Inspection on 04/04/07 for Harrison House

This inspection was carried out on 4th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 12/12/05

Harrison House 25/08/05

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 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Harrison House Dysart Road Grantham Lincs NG31 7DL Lead Inspector Mr David Bacon Key Unannounced Inspection 4 April 2007 08:00 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 DS0000041720.V323980.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 DS0000041720.V323980.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Harrison House Address Dysart Road Grantham Lincs NG31 7DL 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) 01476 565901 01476 571250 www.lincolnshire.gov.uk Lincolnshire County Council Manager post vacant Care Home 24 Category(ies) of Dementia - over 65 years of age (1), Old age, registration, with number not falling within any other category (22), of places Physical disability (1) Harrison House DS0000041720.V323980.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Conditions of registration The Category PD is restricted to the immediate care of people between the ages of 55 and 64 inclusive. Conditions of Registration The Category DE (E) applies to one named person only and will cease to apply when that person is no longer accommodated at the home. Conditions of Registration 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. Conditions of Registration The PD place is in the Primrose Unit, room 9. 12th December 2005 Date of last inspection 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 registered 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 rehabilitation 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 DS0000041720.V323980.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection took place over five hours; it was unannounced and was carried out by one inspector. A tour of the premises was conducted, service users care records and staff records were inspected along with administrative systems. The care received by three service users was looked at in detail. This process is called “case tracking” and individual service users care records and general home records were looked at as part of this. The inspector spoke with five service users, the acting manager, five staff members and a visiting health care professional. Feedback was also received prior to the visit from five satisfaction surveys completed by or on behalf of service users. The homes internal satisfaction surveys were viewed as part of the site visit. What the service does well: What has improved since the last inspection? It was identified during the previous site visit that footplates on wheelchairs were not always used so as to safeguard the health and welfare of service users although this matter has now been addressed. Harrison House DS0000041720.V323980.R01.S.doc Version 5.2 Page 6 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 DS0000041720.V323980.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 DS0000041720.V323980.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): 3, 6 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Comprehensive systems are in place for the introduction of service users to the home. Service users are satisfied with the admission process and can be assured that their care needs will be appropriately met. EVIDENCE: Harrison House now only accepts referrals for service users requiring shortterm care and those being part of the intermediate care service of which comprehensive admission policies and procedures are in place. The care records viewed identified that following an initial referral a comprehensive assessment of each service users care needs had been undertaken, which included any risks, short and long term objectives, a Harrison House DS0000041720.V323980.R01.S.doc Version 5.2 Page 9 treatment and recovery plan and included individuals likes and general preferences. The records seen clearly documented service users involvement in the assessment process and included contact details of relevant supporting agencies. Discussions held with service users confirmed that they were satisfied with the homes admission arrangements. Comments included: “Well, at a time when I felt vulnerable they have taken very good care of me”. “They welcome you expertly”. “I don’t remember much about my arrival and there is some information provided but they seem to know what you want”. “From the moment I arrived they have been very kind and explain it all”. The care staff spoken with were clearly aware of service users care needs, how these were met and of the homes admission procedures. Harrison House DS0000041720.V323980.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): 7, 8, 9, 10 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The service users spoken with feel they are treated with respect and they are satisfied with the care and health care provided. Care records provide staff with comprehensive information about service users care needs and how these are to be met. Procedures for the administration of medication are appropriate. EVIDENCE: The service users spoken with confirmed that they were involved in the care planning process and made aware of their rights regarding information written about them. Service users said their individual care needs were met and that staff consistently treated them with dignity and respect, which was further confirmed in the completed satisfaction questionnaires seen. Comments included: “Well, it’s early for me to comment but they involve you in your care here, you are encouraged to say what you need”. “I felt very weak arriving here but they treat you very well and as you would hope”. “The staff are Harrison House DS0000041720.V323980.R01.S.doc Version 5.2 Page 11 attentive and very helpful”. “I’m very satisfied with how I’ve been treated here, they give you what you need to get you right again”. A care plan is completed for each service user and information within these clearly documents each individual’s care needs, any goals and how these are met. Information regarding any health care needs is also clearly detailed, which includes information regarding supporting agencies and records are updated and reviewed as necessary. The staff spoken with confirmed that they received comprehensive awareness training to promote service users privacy, dignity, choice, rights and independence. The health care professional spoken with was fully satisfied with the care provided by the home and confirmed that staff appropriately follow any given instruction or advice. Medication systems were well maintained and clearly documented medicines as receipted into the building, as administered and disposed. Systems are in place to enable service users to administer their own medicines where this is risk assessed as appropriate. Staff whom administer medication receive specific awareness training regarding this. Harrison House DS0000041720.V323980.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): 12, 13, 14, 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Clear guidelines are in place for staff to ensure service users rights and choices are promoted. The services users enjoy the food provided but are not fully aware that a choice is available. Some activities are provided although these are limited. EVIDENCE: Service users said there were no restrictions as to how they could spend their time and that their visitors were made welcome. Service users also said that they enjoyed the meals although not all were aware that a choice of food was available at each mealtime. Comments included: “The food seems good enough, it tastes alright to me”. “They come round and tell you what there is to eat but I’m not sure there is a choice”. “So far the food has been good, there is plenty, you don’t go hungry”. “I’m not aware that you could have something different, I like the food so it suits me”. Service users are initially consulted with about their likes and dislikes as part of the admission process. Harrison House DS0000041720.V323980.R01.S.doc Version 5.2 Page 13 Further discussions held with service users confirmed that they would prefer a wider variety of activities to be available and more notification about these around the home. Comments included: “It suits me not to get involved, there is a woman who does some activities but it didn’t really appeal”. “I like the fact that you can join in if you want to but it would be nice if there was more variety”. “I have seen some things going on but they are not for me”. “It is good because they invite you to join in but you don’t have to”. It is acknowledged that the majority of service users stay at the home for short periods of time, which creates difficulties for staff to secure the service users views regarding this although it is recommended that some improvements are made to more fully meet individual’s preferences regarding this. Information about the activities provided is displayed in the home. Harrison House DS0000041720.V323980.