CARE HOMES FOR OLDER PEOPLE
Haydon View North Bank Haydon Bridge Hexham Northumberland NE47 6NA Lead Inspector
Jim Lamb Key Unannounced Inspection 14th May 2007 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Haydon View DS0000000534.V337979.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. Haydon View DS0000000534.V337979.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Haydon View Address North Bank Haydon Bridge Hexham Northumberland NE47 6NA 01434-684465 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) Kay Care Services Limited Miss Sara Alison Hodgson Care Home 27 Category(ies) of Dementia - over 65 years of age (12), Learning registration, with number disability over 65 years of age (1), Old age, not of places falling within any other category (14) Haydon View DS0000000534.V337979.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 29th November 2005 Brief Description of the Service: Haydon View is a residential care home providing personal care and accommodation for 27 older people. The home is located in a residential area of the village of Haydon Bridge, close to shops, pubs and other local amenities. The home is a detached property and there is lift access. The service users have access to landscaped gardens and an external sunroom that has superb views over the valley. All prospective service users have access to information about the home prior to admission. Fees for the home are £418.00 per week. Haydon View DS0000000534.V337979.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. How the inspection was carried out Before the visit: We looked at: • Information we have received since the last visit. • How the service dealt with any complaints & concerns since the last visit. • Any changes to how the home is run. • The provider’s view of how well they care for people. • The views of people who use the service & their relatives, staff & other professionals. The Visit: An unannounced visit was made on 14.5.07. During the visit we: • • • • • • Talked with people who use the service, relatives, staff, and the manager. Looked at information about the people who use the service & how well their needs are met, Looked at other records which must be kept, Checked that staff had the knowledge, skills & training to meet the needs of the people they care for, Looked around the building to make sure it was clean, safe & comfortable, Checked what improvements had been made since the last visit. We told the manager/provider what we found. What the service does well:
Staff were friendly and relaxed and showed a good understanding of the service users needs. Arrangements for service users to maintain contact with their family and friends are good. A variety of social activities were available providing Service users with the opportunity to join in. Meals are varied, well balanced, offering good choice and nutritious food at all meals. All of the service users spoken to were pleased with the quality and choice available.
Haydon View DS0000000534.V337979.R01.S.doc Version 5.2 Page 6 The home is well staffed with a skilled, consistent and trained staff team giving security to service users. Staff recruitment and training records were clear and concise and contained all relevant information. The vetting process helps protect residents. The staff had a good understanding of service users individual needs. More than eighty percent of staff are qualified to National Vocational Qualification in Care level 2 (NVQ) or above providing residents with a trained, skilled staff team. People who move into the home have a thorough assessment of their needs completed. The information is used to plan the care they require in recorded care plans. Service users speak very highly of the standard of care provided. Comments include “I’m very happy with the care I receive”, “I am well cared for here, the staff are very kind”, “This is a nice place, I never get tired of the views from the sitting room window”, and, “I can see my visitors in private if I wish”. Service users feel they are treated with respect and that staff observe their privacy and dignity. Arrangements are in place to access a range of health care professionals. All receive prompt medical attention to meet their health care needs. Trained staff deal with medication appropriately. Service users confirmed that they are consulted about the social activities, events and outings that are provided. Many make good use of local community facilities. Any complaints received about the service are dealt with professionally and in a timely manner. There are procedures in place to protect vulnerable adults from harm. Staff are trained in preventing abuse to keep residents safe. Hygiene practices were good protecting the health of residents and staff. Haydon View DS0000000534.V337979.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Haydon View DS0000000534.V337979.R01.S.doc Version 5.2 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 Haydon View DS0000000534.V337979.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1 2 3 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users are provided with enough information about the service to enable them to make a choice about where they want to live. All service users are appropriately assessed prior to admission into the home. All are provided with a written contract explaining their terms and conditions with the home. EVIDENCE: Details of the extra charges and what these are for, are in the contract given to service users and are agreed prior to their admission. The homes Statement of Purpose and the Service Users Guide both contained the full range of information required.
