Inspection on 27/06/06 for Hartisca House

This inspection was carried out on 27th June 2006.

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

Hartisca House 23/05/07

Hartisca House 15/09/05

Hartisca House 05/04/05

Hartisca House 02/12/04

Hartisca House 22/06/04

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

CARE HOMES FOR OLDER PEOPLE Hartisca House Hartwell Road Burley Leeds West Yorkshire LS6 1RY Lead Inspector Chris Levi Key Unannounced Inspection 27th June 2006 09:00 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 Hartisca House DS0000001458.V297875.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. Hartisca House DS0000001458.V297875.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hartisca House Address Hartwell Road Burley Leeds West Yorkshire LS6 1RY (0113) 2426919 (0113) 2426871 hartiscahouse@schealthcare.co.uk www.schealthcare.co.uk Southern Cross Healthcare Services Limited 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) Mrs Edna Patricia Woellner Care Home 26 Category(ies) of Dementia (26) registration, with number of places Hartisca House DS0000001458.V297875.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th September 2005 Brief Description of the Service: Hartisca House provides care for older people with dementia. The home was purpose built as a care home, though not specifically designed for the care of people with dementia. Bedrooms meet the minimum size requirements and some have en-suite facilities. The ratio of double to single occupancy rooms is satisfactory. The home is built on two floors with passenger lift access to the first floor. Each floor has a lounge and dining area with food and laundry services being provided from a central area on the ground floor. Sixteen people are accommodated on the first floor and ten on the ground floor. The building does not provide an area where residents can wander freely. A very small, enclosed patio area in front of the building has been made into a more secure area which can be used during the good weather. The home is situated in the Burley area of Leeds, within walking distance of shops, a day centre, church and park. The city centre is a short bus ride away. Because of the vulnerability of the client group external doors are alarmed and the front door can only be opened by staff. The current weekly fees charged by the providers is £410 to £437. Additional charges are made for hairdressing, private chiropody and attendance at a motivation class. This information was provided to The Commission for Social Care Inspection in June 2006. The contents of Inspection reports are discussed at staff, relative and residents meetings. A copy of the report was displayed in the entrance hall. Hartisca House DS0000001458.V297875.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. In April 2006 the Commission for Social Care Inspection (CSCI) made some changes to the way in which care services are inspected. Care services are now judged against outcome groups. The inspection report is divided into separate sections for each outcome group for example Choice of Home. An overall judgement is made for each outcome group based on the findings of the inspection. The judgements reflect how well the service delivers outcomes to the people using the service. The judgements categories are “excellent”, “good”, “adequate” and “poor”. The judgements are recorded within the main body of this report. More detailed information about these changes is available on our website – www.csci.org.uk This unannounced inspection by one inspector took place over one day, starting at 9.00am and finishing at 4.45pm. The person in charge of the home was the manager, Mrs P Woellner. Feedback on the findings of the inspection was given at the end of the visit by the inspector. The inspectors would like to thank everyone who took the time to talk to us and express their views. This report reflects the preference of people living at Hartisca House to be collectively referred to as residents, rather than service users. Before the visit, accumulated information about the home was reviewed. This included looking at the number of reported accidents, complaints and compliments from service users and relatives. This information was used to plan the inspection visit. During the visit to Hartisca House the inspector case tracked a number of residents. Case tracking is the method used to assess whether people who use services receive good quality care that meets their individual needs. Where appropriate, issues relating to the cultural and diverse needs of residents and staff were considered. Using this method the inspectors assessed all twenty-two key standards from the Care Homes for Older People National Minimum Standards, plus other standards relevant to the visit. The inspector spoke with identified residents and relevant members of the staff team who provide support to the residents. Documentation relating to these residents was looked at. Contact was made with relatives and other external professionals to obtain their opinions about the quality of services provided at the home. Hartisca House DS0000001458.V297875.R01.S.doc Version 5.2 Page 6 Three residents completed a CSCI survey and gave their individual views about living at Hartisca House. Surveys and comment cards for residents and relatives were left at the home. These cards provide people with an opportunity to share their views of the service with the CSCI. Comments received in this way are shared with the provider without revealing the identity of those completing them. A number of direct quotes from residents, staff and visitors were also included in the report. What the service does well: What has improved since the last inspection? What they could do better: Hartisca House DS0000001458.V297875.R01.S.doc Version 5.2 Page 7 The 5 yearly electrical installation safety check must be carried out. This was identified at the previous inspection report. The communal areas are in poor decorative order. The number of care staff with NVQ level two needs to increase to achieve the target of 50 of care staff holding an NVQ level2 qualification. 