Inspection on 11/08/06 for Housman Court

This inspection was carried out on 11th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Housman Court 01/09/09

Housman Court 08/08/07

Housman Court 08/02/06

Housman Court 09/08/05

Housman Court 11/01/05

Housman Court 28/06/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Housman Court School Drive Bromsgrove Worcestershire B60 1AZ Lead Inspector Y South Unannounced Inspection 11th August 2006 08:30 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 Housman Court DS0000018484.V308097.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. Housman Court DS0000018484.V308097.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Housman Court Address School Drive Bromsgrove Worcestershire B60 1AZ 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) 01527 575440 01527 577439 carolonley@housmancourt.wanadoo.co.uk Somerset Redstone Trust Caroline Ann Onley Care Home 30 Category(ies) of Dementia - over 65 years of age (14), Old age, registration, with number not falling within any other category (30), of places Physical disability over 65 years of age (30) Housman Court DS0000018484.V308097.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home to accommodate one named person under 65. Date of last inspection 8th February 2006 Brief Description of the Service: Housman Court is an established care home for older people, purpose built in 1988. It is situated in the centre of Bromsgrove within easy reach of shops, post office, library and swimming pool. There are thirty single rooms with en-suite facilities and communal lounges and dining areas. There are also assisted bathrooms for those who need help and communal toilets. A shaft lift enables easy movement between floors and handrails are fitted where they will be useful. Housman Court provides accommodation and care for up to thirty older people some of whom may have a physical disability or dementia type illness. The home is in the centre of a sheltered housing complex with landscaped gardens. Somerset Redstone Trust runs both Housman Court and the sheltered housing complex of five separate units. Caroline Onley is the registered manager of the home. Maureen Price, director of operations, carries out the monthly visits on behalf of the Trust. On 04/07/06 the manager quoted the current scale of charges as £378 to £430. Additional charges are made for hairdressing, chiropody, papers, toiletries and transport. Housman Court DS0000018484.V308097.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection incorporates information received by the Commission for Social care Inspection since 08.02.06 and the information obtained during fieldwork on 11.08.06. The fieldwork took place over eight and a half hours during which the inspector spoke to residents, staff, and the manager. A partial tour of the premises was also undertaken. Prior to the fieldwork the home was asked by the Commission for Social Care Inspection to distribute questionnaires to the residents, relatives and health care professionals. To date twenty responses have been received. The focus of this inspection was on the key National Minimum Standards and the requirements and recommendation that arose out of the previous inspection. What the service does well: What has improved since the last inspection? Since the last inspection the standard of care planning and reviewing of plans had improved and risk assessments were also being carried out and reviewed appropriately. Improvements had been made to the management of medication, staff recruitment, training and support. Health and safety matters in the home had been addressed. Housman Court DS0000018484.V308097.R01.S.doc Version 5.2 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. Housman Court DS0000018484.V308097.R01.S.doc Version 5.2 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 Housman Court DS0000018484.V308097.R01.S.doc Version 5.2 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, (6 NA) Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents and their families are provided with the information and opportunities they need to help them make a choice regarding their future accommodation and care. Needs are assessed prior to admission to ensure the home is able to provide the care each individual needs. EVIDENCE: An assessment was made of the care records of three residents. These demonstrated that someone from the home had undertaken an assessment of needs before a place was offered. Minor suggestions for improvement were made which included more information regarding dietary preference, activities and interests, religion, culture and family links. Housman Court DS0000018484.V308097.R01.S.doc Version 5.2 Page 9 Two residents and a relative confirmed that needs had been assessed, they had been invited to visit the home and have a trial stay. Information was provided about the home and their questions had been answered. They were happy with their choice. Housman Court DS0000018484.V308097.R01.S.doc Version 5.2 Page 10 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, 8, 9, 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff are able to obtain the care information they need from the care plans in order to be able to provide the correct care. Residents receive their prescribed medication safely and their rights to privacy and dignity are upheld. EVIDENCE: Three care plans were assessed. These contained information that informed and guided the staff on how the individual’s care needs should be addressed. Relevant assessments had been undertaken regarding skin care, nutrition, moving and handling and other identified risks. It was suggested that ideal weights were printed on the weight record to guide staff. In two cases care plans were needed regarding pressure care as risks had been identified, and clarification was needed on the frequency a blood test needed to be undertaken. Housman Court DS0000018484.V308097.R01.S.doc Version 5.2 Page 11 One resident had a wound that was attended to by the district nurses. Despite best efforts communication was limited between the nurses and the home. However it was considered that a care plan should be in place advising the staff that the resident had a wound and how it was being cared for. A report on progress should be sought from the district nurse at least as often as the monthly reviews of care plans that were being undertaken. The records indicated that residents were receiving visits from health care professionals including the GPs, district nurses, opticians, dentists, tissue viability specialists, speech therapists, continence advisers and diabetic