Inspection on 25/08/05 for Harrison House

This inspection was carried out on 25th August 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Harrison House 04/04/07

Harrison House 12/12/05

Harrison House 07/03/05

Harrison House 11/10/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Harrison House Dysart Road Grantham Lincs NG31 7DL Lead Inspector Doug Tunmore Unannounced 25 August 2005 09:00 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. Harrison House C53 CO4 S41720 Harrison House V245513 250805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Harrison House Address Dysart Road Grantham Lincs. NG31 7DL 01476 565901 01476 571250 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) Lincolnshire County Council Mrs S Lawrence Care Home 24 Category(ies) of Old Age (OP) - 22 registration, with number Dementia - over 65 years of age (DE(E)) - 1 of places Physical disability (PD) - 1 Harrison House C53 CO4 S41720 Harrison House V245513 250805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: The Category PD is restricted to the immediate care of people between the ages of 55 and 64 inclusive. The Category DE (E) applies to one named person only and will cease to apply when that person is no longer accomodated at the home. The 1 DE place applies to one named person only and will revert to an OP place when that person no longer resides at the home. The PD place is in the Primrose Unit, room 9. Date of last inspection 7 March 2005 Brief Description of the Service: Harrison House is a purpose built, two-storey unit, owned and managed by Lincolnshire County Council, Social Services Directorate. The home is situated approximately half a mile from the town centre of Grantham, with shops and local facilities and is on the main bus route. There is a car park to the front of the building and there are large gardens to the side and rear of the home. The home is registerd to provide personal care only. The home no longer admits residents on a long term basis, concentrating on intermediate, rehabilitation and short term care. Intermediate care is provided within dedicated accommodation with specialist facilities, equipment and staff to deliver short term intensive rehabilitaion to enable residents to return home. The home is composed of four wings. These being Cornflower and Green Leaves for intermediate care, Primrose for short stay and Blue Haven for long stay, which is being phased out. There is also a day care centre. This is reflected in the homes Statement of Purpose and Service Users Guide. Harrison House C53 CO4 S41720 Harrison House V245513 250805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and started at 9.45 am. The main method of inspection used was called case tracking, which involved selecting two residents and tracking the care they receive through the checking of their records, discussion with them, the care staff and observations of care practice. A partial tour of the premises took place. What the service does well: What has improved since the last inspection? What they could do better: The home must ensure that residents or their representatives sign care plans, so as to show that they agree with their care plan. The home also needs to be more prescriptive regarding the personal care given to residents and record Harrison House C53 CO4 S41720 Harrison House V245513 250805 Stage 4.doc Version 1.40 Page 6 how their privacy and dignity is maintained when intimate care tasks are being undertaken. 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. Harrison House C53 CO4 S41720 Harrison House V245513 250805 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 Harrison House C53 CO4 S41720 Harrison House V245513 250805 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) 3 Residents are admitted into the home only after a full needs assessment has been carried out, either by the home or health care or social care agencies. Written confirmation that the home can meet a prospective residents needs is also undertaken prior to admission. EVIDENCE: The home has a detailed admission procedure, which identifies the needs of residents coming into the home. One resident said that she was visited prior to admission by someone from the home and that her family were involved in this process. Residents files had assessments undertaken either by the home, hospital or and the Social Services Department. Files seen showed that residents received a letter from the home confirming that the home could meet their needs. The care worker spoken to knew about the care needs of residents and was aware of the homes pre-admission assessment procedures. She also said that prospective residents and their families are welcome to visit the home prior to admission. One resident stated that ‘I was admitted straight from hospital, this is like a second home for me and I’m coming back for Christmas’. Harrison House C53 CO4 S41720 Harrison House V245513 250805 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 There is good care planning in this home, which helps ensure that the general health and welfare of residents is addressed. Medication is administered as per the homes policies and procedures with residents enabled to administer their own medication if the so wish. EVIDENCE: All residents have detailed care plans, which describe their health and welfare needs. Care plans outlined risk assessments, nutritional and dependency assessments. Care plans also evidenced that they have been reviewed during the stay of residents. Two files showed that care plans had not been signed by the residents to show that they agree with the care being provided. A resident stated that she had not signed her care plan. Individual care plans evidenced that accidents are recorded in the home’s accident book and in the resident daily notes. The home also uses body maps for the mapping of any cuts or abrasions to residents. One accident form was checked through the homes accident procedures and it was found that abrasions to a resident had been recorded appropriately on the body map. Risk assessments are in place for individual residents relating to prevention of falls. One visiting community nurse confirmed that there was good communication between the home and herself. The community nurse also said that staff were helpful and could follow instructions given to them regarding the care of residents. Files seen confirmed Harrison House C53 CO4 S41720 Harrison House V245513 250805 Stage 4.doc Version 1.40 Page 10 that health care professionals visit the home when required by the residents. A carer was aware of the intimate care needs of residents. However, care plans were not prescriptive regarding the intimate care needs required by residents or the need to maintain the privacy and dignity of residents. One resident said that ‘ Whilst in the home I shower every night as I have the support of the staff due to my physical disability, the carers are very good with me when they help shower me’. A carer confirmed that she had undertaken National Vocational Training in caring for older people and this course covered providing personal care for residents. The home medication