Inspection on 27/10/05 for Harts House Nursing Home

This inspection was carried out on 27th October 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 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

Harts House Nursing Home 03/10/07

Harts House Nursing Home 25/07/06

Harts House Nursing Home 18/04/05

Harts House Nursing Home 12/10/04

Harts House Nursing Home 13/05/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Harts House Nursing Home Harts Grove Woodford Green Essex IG8 ODP Lead Inspector Ms Gwen Lording Unannounced Inspection 27 October 2005 07:30 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 Harts House Nursing Home DS0000025955.V260335.R01.S.doc Version 5.0 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. Harts House Nursing Home DS0000025955.V260335.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Harts House Nursing Home Address Harts Grove Woodford Green Essex IG8 ODP 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) 0208 502 9111 0208 502 9444 BUPA Care Homes (GL) Ltd Care Home 61 Category(ies) of Old age, not falling within any other category registration, with number (61) of places Harts House Nursing Home DS0000025955.V260335.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 2 beds may be used for respite care for residents aged between 50 and 65 years To include one named person under 65 years of age. Date of last inspection 18th April 2005 Brief Description of the Service: Harts House Nursing Home is owned and operated by BUPA Care Homes. The home is registered to provide care with nursing for up to 61 elderly people over the age of sixty-five years. The home is situated in a quiet residential area of Woodford in the London Borough of Redbridge. There are good transport links and the home is close to shops and other amenities and community facilities. All the rooms have en-suite facilities and the premises have been fully adapted to accommodate service users with a range of physical disabilities associated with old age and are suitably equipped. The external grounds and the premises are well maintained and secure. The home employs activities co-ordinators, catering, domestic, maintenance, laundry and administrative staff, as well as registered nurses and care staff. Harts House Nursing Home DS0000025955.V260335.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over one day, commenced at 7.30am and lasted four and a half hours. The Inspector spoke to a number of residents on each floor of the home, including one service user admitted to the home the previous day and one service user admitted for respite care. In addition the relatives of two residents were spoken to get their views and comments about the care in the home. There was also an opportunity to speak to a visiting health care professional, a Tissue Viability Nurse. Discussion took place with the Head of Care, the Chef Manager, maintenance person and several members of nursing and care staff. A tour of the home was made and a number of staff and care records were looked at. The previous registered manager left the home in May this year following a prolonged period of absence due to ill health. The Head of Care has been in charge of the home throughout this time. The registered providers have now successfully appointed a manager and are undertaking the required checks and references. An application will then be submitted to the Commission for this person to be registered as the manager. The Inspector would like to thank the residents, their relatives, visitors and staff for their input during the visit. What the service does well: Harts House provides an attractive and comfortable living environment for residents. The décor, furnishings and fittings are maintained to a high standard. The home fully supports service users to exercise choice and control of their lives and offers a range of activities to suit individual’s expectations, preferences, interests and capacities. Residents and their relatives are consulted and kept informed about issues affecting the home through regular newsletters and meetings. Relatives/ visitors were very positive about the care and commented that staff are very welcoming when they visit. Harts House Nursing Home DS0000025955.V260335.R01.S.doc Version 5.0 Page 6 The home is able to offer a wide variety and choice of meals and residents commented positively on the quality and variety of the meals available to them. 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. Harts House Nursing Home DS0000025955.V260335.R01.S.doc Version 5.0 Page 7 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Harts House Nursing Home DS0000025955.V260335.R01.S.doc Version 5.0 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 Harts House Nursing Home DS0000025955.V260335.R01.S.doc Version 5.0 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): Standard 1 Information contained in the Statement of Purpose and Service User Guide is clear and helps prospective residents and their families choose a service that is right for them. Standard 3 was tested at the previous inspection and met in full. EVIDENCE: The home’s Statement of Purpose and Service User Guide provide current and prospective residents with information about the organisation and the service. An information pack is sent out to all prospective residents. However, the management structure, as displayed on the resident’s information board, must be amended as it still details the name of the previous registered manager. The home does not offer intermediate care. Harts House Nursing Home DS0000025955.V260335.R01.S.doc Version 5.0 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): Standards 7, 8, 9 and 10 Residents’ health, personal care and social care needs are set out in an individual plan of care and provide staff with the information they need to satisfactorily identify and meet residents needs. However, individuals preferences and views around