Inspection on 21/02/07 for Huws Care Home

This inspection was carried out on 21st February 2007.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Huws Care Home 19/03/09

Huws Care Home 27/02/06

Huws Care Home 21/02/05

Huws Care Home 24/06/04

Huws Care Home 25/11/03

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Huws Care Home 93 Harlaxton Drive Lenton Nottingham NG7 1JD Lead Inspector Stuart Hannay Key Unannounced Inspection 21st February 2007 10:30 Huws Care Home DS0000026447.V326651.R01.S.doc Version 5.2 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 Huws Care Home DS0000026447.V326651.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 Adults 18-65. 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. Huws Care Home DS0000026447.V326651.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Huws Care Home Address 93 Harlaxton Drive Lenton Nottingham NG7 1JD 0115 9475799 0115 9243579 huws@efitzroy.org.uk www.efitzroy.org.uk Elizabeth Fitzroy Support 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) Manager post vacant Care Home 13 Category(ies) of Learning disability (13) registration, with number of places Huws Care Home DS0000026447.V326651.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th February 2006 Brief Description of the Service: Huws care home provides nursing care and support to a maximum of 13 adults with complex learning and physical disabilities. The home is situated in an established residential area in the Lenton area of Nottingham, close to shops and local transport. Service users have the use of a communal dining room, a quiet lounge, a main lounge and conservatory. There are five single bedrooms and four shared bedrooms. There is a separate day centre adjacent to the home for service users. Huws Care Home DS0000026447.V326651.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection for the home and lasted for around 6 hours. The assistant manager, the regional manager and two support workers were interviewed. The following records were checked: the staffing rota, staff training, fire drills, health and safety certificates and three service users’ care plans. An inspection was made of the buildings and the gardens. The inspector met with all the service users who were present in the home but did not conduct formal interviews. What the service does well: There was a relaxed and friendly atmosphere at the home on the day of the inspection. Staff were friendly and respectful towards the service users. All of the service users have lived at Huws for at least five years and the routines appeared to be flexible; staff said that service users were supported to attend their day placements and other activities but generally they were free to spend their time as they wished. Staffing levels were well maintained and the staff interviewed felt that these were currently sufficient. There are staff hours available to help service users take part in social activities or to provide extra care at the home if necessary. The staff were knowledgeable about the service users and could speak in detail of their differing abilities; there was a positive attitude observed towards the service users, both in the interaction between staff and service users and in the written records. Although the service users did not often use words to describe how they felt, the staff were very aware of non-verbal information and responsive to the service users’ wishes. Staff had received statutory training and training relating to understanding the needs of the service users. They received professional supervision and generally felt that their managers were supportive. Comprehensive checks had been made on staff when they were recruited and there is a detailed induction programme for new starters. The home was clean and tidy. Effort had been taken to ensure that there is a ‘homely’ feel to the building, including the bedrooms, which were pleasantly decorated and furnished. In the forthcoming year there are plans to convert the day centre building into service user accommodation, ensuring that all service users will have their own rooms. The décor was reasonable in the home and the assistant manager said that areas in the home would be refurbished after the completion of the new accommodation as changes would also be made to the existing building. Huws Care Home DS0000026447.V326651.R01.S.doc Version 5.2 Page 6 The home has complaints procedures and staff interviewed were aware of the adult protection procedures. There were no obvious health and safety hazards noted on the day of the inspection and the fire alarm and emergency lighting systems had been regularly tested and serviced. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Huws Care Home DS0000026447.V326651.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Huws Care Home DS0000026447.V326651.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A full assessment is made of potential service users prior to them coming to the home to ensure that the service is suitable and their needs could be met. EVIDENCE: There have been no new admissions to the home for several years. Assessments of service users’ needs had been made in the three service users’ plans that were checked. Staff interviews indicated that the staff had good knowledge of the service users needs. Huws Care Home DS0000026447.V326651.