CARE HOMES FOR OLDER PEOPLE
Haven Lea Residential Care Home Shaw Lane Prescot Knowsley Merseyside L35 5BS Lead Inspector
Mrs Joanne Revie Unannounced Inspection 7th October 2005 10:00 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 Haven Lea Residential Care Home DS0000021472.V257328.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Haven Lea Residential Care Home DS0000021472.V257328.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Haven Lea Residential Care Home Address Shaw Lane Prescot Knowsley Merseyside L35 5BS 0151-430-8434 0151 430 8434 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) York Valley Limited Mrs Ena Hampton Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30), Physical disability (2), Physical disability of places over 65 years of age (30) Haven Lea Residential Care Home DS0000021472.V257328.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. Service Users to Include up to 30 (OP) and up to 30 (PD(E)) Service users in category of physical disability must be at least 55 years of age 12/05/05 Date of last inspection Brief Description of the Service: Haven Lea is a purpose built home which provides personal care to thirty Older People. It is registered to provide care to service users who have physical disabilities. It is owned by a company called York Valley ltd. Accommodation is on two floors. It has its own private garden and is situated close to Whistion hospital. Public transport links are good therefore it is easy to reach. Haven Lea Residential Care Home DS0000021472.V257328.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was the second unannounced visit that has been made to the home this year. The focus of this visit was to assess progress in meeting requirements, which had been identified as outstanding during the last visit. An application has been made by the appointed manager to be the registered manager of the home. Therefore Mrs Ena Hampton is not the manager as identified above. The new managers details will be included in future report templates providing she successfully completes the Fit Persons process with CSCI. Until such time she will be referred to as the appointed manager. A variety of documentation was viewed during the visit. The details of these documents will be included in the evidence section of the report. Discussions were held with four service users, a district nurse, the appointed manager and the deputy manager. Their views have been reflected within the report. What the service does well:
The service employs a dedicated team of staff who have worked at the home for a long time. This means that service users receive care from staff that know them well. The appointed manager welcomes outside input into the development of staff and the home. This shows that she tries hard to give the best service possible All service users spoken with commented positively on staffs ability and their attitude to their work. Comments were made such as Staff are very kind- I’m very happy here”, and “ staff are excellent- I cant fault them”, The service ensures that it gathers as much information as possible about service users needs before they are admitted to the home. This is important as it greatly reduces the risks of a service user being wrongly placed and also ensures the service has the opportunity to assess whether it can meet the service users needs. The service has a number of beds contracted with the local authority for emergency admissions. This means that in this case full information is not always received prior to admission One service user who had come into the home quickly stated that “ staff were very understanding they stopped me worrying”.
Haven Lea Residential Care Home DS0000021472.V257328.R01.S.doc Version 5.0 Page 6 Another service user spoken with confirmed that she was happy with the service by saying “ Im very well looked after, I can go to bed when I want, get up when I want, I have my own things in my room, and I can do what I wantwhat more do I need?” This is important as it shows service users are supported to make choices about their care. A district nurse stated that “ staff are good, they always follow our direction and let us know if anything changes”. This is important as it shows staff have a good understanding and recognise when medical advice is needed. What has improved since the last inspection?
