Inspection on 04/07/05 for Harwood House Nursing Home

This inspection was carried out on 4th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 Nursing Home 27/09/06

Harwood House Nursing Home 22/11/05

Harwood House Nursing Home 21/10/04

Harwood House Nursing Home 19/08/04

Harwood House Nursing Home 12/02/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE HARWOOD HOUSE NURSING HOME Spring Lane Cookham Dean SL6 6PW Lead Inspector Susan Cledwyn-Davies Unannounced 4 July 2005, 9.20am-3.10pm 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 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 H52-H01-S10987-Harwood House-V228019040705-Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Harwood House Nursing Home Address Spring Lane, Cookham Dean, SL6 6PW 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) 01628 478000 Harwood House Ltd Care home with nursing (N) 30 Category(ies) of Old age, not falling within any other category registration, with number (OP) of places HARWOOD HOUSE NURSING HOME H52-H01-S10987-Harwood House-V228019040705-Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The number of persons for whom nursing accommodation and care is provided at any one time shall not exceed 23 (twenty-three). 2. The rooms that can be used for nursing accommodation and care are: Ground Floor: 1,4,6,8,30,31,31,33,34,35 First floor: 12,14,17,18,19,21,22 Second Floor: 26 3. Chronically disabled persons under the age of 60 will not be received except for convalescence or respite care for periods not exceeding three weeks. 4. Two particular service users under the age of 65 may be accommodated for nursing care. Date of last inspection 21 October 2004 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 H52-H01-S10987-Harwood House-V228019040705-Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place between 9.20am and 3.10pm. Included in the inspection was a partial tour of the building, discussion with the manager and 5 staff, conversation with 8 service users, 3 relatives and examination of the records. There was as a discussion with the manager and deputy manager in which it was agreed that the term resident would be used in this report rather than service user. 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 H52-H01-S10987-Harwood House-V228019040705-Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection HARWOOD HOUSE NURSING HOME H52-H01-S10987-Harwood House-V228019040705-Stage 4.doc Version 1.40 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 standard(s) 1, 2, 3, 4 and 5 Prospective residents have adequate information about the home and are given a written contract of terms and conditions. All residents have their needs assessed prior to coming into the home. Prospective residents and relatives are able to visit the home prior to admission. EVIDENCE: The statement of purpose and service user guide are displayed in the entrance hall and copies of these are given to all prospective residents. The statement of purpose was seen. The full details of the proprietor and of the responsible individual are not included. A requirement is made to amend the statement and include details as noted in the regulations as a minimum. These details need to be copied to CSCI. All prospective residents are assessed prior to admission. Both residents and relatives are encouraged to visit the home. Residents and relatives confirmed this. A pro-forma contract is given to prospective residents with the homes information. The care plans demonstrated that needs are assessed and met. HARWOOD HOUSE NURSING HOME H52-H01-S10987-Harwood House-V228019040705-Stage 4.doc Version 1.40 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 standard(s) 7, 8, 9 and 10 Residents care needs are set out in an individual plan and health care needs are met. Medication is safely administered and stored. Residents feel they are treated with respect. EVIDENCE: Four care plans were seen in detail. These plans included preadmission assessments, comprehensive care plan with manual handling assessment, pressure area care and nutrition assessment all of which are reviewed monthly. The care plan is seen and discussed with residents and/or relatives. Risk assessments for use of bed rails and body maps noting bruises etc. kept in the individual rooms with fluid charts and turning records. In discussion with residents and relatives the care was seen as very good. Healthcare is provided by a local GP. The medical support is good. Medication is stored in the treatment room. The drug fridge needs to have the temperature checked daily. This would normally happen but it appears that the record sheet ran out. A recommendation is made to ensure that this check continues. Medication storage and administration records were orderly and professional. There was discussion about the administration of medication into plastic pots in the treatment room and this being taken round the home instead of taking the medication trolley. The staff have tried to take the trolley HARWOOD HOUSE NURSING HOME H52-H01-S10987-Harwood House-V228019040705-Stage 4.doc Version 1.40 Page 9 round the home and found this more problematic. The pharmacy inspector is being asked for further advice and clarification. It was suggested that nurses who administer medication have a 6 monthly assessment to ensure that the homes medication policy is being followed satisfactorily. Residents stay in their room or in the lounge and dining room. Their choice is respected. HARWOOD HOUSE NURSING HOME H52-H01-S10987-Harwood House-V228019040705-Stage 4.doc Version 1.40 Page 10 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 standard(s) 13 Residents maintain contact with family and friends. EVIDENCE: Relatives visiting during the inspection confirmed that