Inspection on 10/07/06 for Hartland House

This inspection was carried out on 10th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Hartland House 14/11/05

Hartland House 14/07/05

Hartland House 20/09/04

Hartland House 27/04/04

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 Hartland House Beetham Road Milnthorpe Cumbria LA7 7QW Lead Inspector Mrs Margaret Drury Unannounced Inspection 10th July 2006 09:10 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 Hartland House DS0000022645.V296693.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. Hartland House DS0000022645.V296693.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hartland House Address Beetham Road Milnthorpe Cumbria LA7 7QW 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) 015395 62251 015395 64891 abbeyfieldhh@aol.com Abbeyfield Lakeland Extra Care Society Limited Mr Derek Nichols Care Home 23 Category(ies) of Dementia - over 65 years of age (7), Old age, registration, with number not falling within any other category (23) of places Hartland House DS0000022645.V296693.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. The home is registered for a maximum of 23 service users to include: up to 23 service users in the category of OP (Old age, not falling within any other category) up to 7 service users in the category of DE(E) (Dementia over 65 years of age) Date of last inspection 14th November 2005 Brief Description of the Service: Hartland House is owned by Abbeyfield Lakeland Extra Care Society Ltd and is managed on a day-to-day basis by Derek Nichols. It is situated on the outskirts of Milnthorpe in South Cumbria. The home is registered to care for up to 24 older people, 7 of whom may have varying forms of dementia. Hartland House is a modern detached building that has been extended and adapted for its present use as a care home. There are 22 single bedrooms and 1 double, all with en-suite toilet and shower facilities. There are extensive communal areas, including small sitting areas where residents can just sit or meet with their visitors in private. There are well kept gardens with patio areas and garden furniture. Hartland House DS0000022645.V296693.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit to the home, which forms part of the key inspection, took place over one day in July. During the inspection time was spent talking to residents, the manager, deputy manager, chef and members of the staff team. Records pertaining to the care of residents were inspected and discussions about the general running of the home took place. The report may refer to “case tracking”, a process by which the inspector is able to focus on a small number of residents and includes a review of their care documentation. It should be noted that this is not detrimental to other people living in the home. A tour of the building took place during which the physical aspects of the environment were inspected. The fees for this service range from £390.00 to £480.00 per week as at April 2006, with extra charges for newspapers and private telephones. This home does not provide intermediate care. What the service does well: Hartland House provides a safe and comfortable environment in a building suited for it’s stated purpose. The residents benefit from a trained, experienced and stable staff team who, together with the manager and deputy manager, deliver a very high standard of care. There is an in-depth admissions process with all prospective residents fully assessed prior to admission. Dietary needs of residents are well catered for with a balanced and varied selection of good quality food and home cooked meals. The home has an excellent set of policies and procedures that ensure the safety and wellbeing of the residents and staff. Hartland House DS0000022645.V296693.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Hartland House DS0000022645.V296693.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 Hartland House DS0000022645.V296693.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3, 4 & 5 The quality in this outcome area is good. Admissions to the home only take place if the manager is confident staff have the skills, ability and qualifications to meet the assessed needs. Each resident is provided with a contract and terms/ conditions of residency that sets out in detail the facilities the home provides. This judgement was made using the available evidence including a visit to the service. EVIDENCE: Admissions to the home do not take place until a full assessment of needs has been completed. The dependency levels of those already living in the home are also taken into consideration when assessing prospective residents. All prospective residents and their families are invited and encouraged to visit the home prior to their admission. This gives opportunity for them to meet the staff and talk to other people living in the home. Many residents have had overnight stays or respite care and are already familiar with the home and the facilities on offer. Hartland House DS0000022645.V296693.R01.S.doc Version 5.2 Page 9 All residents are given a contract and terms and conditions of residency and there is a copy held on each resident’s file. This home does not provide intermediate care. Hartland House DS0000022645.V296693.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 & 11 The quality in this outcome area is good. Hartland House provides a high standard of care, which meets the needs of the residents living there. Health care needs, including medication, are carefully monitored and residents and relatives are confident that the home can meet their needs. Care plans are of a high standard and ensure that each person receives the care they need to be healthy and safe, whilst promoting privacy and dignity. This judgement was made using available evidence including a visit to the service. EVIDENCE: The deputy manager has delegated responsibility for the care planning system, which is comprehensive and extremely effective. Each resident has a care plan that is used as a working tool and is understood by all staff. It is written in clear language with resident involvement and is used to ensure the correct level of care is provided. Each care plan includes a comprehensive risk assessment. Management of risk takes into account the needs of residents and demonstrates a balanced view in Hartland House DS0000022645.V296693.R01.S.doc Version 5.2 Page 