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A ‘person centred plan’ is maintained which identifies how service users would wish to live and how their healthcare needs should be met. This ensures that the needs and wishes of the service users are clearly spelled out and staff can take appropriate action to meet these. EVIDENCE: Three care plans were examined in detail. The care plans seen were comprehensive and described in clear detail how the service users would wish to live their lives and what action staff needed to take to enable them to do this. The plans included photographs of the service users and people who are important to them. Their health and personal care needs had been assessed and any contacts with health professionals were recorded, including any prescribed treatments. The plans also focussed on how the service users communicate their needs and identified triggers to challenging behaviours. Huws Care Home DS0000026447.V326651.R01.S.doc Version 5.2 Page 10 Risk assessments were completed for every area of activity and the plans had been regularly reviewed. Huws Care Home DS0000026447.V326651.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are able to take part in activities, which they enjoy. Links with families are encouraged and supported so that service users can maintain important relationships. Dietary needs and preferences are recorded in care plans to ensure well - balanced diets are provided. EVIDENCE: Service users’ plans included leisure and social activities and identified specific things that they enjoyed doing. As well as informal activities, such as shopping trips, restaurant and pub visits, there were a number of organised activities. Activities were taking place in the home on the day of the inspection, including arts and crafts; other service users were involved trips with staff to planned placements or to take part in social activities. Activities were tailored to the individual needs of service users and staff ensured that service users with higher levels of need did not miss out on trips – staff interviewed said that the good staffing levels enabled them to do this. Service users also go on holidays. Huws Care Home DS0000026447.V326651.R01.S.doc Version 5.2 Page 12 The care plans checked included information about maintaining and encouraging links with the families in line with what service users wanted. Dietary likes and dislikes were recorded in the care plans as well as information pertaining to health issues around diets such as diabetes. Huws Care Home DS0000026447.V326651.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 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 this service. Service users plans identify clearly how personal care should be provided in live with their preferences, showing that their views are taken into account. There is a focus on the well being of the service users, which includes their physical and emotional health. The medication system was generally well managed but storage is not completely safe and the administration of records is not fully accurate. EVIDENCE: Information about how service users would like personal care to be provided to them is recorded in a detailed and sensitive way, ensuring that the care can be provided successfully. The plans are reviewed regularly to ensure that health and personal care needs are being met effectively. Service users have been assessed as to whether they can look after their own medication but it was felt that there were no service users at present who could safely do this. The medication storage system was checked. Medication was locked in cabinets and in the medication fridge, however the treatment room did not have a lock on the door. The assistant manager explained that the medication had only recently been moved into this room and that a new lock was due to be fitted. All the prescription information was clearly visible on bottles and boxes and the assistant manager said the home’s pharmacist has checked the system. Huws Care Home DS0000026447.V326651.R01.S.doc Version 5.2 Page 14 The records of administration were fully completed with no gaps on the recording sheets. On two service users’ sheets, handwritten entries had been made of medication received into the home, or amendments to dosages of the printed information from the pharmacist. The person making the entry had not signed these nor had a witness signed to show that the information had been checked and was accurate. Huws Care Home DS0000026447.V326651.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had a complaints procedure that is clear and accessible and includes all the required information to allow service users and their advocates to raise concerns. Adult protection policies and procedures are in place and staff receive regular training in identifying and reporting any issues; this reduces the risk to vulnerable service users. EVIDENCE: The home’s complaints procedures had been checked on previous inspections and identified that service users, staff and relatives had access to a clear procedure, which enables them to make complaints. The procedures themselves were not checked during this inspection but staff interviewed said that they had not changed. One neighbour had raised a concern with the manager about a building issue – this was fully recorded and had been addressed. No complaints had been received about the service, either to the home or to the Commission For Social Care Inspection. Previous inspections have identified that the home has good Adult Protection procedures. The procedures themselves were not checked on the day. Staff interviewed were able to clearly describe any action they would need to take to report concerns and had undertaken training on the recognition and reporting of abusive practice. Huws Care Home DS0000026447.V326651.