Inspection on 25/01/06 for Haversham House

This inspection was carried out on 25th January 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

Haversham House 23/01/07

Haversham House 12/07/05

Haversham House 12/10/04

Haversham House 18/05/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Haversham House Longton Road Trentham Stoke-on-Trent Staffordshire ST4 8JD Lead Inspector Norma Welsby Announced Inspection 25th January 2006 10:30 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 Haversham House DS0000008235.V274734.R01.S.doc Version 5.1 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. Haversham House DS0000008235.V274734.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Haversham House Address Longton Road Trentham Stoke-on-Trent Staffordshire ST4 8JD 01782 643676 01782 643674 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) Medichoice Ltd. Miss Jane Christine Picken Care Home 33 Category(ies) of Dementia (3), Dementia - over 65 years of age registration, with number (18), Mental disorder, excluding learning of places disability or dementia (2), Mental Disorder, excluding learning disability or dementia - over 65 years of age (2), Old age, not falling within any other category (33), Physical disability over 65 years of age (6) Haversham House DS0000008235.V274734.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. MD - to be minimum of 55 years on admission DE - to be minimum of 55 years on admission Date of last inspection 7/9/05 Brief Description of the Service: Haversham House is a private residential care home registered for up to 33 older people, some of whom may be mentally frail or physically frail. At the time of this Announced Inspection, Haversham House was fully occupied and had also received several recent enquiries and had a waiting list. The home has a specialist Elderly Mentally Infirm (EMI) unit on the first floor, which can accommodate up to eight residents, while the remaining residents, who have mixed dependency needs, occupy the ground floor communal areas that have been significantly improved during the past couple of years. Haversham House is located off the busy Longton Road in Trentham and as such provides good access to a wide rang of community resources. The property provides an attractive and well maintained appearance with good car parking facilities. The large open plan lounge on the ground floor leads to a patio and enclosed garden. In total there are 31 single and 1 shared bedroom, which is used by a married couple. While there are an ample number of toilets throughout the building, the home currently has a shortfall of assisted bathrooms, but this is due to be addressed with the building of a two storey extension that was nearly completed at the time of this inspection. Haversham House has submitted an application to register an additional 10 bedrooms, all of which will have an en suite. Other facilities will also be provided and it is hoped that work will be completed in March 2006. Haversham House DS0000008235.V274734.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Inspector was very satisfied with the outcome of this Announced Inspection. The Inspection was very positively received and the Registered Manager, Miss Janet Picken and the Managing Director, Mrs Ann Hill, provided helpful assistance throughout the day. During this inspection a wide range of standards were assessed and the findings were very satisfactory. Some standards that have previously been inspected in detail and have been found to be fully met were not examined on this occasion. As a result of this inspection no new requirements were made, but the Inspector did identify 6 recommendations that were discussed with the Registered Manager during the inspection process. The Inspector observed that residents were very well presented and during the afternoon a singer visited to provide entertainment that was much enjoyed. Staff were seen to be responding appropriately to the needs of residents and the environment throughout was found to be comfortable, clean and hygienic. A relative who was visiting at the time of the inspection was consulted on a variety of issues and her satisfaction was expressed. Neither the home nor the CSCI had received any complaints about Haversham House during the past year. The extension had progressed well since the last inspection in September 2005. It is envisaged that it will be completed and ready to register in March 2006. The extension will provide 10 additional single en suite bedrooms and there is an application for these to be registered for elderly mentally frail residents. The home will need to provide the Inspector with confirmation of the total communal floor space to be provided. The home was fully occupied at the time of this Announced Inspection, but was still receiving lots of enquiries and has a waiting list. While it is not envisaged that the home will experience any difficulty in filling the new vacancies, it was discussed and agreed that there would be a very gradual introduction of new admissions to ensure best practice. Haversham House DS0000008235.V274734.R01.S.doc Version 5.1 Page 6 What the service does well: What has improved since the last inspection? Care plan documents continue to improve. There was evidence of monthly reviews, risk assessments and monitoring of changing needs. The Inspector highlighted one area that should be improved, making a recommendation that specific details, pertinent to the individual should be detailed rather than more