Inspection on 02/08/05 for Harwood House

This inspection was carried out on 2nd August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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

Harwood House 19/06/07

Harwood House 10/01/06

Harwood House 30/11/04

Harwood House 02/09/04

Harwood House 09/12/03

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

CARE HOME ADULTS 18-65 Harwood House Birtley Lane Birtley Chester le Street Co Durham DH3 1AX Lead Inspector Trevor Jarvis Announced Tuesday, 02 August 2005 at 10:00am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Harwood House B52-B02 S7433 Harwood House V206189 020805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Harwood House Address Birtley Lane Birtley Chester le Street Co Durham DH3 1AX 0191 492 3921 0191 492 3892 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Northgate & Prudhoe NHS Trust Mrs Jean McNestry Care Home 5 Category(ies) of LD(E) Learning disability over 65 (4) registration, with number PD(E) Physical disability over 65 (1) of places SI(E) Sensory Impairment over 65 (1) LD Learning disability (2) Harwood House B52-B02 S7433 Harwood House V206189 020805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30 November 2004 Brief Description of the Service: Harwood House is a spacious, purpose-build bungalow with five generously sized bedrooms of which one is with en-suite facilities offering 24 - hour care, supporting and encouraging adults with learning dificulties and complex needs, who are not quite able to look after themselves. The home cannot provide nursing care. Facilities, including bathrooms and toilets are adapted for service users who are physically frail or disabled, and also has an emergency pull cord system. Access to the front of the dwelling is ramped and ample car parking for staff and visitiors is available to the side. The pleasantwell kept enclosed gardens at the back of the home include raised flowerbeds, to which service users may tend to if they choose. The home currently provides accomodation for five people with a learning disability,one of whom also has physical disabilities and uses a wheelchair. The home is owned by Northgate & Prudhoe NHS Trust. Staff are available 24 hours per day, seven days a week to support people in theirdaily lives and to provide waking night cover. The home is situated in a residential area of Bitley and is within walking distance of local shops, pubs, churches and other community facilities. the area is well served by public transport, which include those running to central Gateshead, Washington and Chester-le Street, and ther people living at the hoemhave the use of a privately owned adapted people carrier as well. Harwood House B52-B02 S7433 Harwood House V206189 020805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Harwood House was told that there was going to be an inspection and when it would be conducted as part of the routine yearly programme. It was done in August 2005. Three service users completed pictorial comment cards and returned them to the CSCI. In addition three relatives of service users completed comment cards. On the day the inspector spent nine hours at Harwood House talking with service users, the manager and staff and was shown around the home. The inspector also joined people for lunch and tea and checked the home’s paperwork. Throughout the rest of this report the people who live here will be referred to as ‘service users’. What the service does well: The home is a nice, clean, well-furnished place to stay. It is bright, comfortable and modern place for the residents to live. It is spacious and has lots of lounges and sitting areas for the people who here to choose from. It also has good access for the person who has a physical disability. Service users have a strong sense of ownership of the home and their views are taken into account on lots of issues. “One of the service users said this is a nice home”. The staff are very friendly, good humoured and caring at Harwood House and will go out of their way to try and improve the quality of the lives of service users. There are plenty of staff on duty to help service users when they are at home or out and about. Staff have training to help them provide good care. Staff understand the different needs of the residents and know how to support them in the right way. Staff keep records that show what residents can manage themselves and exactly how to help them with the daily things that they can’t manage. The management and organisation of the home is very good, and ensures that service users are well cared for and safe. The home works well with other healthcare professionals and organisations, to ensure service users receive appropriate care. The home offers varied and good nutritious food. Harwood House B52-B02 S7433 Harwood House V206189 020805 Stage 4.doc Version 1.40 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. Harwood House B52-B02 S7433 Harwood House V206189 020805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Harwood House B52-B02 S7433 Harwood House V206189 020805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 The assessment records fully demonstrate that staff know and understand the needs of the service users. EVIDENCE: Before anyone moves to this home a full assessment of their needs is carried out to make sure that the service is suitable for them. Since the last inspection one new resident has moved into the bungalow. Detailed assessment documents are stored in their care file that show how it was decided that the new person’s needs could be met at the home. The people involved in the assessment process included health professionals from the Trust, social workers, Harwood House staff, the prospective resident and their representatives. In this way, everyone involved in the resident’s care could help decide if the service at Harwood house was right for that person. The staff who were spoken to showed that they knew a great deal of information about all aspects of people’s lives and their on- going and changing needs. They were able to