, a passenger lift and a ramp (at the rear) are available to residents who have poor mobility. Domestic staff are employed and for their guidance, there are procedures in place for control of infection and control of substances hazardous to health in addition to relevant training. Staff confirmed that there is no shortage of cleaning materials and protective clothing, aprons and gloves are provided. The building was clean in odour free in the areas, which were visited, and residents had no complaints about standards of hygiene in Harrison House. Harrison House DS0000005407.V346291.R01.S.doc Version 5.2 Page 18 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. The numbers and skill mix of staff in Harrison House are meeting residents’ support needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Standards 27,28,29, 30. Harrison House has a staff roster, which provides the names and designation of staff on duty for each shift. Some of the staff are long-term employed and very experienced in care practice, others are more recently employed and have received induction training. The training records show that mandatory training is regularly updated in addition to service specific training such as dementia care, medication administration and POVA. Over 50 of care staff have NVQ qualifications level 2 –3 or are working towards them. Parkhaven Trust has a recruitment procedure, which includes advertising posts, interviewing job candidates and taking up two references and criminal records bureau clearance before they take up their posts. A sample of staff files was read and these had been satisfactorily maintained and were secured. Staff confirmed that they have been issued with job descriptions and contracts Harrison House DS0000005407.V346291.R01.S.doc Version 5.2 Page 19 of employment. In addition to care staff, ancillary staff are employed for cooking, domestic duties, administration and management. Harrison House DS0000005407.V346291.R01.S.doc Version 5.2 Page 20 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Harrison House is managed in the best interests of residents and their safety and welfare is protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Standards 31,33, 35, 38. The registered manager of Harrison House is Mrs. Claire Burgess. Mrs. Burgess has a management qualification and is experienced in care management. Staff said that they are well supported by the manager and find her to be approachable. Harrison House has a quality assurance system, which is based on seeking the views of residents and their representatives through distribution of quality Harrison House DS0000005407.V346291.R01.S.doc Version 5.2 Page 21 questionnaires. There is ongoing consultation with residents through meetings and in the compliments and complaints book. Residents said they feel free to express their opinions and feel confident that their views are valued and responded to. Residents confirmed that they or their representatives, are encouraged to retain control of personal finances. In some instances, small amounts of personal allowance are held on residents’ behalf. A full and audited record of all expenditure is maintained in Harrison House, and receipts are retained for any purchases made. A record of accidents is maintained and staff receive patient handling training. First aid, health & safety and food hygiene training is also provided for staff and there is training and guidance in infection control and COSHH. The laundry was visited and was well organised with infection control procedures in place and all equipment was in working order. The fire book and servicing certification for equipment in Harrison House were satisfactory at the time of this visit. The window on the first floor landing is in need of attention regarding the opening mechanism, which was faulty at the time of the visit. A recommendation is given that remedial work is carried out, to ensure that no risk is posed to residents or staff. Harrison House DS0000005407.V346291.R01.S.doc Version 5.2 Page 22 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 3 X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Harrison House DS0000005407.V346291.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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. 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. Refer to Standard OP38 Good Practice Recommendations To ensure the safety of residents and staff, it is recommended that remedial work is carried out to the first floor landing window as the opening mechanism was faulty during the visit. Harrison House DS0000005407.V346291.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG National Enquiry Line: 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 © 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 Harrison House DS0000005407.V346291.R01.S.doc Version 5.2 Page 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. 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