generalised comments, which do not provide a clear and full picture. The Registered Manager and the deputy manager, who has responsibility for care planning, acknowledged this point. Staff training remains a high priority and staff at Haversham House have achieved a very high percentage of staff with NVQ qualifications. As stated above, 73 of staff have achieved at least NVQ level 2 and this is due to increase to 82 as 2 more staff have nearly completed level 2 and 2 more staff have nearly completed level 3. The home has completed the programme to fit radiator covers to communal areas and bedrooms. Haversham House DS0000008235.V274734.R01.S.doc Version 5.1 Page 7 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. Haversham House DS0000008235.V274734.R01.S.doc Version 5.1 Page 8 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 Haversham House DS0000008235.V274734.R01.S.doc Version 5.1 Page 9 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): This group of standards were not inspected in any detail during this inspection. Previous examinations of these standards have found that the home had fully met all of the above. Standard 6 is not applicable to Haversham House as it does not provide intermediate care. EVIDENCE: Haversham House DS0000008235.V274734.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 & 10 The Inspector found care planning to be of a good standard. The health and personal care needs of residents were being met appropriately. The home had comprehensive policies and procedures in place for the management and administration of residents’ medication. All policies and procedures were being reviewed and updated. EVIDENCE: Each of the standards inspected in this group were fully met. Just two recommendations were made and are detailed below. The Inspector examined three care plans in detail and was generally very satisfied with the findings. There was good evidence of thorough contemporaneous documentation and regular reviews. Risk assessments were also in place. The Inspector raised just one recommendation that staff should ensure that information is recorded in a specific manner that describes the identified need of the individual and the use of generalised expressions should be avoided. Haversham House DS0000008235.V274734.R01.S.doc Version 5.1 Page 11 The Inspector found a good level of evidence of a range of health care input at Haversham House, which was well documented. Staff commented favourably about the support the home received from a variety of health care professionals and this was also echoed in comments from residents. The Inspector was told that none of the residents were self-medicating and all were administered their medication by staff. Medication administration records were examined and found to be satisfactory, although the Inspector did recommend that the home maintain a record of staff initials alongside their names/signatures. The deputy manager has responsibility for overseeing the management of medication and she spent time with the Inspector reviewing this standard. Storage facilities were found to be satisfactory and the Inspector was told that all staff that are responsible for administering medication have had appropriate training. The Inspector made several observations throughout the day as well as consulting with residents and staff. It was found that staff at Haversham House have a good insight into the principles of good care and the importance of principles such as privacy and dignity. During this inspection the Inspector observed residents to be well presented in attractive and suitable clothing, hair was nicely tended and generally there was a good impression of attention to detail. When asked several residents were able to confirm to the Inspector that they felt well cared for and treated with respect. Staff were observed while undertaking a variety of tasks and these observations also conveyed a feel of respect and the dignity of elderly frail residents being upheld. The obvious rapport that exits between staff and residents was pleasing to see and is a contributory factor in the staff achieving good standards of practice. Haversham House DS0000008235.V274734.R01.S.doc Version 5.1 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): 12 & 15 Haversham House provides a very good range of social, religious and recreational activities and opportunities. Contact with families is promoted. Residents are extensively consulted and encouraged to make choices that determine personal routines and activities for daily life. The quality of meals continues to be of a very good standard. EVIDENCE: Both of the above standards were found to be fully met with just one recommendation made during this inspection. Haversham House continues to promote a wide range of social care activities and evidence of this was apparent on the day of this inspection. An activity assistant is deployed in the home for 25 hours each week and each morning commences by reviewing newspaper coverage and local news. Reminiscence sessions and quizzes are also very popular and much use is made of the services of the local libraries. There are good links with local churches including volunteers who assist with a range of activities. The home also has the benefit of its own adapted minibus, which is shared with its sister home located just a couple of minutes away. Haversham House DS0000008235.V274734.R01.S.doc Version 5.1 Page 13 A driver is contracted to work 10 hours each week and on average there are two weekly outings. When