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home was clean, comfortable and generally well maintained enabling service users to live in a pleasant environment. Service users have access to a good range of communal and private space allowing for a homely, noninstitutional atmosphere. Some of the décor and the fittings and fixtures in the communal areas are not in good condition. EVIDENCE: All areas of the home were clean and tidy on the day of the inspection. Service users’ bedrooms were highly personalised and well decorated. Service users can have access to their rooms whenever they wish. They had been involved in deciding how the rooms would be decorated choosing colours or wallpapers. The communal areas were pleasantly decorated with a ‘homely’ feel. Eight of the twelve service users currently share a room. Huws Care Home DS0000026447.V326651.R01.S.doc Version 5.2 Page 17 The landscaped gardens were secure, attractive and accessible to all the service users. Some parts of the home were in need of redecoration and, as identified in the previous report, some carpets were looking worn. The home’s assistant manager and area manager said that there is to be major building work commencing in June 2007 to convert the adjacent day centre into more living accommodation. This will enable all the service users to have their own bedroom and more personal space. As a consequence, there will be building work in the existing part of the home and therefore they did not want to start refurbishment until this is finished. Huws Care Home DS0000026447.V326651.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 and 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff were well trained and deployed in numbers which supported the service users in leading fulfilling lives. Checks were made on staff before they started work at the home to ensure that vulnerable people were protected. Staff receive regular professional supervision to ensure that they have the skills, training and aptitude to provide support to service users. EVIDENCE: Staff at the home had received a range of statutory training and training related to the specific needs of service users. Those interviewed were knowledgeable, not only about the specific needs of the service users, but also their individual personalities. Two support workers were spoken with and they both felt that they felt they worked well as a team. The recruitment records of two employees were checked and these contained the required information: application forms, employment histories, references, CRB and POVA checks. All staff interviewed had received regular professional supervision from their line managers. Huws Care Home DS0000026447.V326651.R01.S.doc Version 5.2 Page 19 All statutory training for staff was up to date. This included moving and handling training, food hygiene training, health and safety, first aid and fire safety. There is a detailed induction programme for new staff; one recently recruited support worker interviewed said that she had received all her statutory training within weeks of starting at the home, that she received regular supervision and support from her mentor and had worked as a supernumerary member of the team for a number of shifts. Huws Care Home DS0000026447.V326651.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 ,42 and 43 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had effective management systems in place and the service users care and lifestyle needs were considered as a priority. Effective health and safety systems were in place to minimise the risk to service users and staff. The building was safe without any obvious risks to service users. The home has not provided regular monitoring reports. EVIDENCE: The home does not have a registered manager at present. Two staff members interviewed said that the senior staff and the assistant manager are very approachable and supportive, taking their views and concerns seriously. Although the service users were not able to express their views verbally, from observation of the care, the care plans and interviews with staff, it would Huws Care Home DS0000026447.V326651.R01.S.doc Version 5.2 Page 21 appear that their needs are considered as paramount in the provision of the service. The fire training was up-to-date and alarm testing records were fully completed. Fire drills had been carried out at regular frequencies and staff members interviewed were able to explain the procedure to be followed in the event of a fire. The home had records to show that the fire alarm and nurse call systems had been checked annually. The home’s line manager makes regular visits to the home, however she has not provided monthly written records of these. Huws Care Home DS0000026447.V326651.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 Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 x 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 3 2 Huws Care Home DS0000026447.V326651.R01.S.doc Version 5.2 Page 23 YES Are there any outstanding requirements from the last inspection? 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 YA20 Regulation 13(2) Requirement The registered provider must ensure that medication is stored in a secure manner. Timescale for action 01/04/07 2. YA20 13 (2) 3. YA24 23 2 (b) 4. YA43 26 (4) (c) The registered person must 01/04/07 ensure that all records used in drugs and medical administration are signed and documented correctly. The registered person must 01/09/07 ensure that all areas of the home must be well maintained. Redecorated following the building work is required. Worn and damaged carpets must be replaced. Monthly monitoring visits must 01/04/07 be undertaken and records kept. A copy of the report must be sent to the CSCI office. Huws Care Home DS0000026447.V326651.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. Refer to Standard Good Practice Recommendations Huws Care Home DS0000026447.V326651.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Huws Care Home DS0000026447.V326651.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. 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