Inspection on 14/08/06 for Haughgate House Nursing Home

This inspection was carried out on 14th August 2006.

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

Haughgate House Nursing Home 18/08/08

Haughgate House Nursing Home 16/11/05

Haughgate House Nursing Home 15/08/05

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Haughgate House Nursing Home Haugh Lane Woodbridge Suffolk IP12 1JG Lead Inspector Kevin Dally Unannounced Inspection 14th August 2006 09:30 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 Haughgate House Nursing Home DS0000063952.V304304.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Haughgate House Nursing Home DS0000063952.V304304.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Haughgate House Nursing Home Address Haugh Lane Woodbridge Suffolk IP12 1JG 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) 01394 386249 01394 386249 Haughcare Limited Penelope Hull Care Home 31 Category(ies) of Old age, not falling within any other category registration, with number (31) of places Haughgate House Nursing Home DS0000063952.V304304.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th May 2006 Brief Description of the Service: Haughgate house was originally a converted home with an extension, but as the result of a recent building programme, 14 additional bedrooms, two new lounges, a sluice room, and bathroom facilities have been provided. The home now provides 31 care places in total for residents with medical nursing needs. The home is located on the outskirts of Woodbridge, close to the A12. All services can be located in the centre of Woodbridge, which is approximately 2.5 miles away. All bedrooms in the new extension are single with ensuite toilet facilities and hand washbasins. One double room is available in the main house along with a large dining room, nursing bay, treatment room, kitchen and a further two bathrooms, one of which is assisted. All bedrooms and communal areas for service users are on the ground floor with level access to all areas. The first floor accommodation has been converted into office space for the owners, the manager, and for use as a training room. The homes weekly fee range is from £580 to £640 per week. Haughgate House Nursing Home DS0000063952.V304304.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Haughgate house is a care home, which can provide up to 31 nursing places for residents. This unannounced inspection was undertaken on the 14th August 2006 between 9.30am and 6pm, and was a key inspection that assessed the core standards relating to older people. This report has been written using accumulated evidence gathered prior to and during the inspection. Mr and Mrs Carter, the owners, and Ms Penny Hull, the manager, were present for the duration of the inspection and fully contributed to the inspection process. This inspection focused on the outcomes for residents around the provision of nursing care, and the medication practises of the home. Additionally, a selection of residents’ care plans, risk assessments; accident and incident reporting and nursing assessments were checked for evidence of good record keeping and management monitoring. The meals provided and the environment was assessed. The complaints book and quality assurance systems were checked. The staff rotas were assessed. Residents, relatives and staff provided additional feedback about the service provision and how residents’ care needs were met. Comment cards were received in advance from 6 residents and 5 relatives. Three staff members’ records were checked, and staff training and supervision practises were examined. The home’s revised medication policy was reviewed. The inspection found that of the 33 National Minimum Standards inspected, the home fully met 32 standards, with 1 being partially met. What the service does well: This inspection found that the quality of the personal and nursing care offered by the home, continued to be to very good standards. Residents spoken with confirmed that the service met their care and support needs and that the quality of care was very good. Residents commented that staff were friendly and welcoming even though the home had recently expanded in size. Positively the home now provides an activities co-ordinator each weekday and who ensured that residents’ leisure and social needs are met. Residents were observed being positively supported by staff with their daily tasks and personal activities. The home was found to be clean, warm and well maintained. There had been a number of challenges with opening the new extension but these did not appear to have impacted on the continued operation of the service, including sufficient new staff. Haughgate House Nursing Home DS0000063952.V304304.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Haughgate House Nursing Home DS0000063952.V304304.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Haughgate House Nursing Home DS0000063952.V304304.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5. Std 6 Not applicable Quality in this outcome area is good. People can expect to receive sufficient information about the service, and could expect to have their nursing care needs thoroughly assessed and met by the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: In May 2006 the home registered an additional 14 places for residents, and at that time provided the Commission with an updated Statement of Purpose and Service User Guide. This identified the relevant changes to the home, which met the requirements of the regulations. The home had a standard contract of the terms and conditions of the service, which it would offer to new residents. As the majority of residents were private clients, most had received a personalised contract that detailed the fees payable. Two residents’ records checked confirmed that these documents were in place that described the conditions of residence. Haughgate House Nursing Home DS0000063952.V304304.R01.S.doc