It was identified that the appointed manager and the staff team have addressed all outstanding requirements that were issued after the last inspection. This shows that the appointed manager is aware of her responsibilities and wants to develop the service. New care plans have been implemented for each service user. These meet the requirements of current legislation and give clear guidelines on the care that is required to meet the service users needs. This means that staff have clear instructions to follow for each service user. Weekly menus have been developed since the last visit and Service Users are now made aware of the variety of flooring available for their bedroom. This is important as it promotes the service users involvement in the home and shows that the service is trying to offer choice. An assessment has also been developed for those service users who want to take responsibility for their own medication. This is further evidence of offering choice. Activities have been developed further since the last visit. In particular a minibus is now available to take service users on outings. The outings include trips to local garden centres. On the day of the visit plans were being made to transport service users to Blackpool to see an ice show. One service user stated that staff had supported him to go and watch a local rugby team. He stressed how important this was to him and stated, “I’ve landed on my feet here, the staff are marvellous” Another service user has been supported to visit family locally. Staff are trying to provide a range of indoor activities on a daily basis. This includes a travelling cinema, which visits the home monthly, bingo, reminiscence and music afternoons and quizzes. Outside musical entertainers have also visited for the service users enjoyment Haven Lea Residential Care Home DS0000021472.V257328.R01.S.doc Version 5.0 Page 7 It was identified during the last inspection that a large proportion of the home had been redecorated. During this visit it was identified that this had been completed. Staff have spent time redecorating the halls and corridor of the home. This shows staff are dedicated to providing a homely place to live. The appointed manager has further developed the Homes Statement of Purpose so that a copy of the complaints procedure has been included. This is important as this document acts as the homes brochure and all who read it should be able to view clear details on how to raise concerns and who to raise those concerns to. Staff recruitment and training has been further developed since the last visit. New staff receive an induction period, which is in line with legislation and reflects good practise. Staff have undertaken refresher training in manual handling, and first aid since the last inspection. This delivery of training and staff development shows that the appointed manager is trying hard to ensure that staff receive up to date information so that they can undertake their duties well. Senior staff have also undertaken training in the protection of vulnerable adults. This covers categories of abuse and what actions to take if suspected abuse occurs. This means that staff have the skills to keep the service users safe. The appointed manager has further developed the homes accident form and is ensuring that either herself of the deputy manager views these records when accidents have occurred. This is important, as actions may need to be taken by management to reduce risks to prevent further accidents occurring. This shows that management are trying to keep service users safe. What they could do better:
The appointed manager has arranged for Staff to attend Courses for Health and Safety training She should ensure that these intentions are carried through to further develop staff. Some care plans viewed were found to have missing service users/representatives signatures. The appointed manager is struggling to make contact with some family members who visit infrequently. In cases like this it is recommended that a request is made in writing and a copy of the request held on the service users file. Some of the daily records written by staff were found to be repetitive and were written in blue ink. Staff should be reminded that these records are legal documents and that black ink is preferable to blue. This would also reflect good practise. Haven Lea Residential Care Home DS0000021472.V257328.R01.S.doc Version 5.0 Page 8 Staff should follow the numerical order of the service users needs in the care plan when writing daily records. This would save repetition and would make the daily records more individual to the service user. Generally the home presented as a comfortable place to love. However the flooring to the conservatory area is starting to look worn. Plans should be developed for its replacement in the near future. The carpet to one stair riser on stairwell one was found to be loose. The deputy manager expressed her intention to have this fixed. This intention should be followed through. Some shortfalls were identified in activities relating to Health and Safety. Staff were undertaking regular fire drill practise but this is now overdue. This must be addressed. The appointed manager has been trying to arrange an electrical safety test since September but was still awaiting a date. This must be followed through and a copy of a current certificate forwarded to CSCI once complete. Medicines are stored safely by the home however on viewing records it became apparent that some signatures were missing. Staff must be reminded of the importance of signing all medication administration records. Ensuring a list of staff initials and signatures is kept for reference if a check is required against the medication administration records could further develop the management of medications. This would also reflect good practise. 