preferred gender care must be sought and included in care plans to ensure that the arrangements for their personal care are upheld. There are clear medication policies and procedures for staff to follow, and the review of medication records show that staff are following the policies and procedures, and residents were being safeguarded with regard to their medication. EVIDENCE: Individual care plans were available for each resident and the care plans of eight residents were examined. The records for these residents were found to be generally detailed and comprehensive, and followed on from a full assessment of the resident’s needs. The records indicated that residents are seen by other health care professionals such as physiotherapists, specialist nurses and doctors. There was evidence that care plans are reviewed on a monthly basis and updated to reflect changing needs. Harts House Nursing Home DS0000025955.V260335.R01.S.doc Version 5.0 Page 11 The Inspector was able to meet with a community Tissue Viability Nurse who was visiting the home. She commented that all staff are very professional and make sure that suitable and appropriate arrangements are made for her to consult with residents. She is confident that staff will carry out any instructions directed by her. She raised an issue with regard to the provision of a more suitable mattress for a resident with a pressure sore and this was addressed by the Head of Care. Staff talked about and were observed to treat residents in a respectful and sensitive manner. They understood the need to promote their dignity through practices such as in the way they addressed residents and when entering bedrooms, bathrooms and toilets. Residents and relatives spoken to said that most staff were respectful and thoughtful when attending to their personal care. It was noted in a communication record that one resident had asked not to be cared for by a particular member of care staff. This was discussed with the Head of Care and was in relation to a specific request that the resident did not wish to receive care from “male” care staff. As the home employs both male and female care staff the individual views and preferences of all residents must be sought with regard to the arrangements for the provision of care. This information should be recorded in the individual’s care plan to ensure that the arrangements for their personal care are provided by staff of the preferred gender. At the previous inspection a requirement was made for risk assessments to be reviewed regularly where residents’ are able to take responsibility for their own medication. Examination of care plans showed that this requirement has now been met. Harts House Nursing Home DS0000025955.V260335.R01.S.doc Version 5.0 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): Standard 15 The meals in the home are very good and individual preferences and specialist dietary needs are catered for. Standards 12, 13 and 14 were tested at the last inspection and met in full. EVIDENCE: The chef manager has been at the home for a number of years and is able to cater for all tastes and special diets. There is a daily menu and meals are ordered the previous day. On the day of the visit there was a choice of four starters, three main meals and a choice of dessert for lunch. Residents can also order sandwiches or salads and the home can offer snacks at any time of the day. The visit took place whilst breakfast was being served. Residents were served a choice of cooked breakfast, cereals, fresh fruit and toast with individual pots of tea/ coffee and fresh juices. The majority of residents choose to eat breakfast in their rooms but can eat in one of the dining rooms if they wish. Those residents spoken to said that they enjoyed the food and particularly appreciated the “quality and variety” of meals available to them. Relatives/ visitors are offered a drink and can join residents for meals, at a small extra cost. Harts House Nursing Home DS0000025955.V260335.R01.S.doc Version 5.0 Page 13 A score of 4 – Standard Exceeded – has been awarded to Standard 15. The Chef Manager, kitchen staff and staff in the home are to be commended for the variety and choice of meals and the flexibility in its provision. Harts House Nursing Home DS0000025955.V260335.R01.S.doc Version 5.0 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): Standard 18 The majority of the staff, including administrative and ancillary staff, have now received training in Adult Protection/ Abuse Awareness to ensure that there is a proper response to any suspicion or allegation of abuse. Standard 16 was tested at the previous inspection and met in full. EVIDENCE: There is a written policy and procedure for the protection of vulnerable adults, dealing with allegations of abuse and whistle blowing. There is an ongoing programme of training in Adult Protection/ Abuse Awareness, which has now been extended to include all staff working in the home including administrative and ancillary staff. All newly recruited staff receive this training during their induction. This is a requirement from the previous inspection, which has now been met. Those staff spoken to during the inspection were aware of the action to be taken if there were concerns about the welfare and safety of residents. Harts House Nursing Home DS0000025955.V260335.R01.S.doc Version 5.0 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): Standards 19, 23, 24, 25 and 26 Residents at Harts House enjoy a very attractive, safe and comfortable living environment, which with the good standard of cleanliness and hygiene adds considerably to their quality of life. Standards 19 and 20 were tested at the previous inspection and met in full. EVIDENCE: The building was toured, accompanied by the Head of Care, at the start of the visit, and all floors were visited unaccompanied later during the morning. Some bedrooms were seen either by invitation of the