Version 5.2 Page 9 The manager confirmed that prior to any new admission, potential residents were encouraged to visit the home, but where this was not possible, their relatives were encouraged to view the facilities. Further, the manager would visit potential clients at their home, or in hospital to undertake an assessment of their nursing care needs. During the inspection two resident’s records were checked and these contained detailed “Stars” assessments that assessed 30 areas of personal and nursing care need. Using the nursing process, significant needs identified from the Stars assessment would be used to construct the care plan. One new resident spoken with confirmed that their family had assisted them to find a suitable care home, as they had previously lived outside the County. An assessment of their care needs had been completed by the home, and the care plan had been discussed with them. Three service users’ spoken with confirmed the care they received was good, and that the home met their personal care needs. Comments included “I am happy with the care” and, “I am very pleased with the home, staff are so thoughtful”. Six questionnaires received from residents were returned directly to the CSCI. Information gathered included the following results: Always Do you receive the medical support you need? 4 Usually 1 Sometimes 1 Never 0 One resident stated, “The medical care is excellent and there is never any delay in getting in touch with the Doctor. Alternatively one resident stated, “ I would appreciate knowing when the Doctor has been called, and what the treatment is”. Five questionnaires received from relatives were returned directly to the CSCI. Information gathered included the following results: Yes Are you satisfied with the overall care received? 5 No 0 Haughgate House Nursing Home DS0000063952.V304304.R01.S.doc Version 5.2 Page 10 One relative commented, “The care and attention my relative received has been of a high and consistent quality during their stay”. “Even though the home has doubled in size, there is always a friendly welcome and I feel my relative is part of a large happy family”. The home ensured that staff who worked with residents with medical nursing needs received sufficient training, and acquired the skills necessary to support these residents. Four staff members’ interviewed and records checked confirmed the home could meet the care needs of the service user group. The home’s records and policies checked were found to be in place and available for staff guidance. Staff confirmed they were well supported in their job and that the quality of care provided by the home was “good, and that staff worked as a team”. Haughgate House Nursing Home DS0000063952.V304304.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11 Quality in this outcome area is good. People can expect to receive well-planned nursing care with good access to healthcare professionals, and mostly adequate arrangements for receiving medication. People can expect to be treated with respect and dignity by staff. The wishes of a dying resident would be taken into account. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three residents’ nursing care plans were checked. One service user, who required additional medical support for Parkinson’s, and another resident identified as receiving treatment for pressure ulcers, were tracked. Haughgate House Nursing Home DS0000063952.V304304.R01.S.doc Version 5.2 Page 12 Comprehensive needs assessments had been completed for these residents and the information had been transferred to their care plans. These plans included assessment of each resident’s moving and handling needs, pressure area risk assessments, catheter care requirements, weight records - one of which was in some detail, “MUST” nutritional charts, and falls assessments. Specific areas of nursing problems had been identified within each care plan, for example, “Poor mobility”, and the care plan fully described for staff the nursing care interventions required to be followed. Each problem had been dated and signed for, and were reviewed on a regular basis to confirm their current treatment. The home continued to use a sheet called an ‘Accountability sheet’, which identified the accountable nurse for each shift, and once signed by the nurse, meant that all identified care within the plan, had been given to the residents. If there were no significant changes or observations for that service user, then no other recording was made. Any significant changes would be recorded on the evaluation section of the care plan. “MUST” nutritional records had been provided for all three residents, but had only been completed monthly for one resident where nutritional concerns had been identified. The remaining two residents’ nutritional charts had been completed approximately every 3 months. One of these resident’s nutritional records indicated they were gradually losing weight. A check of the accident book revealed 87 falls since January 2006, of which around 30 were attributed to one resident who experienced frequent falls, but the causes of these were well documented. This resident’s records were clear and had been fully updated, and their plan of care reflected the strategies undertaken to reduce these. This included the use of protector aids, reminders to the resident to call for assistance, wearing a wrist pendent to call staff, physiotherapy exercises, use of a high chair and walking frame, to prevent falling. Further, a detailed record of their falls was kept, and management continued to closely monitoring these. Their family was also aware of the problems. Another resident, who had experienced 10 falls during this period, had been identified by the home as requiring a higher level of care and supervision. The home had identified they were no longer able to meet their needs and so alternative arrangements had been made to provide them with a more suitable