11 maintaining safety while also offering choice. The rights of others living in the home are also considered when drawing up an assessment of risk. The care plans are updated each month by the senior care staff and reviewed by the deputy manager. All professional healthcare visits are recorded in detail and the manager and deputy manager confirmed that they have a very good working relationship with doctors and district nurses who visit the home when required. Optical, chiropody and dental services are arranged when necessary. The medication is received in a monitored dosage system and all the lead senior carers responsible for giving out the medication have completed training in “safe handling of medication”. Records were checked and found to be in order. Residents who spoke with the inspector said that the staff always treated them with respect and kindness and that any personal care required is given in the privacy of their own rooms. They are always asked how they wish to be addressed. The home has a policy that deals with the death of a resident and wherever possible the wishes are noted on the care plans. Extra staff are made available when required and family members are welcome to spend as much time as necessary at the home. Hartland House DS0000022645.V296693.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 The quality in this outcome area is good. The routines of the home are planned around the residents’ needs and wishes and are flexible enough to meet the changing needs of the individual. Family and friends feel welcome and know they can visit the home at anytime. Maintaining independence and enabling the residents to make their own decisions about how they wish to live is a key objective for the home. The Head of Catering is responsible for providing quality, nutritional meals that meet the cultural and dietary needs of the residents. This judgement was made using available evidence including a visit to the service. EVIDENCE: Routines in the home are flexible and suit the needs of the residents. Those who spoke to the inspector were pleased that they could spend their days as they wish. Some residents choose to take their meals in their rooms Cultural needs are met by regular visits by the clergy and communion for those residents who wish to take it. The home has appointed an activities coHartland House DS0000022645.V296693.R01.S.doc Version 5.2 Page 13 ordinator who arranges activities for the residents. These include, card making, armchair aerobics, dominoes and scrabble. Some residents have formed into small groups and play dominoes regularly and the inspector was able to see one group playing a game. Regular residents’ meetings take place with minutes displayed for all to read. Residents told the inspector that they were able to make comments to the manager and/or members of staff anytime about the running of the home. Family members and other visitors are always made welcome with visiting times flexible enough to suit everybody. Some family members bring in their dogs to visit residents. Some residents are able to deal with their own finances but in other cases family members or solicitors assist with financial affairs. The dining room is well decorated with views over the garden the tables nicely set. Residents enjoy a varied and nutritious menu with a choice at every meal. Special diets are also catered for and those residents who need assistance are given help in such a way as to retain their dignity. Hartland House DS0000022645.V296693.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 17, 18 & 18 The quality in this outcome area is good. The home has a complaints procedure that is up to date, clearly written and easy to understand. Residents feel confident that any issue they raise will be dealt with promptly. Training of staff in the area of protection is arranged and staff have a good knowledge of adult protection, which protects and safeguard the residents. This judgement was made using available evidence including a visit to the service EVIDENCE: The home has a complaints book in place but there have been none to record. The home encourages open dialogue and many of the residents are well able to express their opinions. There is a copy of the complaints procedure on display in the hall. There are policies and procedures in place that outline the rights of those living in the home and these also form part of the terms and conditions of residency. All the residents who were able, and wanted to, took place in the recent local elections. For those who were unable to vote in person, postal votes were organised. Adult protection issues are discussed during staff induction and this area is also covered in the NVQ training course. Staff interviewed showed a good awareness of abuse issues and the process to follow should this be necessary. Hartland House DS0000022645.V296693.R01.S.doc Version 5.2 Page 15 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, 20, 21, 23, 24, 25 & 26 The quality in this area is excellent. This judgement was made using the available evidence including a visit to the service. The home provides a very well maintained, clean, comfortable and attractive home in which to live and which meets all the assessed needs of the residents. The rooms are well planned with all having en-suite toilet and shower facilities. There is a selection of communal areas giving the residents the choice of where to sit and/or meet with their visitors. EVIDENCE: Hartland House is an extremely well maintained home with an annual programme of repairs and maintenance. Since the last inspection a new hairdressing salon has been provided and new furniture has been purchased for the television lounge. The hall and corridors have been decorated and the conservatory refurbished. There is a well-appointed television lounge, a bright airy lounge/dining room and a conservatory overlooking the garden. There are also further small sitting Hartland House DS0000022645.V296693.R01.S.doc Version 5.2 Page 16 areas that are ideal for residents to use. All these facilities provide ample communal space for sitting quietly with visitors, watching television or taking part in any activities. There is a well-kept garden to the side of the home where the residents can sit. The home has recently increased the registered numbers by one to provide the facility of a double room although this is currently being used as a