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Inspection on 06/12/07 for Haunton Hall Nursing Home

Also see our care home review for Haunton Hall Nursing Home for more information

This inspection was carried out on 6th December 2007.

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.

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 takes great pride in the home and has many ideas to take the home forward. She worked in the home for many years and recently changed role from care manager to home manager. The home is very well maintained and very homely. The staff is well trained and friendly. The home ensures that service users receive good wholesome meals, which are prepared on the premises. The records required to complete the inspection were available. The home was planning for Christmas and the home had been decorated beautifully.

What has improved since the last inspection?

The manager had completed the Registered Managers Award and the NVQ training for the staff was ongoing. Dementia care had been readdressed with the introduction of Yesterday, Today and Tomorrow Training. Other care issues were also being addressed such as activities and continence.

What the care home could do better:

Care documentation was extensive but repetitive and not always that informative. The manager was considering new ways to prevent repeating the information and this will be addressed as an internal issue. No requirements were made.

CARE HOMES FOR OLDER PEOPLE Haunton Hall Nursing Home Haunton Tamworth Staffordshire B79 9HW Lead Inspector Joanna Wooller Key Unannounced Inspection 6th December 2007 09:00 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 Haunton Hall Nursing Home DS0000022333.V351733.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. Haunton Hall Nursing Home DS0000022333.V351733.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Haunton Hall Nursing Home Address Haunton Tamworth Staffordshire B79 9HW 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) 01827 373631 01827 373696 Ashbourne Homes Ltd Mrs Joanne Bryant Care Home 105 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (39), Old age, not falling within any other of places category (105), Physical disability over 65 years of age (44) Haunton Hall Nursing Home DS0000022333.V351733.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The number of persons received into the Home requiring nursing care shall not exceed 44 Category PD minimum age 60 years Date of last inspection 15th August 2006 Brief Description of the Service: Haunton Hall Nursing Home is situated in the hamlet of Haunton Nr Tamworth. The premises, formerly a converted Georgian farmhouse and a convent school, are in a rural setting amongst open countryside in seven acres of wellmaintained grounds. The nearest centre for local services, shops, and entertainment is Tamworth. The local bus serving the home operates four times a day. The home is currently registered to provide care for 105 elderly people. Nursing care is provided for up to a maximum of 44 patients, and personal care is delivered to 61 residents. Up to 39 residents may receive care for dementia related conditions, and other residents may have needs associated with old age. Within the home, which is on four floors, there are six separate units corresponding to the differing needs of service users. Facilities comprise the following; six dining rooms and nine lounges, 75 single bedrooms (72 ) and 15 shared rooms, smoking room, and hairdressing facility. Service facilities, including kitchens and laundry, are adequate to meet the needs of the home. Registered managers assisted by nurses and teams of care assistants provide care. Doctors from a GP practice in Tamworth service the home along with district nurses, community psychiatric nurses and a pharmacist. Other NHS services and facilities are accessed as required. Activities, hobbies and entertainment take place with transport provided as required. Current scale of charges range from £359 to £510 per week. Haunton Hall Nursing Home DS0000022333.V351733.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 6th December by the lead inspector. The Manager was in the home. The inspection included the following elements; A tour of the building, Observation and inspection of records relating to provision of care, Discussions with several service users, Discussions with several of the staff members on duty, Observation and sampling of other services provided such as catering and laundry, and an inspection of the managerial aspects such as staffing issues, training, recruitment and health & safety. The Inspector was made welcome in the home and all assistance was given to gain the evidence required for the report. The Commission had received no complaints since the last inspection. Service Users spoken to at the visit were complimentary about the staff working at the home. “I feel very comfortable here – like a pig in mud!” one lady said. She liked her comfortable room and the staff is wonderful, she said. Another lady spoken to said “I feel well cared for and very comfortable. I enjoy my family visiting and friends come to see me too.” What the service does well: What has improved since the last inspection? Haunton Hall Nursing Home DS0000022333.V351733.R01.S.doc Version 5.2 Page 6 The manager had completed the Registered Managers Award and the NVQ training for the staff was ongoing. Dementia care had been readdressed with the introduction of Yesterday, Today and Tomorrow Training. Other care issues were also being addressed such as activities and continence. 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. The summary of this inspection report can be made available in other formats on request. Haunton Hall Nursing Home DS0000022333.V351733.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 Haunton Hall Nursing Home DS0000022333.V351733.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are only admitted into the home following full assessment of their individual needs. EVIDENCE: Prospective residents are given the opportunity to spend time in the home. An individual member of staff is allocated to give them information, special attention, help them to feel comfortable in their surroundings, and enable them to ask any questions about life in the home. The manager at present completes the assessment and she tries to involve members of the multi-disciplinary team if possible. Admissions to the home only take place if the service is confident staff have the skills, ability and qualifications to meet the assessed needs of the prospective service user. The manager considers the other service users in the home prior to consenting to the admission. Haunton Hall Nursing Home DS0000022333.V351733.R01.S.doc Version 5.2 Page 9 The staff team are qualified and experienced to work with the needs of the service users in the home. The staff understand the cultural expectations of some service users through the home providing training and guidance to staff to enable them to be responsive to the service users individual needs. Assessment forms are fully completed in the service users records and a letter is sent to the service user or their representative to confirm the admission is suitable. The manager plans to extend the assessment process to make it more indepth and involve family members in the planning of care. Haunton Hall Nursing Home DS0000022333.V351733.