home. One resident was observed to have bruising on their hand, so their records were checked. This bruising was explained within the notes, but had not been identified on their care plan for follow up and monitoring, which was required. From residents, relatives and staff spoken with during the inspection, it was confirmed that the home continued to provide good quality care and support for residents. Haughgate House Nursing Home DS0000063952.V304304.R01.S.doc Version 5.2 Page 13 Six questionnaires received from residents were returned directly to the CSCI. Information gathered included the following results: Always Do you receive the care and support you need? 3 Usually 2 Sometimes 1 Never 0 Comments included, “The care and support here is first class and the friendly atmosphere is wonderful” and, “It takes time to discover what care and support is needed”. Alternatively one resident stated, “I don’t think I am being as well looked after as I could be”. (This comment was fully discussed with the manager and it was revealed that the comment related to one recent incident. The management have investigated this matter. (Please also refer to the comments made by residents and relatives under standard 4) An audit of 4 residents’ medications was undertaken including a stock check of medication against the records provided. This check confirmed that the home’s medication continued to be stored in either the medication cupboard or mobile trolley. The deputy manager was responsible for overseeing the ordering of the monthly medication, and would ensure that medication was ordered each 28 days. Prescriptions from the Doctor would be sent to the pharmacy, who would make up the order and supply to the home. A new audit sheet recorded the quantities of all incoming medication, and this provided an audit trail of the exact amount of medication stock within the home. A company, who is licensed with the Home Office, now disposes of any unused medication. Registered nurses administer medication directly from residents’ prescribed packets or bottles. An audit of 4 residents’ medications revealed that these were mostly very well maintained with only 1 gap in the administration records, which had not been signed for. Further, a count of these 4 residents’ medication revealed that 3 of 4 residents’ medication were correct, but one resident’s medication count was short of 2 tablets. The home was required to investigate this matter. The home’s medication policy was checked which provided guidance for staff including the details of what arrangements were in place around the recording, handling, safekeeping, safe administration, self administration, and disposal of medicines received into the home. The procedure for the administration of medication and recording required further development to ensure that guidance is provided for the safe administration by nursing staff around these procedures. Discussion with several residents at the home confirmed they thought the staff group were polite and respectful. One resident confirmed that staff never entered their room without knocking, and respected their privacy. Haughgate House Nursing Home DS0000063952.V304304.R01.S.doc Version 5.2 Page 14 The home had clear policies and procedures on the assistance of residents who may be dying, including ensuring that relatives are kept fully informed. This would include contacting relatives day or night. Haughgate House Nursing Home DS0000063952.V304304.R01.S.doc Version 5.2 Page 15 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. Residents are supported to integrate into the family environment and be involved in recreational activities. Residents can exercise personal choice, and make some lifestyle decisions. Residents could expect the provision of a good diet. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Discussion with three service users, a relative and the staff group confirmed that service users are able to follow their own routines and a variety of leisure and personal pursuits. Positively the home now employed an activities coordinator who works Monday to Friday during the day. The co-ordinator confirmed that they were now in the process of developing a programme of activities, including one to one sessions with individuals. The co-ordinator has consulted with residents to ask them what activities they wanted and this has resulted in shopping trips with residents, Bingo, reminiscence sessions, exercise activities, massage sessions, music sessions, baking sessions, reading and the summer fate. The summer fate raised around £900 and this was banked into a special residents’ account, and will be used to provide residents with a practical gift at Christmas. Haughgate House Nursing Home DS0000063952.V304304.R01.S.doc Version 5.2 Page 16 Residents’ confirmed they were able to keep in contact with friends and family and comment cards received from 5 relatives confirmed they were made to feel welcome at the home, and could visit their relative in private. One resident spoken with clearly stated they preferred their own company, and did not wish to join in on the planned activities. However they had been made aware that they could join the activities at any time. Another resident stated that they had been assisted to attend a local church service, which they really enjoyed. Further that activities which they enjoyed, had been provided. Residents also confirmed that they could retire to bed when they wanted and would ask a staff member to help them. Meal times are as flexible as possible and during the inspection the lunchtime meal was observed being served to residents in the new dining room in the new extension. Staff members’ assisted some residents and this varied from encouragement to actually assisting them feed. Pureed meals were provided with each component separated to encourage appetite. The meal on the day of the inspection was a choice of cod in parsley sauce or sausage casserole