sheets were seen and showed that all medication had been signed for on the day of the inspection. Files seen showed that residents who self medicate have signed a risk assessment form. One resident said that she self medicates and that the home undertook an assessment on her before she could self medicate. The pharmacist carried out an inspection on the 12/05/05 and no requirements were made. Harrison House C53 CO4 S41720 Harrison House V245513 250805 Stage 4.doc Version 1.40 Page 11 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) 13,14,15 Relatives and friends of residents are made welcome in this home. Meals are well managed and reflect resident’s likes and dislikes EVIDENCE: The homes visitors signing in book was seen and showed that numbers of visitors attend this home on a daily basis at differing times of the day. The community nurse confirmed that she ‘always gets a cheerful greeting’ when she visits. The visiting vicar commented that ‘ the home is very welcoming to the service and they all make it happen, staff are very much a part of what I do’. Residents confirmed that they have visitors and that are made welcome by care staff. A resident stated that she was in for short stay and that she has attended the religious service which she enjoys. She also said that when she returns home and staff see her in the street they wave and call out a greeting’. Residents are able to come and go as they wish from the home, due to being short stay or undertaking intermediate care. The home has a service users questionnaire, which is used prior to residents returning home. These were seen and evidenced that residents were very happy with their stay and felt enabled to discuss their care needs or any other issue before and during their stay. The Commission sent out residents and relatives and visitors comment cards prior to this inspection. One relatives comment cards stated that ‘my Harrison House C53 CO4 S41720 Harrison House V245513 250805 Stage 4.doc Version 1.40 Page 12 mother has been at Harrison House and up to now, I haven’t had to complain whatsoever. They have got a very good team working here’. The inspector joined two residents for lunch and found the meal provided to be hot and delicious. Residents said that they have a choice of meals and that ‘its like having Sunday lunch out’. The cook was spoken to and recorded in her files the likes and dislikes, as well as specialised diets required by individual residents. Harrison House C53 CO4 S41720 Harrison House V245513 250805 Stage 4.doc Version 1.40 Page 13 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 Residents benefit from a robust complaints and adult protection procedures. They also benefit from the staff teams knowledge and awareness of the homes polices and procedures. EVIDENCE: The home has a complaints and adult protection policy. The complaints log was seen and showed that no complaints have been made since the homes last inspection. There has been one report of an adult abuse allegation. The Commission was informed of this allegation and the home has appropriately followed the adult protection procedures. The homes training programme was seen and showed that adult protection training has been undertaken in this home in 2004. A care worker confirmed that she had undertaken in-house training on adult protection and that she was aware of the homes policies and procedures. A resident stated that she fells safe in the home she said that ‘I can have the light on all night if I choose; staff are about all night, all staff are kind even when I was really poorly’. Harrison House C53 CO4 S41720 Harrison House V245513 250805 Stage 4.doc Version 1.40 Page 14 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) 19,26 The home is well maintained, the standard of the environment and its facilities are appropriate to the needs of residents. EVIDENCE: The home has a maintenance book, which records work that has been undertaken in 2005. Copies of the homes regulation 26 reports kept at the home evidenced that a rolling maintenance programme is in operation at this home. The home also has a handyman who carries out regular repairs and decoration of the home. One resident commented that her room has been changed around to accommodate her disability. This was reflected in her care plan, which also had a risk assessment, which highlighted risks to residents posed by the homes environment and action to be taken. A partial tour of the building found it to be clean and tidy with no unpleasant odours detected. Two visitors to the home said that the home is always clean and smells nice. Harrison House C53 CO4 S41720 Harrison House V245513 250805 Stage 4.doc Version 1.40 Page 15 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) These outcomes were not looked at during this inspection. EVIDENCE: Harrison House C53 CO4 S41720 Harrison House V245513 250805 Stage 4.doc Version 1.40 Page 16 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) 37 The home undertakes those checks required to ensure the safety of residents, which are in line with their policies and procedures. . EVIDENCE: There are a range of policies and procedures available in the home relating to fire safety and fire risk assessments. There was also evidence that fire alarm checks, fire drills and emergency lighting checks are carried out. Staff also receive fire training as part of the homes initial training when they commence work at the home. The Fire Safety and Rescue Officer visited the home on the 01/03/05 and carried out an inspection no requirements relating to fire hazards within the home were made. The Commission for Social Care Inspection has received regular reports (regulation 26) from the Social Services Department, detailing any event at the home which has come to their attention during their visits. Harrison House C53 CO4 S41720 Harrison House V245513 250805 Stage 4.doc Version 1.40 Page 17 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 x 4 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 4 9 3 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 4 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x x x 3 x Harrison House C53 CO4 S41720 Harrison House V245513 250805 Stage 4.doc Version 1.40 Page 18 yes 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 7 Regulation 15(2)(c) Requirement Timescale for action 15/11/05 2. 10 12(4)(a) The home must ensure that care plans are signed by residents or their representative confirming that they agree with the plan of care. The home must record in 15/11/05 residents care plans how they are going to maintain the privacy and dignity of residents when undertaking personal care. 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 Good Practice Recommendations Harrison House C53 CO4 S41720 Harrison House V245513 250805 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection Unity House, The Point Weaver Road, off Whisby Road Lincoln LN6 3QN 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 Harrison House C53 CO4 S41720 Harrison House V245513 250805 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. 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