asked several residents commented favourably to the Inspector about the provision of social care opportunities at Haversham House. Without exception, all residents who were consulted confirmed to the Inspector that they were very satisfied with the quality, quantity and variety of meals provided. Special diets are catered for as required; at the time of this inspection, this included just diabetic and soft diets. Three residents were in need of some degree of assistance at mealtimes, but this varied from day to day. The daily menu was found to be on display in the main foyer adjacent to the dining room and several residents confirmed that they had been satisfied with the provision of meals that day. One resident was celebrating her birthday and at teatime a homemade birthday cake was provided and much enjoyed by residents. The four weekly menus are regularly reviewed in consultation with residents and adjusted to incorporate seasonal variations. The Inspector observed the tables in both the ground floor dining room and the first floor EMI unit and noted that transparent covers had been placed over the cotton tablecloths. It was ascertained that the reason for this was because recent spillages had stained the tablecloths and this was felt to provide a practical solution. While the Inspector acknowledged the home’s problem in this respect, it was felt that the appearance of the plastic sheets detracted from the table settings and good standards generally achieved. The Inspector therefore made a recommendation that consideration be given to finding an alternative solution. Haversham House DS0000008235.V274734.R01.S.doc Version 5.1 Page 14 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 Haversham House has an established complaints procedure. There are written policies and procedures in place in respect of protecting residents from abuse, along with associated staff training. All policies and procedures were being reviewed. EVIDENCE: The Inspector found that standards 16 & 18 were fully met. The home’s complaints procedure was seen on display in the home and a copy is also included in the Statement of Purpose and Service User Guide. During the past year the home has not received any internal complaints, nor have any been received by the Commission for Social Care Inspection. When asked a couple of residents confirmed to the Inspector that they were aware of their right to complain if dissatisfied and would feel comfortable about raising matters directly with senior staff. Staff have been provided with information, guidelines and training in respect of vulnerable adults and correct procedures to follow, including whistle blowing. When the Inspector examined staff files it was recommended that a recent photograph should be on file with other pertinent details. Haversham House DS0000008235.V274734.R01.S.doc Version 5.1 Page 15 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): 19,20,23,24 & 26 The location and layout of Haversham House is suitable for its stated purpose. The home provides a comfortable and homely environment and there is an attractive enclosed garden/patio that provides residents with opportunities to sit outside in pleasant weather. A 10-bedded extension was nearing completion and this will also provide an enclosed courtyard garden. EVIDENCE: Each of the standards examined in this group during this inspection were found to have been met. Haversham House provides a comfortable and homely environment. Residents have a very pleasant ground floor lounge and there is a separate lounge-diner on the first floor that is used by residents with a mental frailty. The dining room on the ground floor is due to be extended into the current staffroom to provide sufficient space for the additional residents. Haversham House DS0000008235.V274734.R01.S.doc Version 5.1 Page 16 The home will need to confirm with the Inspector the total provision of communal space on the ground floor, prior to the registration of the extension. In consultation with residents, the Inspector was alerted to one resident’s difficulty in accessing her bedroom independently due to her need for a zimmer frame and the awkwardness of the bedroom door. It was apparent that this lady did not want to cause inconvenience to staff each time she wished to visit her bedroom and in any case wished to remain as independent as possible. The Inspector therefore recommended that serious consideration be given to the use of a mobile fire door guard, but that prior to taking any action the fire officer be consulted. An outstanding requirement remains in respect of the home’s ratio of assisted bathrooms, but assurances have been given that this will be addressed on completion of the extension. Samples of bedrooms were inspected during this announced inspection and each was found to be satisfactory. There was evidence of personalisation and personal belongings by way of photographs, ornaments and small pieces of furniture. Throughout the home was found to be clean, pleasant and hygienic. Some corridor décor and carpets were damaged or soiled with age and use, but hopefully this will be addressed when decorators are on site to complete the extension. Haversham House DS0000008235.V274734.R01.S.doc Version 5.1 Page 17 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 The staffing arrangements provided at Haversham House continue to be satisfactory. Staff are appropriately deployed in suitable numbers and have achieved a high standard of NVQ qualifications. EVIDENCE: The Inspector