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. Hartisca House DS0000001458.V297875.R01.S.doc Version 5.2 Page 8 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 Hartisca House DS0000001458.V297875.R01.S.doc Version 5.2 Page 9 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 the following standard(s): 1, 2, 3, 4 and 5. Quality in this outcome group outcome is good. This judgement has been made because evidence demonstrated that the manager provides good quality information to prospective residents and their families about the services provided at Hartisca House. Appropriate assessments of residents needs are considered before moving to the home. EVIDENCE: The Statement of Purpose provided by Southern Cross, the organisation that owns Hartisca House has been updated. The Service User Guide produced by the Manager of the home is a document that provides very specific information about the services available at Hartisca House. It is a very useful detailed document that should help people make a decision about living at the home. This information along with the last inspection report and guidance on accessing dementia support services is displayed in the entrance hall. Hartisca House DS0000001458.V297875.R01.S.doc Version 5.2 Page 10 One relative said she had visited the home before her husband had been admitted and the staff had been very helpful. They had spent time talking to her about the services provided at the home and made her feel welcome. She confirmed that her husband had a written contract of occupancy. To ensure prospective residents needs can be met, the manager visits people in their own home or in hospital before they are admitted to Hartisca House. There was written evidence that pre admission assessments were detailed to provide staff with information to form the basis of a care plan on the residents admission to the home. Hartisca House DS0000001458.V297875.R01.S.doc Version 5.2 Page 11 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 the following standard(s): 7, 8, 9 and 10. Quality in this outcome group outcome is good. This judgement has been made because evidence was seen that: Staff at Hartisca House meet the health and care needs of residents. Medication for residents is managed in a safe and professional way by staff. It was observed and confirmed by a number of residents that they are treated with dignity and respect by staff at the home. EVIDENCE: The care plans of two residents were looked at. Both accurately reflected the need of the residents, and how staff would meet the identified needs. There was evidence that where a risk to a resident was identified an appropriate risk assessment was in place. Hartisca House DS0000001458.V297875.R01.S.doc Version 5.2 Page 12 There was evidence of visits by external professionals, to provide residents with specialist care or assessments. A district nurse visiting a resident at the home said, she found staff to be courteous, helpful and knew the residents well. Residents or their representative had signed that they agreed to the plan of care being provided. These plans are reviewed regularly to ensure they meet the changing needs of residents. Systems relating to residents medication were looked at. The deputy manager has specific responsibility for ensuring the systems are safe. She said the local pharmacist had changed and an error in checking resident’s prescriptions had occurred. The manager said she intended to discuss this with the pharmacist to ensure the error was not repeated. All staff that administers medication have attended a safe administration of medicines training course. None of the residents were able to self medicate due to their dementia. There is a range of medication policies relating to all areas of medication in a care home. They demonstrated good, safe practice. Controlled drugs are stored as required. One set of medication was checked, and found to be correct. Staff at the home ensure they respect residents dignity. They are trained to understand the different approaches needed when caring for older people with dementia. They are good at understanding the individual’s needs and how to meet them in a confident friendly manner. This was confirmed by a number of visitors. Hartisca House DS0000001458.V297875.R01.S.doc Version 5.2 Page 13 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 the following standard(s): 12, 13, 14 and 15. Quality in this outcome group outcome is good. This judgement has been made based on evidence that: Residents are given opportunities to choose how they spend their day. Social activities provided meet the individual residents needs. Staff work hard to maintain residents independence, and provide a person centred approach to