Haydon View DS0000000534.V337979.R01.S.doc Version 5.2 Page 10 Two service users’ files were checked and each included a full needs assessment. They contained a range of appropriate information. The service users are involved in drawing up both these initial assessments and the home’s subsequent service user plans. The two service user plans checked were comprehensive, and listed details of service user’s needs and actions taken by the staff to meet these needs. The service users feedback cards all showed their needs were met and they were happy with the care offered to them. Staff interviewed had had a range of relevant training and experience. Haydon View DS0000000534.V337979.R01.S.doc Version 5.2 Page 11 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care planning system is clear enough to ensure that staff have the information they need to meet the assessed needs of the service users. Service users are supported to make decisions about their lives, and take risks to promote their independence. EVIDENCE: There are comprehensive assessments in the service users’ care plans. There is also a risk assessment of service users. These have been agreed and signed by service users and their representatives. The proprietor is currently devising a new risk assessment format. There are advocacy arrangements, as well as family input, to represent service users. Each service user has an allocated key worker.
Haydon View DS0000000534.V337979.R01.S.doc Version 5.2 Page 12 Care plans are drawn up with service users. Plans are amended and reviewed on a regular basis. There are systems in place that will ensure that the placement and the service users plans are reviewed annually. These involve the care managers and the service users representatives. In-house reviews also take place. Each service user receives support from staff to manage their finances. Service users’ feedback cards all showed that they are able to make decisions for themselves, and that they are happy with the care that they receive. Haydon View DS0000000534.V337979.R01.S.doc Version 5.2 Page 13 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): 12 13 14 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The meals in the home are good, offering both choice and variety. The service users have opportunities for personal development and leisure activities. They are supported to maintain very good links with the community and their relatives and friends. EVIDENCE: Each service user has a life skills assessment carried out. This is reviewed and updated on a regular basis. All service users participate in this process. Service users use a range of community-based services. Three service users attend a local community club located in the village centre. Service users are supported to live a normal life in the community. They are supported and encouraged to be in control of their own lives, to enjoy their own interests. The home makes good use of the community transport mini bus. Haydon View DS0000000534.V337979.R01.S.doc Version 5.2 Page 14 All service users are encouraged to join in with daily activities held daily. Some of these include; chair aerobics, arts and crafts, carpet bowls, bingo, quizzes, music sessions, and lots of board games. The service users said they were pleased with the variety of activities available. The home also has a service users committee, they meet every six weeks, and they decide on the type of activities they want, they plan outings, and choose visiting entertainers they want to see. Minutes of these meeting are kept. All service users are supported to maintain very close links with their families. They can choose who they want to see and when. Daily routines promote independence, choice and freedom of movement. The Home’s menus are based on the known likes and dislikes of the service users. At least two hot meals are provided each day. Without exception, all service users spoken to, said the meals were very good. Haydon View DS0000000534.V337979.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): 16 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a good, clear, user-friendly complaints system and service user’s views are listened to and acted upon. Procedures are in place to protect service users from harm, and these are followed. EVIDENCE: There is a complaints procedure. It contains details of how to contact the CSCI to make a complaint, if complainants are not happy with the homes investigation and response. The procedure is written in a way that ensures service users fully understand its contents. The service users confirmed that they had been given copies of the procedure and that staff listened to their complaints and dealt with them fairly. One service user said, “If I was unhappy about anything, they would soon hear about it, and I would speak up for anyone else if I had to”. All complaints are investigated within 28 days. During the last twelve months there have been no complaints received.
Haydon View DS0000000534.V337979.R01.S.doc Version 5.2 Page 16 The service has a Whistle Blowing policy and a copy of the Local Authorities Vulnerable Adults procedures. Training of staff in the area of protection is regularly arranged. The service ensures, through training, and supervision, that care staff fully comply with policy and procedures in relation to protecting and safeguarding the rights of the service users. The service also has a copy of the Department of Health’s document, “NO SECRETS”. The service keeps detailed financial records on behalf of the service users. The cash balance held for two service users was checked, both were found to be correct. Staff will support those who need help in financial matters. They work to a clear robust policy that protects service users from financial abuse. Receipts of personal spending are kept. Haydon View DS0000000534.V337979.R01.S.doc Version 5.2 Page 17 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): 19 20 21 22 23 24 25 26 Quality in this outcome area is adequate.. This judgement has been made using available evidence including a visit to this service. The home provides a comfortable and safe environment for those living there. The standard and decoration within the home is generally very good. Some areas still need to be improved. Communal areas and bedrooms are large, and meet the service users needs. All areas within the home are clean, tidy and free from offensive odours. EVIDENCE: The home was clean, and generally well decorated and well maintained. The rear lounge needs to be decorated, with new furniture and flooring. The dining room lighting is rather dim and needs to be improved, new flooring and decoration in this area will enhance this room greatly.