served with seasonal vegetables. The meal looked and smelt appetising and was served hot to residents. The new menu was checked and this revealed that good hot food choices were being offered including teatime meals. Further, the home had surveyed residents in February 2006 about the supper menu, which received a good response from residents. Six questionnaires received from residents were returned directly to the CSCI. Information gathered included the following results: Always Are there activities arranged by the home that you can take part in Do you like the meals at the home? 4 Usually 2 Sometimes 0 Never 0 4 1 1 0 Comments about the activities included. “ The sound or noise levels from video and TV’s are often too high. Not all old people are hard of hearing”, and “I am limited as to what I can take part in, for which no one can be blamed, but the new activity co-ordinator is pleased with my interest in reading. She understands my need to keep in touch by letter with a range of friends and relatives. So she comes to talk and discuss things quite often”. Haughgate House Nursing Home DS0000063952.V304304.R01.S.doc Version 5.2 Page 17 Comments about the meals included, “The variety has improved over the past few months” and, “The food is excellent, and I appreciate how well the cooks cope with my very restricted diet”. Alternatively one resident stated, “Not of most peoples taste, more of the budget should be spent on a more varied diet”. Haughgate House Nursing Home DS0000063952.V304304.R01.S.doc Version 5.2 Page 18 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): 16,18 Quality in this outcome area is good. People could expect that complaints would be dealt with and the home would ensure the safety and protection of residents against abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home had a complaints policy, which included appropriate details about how a complaint can be made to the home. The home had a complaints book in operation, and there had been one complaint received by the home, since the last inspection around clothing. The home had investigated this complaint and resolved the issue. The home understood its responsibility to report any allegations of abuse to Social Services, and care staff would receive training around abuse awareness. Two staff members’ records were checked, and this included a Criminal Records Bureau checks (CRB), Protection of Vulnerable Adults (POVA) check, 2 written references, and identity checks. Haughgate House Nursing Home DS0000063952.V304304.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25,26 Quality in this outcome area is good. People can expect a clean, warm and well-maintained home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Haughgate House is a converted home, with extensions, and extensive gardens. There are places for 31 residents with medical nursing needs. All bedrooms and communal areas for service users are on the ground floor with level access to all areas. The first floor area now provided office space for the owners and the manager, and a training room for the staff group. All bedrooms in the new extension are single rooms, with ensuite facilities, and an assisted bathroom and separate sluice area are available in this part of the home. One double room is available in the main house along with a large dining room, nurses bay, treatment room, kitchen and a further two bathrooms, one of which is assisted. Haughgate House Nursing Home DS0000063952.V304304.R01.S.doc Version 5.2 Page 20 A brief environmental tour of the new premises concluded that resident’s personal rooms were very well decorated, comfortable, with fixtures and fittings, and were well maintained. The new lounges had now been provided with appropriate curtains, and were provided with quality furnishings. A complete audit of rooms within the new extension was undertaken in May 2006, and these were appropriate to meet the residents needs, including ensuring their safety. The home, including residents’ rooms was adequately ventilated during the hot summer months. Most rooms had windows with views over the garden area. Hot water tap temperatures in the new extension were fully checked in May 2006, so were not checked on this occasion. Residents spoken with confirmed that their rooms met their needs and were able to bring personal furniture, if they wished to, otherwise they could use the new furniture provided. The bathroom area was checked and had been provided with suitable aids and adaptations to assist residents. One hoist checked was newly purchased, and suitable for purpose. Hallway areas were very wide and wheelchair accessible, with handrails provided for more mobile residents. On the day of the inspection the home was found to be very clean, hygienic and odour free. The bathrooms, toilets and bedrooms seen were provided with hand wash facilities and hand towels. Residents and staff confirmed that the home was very well maintained, and always clean, hygienic and odour free. Six questionnaires received from residents were returned directly to the CSCI. One resident did not answer this question. Information gathered included the following results: Always Is the home fresh and clean? 4 Usually 1 Sometimes 0 Never 0 Haughgate House Nursing Home DS0000063952.V304304.