care. This includes involving where possible the relatives and friends in the lives of residents at the home Food served is nutritious and available throughout the day and night. This is an important factor when providing care to people with dementia, to help them maintain their physical wellbeing. EVIDENCE: Hartisca House DS0000001458.V297875.R01.S.doc Version 5.2 Page 14 Residents are free to get up and go to bed when they choose, and move around the house freely. An activities co coordinator is employed at the home with special responsibility to ensure that activities are appropriate to the individual residents. A record of these activities is kept. These were looked at and appeared relevant to the two residents case tracked. All staff participate in activities with residents, and a visitor commended staff on the range on offer on a daily basis. She said the manager send relatives a monthly newsletter informing them what was happening in the coming month. Social events such as a walk in the park, a picnic, a visit to the shops are appreciated by the people who live at Hartisca House. The manager said that two weekends away at the coast were planned for this year. Relatives meetings take place on a regular basis. The notes of these meeting were seen. A visitor said she valued the meetings, as it gave people the opportunities to feel involved with the services provided. One relative said she thought the home was “brilliant.” Another said, “ It is very nice here. I am made to feel welcome and staff let me know if there are any changes in my husband.” Three relatives agreed to help residents complete CSCI residents surveys. The response from each was positive about services provided at the home. Residents independence is encouraged. Suitable risk assessments were seen where an activity might result in a risk to the resident. On the day of the inspection, a resident was visiting her husband whom she had not seen for a considerable time, as he was living in another care home in the city. She said it had been wonderful to see him again. The manager has undertaken special consideration to the nutritional needs of residents with dementia. Lunchtime was observed and evidence of good practice was noted. All residents were shown the choices of food available. For those residents not wanting a full meal options of buffet food were available. The dining room and tables were set to look attractive. Staff were observed offering discreet support to those residents who needed assistance or encouragement to eat. It was suggested that residents be shown the vegetables available to ensure resident choice is maximised. Throughout the day snacks of fruit, sandwiches, yogurt and drinks were available. For those residents with low weight there was evidence that high nutritional drinks were available. Hartisca House DS0000001458.V297875.R01.S.doc Version 5.2 Page 15 The chef was aware of the importance of nutritional food for older people and had recently attended a course to support this understanding. As he is the only person employed in the kitchen, he has little time to make home produced baking or soups. It is recommended that additional resources be given to the catering provision; to enable an increase in home produced food of nutritional benefit to residents. Hartisca House DS0000001458.V297875.R01.S.doc Version 5.2 Page 16 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 the following standard(s): 16 and 18 Quality in this outcome group outcome is good. This judgement has been made as evidence confirmed systems are in place to protect residents from abuse, and encourage them or their relatives to make complaints. EVIDENCE: The complaints procedure is displayed in the entrance hall. No complaint had been recorded since the last inspection. The key worker for each resident contacts their relative on a monthly basis to ensure they are keep up to date with information about the resident. They also ask relatives if they have any concerns or complaints about services in the home. Notes of these conversations are recorded in the care plans. Relatives confirmed they felt confident to make complaint and were sure it would be dealt with appropriately. Staff confirmed they had attended training on adult abuse and all were clear about their responsibility to report any concerns to the senior in charge. Hartisca House DS0000001458.V297875.R01.S.doc Version 5.2 Page 17 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 the following standard(s): 19 and 26. Quality in this outcome group outcome is adequate. This judgement has been made based on evidence seen when touring the building. The home environment is showing signs of wear and tear and requires attention to bring it up to a good standard. EVIDENCE: Communal areas in the home, especially corridors are in a poor state of decoration and require redecoration and replacement carpets. Some work to upgrade the toilet pans in the en suite bathrooms is still outstanding, but the manager has a refurbishment plan to include this work. To the outside area of the home is an enclosed garden seating area. A number of residents were enjoying the sunshine, watching the activities of the handyman produce summer hanging baskets that made the area very attractive. Hartisca House DS0000001458.V297875.R01.S.doc Version 5.2 Page 18 A number of bedrooms for residents were seen. They were all personalised with items from their own home. A family had