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users health and personal and social care needs are met and documented in individual care plans. Service users are administered medication safely following the homes policies and procedures. Service users are treated with respect. EVIDENCE: Each service users has an extensive record of their care in the form of a care plan, which is reviewed monthly and signed by the service user or a representative when possible. All areas of care are addressed and reviewed as required including nutrition, mobility and individual risk assessments. The staff have skills and ability to support and encourage service users to be involved in the ongoing development of their care plan and make the interesting, and worthwhile using a variety of ways. Key workers and named nurses build up special relationships with service users. The care records are, in places, repetitive and the manager is looking at ways to reduce the amount of writing but make the reports more meaningful. Haunton Hall Nursing Home DS0000022333.V351733.R01.S.doc Version 5.2 Page 11 The medication policy and procedure that is followed by the staff ensures that the medication is stored, administered and recorded appropriately. In house audit and pharmacy audits are carried out. The aims and objectives of the home reinforce the importance of treating service users with respect and dignity and these values should be applicable to all aspects of their life and are fundamental to the philosophy of care. Particular attention is given to ensuring privacy and dignity when delivering personal care. Staff do make every effort to enable service users to choose who delivers their care and respect their preferences. The recruitment of staff takes into consideration the need to employ a varied and balanced staff group. Induction training covers privacy and dignity and the importance of treating service users as individuals. Haunton Hall Nursing Home DS0000022333.V351733.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users preferences and expectations are discussed prior to admission and their hobbies and interests are encouraged. Service users maintain contact with family and friends and they are helped to exercise choice and lifestyle control. Service users do receive wholesome and appealing meals. EVIDENCE: Service users are offered flexible mealtimes between 7am and 10.30. Service users are offered a choice of meal at each mealtime to suit their individual tastes. All dietary needs are catered for and the service users enjoy the home cooked cakes and pastries. Food and mealtimes are treated as an occasion and something to be looked forward to. An experienced cook is responsible for providing quality nutritional meals that meet the cultural and dietary needs of the service users. The cook may meet regularly with service users, listen to their choices and suggestions for the menu, and encourage them to be adventurous and try new tastes as well as traditional foods. The cook is familiar with the dietary requirements recorded in the service users care plan and provides a diet that meets their individual needs. Care staff are sensitive to the needs of those service users who find it difficult to eat and give discreet assistance with feeding as required. Haunton Hall Nursing Home DS0000022333.V351733.R01.S.doc Version 5.2 Page 13 They are aware of the importance of feeding at the pace of the service user, making them feel comfortable and unhurried. Tables were set attractively with the necessary cutlery and aids to help individuals during their meal. Birthdays and celebrations are made special for individual service users. Service users enjoy the flexibility of meal arrangements and enjoyed being able to eat in their own room if they wished. Regular drinks are available and staff will always make a cup of tea at any time when asked. The routines of the home are planned around the service users needs and wishes. Daily systems enable the service to be flexible and changed to meet individual wishes. The manager and her staff encourage service users to take control of their life and be actively involved in the running of the home. Service users have the confidence to discuss what makes them happy and comment where improvements can be made. The home takes service users feedback seriously and makes changes where possible. There was evidence for the service users that the staff listens to them and makes considerable effort to provide a flexible service, which enables them to enjoy a better quality of life. The home has confidence in its quality assurance system to confirm that practice reflects the policies, procedures and guidance. Sufficient staff resources are provided to allow time for activities and stimulation. The home has their own activities coordinator who knows the service users well and she is familiar with the service users individual likes and dislikes which is recorded in the care records. The home displays photographs and information posters about service users events and activities. When service users have particular interests every effort is made by staff to help the service user maintain their interest and keep up any community involvement. Family and friends are welcome and know they can visit the home at any time. One lady told the inspector that the staff always makes time to talk to visitors and share information with the agreement of the service user. The design of the home provides seating areas within the communal areas of the home where service users can entertain their visitors, in addition to the privacy of their own room. It is clear that the home encourages individuals and groups from the community to visit the home. Maintaining independence and enabling residents to make their own decisions about how they wish to live is a key objective for the home. Service users are encouraged to take responsibility for their own financial affairs and to use their money as they wish. Staff will support those service users who need help in financial matters, they work to a clear robust policy that protects the service users from financial abuse and clearly directs staff in their practice. The home is able to offer service users information and telephone numbers for contacting independent people who will act as advocates on the service users’ behalf where the service user prefers the help of an independent person. Haunton Hall Nursing Home DS0000022333.V351733.R01.S.doc Version 5.2 Page 14 Service users have the choice to bring a limited amount of small goods with them on admission to the home and are encouraged to keep personal items, which are important to them in their own room. Haunton Hall Nursing Home DS0000022333.V351733.