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. Staff levels would be adequate. People can expect that staff will have been appropriately recruited and received basic training in order to meet the needs of elderly residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Now that the new extension is operational, and numbers of residents increasing, the home had employed and trained around 9 new staff members who would be included within an expanded rota. The home now provides one nurse on duty each shift, with 5 care staff on an early, 3 to 4 on a late, and 2 care staff at night. The morning care staff rota overlapped for a 1-hour period allowing for additional support to be offered to residents during the busy morning period. On the day of the inspection sufficient numbers of staff were found in place for the day shifts. The rota was checked and confirmed that appropriate numbers of staff were in place for the week commencing the 6th August 2006. This did include the use of 1 or 2 agency staff to ensure that levels were maintained. Discussion with residents, relatives and staff confirmed that there were adequate numbers of staff to meet resident’s needs. Six questionnaires received from residents were returned directly to the CSCI. Information gathered included the following results: Haughgate House Nursing Home DS0000063952.V304304.R01.S.doc Version 5.2 Page 22 Always Are staff available when you need them? 3 Usually 1 Sometimes 2 Never 0 One resident commented, “Response to day time bells can be long. Response to night time bells calls are excellent”. It was therefore recommended that the home review their call bell response times to ensure that these are being answered promptly. Three staff members’ recruitment records were checked and suitable recruitment and employment procedures were found to be in place. Records included appropriate Criminal Record Bureau (CRB) checks, 2 references, an identity check, and an application form detailing former experience, a health check and their photo. The records for one nurse evidenced the home had a maintained a record of their Professional Identification Number (PIN) from the Nursing and Midwifery Council (NMC), which was current. Care staff spoken with and staff records checked confirmed they received ongoing training relevant to the care needs of the service user group. One new staff member’s training records included a record of their recent induction including moving and handling, adult protection training, Parkinson’s training, food hygiene training, and NVQ 2 training. One nurse’s records evidenced all core training had been undertaken in addition to some specialist training around Cardio Pulmonary Resuscitation training. It was recommended the home encourage further training opportunities for nurses, for example, wound care. One staff members records checked revealed that they had received Protection of Vulnerable Adults training in 2003. The home confirmed that 51 of care staff had obtained their NVQ 2 in care and that funding was being obtained for additional staff members. Haughgate House Nursing Home DS0000063952.V304304.R01.S.doc Version 5.2 Page 23 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): Quality in this outcome area is good. People could expect the home to be adequately managed including the provision of a safe environment for residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Haughcare Ltd runs Haughgate House with the owners, Mr and Mrs Carter in attendance on a daily basis to oversee the smooth operation of the service. The manager Ms Penny Hull is a first level registered nurse, and who now largely oversees the day-to-day operation of the home, with assistance from the deputy manager. Comments received from residents confirmed that they were satisfied with the operation of the service and were aware of who they could take any problems to, including the manager. Haughgate House Nursing Home DS0000063952.V304304.R01.S.doc Version 5.2 Page 24 Residents, relatives, and staff spoken with confirmed that the management continued to be very approachable, and worked with staff to improve services. Quality assurance continued to be undertaken by the home and this included an annual survey of the services provided, which was next due in August 2006. In February 2006, a supper meal survey had been undertaken and the comments received used to reconstruct a new menu plan. From feedback received from residents, they felt included and informed about the developments around the home. The owners confirmed that the home continued to be financially viable and that budget sheets and monthly accounts were available for inspection. Further, that audited accounts would be available after October 2006. Staff spoken with and records checked revealed that supervision continued to be undertaken for both nursing and care staff. Records confirmed that staff had received moving and handling training, and manual handling risk assessments had been undertaken for residents. The home was found well maintained and a survey of 17 rooms by the CSCI in May 2006 found that hot water tap temperatures had been appropriately maintained within the new extension area. Haughgate House Nursing Home DS0000063952.V304304.R01.S.doc Version 5.2 Page 25 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 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 X 3 X 3 Haughgate House Nursing Home DS0000063952.V304304.R01.S.doc Version 5.2 Page 26 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. 1. 2. 3. Standard OP7 OP9 OP9 OP9 Regulation 15(1) 13(2) 13(2) 13(2) Requirement One resident’s care plan must include a record of their recent bruising. Medication records must be signed for. The home must investigate why one resident’s medication audit revealed two missing tablets. The medication policy must be further developed. Timescale for action 18/09/06 18/09/06 18/09/06 18/10/06 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. 3. 4. Refer to Standard OP7 OP27 OP30 OP30 Good Practice Recommendations Nursing staff should consider more frequent weight checks of residents’ who may be losing weight. The home should ensure that call bells are promptly answered. Nurses should be encouraged to undertake additional training relevant to their job roles. Vulnerable Adults training updates should be provided for one member of the care staff. DS0000063952.V304304.R01.S.doc Version 5.2 Page 27 Haughgate House Nursing Home Haughgate House Nursing Home DS0000063952.V304304.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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