Inspection on 31/05/07 for Henrietta House

This inspection was carried out on 31st May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Henrietta House 21/12/05

Henrietta House 26/05/05

Henrietta House 04/11/04

Henrietta House 15/07/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Firstlings

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

CARE HOMES FOR OLDER PEOPLE Henrietta House 3 Dynevor Road Bedford Bedfordshire MK40 2DB Lead Inspector Andrea James Unannounced Inspection 31st May 2007 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Henrietta House DS0000015001.V341755.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. Henrietta House DS0000015001.V341755.R01.S.doc Version 5.2 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 F/P 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.V341755.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st December 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 20 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.V341755.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection, which was carried out on the 31st of May 2007. The Registered manager and one of the providers were available for the inspection process. The inspection followed a case tracking methodology where a sample of the people using the service was chosen. They were spoken to and their files viewed, where possible relatives and care staff involved with the selected users were also interviewed. The report also contained information and discussions with other users and relatives visiting the service to include health care professionals and district nurses. The service also provided their first AQAA (Annual Quality Assurance assessment) that provided good information about the progression of the service. A partial tour of the premises was undertaken and verbal feedback was given while the inspection took place. The inspector would like to thank the users of the service, care staff, the manager, provider, relatives and external professionals for their valued contribution to the inspection process. What the service does well: The service provided very good standards of care that embraced the fundamental principles of good care practices. They provided good quality care with the correct amount of trained staff 24 hours per day. The majority of the staff have been in the home for a number of years and as a result users received a continuity of care. The service was fully occupied and new admissions were offered trail visits before permanent residency was taken up. Full assessments were carried out prior and during the first weeks of care commencing. Nutrition was maintained, all users were given a choice of meals. Fresh fruits and juice was available throughout the day and the inspector observed the users of the service being offered hot beverages at regular intervals throughout the day. The people using the service were able to 5 major celebrations throughout the year to include Christmas and summer fetes and all users birthdays were celebrated with gifts offered on all occasions. Relatives said they were always invited to attend these events. The people using the service had regular visits to church pubs, theatres, concerts and museums. The activities provided were to ensure mental alertness. On the day of the inspection two different activities Henrietta House DS0000015001.V341755.R01.S.doc Version 5.2 Page 6 were observed in the afternoon. People using the service were encouraged to maintain their own hobbies. The service had not received any complaints since the last inspection but received several commendations on their service delivery. The people using the service appeared relaxed and comfortable and all wanted to inform the inspector of their positive experiences of the service. Relatives and professionals all spoke positively about the standards of care. Comments such as “carers are amazing,” “ they are very efficient” and “they have so much patience” were used to describe the calibre of the staff team, and the high standards of service delivery. What has improved since the last inspection? What they could do better: The agency should ensure that: • • Risk assessments are clear and identify the level of risk for each user with the planned action clearly stated. All care plans should be made specific to ensure consistency of care is carried out for users needing personal care. Please contact the provider for advice of actions taken in response to this Henrietta House DS0000015001.V341755.R01.S.doc Version 5.2 Page 7 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. Henrietta House DS0000015001.V341755.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 Henrietta House DS0000015001.V341755.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&6. People who use the service experience an excellent quality outcome in this area. We have made this judgement using a range of evidence, including a visit to the service. Very good systems were in place to ensure people using the service received sufficient information to make a decisions to use the service, good care needs assessments were undertaken and perspective users had the opportunity to visit the home prior to admission, as a result users were able to make informed choices about using the service. The home did not provide intermediate care. EVIDENCE: The people using the service commented that they were given all the information in order to make decisions about living at the home. The care packages seen in users bedrooms showed that all users were provided with a Statement of Purpose and a Service User Guide. Henrietta House DS0000015001.V341755.R01.S.doc Version 5.2 Page 10 Users spoken to said they were allowed to visit the home on several occasions before they took up permanent residency. One user said she received respite care for a number of weeks and decided to make it her home, as she felt more comfortable. Perspective users received a pre- admission assessment by the manager. The document covered all aspects of daily living including risk assessments. The home offered a two months settling in period. Relatives spoken to said they were sure that the home could meet the needs of their relative because it came highly recommended from other friends. Relatives said they were made to feel welcome and staff would always offer them a cup of tea and cake when they arrived. Health care professionals said they were also made to feel welcomed and found that the communication between them and the home was excellent. Henrietta House DS0000015001.V341755.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. