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Inspection on 22/11/05 for Harwood House Nursing Home

Also see our care home review for Harwood House Nursing Home for more information

This inspection was carried out on 22nd November 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The manager and staff are welcoming to visitors. There is a relaxed content atmosphere. Residents were happy with the care and found staff very friendly and helpful. The standard of personal care is good. Each resident is treated as an individual. This is an old house and is decorated and furnished in style. The residents` accommodation is varied. Residents enjoyed the difference.

What has improved since the last inspection?

Residents and relatives are encouraged to be more involved in the home by the residents and relatives meetings and establishing the Friends of the Home. More emphasis is being put on activities and variety in the home. Changes are being made to office and staff accommodation to improve it.

What the care home could do better:

The kitchen is generally well managed. It is important to check and record fridge and freezer temperatures daily and to make sure that all food in the freezer is named and dated. The laundry should be organised with better use of space. Staff training should be recorded centrally to ensure that all staff receive the necessary training.

CARE HOMES FOR OLDER PEOPLE Harwood House Nursing Home Spring Lane Cookham Dean Berkshire SL6 6PW Lead Inspector Susan Cledwyn-Davies Unannounced Inspection 22nd November 2005 9:25 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 Harwood House Nursing Home DS0000010987.V264056.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. Harwood House Nursing Home DS0000010987.V264056.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Harwood House Nursing Home Address Spring Lane Cookham Dean Berkshire SL6 6PW 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) 01628 478000 01628 478012 Harwood House Limited Ms Morag Forsyth Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30), Physical disability (30) of places Harwood House Nursing Home DS0000010987.V264056.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. No physically disabled adults under the age of 60 to be admitted. Date of last inspection 4th July 2005 Brief Description of the Service: Harwood House is located approximately three miles from Maidenhead in a rural setting at the end of a hedged driveway on raised ground with views over trees and fields with Windsor and the Thames Valley beyond. The home provides accommodation for 30 service users, 23 of whom may require nursing care.There is a sitting room and separate sun lounge with French windows leading onto a large patio, used extensively in the summer months.The accommodation is on three floors with a small passenger lift available to transport wheelchairs between floors. The house stands in attractive grounds and gardens.The gardens can be approached from various areas of the house and are laid out to lawns, flowerbeds and trees. There are pleasant views from most areas of the house and garden. Harwood House Nursing Home DS0000010987.V264056.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place between 9.25am and 2.30pm. Included in the inspection was a partial tour of the home, conversation with residents and staff, discussion with the manager and examination of records. There are 27 residents in the home. By agreement with the manager the service users are called residents within this report. What the service does well: 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 Nursing Home DS0000010987.V264056.R01.S.doc Version 5.0 Page 6 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 Harwood House Nursing Home DS0000010987.V264056.R01.S.doc Version 5.0 Page 7 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): The standard when inspected previously was satisfactory and there were no outstanding requirements or recommendations. EVIDENCE: The new manager advised that the statement of purpose had been amended to include her appointment. The service user guide was being amended. Harwood House Nursing Home DS0000010987.V264056.R01.S.doc Version 5.0 Page 8 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): 9 Medication storage and administration is well managed. EVIDENCE: There was a previous requirement to ensure that the medication trolley is taken around the home and that medication is not prepared in pots. The manager and staff confirmed that the medication trolley is now taken round the home. Medication records are well maintained and checked regularly by both the deputy manager and manager. Harwood House Nursing Home DS0000010987.V264056.R01.S.doc Version 5.0 Page 9 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, 14 and 15 Residents are content with the lifestyle in the home. Residents confirmed that they are helped to make choices. There is an appealing and balanced diet available. EVIDENCE: Residents confirmed they were happy with the care and found their views listened to. There is an activities record, both group and individual activities are organised. One resident spoke of really enjoying having her book read to her twice a week in her room. The new manager is developing the activities further e.g. sherry afternoons, a notice board to display future activities and other ideas. A recent firework party and Halloween party was successful. There is a choice available in how to spend the day, to join in activities and in meals. This was confirmed by residents, staff and by observation. A cook and assistant cook provide the meals. There is a main meal prepared and a number of alternatives. Residents are asked just prior to the meal for their choice and this is recorded. Residents confirmed that the food provided was satisfactory. The kitchen is well organised, clean and tidy. A recent Harwood