Inspection on 10/08/09 for Hay House Nursing Home

This inspection was carried out on 10th August 2009.

CQC found this care home to be providing an Adequate service.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Hay House Nursing Home 02/11/09

Hay House Nursing Home 24/06/09

Hay House Nursing Home 01/10/08

Hay House Nursing Home 05/11/07

Hay House Nursing Home 21/06/06

Hay House Nursing Home 16/12/05

Hay House Nursing Home 26/07/05

Hay House Nursing Home 21/10/04

Hay House Nursing Home 22/04/04

Extracts from inspection reports are licensed from CQC, this page was updated on 15/11/2009.

Random inspection report Care homes for older people Name: Address: Hay House Nursing Home Broadclyst Exeter Devon EX5 3JL one star adequate service 06/11/2008 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Teresa Anderson Date: 1 0 0 8 2 0 0 9 Information about the care home Name of care home: Address: Hay House Nursing Home Broadclyst Exeter Devon EX5 3JL 01392461779 01392460040 info@hayhousecare.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Chartbeech Ltd care home 35 Number of places (if applicable): Under 65 Over 65 35 35 dementia mental disorder, excluding learning disability or dementia Conditions of registration: 0 0 On the termination of the placement of the named service user, the registered person will notify the Commission in writing and the particulars and conditions of this registration will revert to those held on the 8th November 2004. Staffing minimum as agreed with the previous registration authority 29/01/2002 and detailed in the variation of registration report of the same date, is observed. The manager, Ms Rachel Somers, must obtain the Registered Manager`s Award by 2005 The maximum number of persons accommodated at the home, including the named service user, will remain at 35 There is a named Registered Mental Nurse as a lead for mental health care at the home. To admit one named person outside the categories of registration as detailed in the Care Homes for Older People Page 2 of 12 notice dated 5th November 2004 Date of last inspection Brief description of the care home Hay House is registered as a care home that provides accomodation with nursing for up to 35 people over the age of 65, with dementia or a mental disorder. The building is Georgian and is set in an elevated position with views to Broadclyst and Killerton. The house has been extended and adapted for use as a care home and provides provides both shared and single bedrooms, 16 of which have en-suite facilities. There is a passenger lift linking the floors aswell as a wide staircase. Communal facilities are made up of a main lounge, a dining room, a smaller lounge and a large entrance hall. There are Registered Nurses on duty throughout the day and night. 0 6 1 1 2 0 0 8 Care Homes for Older People Page 3 of 12 What we found: We (the commission) carried out this random unannounced inspection to check that the Statutory Requirement Notice issued on 27th July 2009 had been complied with. The notice stated that the service was failing to comply with some of the Care Home Regulations (2001). It gave notice to the Registered Persons (Company Secretary and Registered Manager) that if the service failed to comply with the notice, that the commission would prosecute. The notice was issued when an unannounced random inspection found that the planning of peoples care was not sufficient to meet some peoples health and welfare needs, and that some health and welfare needs were not being met. We visited this home specifically to check that this service had achieved compliance with the Statutory Requirement Notice. We did not inspect any of the outstanding requirements from any previous inspections. The timescale for compliance was set at 9th August 2009. We visited on 10th August. The notice stated that the service must: Review and put systems in place to ensure that people living here receive appropriate support to maintain adequate nutrition at all times. Weigh everyone living here and provide people with nutritional supplements as required and in accordance with the instructions in their care plans. Put in place a system to ensure that instructions from health care professionals relating to all service users health, care and welfare needs are met at all times. Ensure that all care plans are appropriately updated to ensure the needs of the service users are met at all times. We looked at three plans of care. We found that some people have been identified as being at risk of malnutrition. We saw that appropriate care interventions are planned. These include the use of extra calories in food and recording what people at risk eat and drink. Some people are prescribed food supplements and records show these are given. We saw in care records that the effectiveness of care interventions are reviewed. All the information available is analysed, and decisions about future care are based upon this evidence. We talked to staff about their knowledge of peoples care needs. They demonstrate an in depth knowledge of which people living in the home require extra support with their nutrition and with eating. They showed us where records are kept relating to peoples different needs and they showed us where they record what some people have eaten. They told us who has extra calories in their meals and who has nutritional supplements extra to their meals. They also told us who needs support to help prevent them from choking and were able to tell us how they do this. They also told us that there are people living here who are not nutritionally compromised, but are at risk because they do not Care Homes for Older People Page 4 of 12 settle to eat. Staff told us how they help one person to understand that it is time to eat and how they encourage and support this person to eat. Lunch is served in the dining room and information relating to peoples nutritional needs is kept here. This includes