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. Satisfactory systems were in place to ensure all users of the service had an individual care plan with varied risk assessments and they received privacy and dignity, were treated with respect as a result their health care needs were being met. EVIDENCE: All users had individual care plans with current and updated care needs that reflected changing needs of people who use the service. It was however noted that in some files the information available was not clear and could give way to carers making errors in judgements. One example of this was a care plan stated that small assistance was to be given at bath times but it was not clear what assistance was to be given, as this could not be measured. This was also the case for risk assessments where the level of risk was not clear and as a result the outcome was ambiguous. The manager informed the inspector that the issues would be addressed as a matter of urgency. Henrietta House DS0000015001.V341755.R01.S.doc Version 5.2 Page 12 The health care needs of all the people using the service were satisfactorily maintained. Health care professionals spoken to said the home was proactive in their care to the users and very good communication was maintained to ensure users receive a good service. They said the carers were very professional in their manner and kept good records of the users. The health care assistant commended the home in wanting to keep users when they are at the end of their lives. Users of the service and relatives spoken to all said that the care staff and manager treated them with respect and their privacy and dignity were always maintained. The home had good policies and procedures in place for administering, storing, disposing and recording of all medication. The senior staff were the only ones allowed to administer medication. The medication rounds were observed and the staff appeared competent in carrying out this task. They were also knowledgeable about the various medication processes including ordering of prescriptions. They had received medication training. District nurse commented that the home did not abuse medication and it was lovely to see that they used the minimal medication for the people using the service. Henrietta House DS0000015001.V341755.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. The people who use the service experience an Excellent quality outcome in this area. We have made this judgement using a range of evidence, including a visit to the service. Very good systems and programmes were in place that ensured people using the service had a life style filled with activities, good family contacts, nutritious meals and had the ability to make choices about the way they lived their lives, as a result users had good life experiences. EVIDENCE: The people using the service had a vast amount of activities and the service ensured all users were able to undertake activities they choose. There was evidence that diversity was maintained through religious and cultural means. The home had a monthly activities programme and again choice was offered. On the day of the inspection two activities were offered to users. Relatives said they were regular visitors to the home and the people using the service always had activities. The home ensured users were able to maintain contact with their families. On the day of the inspection over 8 relatives visited the home and all said they Henrietta House DS0000015001.V341755.R01.S.doc Version 5.2 Page 14 were made to feel welcome. It was observed that staff offered them cups of teas and cakes. Relatives said they were also invited to birthday parties and summer fetes. They spoke positively about the communication they received from the home. On relative said for every change in her mothers care she was kept informed, even when they called the doctor. Dietary needs were provided for different religious groups. Four different faiths visited the home on a regular basis. One user was escorted to church on a weekly basis and another to the Salvation Army. The service had the facility to transcribe all documentation into four different languages and staff were employed from different cultural backgrounds to meet the cultural diversity of the people who use the service. The cook was spoken to and appeared knowledgeable about the dietary needs of the people using the service she had undertaken several training courses and had recently embarked on her NVQ qualification. They received fresh produce twice weekly and users were observed being offered choice in their meals. As a result of regularly monitoring the views of the users the home had made changes to the meals by implementing a starter as a part of the meal and also provided a glass of sherry at midday. Henrietta House DS0000015001.V341755.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 and 18. People who use the service experience a good outcome in this area. We have made this judgement using a range of evidence, including a visit to the service. The service ensured satisfactory polices and procedures were in place, as a result users could complain and were protected against abuse or neglect. EVIDENCE: The service operated an open door policy and most users and relatives were able to go to the manager if they had concerns or complaints. The service had not received any complaints since the last inspection but had several comments on the good standards of care they were delivering. The complaints procedures were displayed in the lobby of the home and in the Service User Guide. Staff were also trained in how to handle and record complaints should they arrive. Written policies and procedures were in place to protect users from abuse and neglect. The policies included the POVA (Protection of Vulnerable Adults) and Whistle blowing procedures. Care staffs also received POVA training, and were able to explain to the inspector the procedures they would follow in the event of a suspected abuse. Henrietta House DS0000015001.V341755.R01.S.doc Version 5.2 Page 16 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 and 26. People who use the service experience a good quality outcome in this area. We have made this judgement using a range of evidence, including a visit to the service. The people living in the home were comfortable and enjoyed the comforts of a well maintained environment, had sufficient toileting facilities and were able to have a bedroom that was decorated to suite individual choices, as a result users enjoyed a pleasant and hygienic environment. EVIDENCE: The home was able to create a warm and welcoming family atmosphere that was noted by all the visitors spoken to on the day of the inspection. It was clean and free from all offensive odours. The cleaner spoken to had worked in the home for 3 years and was undertaking his NVQ level 1 in cleaning. All relatives spoken to said the home had a great sense of “Homeliness” one user said,” this is my home and I am made to feel that I could make it my home”. One user was able to choose the plants for the garden and pride herself in the Henrietta House DS0000015001.V341755.R01.S.doc Version 5.2 Page 17 garden and its appearance. The service users spoken to all drew the inspector’s attention to the garden, which was maintained, to a high standard. The users all but two had individual bedrooms that were individually decorated. One user was able to have her pet in her room while others were able to bring items of there own furnishings to their bedrooms. Each room had the availability of a lockable drawer