talk about with confidence how they worked with the person to identify and sort out issues that might cause frustration or distress. They confirmed that the service user’s needs and wishes are taken into account as well as other aspects of their physical, emotional and spiritual care. Harwood House B52-B02 S7433 Harwood House V206189 020805 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 and 7 Support planning systems ensure that the staff team work consistently in supporting service users adjust to changing needs. Service users are encouraged and supported to make everyday choices and decisions about their lives. EVIDENCE: Support plans and risk assessments are in place for the five service users. These give information about service user’s capabilities and also identify specific needs for each person and show exactly how staff should support them. Medical needs are highlighted on pink sheets in the files. The plans set out instructions to staff about the level of support each person needs with their goals. Meetings attended by the service user, key worker and manager to review plans or objectives are held monthly to check progress or examine difficulties. The manager completes a care plan-monitoring sheet every month. Where service users or their representatives have signed possible support plans. The plans are written in plain English and there are pictorial clues in plans to help residents understand them. Harwood House B52-B02 S7433 Harwood House V206189 020805 Stage 4.doc Version 1.40 Page 10 Service user’s care files also contain daily records and a monthly summary of each resident’s well-being in terms of health, activities, behaviour and relationships prepared by the key worker. In this way shorter-term goals can be set and monitored by staff. The service user’s are encouraged by staff to make their own choices wherever their capabilities allow. Service users make menu choices, choose what to wear each day, decide where to go on holiday, and all have chosen their own colour scheme in their bedroom. These decisions are recorded within daily and monthly records so it can be seen what people have chosen to do. Harwood House B52-B02 S7433 Harwood House V206189 020805 Stage 4.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 14, 15 and 17 Service users have good opportunities to take part in a range of activities. Service users who have relatives are supported to keep in contact with their families and have opportunities to meet others at church or social and leisure events. Service users either learn or maintain skills by being involved in choosing menus, shopping and preparing meals with staff support and are offered a varied, nutritional diet and could be seen to be clearly enjoying their meals. EVIDENCE: Service user’s care records indicated that people are offered a range of activities including and crafts everyday as well as planned holidays. The people make good use of local facilities in the community including shops church and cinema. In this way the home provides fulfilling, active and appropriate leisure interests for the people who live there. Harwood House B52-B02 S7433 Harwood House V206189 020805 Stage 4.doc Version 1.40 Page 12 There is a relaxed atmosphere around this small home and the five people who live here make use of the lounges and their bedrooms for their own interests and for privacy. The service users are all involved with staff support in shopping at local supermarkets and in preparing meals or snacks. They dine with staff in the kitchen/diner when staff encourage service users to join in conversations and this supports their social and communication skills. The inspector joined service users for lunch and tea-time meals. Some service users were observed to be involved in preparing the meals or setting the tables. All service users were encouraged to make their own choice from the different types of dishes prepared. Service users said that they like the food at Harwood House. Harwood House B52-B02 S7433 Harwood House V206189 020805 Stage 4.doc Version 1.40 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19, 20, and 21 The personal and health care needs of service users are identified and met. Following assessments of people’s needs, trained staff take responsibility for managing any service user’s medicines safely. EVIDENCE: Staff were observed to help the service users stay healthy and support them with personal care, like getting dressed and getting washed all the while speaking to them in a respectful and dignified manner. The home has a plan about helping people with medicines and if they are ill. One of the service users has an understanding of the issues relating to death, she speaks of fellow service users, family and fiends having “passed away”. The service user has taken part in discussions about planning her own funeral. Harwood House B52-B02 S7433 Harwood House V206189 020805 Stage 4.doc Version 1.40 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 The views of service users and their relatives are taken seriously and appropriate action will be taken to resolve concerns and complaints. The home works to satisfactory policies and procedures to ensure that people living there are protected from all types of harm and as far as possible from self-harm. EVIDENCE: The home has easy to understood information about how people can complain about the service and it has been given to service users and their relatives. People’s views about life at the home are regularly sought, which means that people’s ideas about how the home could be better are heard. Service users said that they are happy to talk to the staff or manager about any worries they have about the service. They said that they enjoy living at the home and feel safe there. No complaints have been made since the last inspection. The home has information on abuse and protection implemented in January 2005 on what staff should do if they think someone is being abused. All the staff have had training about this. Staff are clear about their responsibilities in this area. Some people