CARE HOMES FOR OLDER PEOPLE
Henrietta House 3 Dynevor Road Bedford Bedfordshire MK40 2DB Lead Inspector
Leonorah Milton Unannounced Inspection 21st December 2005 14.30 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 Henrietta House DS0000015001.V274024.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. Henrietta House DS0000015001.V274024.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Henrietta House Address 3 Dynevor Road Bedford Bedfordshire MK40 2DB 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) 01234 359194 01234 359194 Lansglade Homes Limited Ms Lidia Cunto Care Home 25 Category(ies) of Dementia - over 65 years of age (25), Old age, registration, with number not falling within any other category (25), of places Physical disability over 65 years of age (25) Henrietta House DS0000015001.V274024.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 26th May 2005 Brief Description of the Service: Henrietta House was a large double fronted Victorian building located in a pleasant residential area of Bedford. The property was within walking distance of the town centre and local amenities including the train station and various bus routes. The home had a large and attractive garden at the rear. Parking spaces for a few vehicles was available at the front of the house. The home was registered to provide care for up to twenty-five older people who may also have dementia and/or physical disabilities. The registration for physical disabilities was not applicable to this service as the home was able to care for those with mobility problems associated with old age under the OP category. Langsglade Care Homes Ltd was the registered provider. The directors of the company had changed more than two years ago and had continued to improve on the high standards of care that had been noted at successive inspections. Mrs L Cunto had managed the home effectively for a number of years. The accommodation had been suitably adapted to meet the needs of frail people and was arranged over three floors. The home had twenty-three single rooms, two with en-suite facilities, and one room for shared occupancy. A large lounge and a large dining room were situated on the ground floor of the property, as was a smaller lounge/diner. Toilet and bathing facilities were located for convenient access through out the building. The building was attractively decorated and well maintained. The home had a very welcoming atmosphere and there was a strong emphasis on Henrietta House being a home and on respecting individuals rights. Henrietta House DS0000015001.V274024.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was the second of the statutory two inspections that the Commission for Social Care Inspection (CSCI) is required to carry out each year. This inspection was carried out in accordance with the CSCI’s procedures to assess core care standards within the two inspections as detailed on this report. This inspection therefore focused the core standards not assessed at that visit. During this inspection the arrangements for the care of one service user and her case file were assessed. Conversations took place with this service user, two others and a member of staff. A partial tour of the building took place. The manager and a proprietor were present and received feedback as the inspection progressed. It is recommended that this report be read in conjunction with the report of the inspection carried out in May 2005 for a complete overview of the standard of the operation between these dates. What the service does well: What has improved since the last inspection?
Systems to regularly monitor the running of the home had continued to improve and had ensured that the home complied with legal requirements and best practice guidelines for the operation of a care home. Henrietta House DS0000015001.V274024.R01.S.doc Version 5.1 Page 6 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. Henrietta House DS0000015001.V274024.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Henrietta House DS0000015001.V274024.R01.S.doc Version 5.1 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 The home had ensured that it could meet a service user’s care needs by carrying out a comprehensive assessment of need prior to inspection. EVIDENCE: The case file for a service user who had recently moved into the home was assessed. It contained a pre-admission assessment of need that had taken account of the details specified by Standard 3. The file showed that the service user and her representatives had been consulted during the assessment process, there being a personal statement on record. The home did not provide an intermediate care service. The manager stated that some service users were admitted for short periods of respite care that did not involve a rehabilitation service. Henrietta House DS0000015001.V274024.R01.S.doc Version 5.1 Page 9 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 Satisfactory documents were in place to identify service users’ care needs and show how these would be met. The administration of medicines had mostly been carried out in accordance with good practice guidelines. EVIDENCE: The case file assessed at this inspection contained a comprehensive care plan even though the service user had only resided in the home for a short time. It was evident that this document would be reviewed and added to as the home became more conversant with the service user’s needs. Medicines were secured in locked cabinets in the manager’s office and a purpose built metal lockable trolley. Record seen at this inspection for the administration of medicines had been appropriately maintained, as had the returns book for unused medicines, which had been returned to the pharmacist. Training records indicated that members of staff with the responsibility for handling medications had received training from a pharmacist in the safe handling of medications. The National Pharmacy Association had issued certificates to certify this training.
Henrietta House DS0000015001.V274024.R01.S.doc Version 5.1 Page 10 A senior member of staff explained the home’s medication systems. She was knowledgeable about safe practice. A service user had been given medication via food. The service user’s family had agreed to this intervention. The manager stated that the service user’s Doctor was aware and had approved this practice. She was advised that a record of the GP’s consent should be maintained on the service user’s file. Henrietta House DS0000015001.V274024.R01.S.doc Version 5.1 Page 11 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): These standards were not reviewed, having been assessed as met at the previous inspection. EVIDENCE: Henrietta House DS0000015001.V274024.R01.S.doc Version 5.1 Page 12 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): These core standards were not reviewed, having been assessed as met at the previous inspection. EVIDENCE: Henrietta House DS0000015001.V274024.R01.S.doc Version 5.1 Page 13 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): 26 Satisfactory arrangements were in place to maintain the cleanliness of the home and protect service users from the spread of infection. EVIDENCE: Areas of the building seen at this inspection were clean and orderly. The home had a quality audit system to regularly monitor the standards of hygiene throughout the building. Records indicated that training had been provided in infection control procedures. It was reported that protective equipment was available to limit the spread of infection. Henrietta House DS0000015001.V274024.R01.S.doc Version 5.1 Page 14 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): These core standards were not reviewed, having been assessed as met at the previous inspection. EVIDENCE: Henrietta House DS0000015001.V274024.R01.S.doc Version 5.1 Page 15 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 Satisfactory arrangements were in place to protect service users from harm. EVIDENCE: Accident records were assessed at this inspection. They had been well maintained and showed that in most instances accidents had involved unwitnessed trips and falls. The records showed that the manager had reviewed the circumstances in which accidents had occurred and that a quarterly audit of accidents had been carried out to assess for any common risk factors. The manager stated that where necessary service users’ general practitioners had been asked to review individual’s health and adjust medication if required. Records indicated that training had been provided in safe manual handling practice, fire safety, general health and safety, food hygiene and use of COSHH products.
Henrietta House DS0000015001.V274024.R01.S.doc Version 5.1 Page 16 A comprehensive risk assessment for the operation of the home had been carried out using a model designed for this purpose by an organisation that specialised in health and safety matters. Equipment had been maintained by appropriate contractors. Henrietta House DS0000015001.V274024.R01.S.doc Version 5.1 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 2 10 x 11 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 x x x x x x x 3 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 3 Henrietta House DS0000015001.V274024.R01.S.doc Version 5.1 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Henrietta House DS0000015001.V274024.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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