instructions from the Speech and Language Therapist about those people who are at risk of choking. When asked about these peoples needs staff were able to refer to these instructions to ensure that they gave appropriate care to people. In addition, staff in the kitchen have records relating to who has extra calories and who has a pureed diet (to help overcome the risk of choking). We were shown that pureed meals are now prepared in a liquidiser and that the cook has information about what foods do not puree well. Having read the instructions about how to support specific individuals with eating to reduce the risk of choking, we observed staff following these instructions. We looked at records relating to peoples weight. The home has, since the last inspection, bought new scales which can be used to accurately record the weight of those people who are not mobile. This means that everyone living here can now be weighed so that staff can monitor their weight and take appropriate actions where needed. All of the three people whose care we looked at, had been identified as being at risk of malnutrition. All had plans of care to address this risk. All three have gained weight since the last inspection and since actions have been taken to address the shortcomings identified at that inspection. What the care home does well: What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 5 of 12 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 7 15 People living at this home 09/08/2009 must have a plan of care that clearly identifies the actions to be taken to meet needs and the actions which need to be taken to detect and prevent deterioration in that persons health or welfare. In this way staff will be able to deliver consistent care that is planned for that person as a way of meeting identified needs. 2 7 15(2) You must keep each persons 31/12/2007 plan under review and ensure that revisions to the plan are appropriately made. Where possible the person should be involved in planning their own care this will ensure people get the care they want in a way that is acceptable to them. This requirement was not inspected at the compliance inspection undertaken on 10th August 2009. 3 7 15 Peoples plans of care must be reviewed meaningfully using all the information available, and decisions 09/08/2009 Care Homes for Older People Page 6 of 12 Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action made about care and treatment must be based on this information. In this way people will receive the care and treatment they need to help ensure their needs are met. 4 8 13 People must receive appropriate support to meet their nutritional needs. This will help to ensure that people remain as healthy as they can for as long as they can. 5 8 12 (1) (a) Each person living 30/01/2009 here must have proper provision made to meet their health and welfare needs. This includes making provision to meet needs relating to tissue viability and preventing skin damage, nutrition, hydration, diabetes and mental health needs. This will help to ensure that people remain healthy for as long as possible. This requirement was not inspected at the compliance inspection undertaken on 10th August 2009. 6 9 13 (2) Medicines must be 13/02/2009 managed safely. This includes making sure that records are up to date and accurate, that medicines are stored securely and that Page 7 of 12 09/08/2009 Care Homes for Older People Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action medicines are in date. This requirement was not inspected during the compliance inspection undertaken on 10th August 2009. This will ensure that people get the medicines they need in a dose that is appropriate to their needs, that all medicines are in date and therefore effective and that all medicines recieved into the home can be accounted for. 7 9 13 People must be given the 09/08/2009 medicines they are prescribed. There must be a system in place that ensures this happens. This will help to ensure that people get the medicines they need to keep them as healthy and comfortable as they can be. 8 18 13 (7) (8) All records relating to 13/02/2009 the use of restraint (e.g lapbelts) must relate to the Mental Capacity Act and helping people to make decisions. Where restraint is used there should be clear guidance about the circumstances in which this is to be used and for how long. This requirement was not inspected during the Care Homes for Older People Page 8 of 12 Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action compliance inspection undertaken on 10th August 2009. This will help to ensure that restraint is only used in exceptional circumstances and is used appropriately for as short a time as possible. 9 22 23 (2) (n) An assessment of the 13/02/2009 home must be made to determine if the equipment and adaptations available to people (such as toilet raisers, seat raisers and wheelchair foot plates) are sufficient to meet their mobility and comfort needs, and to help them remain independent. This requirement was not inspected during the compliance inspection undertaken on 10th August 2009. This will help in identifying individual and collective adaptation and equipment needs and to meet those needs for the people living here. 10 38 23 (4) Adequate precautions 13/02/2009 must be taken to ensure that if a fire were to break out that it could be contained appropriately. This includes carrying out regular checks to ensure that all fire doors close. This requirement was not Care Homes for Older People Page 9 of 12 Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action inspected during the compliance inspection undertaken on 10th August 2009. This will help to ensure that the people living here are kept safe. Care Homes for Older People Page 10 of 12 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 11 of 12 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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