Inspection on 06/01/08 for Home From Home

This inspection was carried out on 6th January 2008.

CSCI found this care home to be providing an Good service.

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

Home From Home 25/10/06

Home From Home 03/11/05

Home From Home 01/07/05

Home From Home 18/01/05

Home From Home 17/06/04

Home From Home 25/02/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Home From Home 5a Dragon Lane Newbold Verdon Leicestershire LE9 9NG Lead Inspector Kim Cowley Unannounced Inspection 6 January 2008 11:30 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 Home From Home DS0000001749.V354709.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. Home From Home DS0000001749.V354709.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Home From Home Address 5a Dragon Lane Newbold Verdon Leicestershire LE9 9NG 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) 01455 828662 01455 823338 Home from Home Residential Care for the Elderly Limited Mr Daniel John Crowfoot Mrs Marie Ann Hartley Care Home 10 Category(ies) of Old age, not falling within any other category registration, with number (10) of places Home From Home DS0000001749.V354709.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. To be able to admit the person of category SI identified in correspondence from the previous registration authority dated 28/10/1999. 25th October 2006 Date of last inspection Brief Description of the Service: Home from Home is a small residential care home situated in the rural village of Newbold Verdon. It provides care for 10 older people. Bedrooms, which are all single, are on the ground and first floors, with a stair lift for access. Downstairs there is a large lounge and adjoining dining room. Both these rooms have patio doors, which lead out to the secluded gardens at the rear of the home. Fees, per week, are £350 (private), and from £276 to £327 (social services). Home From Home DS0000001749.V354709.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This was a key inspection that included a visit to the home and inspection planning. Prior to the home visit, the inspector spent half a day reviewing the last inspection report, and information relating to the home received since that inspection. During the course of the inspection, which lasted four hours, the inspector checked all the ‘key’ standards as identified in the National Minimum Standards. This was achieved through a method called case tracking. Case tracking means the inspector looked at the care provided to three residents living at the home by meeting them; talking with the staff who support their care; checking records relating to their health and welfare; and viewing their personal accommodation as well as communal living areas. Other issues relating to the running of the home, including health and safety and management issues, were inspected. The inspector also met with the two Managers, one carer, a relative, and two further residents. What the service does well: Home from Home has a warm, friendly atmosphere. All residents interviewed during the inspection said they liked living there home. One said ‘It’s very nice here. It’s comfortable, clean, and warm, and the food is very good.’ Another commented ‘I’m happy here. I like to sit and chat to the other residents and the staff. We all get on very well.’ Activities at the home include board games, listening to music, and watching television. Volunteers from a local church take residents out to social events in the local community. Residents have a ‘film show’ once a week, taking it in turns to choose the video they watch. Home from Home provides residents with an excellent standard of accommodation. The premises are homely, comfortable, and well decorated and furnished. It is evident that great care has been taken to make the home attractive and pleasant. Residents’ comments about the premises included ‘This home is always very clean’, ‘It’s cosy and warm here’, and ‘My room is lovely.’ Home From Home DS0000001749.V354709.R01.S.doc Version 5.2 Page 6 Relationships between the Managers, the staff, and the residents were good, and all residents praised the staff team. Comments included, ‘If I need anything I ask the staff and they get it for me’, ‘We have some good carers here’, and ‘We can have a chat with the staff when we want to. They are very friendly.’ What has improved since the last inspection? What they could do better: Admission and assessment forms are in need improving so that all the information staff need about a resident is recorded. This will enable staff to get a more complete picture of the residents they are caring for, and help to promote equality and diversity in the home. The staff application form must be updated so that the reference to staff having to ‘lift’ residents is removed. It must also include a heath declaration. These improvements will help to ensure that the staff employed are competent and fit to carry out their duties. The following policies should be put in place: Visiting Arrangements; Individual Care Planning and Review; Management of Service Users Money, Valuables, and Financial Affairs; and Record keeping. This will help the staff to be clear as to their responsibilities in these areas. Home From Home DS0000001749.V354709.R01.S.doc Version 5.2 Page 7 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. Home From Home DS0000001749.V354709.