resident, whilst others were seen because the doors were open or rooms being cleaned. Throughout the inspection the home was found to be clean and hygienic. Comments from residents and relatives indicated that they considered a very good standard was being achieved. The standard of the décor, furnishings and fittings in the home are maintained to a high standard and this is achieved through the employment of two maintenance personnel. There is a very effective system in place for staff to Harts House Nursing Home DS0000025955.V260335.R01.S.doc Version 5.0 Page 16 report items requiring replacement and minor repair. There is an ongoing programme of renewal for the fabric and decoration of the premises. There are a number of rooms throughout the home in which a variety of activities can take place. All the lounges have a different atmosphere, to suit individual preferences, needs and interests. For example small, quiet rooms and larger lounges with televisions. Harts House Nursing Home DS0000025955.V260335.R01.S.doc Version 5.0 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): Standards 27, 28, 29 and 30. The home employs sufficient staff to meet the personal and nursing care needs of the residents during the day. However, the night time staffing arrangements must be reviewed as some residents said that they felt “rushed by staff at night. The procedures for the recruitment of staff are robust and provide safeguards for people living in the home. EVIDENCE: The staffing levels of qualified nurses and care staff were sufficient to meet the nursing needs and personal care needs of residents during the day. However, in discussion with three residents they commented that they “felt rushed by staff at night and staff were not as attentive to their needs as staff were during the day”. The registered providers must review the night time staffing arrangements and ensure that there are sufficient night staff on duty that reflects the number and needs of residents and the layout of the home. In discussion with staff during the visit, it was evident that they fully support the main aims and values of the home. Staff files showed that staff had done training in essential areas such as manual handling, fire training and adult protection. Qualified nursing staff had attended training in wound management. Harts House Nursing Home DS0000025955.V260335.R01.S.doc Version 5.0 Page 18 47 of staff are qualified to NVQ level 2 or above and an additional eight care staff are scheduled to commence NVQ level 2 within the next month. The staff files examined of four staff members employed since the last inspection indicated that the home is undertaking all the necessary recruitment checks to ensure the protection of residents. Harts House Nursing Home DS0000025955.V260335.R01.S.doc Version 5.0 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): Standards 31, 34, 36 and 38 The home is being well managed in the absence of a registered manager and provides a safe environment for residents in the home. Monitoring visits are undertaken regularly by the registered person to monitor and report on the quality of the service provided in the home. Standards 33 and 37 were tested at the previous inspection and met in full. EVIDENCE: The previous registered manager left the home in May this year following a prolonged period of absence due to ill health. The Head of Care has been in charge of the home throughout this time. The registered providers have now successfully appointed a manager and are undertaking the required checks and references. An application will then be submitted to the Commission for this person to be registered as the manager. Harts House Nursing Home DS0000025955.V260335.R01.S.doc Version 5.0 Page 20 At the previous inspection a requirement was made for all qualified nursing staff to receive supervision on a regular basis. The Head of Care stated that all qualified nursing staff are now receiving group supervision on a monthly basis with their peers and this was confirmed in discussion with staff. A wide range of records were looked at, including fire safety, recording of water temperatures and accident reports. These records were detailed, up to date and accurate and confirmed that the home is being run responsible with essential checks being made and acted upon. However, individual resident records/ information must be stored securely and appropriately at all times and not left unattended on the nurses station. Harts House Nursing Home DS0000025955.V260335.R01.S.doc Version 5.0 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 3 X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 3 X X X 3 3 3 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X 3 2 3 Harts House Nursing Home DS0000025955.V260335.R01.S.doc Version 5.0 Page 22 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 Standard OP10 Regulation 12 & 15 Requirement Timescale for action 30/11/05 2 OP27 18 3 OP37 17 Individual residents preferences and views around preferred gender care must be sought and included in care plans to ensure that the arrangements for their personal care are upheld. The registered providers must 30/11/05 review the night time staffing arrangements and ensure that there are sufficient night staff on duty that reflects the number and needs of residents and the layout of the home. Individual resident 27/10/05 records/information must be stored securely and appropriately at all times and not left unattended on the nurses station. 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 Good Practice Recommendations DS0000025955.V260335.R01.S.doc Version 5.0 Page 23 Harts House Nursing Home Standard Harts House Nursing Home DS0000025955.V260335.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU 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 Harts House Nursing Home DS0000025955.V260335.R01.S.doc Version 5.0 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!