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): 16, 18 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The service users spoken with feel able to complain about the care they receive and staff are made aware of the procedures in place to protect service users from abuse. EVIDENCE: There have been no formal complaints made since the last inspection visit and the one safeguarding adults referral has been closed. Complaint policies and procedures are in place and information regarding these is provided to service users and displayed in the home. The service users spoken with said that they felt able to express their views regarding the care provided and that any comments would be welcomed and appropriately acted upon. Comments included: “I have had no need to complain but there is information somewhere and I would talk to the staff”. “They seem easy to talk with so yes, I could go to staff or the managers”. “They tell you about that sort of thing when you arrive”. “I have no need to complain but would do”. Policies and procedures regarding complaints, whistle blowing and abuse are in place and staff receive awareness training regarding this subject matter. The staff members spoken with were aware of the correct action to be taken in the event of an issue of abuse being suspected. Harrison House DS0000041720.V323980.R01.S.doc Version 5.2 Page 15 Harrison House DS0000041720.V323980.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. This judgement has been made using available evidence including a visit to this service. The standard of the physical environment is adequate overall, with the organisation ensuring the maintenance and safety of each area of the home although some areas would benefit from being refurbished. EVIDENCE: All areas viewed were clean, tidy and well maintained and there were no unpleasant odours. During the visit the manager agreed that several areas would benefit from being redecorated. For example, paintwork in corridors and communal areas. The service users spoken with said that they were satisfied with the cleanliness of the home and their individual accommodation, which was viewed as part of a tour of the premises. Comments included: “It is tidy enough, the staff clean your room and everywhere”. “It all seems good and clean”. There is plenty of shared space available to enable service users to receive guests privately if Harrison House DS0000041720.V323980.R01.S.doc Version 5.2 Page 17 they so wish and all communal and private areas contain comfortable and wellmaintained furniture. Domestic are deployed each day to keep all areas clean and odour free. Health and safety policies and procedures are in place for staff, who receive awareness training regarding this and cleaning equipment and products are safely stored. A risk assessment has been undertaken of the premises and of individual service users and health and safety policies and procedures are in place providing guidance to staff. Fire safety systems were being tested and maintained as per fire safety regulations and staff attend regular awareness training. Harrison House DS0000041720.V323980.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): 27, 28, 29, 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Comprehensive recruitment procedures are in place to safeguard service users and the staff receive an induction when commencing work at the home. There are sufficient numbers of staff, appropriately deployed and well trained to allow them to care for service users. EVIDENCE: The staff files viewed clearly evidenced that appropriate recruitment policies and procedures are in place. The staff members spoken with confirmed that they had received induction upon commencing work at the home and that there were enough staff to meet service users needs, which was further evidenced in the records inspected. A comprehensive amount of training, which is ongoing is undertaken by staff whom were satisfied with the training opportunities provided. The service users spoken with confirmed that their care needs were appropriately met. Comments included: “You can’t fault them for the care”. “They come when you need them, they are kind and well mannered, no complaints”. “There seem to be enough on hand, you don’t ever have to really wait either”. “They must be well trained to do so well here”. “I had heard about them being good and I’m not disappointed so there’s your answer”. Harrison House DS0000041720.V323980.R01.S.doc Version 5.2 Page 19 Harrison House DS0000041720.V323980.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): 31, 33, 35, 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is well managed and systems are in place to ensure that care is provided in a safe and appropriate manner. Service users are supported to express their views regarding the care they receive. EVIDENCE: The service users spoken with confirmed that they were satisfied with the management of the home, the care provided and that they felt supported to express their views and that these would be acted upon. Quality satisfaction questionnaires are given or sent to service users or their representatives where appropriate following each stay. Records of any action taken following receipt of these is maintained. Harrison House DS0000041720.V323980.R01.S.doc Version 5.2 Page 21 The home is well maintained throughout of which records are kept and a risk assessment of the premises has been undertaken, which is updated as necessary. The staff members spoken with said they received very good management support. Comments included: “Yes, you can approach the management, they are easy to talk with”. “There is a low turnover of staff which is good, I’m happy to work here”. “The atmosphere is good and there are good levels of support”. Policies and procedures are in place to protect service users where the home has any involvement in their finances. Monies are kept separate and receipts and records of transactions and totals are maintained. Service users sign for any transactions. Harrison House DS0000041720.V323980.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 4 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 4 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 4 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 DS0000041720.V323980.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes 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 OP12 Regulation 12(3) Requirement The registered person must so far as practical ascertain and take into account residents wishes and feelings regarding activities, hobbies and social affiliation, which they may wish to continue at this home (previous timescale 23/03/06 not fully met). Timescale for action 07/05/07 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 OP19 Good Practice Recommendations It is recommended that the overall standard of décor within the home is reviewed and action taken as necessary to maintain the overall homely feel for service users. It is recommended that service users are more clearly notified of the food choices available to them. 2. OP15 Harrison House DS0000041720.V323980.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 DS0000041720.V323980.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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