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 Home From Home DS0000001749.V354709.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): Quality in this outcome area is good. Residents’ needs are assessed prior to admission to ensure the home is suitable for them. This judgement has been made using available evidence including a visit to this service. (Standard 3 was inspected.) EVIDENCE: The home has a mixture of private and social services funded residents. All are fully assessed prior to admission. The Managers visits them in their own homes or in hospital in order to do this. They also talk to relatives/friends and health professionals to get their views on resident’s needs. These steps help to ensure the home is suitable for each resident and that staff can care for them properly. Once admitted, each resident has a four weeks trial period. The Managers said that prospective residents are encouraged to visit the home to have a look round, and to meet staff and other residents. They can also, if they wish, spend a day at the home. This helps them to decide whether they would like to move in. Home From Home DS0000001749.V354709.R01.S.doc Version 5.2 Page 10 Comments from residents and a relative included, ‘My daughter found this home. I came and looked round and I liked it’, ‘We chose this home because it’s small and homely’, and ‘This was the best home we looked at.’ Records relating to three admissions were inspected. Health and personal care needs had been considered, and the Managers had liaised with relevant professionals and family members to get their views on how best to care for the residents in question. The admission and assessment forms are in need of updating and improving. At present there is nowhere to record a resident’s ethnicity/preferred language. The form also asks for ‘marital status’ – this appears to exclude single people or those in partnerships. Updating these forms will enable staff to get a more complete picture of the residents they care for, and help to promote equality and diversity in the home. Standard 6 was not inspected, as this home does not provide intermediate care. Home From Home DS0000001749.V354709.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): Quality in this outcome area is good. Staff in the home, and in the wider community, meet residents’ health and personal care needs. This judgement has been made using available evidence including a visit to this service. (Standards 7, 8, 9, and 10 were inspected.) EVIDENCE: Care plans are comprehensive and contain clear instructions to staff on how to meet residents’ needs. Appropriate risk assessments are in place. Care plans and risk assessments have been regularly reviewed and updated. Fall prevention was discussed, and the Managers explained how they have helped to reduce the numbers of falls in the home using a number of strategies including staff observation. Care plans emphasise the importance of each resident’s quality of life in the home, rather than just focussing on care needs. One section records each resident’s ‘Life History’. This is usually filled by the resident’s family, and provides information about their past, for example, the schools they attended, places they worked, and holidays they had. It helps staff to engage with residents and chat to them about their lives prior to coming into the home. Home From Home DS0000001749.V354709.R01.S.doc Version 5.2 Page 12 Local doctors, district nurses, chiropodists, dentists, opticians, hearing services, and other medical personnel provide services to residents. District nurses train staff where necessary. Care records showed that residents’ health care needs are promptly identified and met. All residents are assessed to see if they are able to self-medicate, with records kept. These measures help to ensure that medication is safely managed and residents are given the opportunity to look after their own medication if they are able to. The safekeeping and administration of medication was discussed and the Managers were reminded of their responsibility to ensure medication is properly labelled and administered on time. All residents interviewed said the staff treated them with respect and helped them to maintain their privacy. One resident commented, ‘The staff are lovely and always ready to help.’ Home From Home DS0000001749.V354709.