specialists. Residents and relatives confirmed that health care was provided and they were pleased with the service. Relatives said that communication between them and the home was good. The doctors who completed and returned the questionnaires confirmed that they were consulted with appropriately, received the correct support from the home and their instructions were carried out correctly. The Commission for Social Care Inspection had been appropriately informed of ill health and accidents. This demonstrated that staff were taking appropriate action. Medication management was assessed. The storage was well arranged and secure. The key safety was acceptable. Records were well maintained. It was recommended that when staff referred to prescribed creams and ointments in the care records they should be named. Staff had received appropriate training and the home was supported by the supplying pharmacist. It was observed that staff treated the residents and visitors with respect. Residents were able to receive their visitors in private or use a quiet lounge if they preferred. The records indicated that residents were offered the keys to their bedroom doors and lockable storage when they were admitted. Staff and relatives confirmed that mail was delivered unopened and assistance given if needed. Private phone calls could be made and received using mobile phones or a pay phone. Housman Court DS0000018484.V308097.R01.S.doc Version 5.2 Page 12 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): 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. A range of in-house and community activities are available in which the residents can choose to participate. They find the variety suits them. Opportunities and support is given to those who wish to attend the church of their choice. Visitors are always welcome and residents are able to choose how they arrange their day. Residents are able to choose from variety of nutritious menus and enjoy their food. EVIDENCE: The pre-inspection questionnaire completed by the manager indicated that activities such as themed days, quizzes, games, crafts, cookery and manicures were provided for residents to participate in if they wished. Housman Court DS0000018484.V308097.R01.S.doc Version 5.2 Page 13 Residents also had opportunities to visit the Stroke Club, go shopping, have meals ‘out’, attend the church of their choice, and visit the library and the theatre. The vicar visits the home monthly and residents visit Stoke Prior church and the Methodist church. Ten questionnaire responses were completed by residents and they all said that the home provided suitable activities in which they could take part. A resident told the inspector that he was happy with what was provided. The food was good and so was the care. A relative said in the questionnaire response that she had noticed an improvement in the provision of activities since the appointment of the new manager. An activities organiser was employed and she told the inspector of the wide range of events that she offered the residents. The residents confirmed that they were able to use their bedrooms whenever they wished as well as the communal rooms. The manager said that residents and relatives were able to take part in bimonthly meetings. Standing agenda items included maintaining an awareness of the complaints procedure. The meetings were also used to give feedback from action taken in response to the homes own questionnaires. Another resident said that the food and choice was very good. The menu samples demonstrated a wide choice. The cook said that the residents were offered a selection each day, diabetic diets were catered for as well as extra nutrition and weight reducing diets where health indicated a need. Residents were observed enjoying an appetising meal that was well presented. Housman Court DS0000018484.V308097.R01.S.doc Version 5.2 Page 14 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): 16, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and relatives are able to raise their concerns with confidence. Staff are appropriately recruited and trained to ensure the protection of vulnerable people who live in the home. EVIDENCE: The manager said that all residents received a copy of the complaints procedure in the Service Users Guide and relatives had access to a copy in the Statement of Purpose. Nine of the residents’ questionnaire responses indicated that they knew who to speak to if they were worried. Seven relatives questionnaires indicated that they were aware of the complaints procedure and the doctors’ responses indicated that they had never received complaints about the home. The pre-inspection questionnaire indicated that the home had received three complaints in the past twelve months. They had all been substantiated. Two had concerned medication. The concerns had not been related to practice. The third concerned missing clothes that had been found and returned. Housman Court DS0000018484.V308097.R01.S.doc Version 5.2 Page 15 Staff said that they had received training in the awareness of abuse and their records confirmed this. Their records also indicated that appropriate checks had been made before they had been offered their jobs. Housman Court DS0000018484.V308097.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are able to live in a clean comfortable well maintained home that meets their needs. Measures are in place to protect residents from infection and reduce the risks where possible. EVIDENCE: A partial tour of the home was undertaken. Everywhere was clean and free from offensive odours. Bedrooms were attractively decorated and furnished. Residents were able to decorate their rooms with their own personal treasures. Housman Court DS0000018484.V308097.R01.S.doc Version 5.2 Page 17 It was observed that space was limited on the top floor and a communal toilet was used to park the linen trolley. The corridor needed to be redecorated and re carpeted. Again the quality of the carpets on the middle floor was very poor. A water valve was under repair, as was a bathroom wall. On the ground floor the kitchen was clean tidy and well arranged. The laundry was well organised but there was only one washing machine and no back up should this fail. The inspector recommended that the proprietor be asked to improve this provision as machines in such an environment are under continuous use and breakdowns cause great disruption to the service if there is not a contingency machine available. The communal lounges and dining rooms were pleasant and comfortable. The manger said that it was planned to extend the ramp from the lounge to enable improved access to the garden. Residents expressed their appreciation of the home and their rooms. Measures were in place to address the risks of cross infection. Personal protective equipment was available and in use. Staff confirmed that they had received relevant training and their certificates were seen. Housman Court DS0000018484.V308097.