CARE HOME ADULTS 18-65
Huws Care Home 93 Harlaxton Drive Lenton Nottingham NG7 1JD Lead Inspector
Fiona Stephenson Unannounced Inspection 27 February 2006 10:30
th Huws Care Home DS0000026447.V275088.R01.S.doc Version 5.1 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.V275088.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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.V275088.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Huws Care Home Address 93 Harlaxton Drive Lenton Nottingham NG7 1JD 0115 9475799 0115 9243579 dbond.huwsefs@ntlworld.com 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) Elizabeth Fitzroy Support Mr David Bond Care Home 13 Category(ies) of Learning disability (13) registration, with number of places Huws Care Home DS0000026447.V275088.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 25th August 2005 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, and people employed by the Elizabeth Fitzroy charity staff this. Huws Care Home DS0000026447.V275088.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection, and was the second statutory inspection for the home in the year 2005-2006. The inspector focused on the care standards not addressed in the previous inspection, using an inspection method called ‘case tracking’. This means that the inspector looked at the care needs of two service users, and tracked their care through looking at their accommodation, checking their care notes, and the information relating to the staff that are their key workers. Due to people who live at the home having complex communication needs and limited understanding, the inspector was not able to speak directly with residents during the inspection. What the service does well: What has improved since the last inspection?
Systems have been introduced to improve the cleanliness of the home, and it is now in a good state of cleanliness. The complaints procedure now clearly shows the name, address and telephone number of the CSCI, giving service users and their relatives greater access to the regulatory authority should they wish to use it. Management of the home are now aware of their responsibilities to inform the CSCI and local contracting authorities if circumstances change in the home that may have an impact on the care being provided to service users. The sluice room and hallways are no longer being used for storage. The home has very few options for storage and the conservatory has been allocated as storage space, with equipment removed from the conservatory when service users are using it.
Huws Care Home DS0000026447.V275088.R01.S.doc Version 5.1 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Huws Care Home DS0000026447.V275088.R01.S.doc Version 5.1 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.V275088.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Prospective service users individual aspirations and needs are assessed. EVIDENCE: The home has not received any new service users for almost six years, however through looking at previous records, and through discussion with the acting manager, the inspector was satisfied that any potential service user would have their needs thoroughly assessed. Huws Care Home DS0000026447.V275088.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 Service users’ assessed and changing needs are documented well in their individual plan of care. EVIDENCE: The inspector checked the care files of two service users living at Huws. The care plans for one service user gave detailed information about all aspects of care, including emotional needs, physical needs, and social needs, and the likes and dislikes of the service user. The other care plan, again was detailed, however there was no information about their likes and dislikes. The acting manager informed the inspector that this should be in the file. The action plans also did not always have a review date so it was difficult to tell when the last review had taken place. Huws Care Home DS0000026447.V275088.R01.S.doc Version 5.1 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16,17 Service users have good opportunities for personal development. EVIDENCE: The care notes of the two service users case tracked demonstrated that they are engaged in activities appropriate to their needs and wants. The female service user case tracked goes to a day centre twice a week, and enjoys beauty therapy such as massage, and nail care. She also goes out on a one to one basis with her key worker to the shops, and has trips to the cinema. The other service user case tracked, goes to the day centre five times a week, has regular contact with his family, and enjoys going to shows and musicals. The inspector observed staff undertaking a cooking activity with service users on the day of inspection. Huws Care Home DS0000026447.V275088.R01.S.doc Version 5.1 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,20. Personal health care and support is good, although recent changes to medication collection means there is currently no audit for medication leaving the premises. EVIDENCE: Care plans and daily notes demonstrated that good thought had gone into ensuring that personal support is given in the way that service users prefer and need. Medication management is generally good. Qualified nurses administer medication, and records demonstrate correct administration. There were no medication disposal records. Management informed the inspector that disposal records had stopped when the company usually responsible for disposal of medicines changed contractor. This was recent, and management accepted they had not thought to continue to record the disposal to ensure an audit trail of medicines entering and leaving the home. Huws Care Home DS0000026447.V275088.R01.S.doc Version 5.1 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Not checked on this occasion. EVIDENCE: Huws Care Home DS0000026447.V275088.R01.S.doc Version 5.1 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,29,30. Service users live in a homely, comfortable and safe environment. EVIDENCE: The inspector checked all communal areas and bedrooms on the ground and first floor. All areas of the home were found to be clean and tidy. The communal areas were homely, and both the shared bedrooms and individual bedrooms were individualised to reflect the personalities and likes of service users who used them. The use of specialised equipment was evident in the home. Carpets in the lounge and hallways are satisfactory however they are looking worn in some places. Huws Care Home DS0000026447.V275088.R01.S.doc Version 5.1 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33,35. Staff are provided with good training opportunities to support them in meeting the needs of service users in their care. There are good staffing levels in the home. EVIDENCE: The inspector checked the staffing levels of the home and found them to be of a sufficient level to support the complex needs of people living at the home. As well as staff on duty within the home, there is also a separate staff team responsible for providing day care activities to service users in the adjacent day centre building. Training records of the staff responsible to the service users case tracked during the inspection were checked. Records showed that staff were provided with training to support them in their day to day work, with training such as ‘working with learning disabilities’, ‘health and safety, and ‘first aid’ being provided. Staff are also encouraged to undertake National Vocational Qualifications in care. Currently three of the 15 staff at the home have obtained an NVQ 3 in care practice; two people are undertaking an NVQ3 in care practice; and five are undertaking and NVQ 2 in care practice. Huws Care Home DS0000026447.V275088.R01.S.doc Version 5.1 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39 There is sufficient monitoring and review by the home to ensure the needs of service users are being met. EVIDENCE: The acting manager informed the inspector of quality standards called REACH standards that the home has adopted. Staff are currently looking at the REACH standard which is ‘I choose what happens in my home’. An example of change that has taken place as a consequence of this standard is to vary the menu with more cultural foods, and to support those service users who are able, to go and pick out foods they wish to eat. The inspector was informed that there is a high uptake of relatives attending yearly reviews and that there is an open culture in the home where relatives are able to express opinions. There is however, no formalised system where relatives or advocates can inform of their general views about the management of the home. Huws Care Home DS0000026447.V275088.R01.S.doc Version 5.1 Page 16 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 X 23 X ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 X 33 3 34 X 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X X X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 4 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 x 2 x X X 3 X X X X Huws Care Home DS0000026447.V275088.R01.S.doc Version 5.1 Page 17 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 YA20 Regulation 13(2) Timescale for action The registered person shall make 06/03/06 arrangements for the recording and disposal of medicines received into the home. Requirement 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 3 Refer to Standard YA39 YA24 YA6 Good Practice Recommendations Consider implementing a customer satisfaction survey to get the opinions of relatives and advocates who visit the home. Consider replacing the worn carpet in the lounge area and in the hallways. Consider ensuring that the care action plans are dated to inform the reader of the last review date, and to ensure that care files have all information (e.g. Likes and dislikes) to inform of the service users needs and wants. Huws Care Home DS0000026447.V275088.R01.S.doc Version 5.1 Page 18 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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