Haydon View DS0000000534.V337979.R01.S.doc Version 5.2 Page 18 The front lounge carpet should be replaced, despite regular cleaning, several areas are marked and stained. The grounds were tidy, safe, highly attractive and accessible. Service users also have access to a large garden sun house. The Environmental Health Department had made a visit to the home. Requirements made by this organisation had been met. The home has an appropriate amount of sitting, recreational and dining space. There are enough rooms for a variety of activities to take place. Service users can see visitors in private in their own rooms. The home is smoking-free. Apart from the dining room, lighting was bright and domestic in design. Room sizes meet the minimum required. There is space on either side of beds when necessary, to enable access for carers and specialist equipment. Some of the bedroom freestanding wardrobes should be secured to the walls. Service users’ bedrooms have opening windows, and first floor windows have window restrictors fitted. The rooms were centrally heated and radiators and pipes were guarded. There was emergency lighting throughout the home. Water is stored at over 60°C. Valves at water outlets ensure water is provided close to 43°C to prevent scalding. The home was clean and free from offensive odours. The laundry facilities are well organised. The washing machine has the specified programme to meet disinfection standards. Haydon View DS0000000534.V337979.R01.S.doc Version 5.2 Page 19 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): 27 28 29 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a good match of well-qualified staff offering consistency of care within the home. There are robust procedures in place for the recruitment and selection of new staff, which helps to protect service users. The staff receive supervision and this provides them with a good understanding of the service users support needs. EVIDENCE: Staff levels on the day of the inspection met the agreed level. Samples of 4 weeks’ rotas showed the required numbers of staff were on duty: 4 staff between 8am and 9pm with 2 staff between 9pm and 8am. Staff said that staffing levels were appropriate. All the staff were over 18 years of age and those left in charge were at least 21. Training needs of staff are identified in supervision and appraisal sessions.
Haydon View DS0000000534.V337979.R01.S.doc Version 5.2 Page 20 The training programme has been reviewed to ensure it meets The National Training Organisation requirements for the first six months. Staff said they receive three days paid training. Two staff files were checked, the service has a rigorous staff recruitment and selection process to ensure that all appropriate checks and references are in place prior to employment. Haydon View DS0000000534.V337979.R01.S.doc Version 5.2 Page 21 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): 31 33 35 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager is supported by the organisation in providing clear leadership throughout the home with all staff demonstrating an awareness of their roles and responsibilities. The health and safety of the service users is promoted. The service is aware of equality and diversity and its implications, and this promotes possitive outcomes for service users. Haydon View DS0000000534.V337979.R01.S.doc Version 5.2 Page 22 EVIDENCE: The manager has several years experience in senior management, she has almost completed the registered managers award. Staff spoken to were clear about their responsibilities. Service users are told when inspections take place, and these are also summarised and discussed in service user meetings. Copies are available for relatives and others to see. The service has developed a range of new policies and procedures which have been linked to the National Minimum Standards. Equality and diversity issues are promoted, policies implemented, and staff training has been arranged. There is a health and safety policy and range of associated procedures. Staff receive training in health and safety and safe working practices (fire safety, moving and handling, first aid, food hygiene, and infection control. Servicing and maintenance agreements are in place for facilities and equipment. Risks in the environment and tasks, including safe working practices are assessed and reviewed. All fire safety checks, tests and instructions to staff are conducted at the required frequency and recorded. Accident reporting was suitably recorded and an analysis of accidents is carried out. Haydon View DS0000000534.V337979.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 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 2 2 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 Haydon View DS0000000534.V337979.R01.S.doc Version 5.2 Page 24 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 OP33 Regulation 24 Requirement As part of the homes quality assurance system, an annual development plan needs to be implemented. The rear lounge needs to be decorated, new flooring and new furniture, The lighting in the dining room needs to be improved, decorated and new flooring. The front lounge needs new flooring. Timescale for action 01/07/07 2. OP19 23 01/11/07 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 Haydon View DS0000000534.V337979.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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
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