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are their families are confident that their concerns and complaints will be listened to and resolved. Service users are protected from abuse. EVIDENCE: The complaints procedure is sited in the entrance hall of the home and all service users and their families are issued with the procedure on admission. The manager states that she would deal with complaints promptly following the policy and procedure. She maintains that the open door policy supports the service users and their families, which avoids any issues becoming complaints. The home has had no complaints in the last six months and the manager ensures that all the staff knows the importance of listening to service users and their families. The Staffordshire adult protection policy and procedure is available in the home for all staff to become familiar with. No adult protection meetings have been held in the previous 12 months. Haunton Hall Nursing Home DS0000022333.V351733.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a safe, well-maintained environment, which is clean, pleasant and hygienic. EVIDENCE: The layout of the home allows safe access in most areas for the service users. The home is well maintained and records support the evidence. The home is comfortable in a homely way with well-lit corridors and cosy seating areas. The lounge/ diners are both well organised to meet the service users needs. Bedrooms are being upgraded as part of the annual plan along with communal areas. The grounds are safe, tidy and accessible in good weather. Haunton Hall Nursing Home DS0000022333.V351733.R01.S.doc Version 5.2 Page 17 The building complies with the requirements of the fire service and the newly required evacuation plan is in place. Fire drills and training refresh the staff knowledge of the large building and the varying zones. The Environmental Health Officer has not visited the home for 18 months. The premises were exceptionally clean, hygienic and free from malodours. Infection control policy and procedures are well followed in the home by all staff. The manager is considering commencing infection control audits. The manager assured the inspector that laundry facilities are well managed and no issues were noted. Haunton Hall Nursing Home DS0000022333.V351733.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27 to 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users needs are met by the numbers and skill mix of the staff which ensures they are in safe hands at all times. Service users are supported by the homes robust recruitment policy and procedure as this ensures staff is suitable to work in the home and they are competent and well trained. EVIDENCE: The manager ensures that the needs of the current service users can be met continually monitor staffing levels. Staffing rotas were made available for the inspector as evidence of staffing levels and staff competence. Trained nurses are on duty for each shift along with the manager and a recently employed care manager is due to start at the home in the New Year. The care staff supports the nurses in the delivery of care and ensuring service users needs are met. The named nurse and key worker role promotes individualised care for the service users and ensures that the service users delivery of care is closely reviewed. Haunton Hall Nursing Home DS0000022333.V351733.R01.S.doc Version 5.2 Page 19 The recruitment policy and procedure is in place, which demonstrates the managers’ commitment to employing and developing highly qualified, professional staff. Training for all employees is recorded and monitored. Staff turnover is low. Staff training has been completed and the percentage completed exceeds 85 with further training arrange prior to Christmas and early in the New Year. The staff were observed to be very calm and chatty with the service users. They responded well to the staffs requests. Several service users said the staff worked very hard but always had to time to have a little chat. Haunton Hall Nursing Home DS0000022333.V351733.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The new manager is very experienced in care home work and has previously been a registered care manager at the home. The manager operates and promotes an open door policy, allowing service users and relatives time to chat about care issues and the progress of the home. Regular relatives meetings are held with invitations and posters used to advertise the meeting in a timely manner. The positive ethos and strong leadership within the home is welcoming and friendly. Haunton Hall Nursing Home DS0000022333.V351733.R01.S.doc Version 5.2 Page 21 The manager and her team are well respected by the service users and their relatives/representatives. One lady said “They are marvellous, they work so hard and are so kind”. Regular support from the operations manager has given the manager the confidence she needs to manage the home. Robust financial procedures are in place, which follow the guidance of the policies and procedure for dealing with monies. Service users have individual pocket money files, which are closely audited by the company. Staff supervision has commenced and evidence of this will be built up over the next few months. The manager discussed that she is aiming to achieve a robust programme of supervision subjects to ensure that the staff feel valued and experienced in the care environment. She will be involving the care manager when she is in post to assist her in staff supervision along with other trained nurses. The health, safety and welfare of staff and service users is promoted and protected by the rigorous testing, recording and monitoring of systems within the home. The maintenance person takes pride in his work and maintains the home in a professional manner and the records seen by the inspector evidence this. The records were seen at the visit and a suggestion to archive some of the paperwork was agreed at the visit. Haunton Hall Nursing Home DS0000022333.V351733.R01.S.doc Version 5.2 Page 22 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X 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 X X X X X X 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 X 3 X 3 X X 3 Haunton Hall Nursing Home DS0000022333.V351733.R01.S.doc Version 5.2 Page 23 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. 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. Refer to Standard Good Practice Recommendations Haunton Hall Nursing Home DS0000022333.V351733.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Haunton Hall Nursing Home DS0000022333.V351733.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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