House Nursing Home DS0000010987.V264056.R01.S.doc Version 5.0 Page 10 environmental health inspection was positive and recommendations have been actioned. In the kitchen there were two problem areas. The record of fridge and freezer temperatures was incomplete and the meat kept in the freezer was not labelled to include the date. Requirements are made about these. Harwood House Nursing Home DS0000010987.V264056.R01.S.doc Version 5.0 Page 11 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. Residents are confident that their complaints will be listened to and acted upon. Residents are protected from abuse. EVIDENCE: There has been one complaint received by CSCI. Following investigation this complaint was not substantiated. No complaints have been made to the manager. Residents confirmed that they were confident that the manager and deputy would listen to their complaints and resolve them if possible. There have been no concerns about the protection of vulnerable adults. The manager has the latest interagency guidelines. Harwood House Nursing Home DS0000010987.V264056.R01.S.doc Version 5.0 Page 12 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 The house is well maintained and comfortable. There is a good standard of hygiene. EVIDENCE: The house is kept well maintained and comfortable. The manager is aiming to replace some of the older furniture e.g. dining chairs with new. The home’s office and staffroom were being redecorated and room use swapped. The office was having computers and Internet access arranged. The laundry is compact and kept orderly. There was discussion with staff to work towards a clear definition between dirty and clean areas and to move equipment and stored linen to provide as much space as possible. The main aim being to prevent contamination of clean clothes and bedding. The manager agreed and was going to reorganise the laundry. Harwood House Nursing Home DS0000010987.V264056.R01.S.doc Version 5.0 Page 13 There is a previous requirement that a bath is replaced or repaired. Quotes have been obtained for a replacement bath and a decision is being made next week. Harwood House Nursing Home DS0000010987.V264056.R01.S.doc Version 5.0 Page 14 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. A satisfactory staff team meets residents’ needs. The recruitment policy and training provided support residents. EVIDENCE: The staff cover includes 9 carers in the morning, 5 in the afternoon and 3 at night. There is a minimum of one qualified staff on duty at all times. There has been some turnover of staff following the retirement of the previous manager; new staff have been recruited. There was a previous requirement that the domestic staff receive Health and Safety training. The domestic support has now changed from an outside contractor to internal appointment. The training is arranged to take place shortly. The recruitment policy is sound. This was shown in the latest 2 recruited staff files. Photographs have been taken for these staff but cannot be added to the file until the computer system is working again with the digital camera. There is good support for NVQ training, 80 of care staff have NVQ 2 or above. Staff are now completing NVQ 3. Training needs analyses have been prepared for all staff. There was no central training record to demonstrate all training given to each staff member. It is recommended that either a paper based or computer based central record is set up. Harwood House Nursing Home DS0000010987.V264056.R01.S.doc Version 5.0 Page 15 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): 33, 35, 36 and 38. Quality assurance continues to develop. Residents’ finances are safeguarded. Health and safety of residents is promoted. Staff supervision is developing. EVIDENCE: Quality assurance continues to develop. The manager is attending an extended managers course for managers of a care home. This is to further her own practice. The first meeting of residents and relatives has taken place and the minutes included suggestions and recommendations to the manager. She is preparing to answer these. A Friends of Harwood House is being set up. Staff meetings are held. The manager in the home holds no residents’ money. All purchases are billed at the end of the month. Harwood House Nursing Home DS0000010987.V264056.R01.S.doc Version 5.0 Page 16 Staff supervision requires new staff to be trained to provide the supervision. This is taking place and supervision will be encouraged. Annual appraisals are also being introduced. Health and safety is managed responsibly. Service records were seen. Health and safety training is provided by an outside consultant when necessary. In discussion it was suggested that a health and safety file be established. Harwood House Nursing Home DS0000010987.V264056.R01.S.doc Version 5.0 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 2 STAFFING Standard No Score 27 3 28 4 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 3 X 3 Harwood House Nursing Home DS0000010987.V264056.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 Standard 15 15 Regulation 13 13 Requirement Timescale for action 01/01/06 It is required that the fridge and freezer temperature be taken each day and a record kept. It is required that all meat frozen 01/01/06 has a label with contents and date. 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 26 30 Good Practice Recommendations That the laundry room be better organised. That a central training record be maintained. Harwood House Nursing Home DS0000010987.V264056.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Berkshire Office 2nd Floor 1015 Arlington Business Park Theale, Berks RG7 4SA 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 Nursing Home DS0000010987.V264056.R01.S.doc Version 5.0 Page 20 - 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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