single. All the other bedrooms are registered as single rooms. All of the bedrooms have en-suite toilet and shower facilities. They are all well decorated and personal to the residents with pictures, ornaments and photographs. Most of the residents have also brought personal items of furniture from their own homes. Although all the residents’ rooms have en-suite showers there is a communal bathroom for those wishing to have a bath in preference to a shower. The home employs a housekeeper and other domestic staff to ensure the cleanliness is always of a high standard. Infection control policies and procedures minimise the risk of cross infection. Hartland House DS0000022645.V296693.R01.S.doc Version 5.2 Page 17 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 & 30 The quality in this outcome area is good. Residents have confidence in the staff team that cares for them. Staff rotas take into consideration the needs of the residents and busy times of the day. Management encourage staff to undertake training and recognise the benefits of a skilled and experienced workforce. The home has a robust recruitment and selection policy in place. This judgement was made using available evidence including a visit to the service. EVIDENCE: The staffing arrangements in this home are very good with 4 members of care staff plus the manager and deputy on duty during the day and 2 waking staff at night. There are also catering and domestic staff. The staff team is both experienced and qualified with 75 having already completed their NVQ level 2 or above and others working towards the awards. The deputy manager is currently completing a course on palliative care. The inspector was able to observe the staff and found their attitude to be caring, supportive and enabling. This attitude ensures that the residents can maintain as much independence for as long as possible. There was a very relaxed atmosphere in the home with management and staff enjoying a good rapport with the residents and visitors. Hartland House DS0000022645.V296693.R01.S.doc Version 5.2 Page 18 There is a full recruitment and selection process that ensures all the legal checks are completed prior to new staff starting work. This ensures the safety and security of the residents. There is a very low staff turnover and those living in the home benefit from the knowledge that a stable staff team, they are familiar with, is responsible for their care. The home does employ overseas staff who have integrated well and are popular with the residents. There is a good staff training and development programme in place and staff have already completed courses in dementia care, fire safety, first aid, moving and handling, safe medication and health and safety. The manager completes an annual training needs analysis to ensure the training budget is sufficient to meet the training needs. Hartland House DS0000022645.V296693.R01.S.doc Version 5.2 Page 19 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 & 38 The quality in this area is good. The manager has the required qualifications and experience and is competent to run the home. He works continuously to ensure a high quality of life for the residents. He is resident focused and leads and supports a strong staff team. The home has sound policies and procedures that are reviewed and updated on a regular basis. This judgement was made using available evidence including a visit to the service EVIDENCE: Discussions with the registered manager confirmed his commitment to giving the highest level of care to the residents. He works closely with the deputy manager and the staff team to ensure all the assessed needs are met. He is well qualified, and has considerable experience in the care and support of older people. During the visit he demonstrated clear lines of responsibility and Hartland House DS0000022645.V296693.R01.S.doc Version 5.2 Page 20 delegation to the senior care team but also provided a “hands on approach” when necessary. Discussions with the residents and staff evidenced that he ensures the home is run in the best interest of the residents some of whom were seen enjoy a laugh and joke with him. Staff supervision takes place every 2 months with the final one of the year taking the form of the annual appraisal. Supervision records are held on file and were made available to the inspector during the visit. Although there is very little residents’ money held at the home there are procedures in place to ensure that any personal finances are safeguarded even though the families have the ultimate responsibility. The internal quality audit system is conducted via residents’ meetings, 6 monthly questionnaires sent to the residents and their families and feed back from the monthly reviews conducted by the key workers. The manager has also extended the scope of the monthly visits by the members of the board of trustees. During the visits the board members examine a certain number of the care standards and complete an audit of those standards. Recommendations are then made to the manager and if there are any improvements to be made these are completed as soon as possible. Minutes of the residents’ meetings are made available for all to read. The home has a full set of policies and procedures in place and the manager is always looking at ways to ensure these are kept completely up to date. The home has a comprehensive health and safety manual and an external consultant completes an annual health and safety audit and produces a report for the manager with a plan of action required if necessary. There are in-house safety checks completed on a regular basis and all risk assessments are up to date. Hartland House DS0000022645.V296693.R01.S.doc Version 5.2 Page 21 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 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 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 3 18 3 4 4 3 X 4 4 4 4 STAFFING Standard No Score 27 4 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 X 3 Hartland House DS0000022645.V296693.R01.S.doc Version 5.2 Page 22 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. 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. Refer to Standard Good Practice Recommendations Hartland House DS0000022645.V296693.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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. 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