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 at least once during a 12 month period. 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. The home is staffed by well recruited and trained staff who are able to provide the care the residents need. EVIDENCE: The duty roster indicated that the home was acceptably staffed to meet the needs of the residents at the time. Five members of staff had been recruited from China. All were able to communicate well in English and were well supported by each other and the other staff. Relatives commented favourably on their caring approach. The home had worked with a recruitment agency and the appropriate checks had been undertaken. References were seen in the two files that were assessed. Checks had also been undertaken by the Criminal Records Bureau. The pre-inspection questionnaire indicated that training had been obtained for staff during the past twelve months in food hygiene, fire safety, abuse awareness, health and safety, manual handling, hand hygiene, dementia care, supervisory management, visual problems and medication administration. In addition staff were on National Vocational Qualifications (NVQ) level 2 and 3 courses. Housman Court DS0000018484.V308097.R01.S.doc Version 5.2 Page 19 57 of the staff had NVQ level 2 or above qualifications and twelve staff had current first aid certificates. Two staff were interviewed by the inspector and confirmed that they were well trained and supported. Their records endorsed their statements. Housman Court DS0000018484.V308097.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is well managed for the benefit of the residents and their financial interests are safe guarded. Health and safety is well addressed for the well being of all in the home however attention is needed to the décor and carpets in some communal areas to ensure a pleasant and safe environment is maintained throughout. Housman Court DS0000018484.V308097.R01.S.doc Version 5.2 Page 21 EVIDENCE: The home manager is experienced and well qualified. She has achieved the Registered Manager’s Award, NVQ levels 4, and is a moving and handling trainer. Recently she has undertaken food hygiene training at level 2, a quality assurance course and a staff management course. The residents, relatives and staff all complemented her ability and attitude. Everyone found her approachable and responsive. Residents personal monies held in safekeeping were secure and the records were seen to be well maintained. It was recommended that a receipt always be given when money was deposited in the home. The manager had been on a quality assurance course recently and had developed a quality assurance system that she was eager to implement. It was clear and logically laid out, covering all aspects of the home, care and staffing. Annual questionnaires were distributed to residents and occasionally food questionnaires as well. The manager said that documents could be provided in larger print and other formats for the residents who had specific needs. However the Romanian, Polish and Burmese residents were happy with written English. The manager said that they had not expressed a need for any specific requirements or support regarding their religions or cultures. As previously said the staff from China had no difficulty with spoken or written English. The staff group ranged in age from 20 years to 50 years and was composed of male and female carers so that personal care could be given to residents by carers of the same sex if preferred. In respect of cultural and religious requirements prayer time and privacy was arranged for some staff. The Fire Risk Assessment had been reviewed. It was very detailed and queries that had been identified were under discussion. Fire safety checks of systems and equipment were being carried out. The manager hoped to be able to send the handyman on a fire wardens’ course. This seemed most appropriate and would equip him to undertake some training with staff. A full premises audit was in progress and the manager said that this would enable her to prioritise future redecoration and refurbishment. and also prepare presentations for finance for large projects. A risk assessment file was seen for the premises. Housman Court DS0000018484.V308097.R01.S.doc Version 5.2 Page 22 The maintenance log demonstrated that an extensive range of checks and servicing was carried out as well as documenting all repairs. The pre-inspection questionnaire indicated that the services and equipment were appropriately serviced and maintained. During the previous inspection it was apparent that the corridors needed Attention to the décor and carpets. This had not been done within the timescale set of 31/05/06. The need is now urgent. The carpets have not responded well to intensive shampooing. The appearance detracts from the general good of the home and may deter prospective residents. Requirements made in the previous inspection report had been addressed. The manager confirmed that a risk assessment had been undertaken regarding freestanding wardrobes and where necessary, these had been secured to the walls. Risk assessments had been undertaken in the bedrooms where there were areas with restricted headroom. Problems with the water system had been attended to. New pipe work and lagging had been installed where necessary. Housman Court DS0000018484.V308097.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 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 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 2 Housman Court DS0000018484.V308097.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Yes 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. 3. Standard OP19 Regulation 23 (2) (b) Requirement The registered provider must ensure that all areas of the home are in good order and well maintained. This requirement is outstanding from the previous report. The timescale of 31.05.06 was not met in regard to corridors and carpets. Timescale for action 31/12/06 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 2 Refer to Standard OP35 OP26 Good Practice Recommendations Receipts should be given for all monies received to be managed for residents or held in safe keeping for them. A second washing machine should be provided. 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