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): Quality in this outcome area is good. Residents’ social needs are identified and met and a wholesome and varied diet is provided. This judgement has been made using available evidence including a visit to this service. (Standards 12, 13, 14, and 15 were inspected.) EVIDENCE: Activities at the home include board games, listening to music, and watching television. Volunteers from a local church take residents out to social events in the local community. Residents have a ‘film show’ once a week, taking it in turns to choose the video they watch. A record is made of all the activities each resident takes part in. This is good practice as it shows how residents’ social needs are met. The record was examined and gave examples of the sort of things residents do in the home, for example: ‘read the paper with staff’, ‘played cards’, and ‘took a walk in the village’. The Managers said they had tried to increase the amount of activities in the home but were of the view that residents did not want to do more, and were satisfied with the activities they had. However she said activities would be Home From Home DS0000001749.V354709.R01.S.doc Version 5.2 Page 14 discussed at the next residents meeting, when those who live in the home will be asked if there were any other activities they would like to take part in. At present residents have their hair done at a local hairdressers. However the Managers said they are in the process of finding a mobile hairdresser. This will be more convenient for residents who do not want to go out to get their hair done. The Managers said visitors are welcome at the home at any time, although they may wish to avoid mealtimes, and they are always offered refreshments. Menus are planned and chosen at residents meetings and changed every four weeks. The food served is mainly traditional English. The Managers said other types of food had been tried, for example curries and pasta dishes, but these have not proved popular with most residents. However they are served on occasions to the residents who want them. The tea menu has recently changed at the residents’ request, after they said they preferred a hot tea in winter and salads and sandwiches in summer. The Managers said that menus would again be discussed at the next residents’ meeting to see if any further improvements are needed. On the day of inspection lunch consisted of roast chicken, stuffing, carrots, cauliflower, and mashed potatoes. Dessert was fruit salad and cream. Residents who didn’t want chicken could have had fish or sausages, although none of them chose these alternatives. All residents interviewed praised the food and the following comments were made: ‘The meals are tasty.’ ‘We get lots to eat.’ ‘The meals are home cooked and very nice indeed.’ Since the last inspection mealtimes have been changed. Lunch has been moved from 12.30 to 1 pm, and tea from 5 – 5.30 pm. The Managers said this is because residents have chosen to get up later, so they prefer to have their meals later too. Home From Home DS0000001749.V354709.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): Quality in this outcome area is good. Residents and their relatives are encouraged to talk to staff about any concerns they might have. This judgement has been made using available evidence including a visit to this service. Standards 16 and 18 were inspected.) EVIDENCE: The home has a written complaints procedure that is made available to residents and their representatives. A copy is kept in each resident’s bedroom so it is easy for them to access. Residents also have the opportunity to raise concerns at residents’ meetings, or individually with staff. There have been no complaints since the last inspection. Since the last inspection the home’s safeguarding/whistleblowing procedure has been improved and updated. It now makes the role of social services clear in the safeguarding process This will help staff to follow the right course of action should concern arise about a resident’s well-being. Home From Home DS0000001749.V354709.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): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the service. Residents live in an environment that is homely, well decorated, and safely maintained. (Standards 19 and 26.) EVIDENCE: Home from Home provides residents with an excellent standard of accommodation. The premises are homely, comfortable, and well decorated and furnished. It is evident that great care has been taken to make the home attractive and pleasant. Since the last inspection a new central heating system has been installed and a number of bedrooms have been redecorated. This has improved the premises for residents and staff. The garden, which is at the rear of the home, is secluded and wheelchair accessible. There is a lawn, a level pathway, and a patio with seating. The home’s lounge/dining room overlooks the garden. Home From Home DS0000001749.V354709.R01.S.doc Version 5.2 Page 17 Care staff are responsible for cleaning, and although they have to balance this with caring for residents, they appear to be doing a good job. All areas of the home inspected were immaculately clean, fresh and tidy. Residents’ comments about the premises included ‘This home is always very clean’, ‘It’s cosy and warm here’, and ‘My room is lovely.’ Home From Home DS0000001749.V354709.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): Quality in this outcome area is good. Well-trained and caring staff meets residents’ needs. The staff application form is in need of improvement. This judgement has been made using available evidence including a visit to the service. (Standards 27, 28, 29 and 30 were inspected.) EVIDENCE: Both Managers work full-time in the home and a shift leader is in charge when they are not on duty. There are three staff on in the morning, two in the afternoon, and one waking member of staff on at night with a further member of staff on call. One carer was interviewed. She told the inspector, ‘I like working here because it really is a “home from home”.’ She also said she was pleased with the training she’d received as this helped her to provide good quality care to the residents. Relationships between the Managers, the staff, and the residents were good, and all residents praised the staff team. Comments included, ‘If I need anything I ask the staff and they get it for me’, ‘We have some good carers here’, and ‘We can have a chat with the staff when we want to. They are very friendly.’ The Managers reported that all staff have CRB/POVA checks before they start work in the home, and two written references are obtained. Staff records, two of which were sampled, confirmed this. This will help to safeguard residents. Home From Home DS0000001749.V354709.R01.S.doc Version 5.2 Page 19 The application form that potential staff complete needs updating. At present it states ‘you will be required to support or lift residents’. However staff no longer ‘lift’ residents, as this considered unsafe for both residents and staff. It must also include ‘A statement by the person as to his mental and physical health.’ These improvements will help to ensure that the staff employed are competent and fit to carry out their duties. Over 50 of staff have achieved NVQ Level 2. Other training is provided where necessary, including moving and handling and first aid. Staff have formal supervision every two months and appraisals once a year. Home From Home DS0000001749.V354709.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents live in a home that is safe and well managed. (Standards 31, 33, 35, 37 and 38 were inspected.) EVIDENCE: The home is jointly managed, and both the Managers have successfully completed NVQ Level 4 and the Registered Manager’s Award. They work fulltime in the home carrying out both care and administrative tasks and live in the grounds where are they are on call 24/7. The Managers said the home is run in the best interests of the residents and they are asked for their views and suggestions individually, at meetings, and via the home’s annual Quality Questionnaires. As both Managers work closely with the residents and know them all personally they are in a good position to get feedback on how the home is run. Home From Home DS0000001749.V354709.R01.S.doc Version 5.2 Page 21 Residents’ finances are looked after by the residents themselves, their relatives, or the local social services department. The Managers will look after small amounts of money on request and records are kept of these transactions. At present there is no policy in place for management of residents’ finances (see Standard 37 below). The home has most of the recommended policies, although the following are missing: Visiting Arrangements Individual Care Planning and Review Management of service users money, valuables, and financial affairs Record keeping These should be put in place so the Managers and staff are clear as to their responsibilities in these areas. Records showed that the health, welfare and safety of residents and staff is a priority in the home. Staff are trained in health and safety during their induction and the premises are risk assessed. Appropriate checks and servicing of equipment has been carried out, as has consultation with the local Fire Officer. In 2007 the home was inspected by the Environmental Health Department and awarded a three star rating, the best a service can achieve. Home From Home DS0000001749.V354709.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 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 4 X X X X X X 4 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X 2 3 Home From Home DS0000001749.V354709.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 OP29 Regulation 19(1)(b) Requirement The staff application form must be updated so the reference to staff having to ‘lift’ residents is removed. It must also include ‘A statement by the person as to his mental and physical health.’ These improvements will help to ensure that the staff employed are competent and fit to carry out their duties. Timescale for action 06/03/08 Home From Home DS0000001749.V354709.R01.S.doc Version 5.2 Page 24 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 OP3 Good Practice Recommendations Admission and assessment forms should be updated and improved in the areas identified under Standard 3. This will enable staff to get a more complete picture of the residents they are caring for, and help to promote equality and diversity in the home. The following policies should be put in place: Visiting Arrangements; Individual Care Planning and Review; Management of Service Users Money, Valuables, and Financial Affairs; and Record keeping. This will help the staff to be clear as to their responsibilities in these areas. 1 OP37 Home From Home DS0000001749.V354709.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection East Midland Regional Office Unit 7 Interchange 25 Business Park Bostocks Lane Nottingham NG10 5QG 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 Home From Home DS0000001749.V354709.R01.S.doc Version 5.2 Page 26 - 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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