do need verbal support and supervision to manage their behavioural needs. Staff do not carry out physical interventions to support service user’s behavioural needs. Service user’s money is kept safely and staff assisting service users to manage their money follows proper procedures. Everything is written down and very frequent checks are made of the records. Harwood House B52-B02 S7433 Harwood House V206189 020805 Stage 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26 and 30 The home provides a safe, comfortable, accessible place for people to live. Service user’s bedrooms promote their independence, individuality, choice and privacy. Service users have access to a range of bathrooms and toilets. The home is clean and hygienic and was free of any noticeable hazards at the time of the inspection. EVIDENCE: The home is modern, bright, well furnished, contemporary and cheerful. The bungalow is well maintained and is accessible for service users and visitors with a physical disability. Service users each have their own private bedroom, which have been decorated to individual tastes, so service users have been involved in choosing their own colour schemes. Service users can and do use their bedrooms for privacy whenever they wish. Staff carry out daily household tasks in support of service users… They encourage and help service users with their domestic skills. The home was very clean and tidy throughout. Harwood House B52-B02 S7433 Harwood House V206189 020805 Stage 4.doc Version 1.40 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33 and 35 Competent, qualified and well trained staff supports Service users. There are sufficient staff on duty to meet the needs of the people who live here. EVIDENCE: Staff know what their job is and have been given information about the home’s rules and policies. Care at Harwood House is delivered by experienced, dedicated staff who fully trained in appropriate subjects to meet service user need and training is meeting Care Standards legislation and is linked towards achieving NVQ standards. Staff receive support through monthly supervision and yearly appraisal sessions. The majority of the staff have worked at Harwood House for several years and have established excellent relationships with the service users. On the day of the inspection, the manager and three staff were working. The manager said that a minimum of three staff are on duty during the day and often four staff are working. Overnight there will be one waking staff member and one sleeping staff member on duty. Photographs of staff on duty the following day are put up on the wall to remind service users who will be supporting them the following day. Harwood House B52-B02 S7433 Harwood House V206189 020805 Stage 4.doc Version 1.40 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 39, 40 and 42 Service users and staff benefit from a well managed and well organised service ensuring that service user’s needs are met. Systems, procedures and practices promote the safety and wellbeing of the people who live there. Staff receive regular training to ensure that practices in place support the health, welfare and safety of service users. EVIDENCE: The registered manager has many years experience of working in the health and social care setting. She remains on target for completing an NVQ Management and Diploma in Care by the end of 2005. There are clear lines of accountability and management support within the organisation. In this way the service users and staff benefit from a well managed service. In conversations staff members confirmed that the manager and her assistant are approachable and supportive. The people who live here are able to express their views about the service they receive. Harwood House B52-B02 S7433 Harwood House V206189 020805 Stage 4.doc Version 1.40 Page 18 Monthly meetings are held with service users and staff also give out pictorial questionnaires to service users for them to indicate likes and dislikes, such as activities. Time was spent observing the good interactions between service users and staff, and there was a friendly relaxed atmosphere in the home. In discussions staff were enthusiastic about the improvements to people’s needs and lifestyle since moving to this home. The manager and team also take responsibility for carrying out audits of the premises and of care practices and records to check that things are running as they should be and quickly put right anything that is wrong. A rolling programme of training is in place to ensure that all staff receive training in health and safety in health and safety matters including fire safety, first aid food hygiene and infection control. Harwood House B52-B02 S7433 Harwood House V206189 020805 Stage 4.doc Version 1.40 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 4 3 4 x x x 4 Standard No 11 12 13 14 15 16 17 x 3 x 3 3 x 3 Standard No 31 32 33 34 35 36 Score x 4 3 x 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Harwood House Score 3 4 3 3 Standard No 37 38 39 40 41 42 43 Score 4 3 3 3 x 3 x B52-B02 S7433 Harwood House V206189 020805 Stage 4.doc Version 1.40 Page 20 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 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. 1. 2. Refer to Standard YA2 YA7 Good Practice Recommendations The service user assessment form should be dated Pictures and graphics in the various documents used to involve service users in the running of the service are to include male figures to reflect the recent changes in gender of service users Daily recording notes will infuture reflect the changing emphasis of recording outcomes for service users 3. YA7 Harwood House B52-B02 S7433 Harwood House V206189 020805 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection Baltic House Port of Tyne Tyne Dock South Shields NE34 9PT 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 Harwood House B52-B02 S7433 Harwood House V206189 020805 Stage 4.doc Version 1.40 Page 22 - 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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