brought a budgie for one resident. The manager continues to use colours on doors and in bathrooms and signage to assist residents recognise where they are in the building. The laundry is very small but contained the appropriate numbers of washing and drying machines to deal with residents laundry. The laundry assistant said she had been trained in infection control, and understood the importance of keeping clean and dirty linen separate to minimise the risk of cross contamination. Hartisca House DS0000001458.V297875.R01.S.doc Version 5.2 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome group outcome is good. This judgement has been made as evidence confirmed: The numbers and skill mix of staff meets residents’ needs. Residents are protected by the homes recruitment procedures. A consistent well-trained staff team benefits the well being of the residents. EVIDENCE: In discussion with staff, they were clear on their roles and responsibilities during their shift. Staffing numbers were satisfactory and staff rotas indicated that the manager considers the needs of both residents and staff when producing the shift patterns. Staff said they enjoyed the benefits of a break before and after doing two consecutive 12-hour shifts. The recruitment and training files of two staff member’s were looked at. There was evidence of a robust recruitment process, to ensure staff were suitable to work with vulnerable adults. Staff confirmed they had received training in safe moving and handling, first aids, fire safety, infection control, and dementia care. The number of care staff with NVQ level 2 is three. This does not achieve the 50 targets. The manager confirmed further eleven carers are undertaking the award. Hartisca House DS0000001458.V297875.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36 and 38. Quality in this outcome group outcome is good. This judgement has been made as evidence confirmed: Hartisca House is a well managed home, with the focus on person centred care for the residents who live at the home. The management approach encourages residents, relatives and staff to be involved in the day-to-day running of the home and the Manager is well supported in her role. Residents’ financial interests are safeguarded. There was evidence of safe working practices. EVIDENCE: Hartisca House DS0000001458.V297875.R01.S.doc Version 5.2 Page 21 The manager of the home who is enthusiastic and highly motivated has completed her Diploma in Dementia Care. She is constantly striving to improve the quality of life for people living in the home through training, research, questioning practices and if necessary making changes. She has a teaching certificate and a management qualification. Her skills and knowledge are shared with staff on a daily basis to ensure that care and support to residents remains person centred. The culture in the home is one of consultation with everyone involved in providing services to the residents. There was evidence staff meetings, resident/relatives meetings. Staff said they enjoyed the working environment, and the manager was very approachable and supportive. The manager conducts monthly audits on all areas of service in the home. The findings are share with relatives. Senior managers audit various aspects of the service during their monthly visits. The home has a robust procedure for managing residents personal monies held at the home. One residents personal allowance was checked against this system and found to be correct. Staff confirmed they receive one to one supervision to discuss any concerns or training and development needs they may have. Notes of these meeting were seen. Prior to the inspection visit documents relating to health and safety maintenance were reviewed. It was noted that the 5-year electrical hardwiring certificate was out of date. This had been identified in the last inspection report. In a telephone conversation with the organisations regional manager, it was agreed that this would be rectified as a matter of urgency, and she would confirm this in writing to the lead inspector. All other maintenance records indicated they were up to date. Hartisca House DS0000001458.V297875.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 3 3 3 3 3 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 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 3 x 3 3 3 2 Hartisca House DS0000001458.V297875.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. 1. 2. 3. Standard OP19 OP28 OP38 Regulation 23 (2) 18 13 Requirement The providers must ensure the communal areas are in good decorative order. The providers must ensure 50 of care staff hold NVQ level 2 awards. The 5-year electrical hard wiring checks must be undertaken as a matter of urgency. (This requirement is outstanding from the last inspection report.) Timescale for action 30/09/06 30/10/06 30/08/06 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 OP15 Good Practice Recommendations The providers should consider recruiting additional kitchen staff. This would benefit residents, as the cook would be able to prepare more home made foods. Hartisca House DS0000001458.V297875.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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 Hartisca House DS0000001458.V297875.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. 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. 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