examined three of the above standards and found each to be met. Haversham House has a good staffing structure enabling every shift, both day and night, to be covered by a senior carer, who is often supported by the manager or deputy also being on duty. Satisfactory numbers of catering and domestic staff, an activity assistant and driver, an administrator and handyman also compliment the care team. The Inspector was told that an average of 698 day and night care hours are used each week, plus the full time hours of the Registered Manager. Care staffing ratios provide for 6 staff on each morning 5 in the afternoon, 4 in the evening and 2 throughout the night plus an on call manager. Observations of staff throughout the period of this announced inspection, confirmed to the Inspector that staff were professional and caring in their duties and care of residents. Haversham House DS0000008235.V274734.R01.S.doc Version 5.1 Page 18 When asked, several residents were also very complimentary about staff and told the Inspector that they felt well cared for and supported by the home. The home has maintained a strong commitment to staff training and at the time of this inspection 73 of staff had achieved NVQ level 2 and this was due to increase to 82 as two more staff had nearly completed the course. Included in this figure 27 had achieved level 3 with this due to increase to 36 . The Registered Manager had already achieved NVQ level 4 and the Registered Managers Award. The Registered Manager, Ms Janet Picken advised the Inspector that staff turnover continues to be minimal and the benefit of having a stable and experienced staff team was seen as a very positive feature of the home. It was also confirmed that thorough recruitment procedures were pursued when new appointments were made. POVA and CRB checks were in place, with just 1 CRB’s outstanding. A sample staff file was examined and this was found to be satisfactory, although the Inspector did recommend that staff details should include a recent photograph. Haversham House DS0000008235.V274734.R01.S.doc Version 5.1 Page 19 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): 31, 33, 35 & 38 Haversham House benefits from an experienced management team and a supportive staffing structure. EVIDENCE: The Inspector found the three standards examined to be satisfactorily met. The Registered Manager, Ms Janet Picken is well supported in her role by the former Registered Manager, Mrs Ann Hill, now a Managing Director and the Registered Provider Mr William Morris. The team of senior carers and deputy, along with all staff who have dedicated roles within the home also compliment the management of the home. Haversham House DS0000008235.V274734.R01.S.doc Version 5.1 Page 20 An Administrator is deployed for 20 hours per week and additional administrative support is also provided by Haversham House’ nearby sister home. The Inspector examined a range of records and found these to be of a good standard. Residents’ financial records were examined and these were satisfactory although the Inspector did make one recommendation that the Registered Manager should undertake a periodical audit of the management and record of residents’ personal allowance. Some quality assurance measures were in place and every encouragement is given to residents and relatives to be actively involved in many aspects of the running of the home. The further development of quality assurance systems is an area that the recently approved Registered Manager may be able to give greater attention to in the future. Several aspects of health and safety were examined including an inspection of the environment, servicing of equipment, staff training, COSHH awareness and risk assessment and these were found to be satisfactory. Staff were provided with appropriate aprons and gloves and these were observed in use during the inspection. Appropriate arrangements were also in place for the disposal of clinical waste. Haversham House DS0000008235.V274734.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 X 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X 3 3 X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Haversham House DS0000008235.V274734.R01.S.doc Version 5.1 Page 22 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 OP21 Regulation 23 Requirement To comply with expected ratio of bathrooms. Timescale for action 31/03/06 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 5 Refer to Standard OP 7 OP 9 OP15 OP29 OP19 Good Practice Recommendations Care plans should detail personal information about the needs of residents and how these are to be met and generalised comments should be avoided. Medication records should contain a sample of staff initials (signed) alongside their name and signature. There should be a review of the use of plastic covers on the dining tables, which detract from the good standards generally achieved. Staff files should contain a recent photograph of the staff member. Consideration should be given to the provision of mobile magnetic fire door guards for those residents who experience difficulty in accessing their bedroom independently. The Registered Manager should undertake a regular audit DS0000008235.V274734.R01.S.doc Version 5.1 Page 23 6 OP35 Haversham House of records relating to the management of residents’ finances. Haversham House DS0000008235.V274734.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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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