and door, which can be used for storage of money, valuables and medication. Shared rooms were provided with a set of screens to ensure privacy for personal care. The environment was well light and the communal furnishings were domestic in nature to meet the needs of the users. Some users had specialist wheelchairs that enabled them to access the outdoors. The home had passenger lifts, chair lifts and the provision of ramps were available indoors and outdoors and grab rails were available in various areas of the home. The home had varied selection of raised toilet seats and hoists to meet users needs. Doorways into communal areas and users bedrooms were of a suitable width to allow hoist and wheelchair access. The home had a call system with an accessible alarm facility provided in every room. The environment was safe and free from hazards and as a result users were able to move about freely. Areas of danger such as the laundry room were kept locked at all times. Henrietta House DS0000015001.V341755.R01.S.doc Version 5.2 Page 18 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 and 30. People who use the service experience an excellent quality outcome in this area. We have made judgement using a range of evidence, including a visit to the service. Systems were in place for recruiting, training and supporting the staff team, as a result the people using the service were protected and were in safe hands at all times. EVIDENCE: The home had good recruitment policies and procedures were in place to cater for the people using the service in several ways. The records seen suggested that staff were employed after satisfactory clearances were undertaken to protect users safety. The home had a mixture of male and female staff in meeting with the diversity needs of the users. The manager explained that she recruited staff to meet the changing needs of the users to include those with language barriers. One staff was able to speak four different languages and as a result the home was able to meet users needs from different cultural backgrounds. The manager was also able to speak two languages. Staff spoken to said they received regular training and records viewed suggested that all staff received mandatory training and several staff had achieved an NVQ qualification in care. New employees received an Induction but this was very basic as it was in a format that required only a tick not Henrietta House DS0000015001.V341755.R01.S.doc Version 5.2 Page 19 detailed information. The home had a training programme for 2007- 2008 where other areas of training needs were identified. The staff rotas suggested that sufficient numbers of staff were rostered on to meet the needs of the people using the service. The home had no staff vacancies and did not use agency staff to provide care. Relatives and external professionals spoken to said the staff were “amazing” and appeared to have so much patience when dealing with the users. One staff was described as being “quietly efficient”. Henrietta House DS0000015001.V341755.R01.S.doc Version 5.2 Page 20 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): 31,32,33,35,36,37 & 38. People who use the service experience an excellent quality outcome in this area. We have made this judgement using a range of evidence, including a visit to the service. Effective systems were in place to ensure people using the service were able to benefit from the ethos, leadership and management of a service that also protected their welfare and safeguarded their interests. EVIDENCE: The manager had an advanced management in care Qualification and had worked in the home for 20 years. The continuity of the management of the home had enabled the service to be able to meet their aims and objectives. The manager operated an open door policy and as a result was able to deliver good people skills through effective communication with care staff, relatives and users of the service. The registered providers also worked closely with the home and were able to support the manager in her role. The home was one of Henrietta House DS0000015001.V341755.R01.S.doc Version 5.2 Page 21 three and all homes worked to benefit each other. The provider informed the inspector that they were due to employ an operational manager who would over see all the services and provide more support to the managers. Supervision was undertaken every other month by the manager and was recorded in the staff files. Staff spoken to confirm that they received regular supervision but felt able to speak to the manager whenever they needed. The inspector observed a good relationship between the manager and all the staff team. The home had a quality assurance system and questionnaires were sent to users and relatives. The information was evaluated and outcomes were displayed in the Service Users Guide and discussed at residents meetings. There was also a quality assurance programme for continual review and updating of policies and procedures. People using the service were protected by the recording policies and procedures. Accidents and incidences were recorded and the Commission was kept informed of changes using the correct formats. The home carried out regular fire drills, fire awareness training, fire risk assessments and strategy documents. Service agreements were in place for regular maintenance of hoists, lifts, chair and other electrical and gas equipment. Systems were in place to control the spread of Infection in accordance with relevant legislations. Policies and procedures for control of Infection included the safe handling and disposal of clinical waste, dealing with spillages, provision of protective clothing, hand washing. The care home provided Infection Control and health and safety training to staff so that they were aware of the importance of prevention. In conclusion the people using the service received various benefits that resulted in effective management of the home. Henrietta House DS0000015001.V341755.R01.S.doc Version 5.2 Page 22 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 4 4 N/A 4 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 4 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 3 3 4 4 4 3 3 STAFFING Standard No Score 27 4 28 3 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 X X 3 4 4 3 Henrietta House DS0000015001.V341755.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15 (1) Requirement Arrangements must be made to ensure all care plans are clear and information can be measured to enable consistent care delivery. Timescale for action 30/07/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP7 Good Practice Recommendations Arrangements should be made to ensure all risk assessments clearly states the level of risk identified for each user. Henrietta House DS0000015001.V341755.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF 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 © 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 Henrietta House DS0000015001.V341755.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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