they are made welcome and that the home is a pleasant place to visit. The Manager encourages visitors proactively; relatives that have lost touch are contacted. HARWOOD HOUSE NURSING HOME H52-H01-S10987-Harwood House-V228019040705-Stage 4.doc Version 1.40 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 standard(s) 16, 17 and 18 Residents are confident that complaints will be listened to and acted upon. Residents’ legal rights are ensured and they are protected from abuse. EVIDENCE: There is a comprehensive complaints procedure. No complaints have been received since the last inspection. Residents and relatives are confident in the staff of the home. Residents voted in the last election. Some residents used postal votes and a few requested and were taken to the polling station. There is an active approach to protecting residents from abuse. The deputy matron attended training and obtained the new guidelines on the interagency approach for the home. HARWOOD HOUSE NURSING HOME H52-H01-S10987-Harwood House-V228019040705-Stage 4.doc Version 1.40 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 standard(s) 19, 22 and 26 Residents live in a safe and well-maintained home that is clean and hygienic. The home has been assessed for suitability by the Occupational Therapist. EVIDENCE: The home is well decorated and furnished. Bedrooms are redecorated and carpets replaced as necessary and when a room is vacated. The assessment by the Occupational Therapist took place in the Autumn 2004. The report noted some recommendations. Action has been taken on some recommendations, there are 2 recommendations needing further action. These are to replace/repair the shower seat in the bathroom of bedroom 34 and to repair/replace the bath in the Mount Hill wing that has a crack on the side. These are made as a requirement. The laundry area is clean and well organised. Housekeeping staff work hard to maintain a clean and fresh home. HARWOOD HOUSE NURSING HOME H52-H01-S10987-Harwood House-V228019040705-Stage 4.doc Version 1.40 Page 13 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 28 The staff numbers and skill mix are satisfactory to care for the residents. NVQ training is strongly encouraged. EVIDENCE: The staffing levels in the home are satisfactory. In the morning there are 10 carers including 4 qualified nurses and senior carers. In the afternoon there are 6 staff including 2 qualified nurses until 5pm, after that 1 qualified nurse, and then 3 staff at night including 1 qualified nurse. This staffing level is for 30 residents. The staffing level provides sufficient staff to provide good quality care. Many staff remain working in this home for years. There are 24 carers, of whom 13 have achieved NVQ level 2; one level 3 and a further 4 are completing level 3. The staff team therefore has over 50 of staff having achieved level 2. The qualified nurses are not included in this calculation. HARWOOD HOUSE NURSING HOME H52-H01-S10987-Harwood House-V228019040705-Stage 4.doc Version 1.40 Page 14 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33 and 38 A suitably qualified and experienced person manages the home. Quality assurance techniques are still being developed. Health and safety issues are understood to be important. EVIDENCE: The manager is retiring in September and the deputy manager is taking over. An application for the new manager to register with CSCI has been made and is being considered. Quality assurance is being further developed. The responsible individual for the home (representative of the proprietor) is preparing the annual development plan. This remains as a recommendation. There has been a recent visit by the health and safety inspector. The report has not yet been returned. One of the recommendations made of a Fire Risk assessment by an outside consultant was completed in the week previous. HARWOOD HOUSE NURSING HOME H52-H01-S10987-Harwood House-V228019040705-Stage 4.doc Version 1.40 Page 15 There was a previous requirement that all domestic staff have COSHH training. The housekeeping staff are arranged through a domestic supply agency. Training is not given. The manager has tried to ensure that the agency provides training but has now agreed that all household staff will attend training in the home. This will also include Manual Handling, Fire and Health and Safety training. The manager will negotiate with the Agency. HARWOOD HOUSE NURSING HOME H52-H01-S10987-Harwood House-V228019040705-Stage 4.doc Version 1.40 Page 16 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 x COMPLAINTS AND PROTECTION 3 x x 2 x x x 3 STAFFING Standard No Score 27 3 28 3 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 x 2 x x x x 2 HARWOOD HOUSE NURSING HOME H52-H01-S10987-Harwood House-V228019040705-Stage 4.doc Version 1.40 Page 17 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 1 Regulation 4 Requirement That the statement of purpose be amended to include details of the proprietor and of the responsible individual. A copy of this to be sent to CSCI. That the named shower seat and bath be repaired/replaced. That all domestic staff receive training in COSHH, Fire, Manaual Handling and H & S. Timescale for action 1.8.2005 2. 3. 22 38 23 13 1.9.2005 1.10.05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 9 Good Practice Recommendations That the temperature of the drug fridge be checked daily and a record kept. HARWOOD HOUSE NURSING HOME H52-H01-S10987-Harwood House-V228019040705-Stage 4.doc Version 1.40 Page 18 Commission for Social Care Inspection 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 H52-H01-S10987-Harwood House-V228019040705-Stage 4.doc Version 1.40 Page 19 - 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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