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. Haven Lea Residential Care Home DS0000021472.V257328.R01.S.doc Version 5.0 Page 9 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 Haven Lea Residential Care Home DS0000021472.V257328.R01.S.doc Version 5.0 Page 10 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): 3 The home reduces the risk of a service user being misplaced by obtaining as much information as possible prior to admission. EVIDENCE: Assessments were viewed for four service users. Assessments showed that the service obtains as much information as possible prior to a service user being admitted to the home. The appointed manager confirmed that service users are invited to spend a day at the home prior to admission whenever possible. A discussion took place with the manager, which showed that she is quick to respond if a service users needs are not being met. Haven Lea Residential Care Home DS0000021472.V257328.R01.S.doc Version 5.0 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): 7,9 EVIDENCE: Four care plans were viewed and a discussion took place with the appointed manager and the deputy manager. The care plans have been greatly developed since the last inspection. Staff are writing clear daily records although at times the information recorded is repetitive. Staff are recording their findings in blue ink. Plans are reviewed monthly. Written guidance is available within the plans for staff to follow. A representative or the service user had signed some plans. Others plans were not signed but it was explained that this is due to infrequent visits from the family. An assessment has been developed for service users who wish to self medicate. Medication Administration records were found to be clear and appropriate however some gaps were evident were the records had not been signed Medication storage was found to be good with all medicines locked within a cabinet within a locked room. Only senior staff that have had training dispense medications. Both the deputy manager and the appointed manager have had further training through the primary care trust. No list of staff signatures and initials was in use
Haven Lea Residential Care Home DS0000021472.V257328.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These standards were assessed during the last inspection; therefore they were not fully reviewed during this visit. However it can be confirmed that good progress has been made in the area:- please view summary” what has improved”. Haven Lea Residential Care Home DS0000021472.V257328.R01.S.doc Version 5.0 Page 13 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): EVIDENCE: No standards were assessed form this section on this occasion. However it can be confirmed that staff files showed that staff have undertaken training on the Protection Of Vulnerable Adults since the last inspection. Haven Lea Residential Care Home DS0000021472.V257328.R01.S.doc Version 5.0 Page 14 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, The home is comfortable environment to live in EVIDENCE: A tour of the environment was undertaken which included all communal areas and a random selection of bedrooms. The corridors and the hall have been redecorated since the last inspection. Furnishings viewed were of good quality however the flooring to the conservatory is starting to look worn it was also identified that the carpet to one stair riser on stairwell one was loose and required gluing. All areas viewed were decorated to a good standard. Haven Lea Residential Care Home DS0000021472.V257328.R01.S.doc Version 5.0 Page 15 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): EVIDENCE: None of the standards from this section were fully assessed during the visit. However it was identified that the appointed manager had addressed requirements in relation to staff training, which were made following the last inspection. Haven Lea Residential Care Home DS0000021472.V257328.R01.S.doc Version 5.0 Page 16 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): 38 Some areas of Health and Safety need to be addressed to ensure service users are safe. EVIDENCE: Fire records were checked which showed that staff have undertaken regular fire drills. However one needs to be performed soon as this is overdue. Contracts are in place for regular maintenance of all fire prevention and fire fighting equipment. The service has a current gas certificate but is awaiting a date for an electrical safety test to be carried out. Accidents are recorded appropriately. Staff files showed that staff have undertaken first aid and manual handling training refreshers. Haven Lea Residential Care Home DS0000021472.V257328.R01.S.doc Version 5.0 Page 17 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 2 10 x 11 x x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 X X X X X X X STAFFING Standard No Score 27 X 28 X 29 X 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x x x x x 2 Haven Lea Residential Care Home DS0000021472.V257328.R01.S.doc Version 5.0 Page 18 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 Standard OP7 Regulation 15. -(2) Requirement The appointed manager must ensure that representatives are written to regarding the missing signatures on service users care plans. A copy of this letter must be kept on file The appointed manager must ensure that staff sign all medication administration records The carpet to the stair riser on stairwell one must be repaired Staff must recommence the undertaking of practise fire drills. An electrical safety test must be carried out and a copy of a current certificate forwarded to CSCI Timescale for action 31/12/05 2 OP9 13. -(2) 30/11/05 3 4 5 OP19 OP38 OP38 12. (1)(a) 23. -(4) 12. (1)(a) 30/11/05 31/12/05 31/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Haven Lea Residential Care Home DS0000021472.V257328.R01.S.doc Version 5.0 Page 19 1 2 3 4 5 OP7 OP7 OP9 OP19 OP38 Staff should write daily records according to the numerical order of the care plan to sae repetition Staff should only complete care plans in black ink A list of staff signatures and initials should be developed The service should develop plans to replace the flooring to the conservatory in the near future The appointed manager should carry through her plans for staff to undertake Health and Safety training. Haven Lea Residential Care Home DS0000021472.V257328.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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