CARE HOMES FOR OLDER PEOPLE
Huyton Hey Manor Residential Care Home Huyton Hey Road Huyton Knowsley Merseyside L36 5RZ Lead Inspector
Mrs Lynn Paterson Unannounced Inspection 10:00 28th July 2006 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 DS0000021478.V295349.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. DS0000021478.V295349.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Huyton Hey Manor Residential Care Home Address Huyton Hey Road Huyton Knowsley Merseyside L36 5RZ 0151-489-3636 0151 426 6415 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) Cranford Care Homes Limited Miss Angharad Lloyd Williams Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30), Physical disability over 65 years of age of places (30) DS0000021478.V295349.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. Service users to include up to 30 OP and 30 PD(E) The service should employ a suitably qualified and experienced manager who is registered with the CSCI Date of last inspection Brief Description of the Service: Huyton Hey Manor is a care home registered to provide placements for 30 persons of the category old age. The home is situated in pleasant grounds in a residential area close to local amenities and Huyton Village centre. Accommodation is provided on three floors and there is a passenger lift to all levels. The home has a variety of aids and adaptations in place around the home to assist residents with mobility. Twenty-four of the bedrooms are single, three are double and none of the bedrooms have en suite facility. There are two communal toilets to the ground floor plus two bathrooms and toilet combined. There are two communal toilets to the first floor plus one shower and toilet combined and two communal toilets and one bathroom to the second floor. DS0000021478.V295349.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The unannounced inspection of Huyton Hey Manor was undertaken on 28th July 2006 and was carried out over a five-hour period. The inspector met with the manager, deputy manager, three staff members and 27 of the 28 residents in placement. . Records care files, policies procedures and other documentation was examined and a tour of the premises was carried out. Fieldwork included speaking with 2 resident’s family members and case tracking four residents, which involved reading all documentation relating to the residents daily living and speaking with the residents and staff who were associated with their care. What the service does well:
The home has continued to carry out refurbishment to the premises and the premises were clean and hygienic and bedrooms were personalised to reflect the choices of the residents. Residents spoken with said they were most happy with their surroundings and comments included: “This home has everything in it to make us comfortable and make us feel very much at home”, ”We love being here “, “ We have got nice views over the garden comfortable places to sit and relax and our own private rooms”. Staff retention and training is good with the responsible person and registered manager recognising the importance of NVQ and various specialist training to aid staff in their personal and professional practices. Staff said they feel valued in their work and able to carry out effective care practices for all the residents living in the home. Staff advised that the manager and her deputy were “very good at their jobs” and ran the home in the very best interests of the staff and the residents. DS0000021478.V295349.R01.S.doc Version 5.2 Page 6 Staff and residents interactions were seen to be of mutual respect and the manager advised that great emphasis is placed upon the staff being able to chat with residents to ensure they are happy with the services provided. What has improved since the last inspection?
The manager and staff were seen to have made many improvements to documentation and practices. This was seen to be most commendable. Care plans had been greatly improved and the care records were seen to be of a very high standard and held full information about care needs and how these needs would be met. Staff training continues to improve. Training is viewed as essential for the delivery of quality care and training commences with induction and is an ongoing process within the home. Information about the home has been revised to include good quality pre admission information a clear detailed statement of purpose. The home has employed a maintenance person who is on call to deal with general small maintenance work around the building. Fire and emergency lighting testing is now fully recorded. Senior Staff advised that they all have delegated responsibilities, which, they say, has improved their knowledge and understanding of the policies and procedures in the home. Quality assurance processes are undertaken on a regular basis to include residents meetings, general interactions between staff and residents and meetings with resident’s representatives.
DS0000021478.V295349.R01.S.doc Version 5.2 Page 7 A Whistle Blowing policy is in place and staff, were clear in their understanding of the content. It was noted that the home continues to update the premises to ensure that the building is equipped with the modifications necessary to support all the residents who reside therein. 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. DS0000021478.V295349.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 DS0000021478.V295349.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1.3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home provides clear information to enable people to make an informed choice about living in the home. Staff members ensure that all prospective residents are subject to a thorough assessment of need to ensure that the home has the facilities to meet all assessed need prior to admission. EVIDENCE: A statement of purpose was available with an abridged version serving as a service user guide. This information was clear and gave full details of the service provision of the home. Resident’s families advised that they felt the information about the home was clear and gave them a good insight into the service provided. The manager advised that she completed a needs led assessment prior to any resident being admitted to the home and files viewed showed that full pre
DS0000021478.V295349.R01.S.doc Version 5.2 Page 10 admission assessments were in place. These assessments were of a good quality and held valuable information about what care and support the person needed to enable them to live comfortably in Huyton Hey Manor. Three care files viewed at random held full detail of pre admission assessments being carried out and the three residents were spoken with and they confirmed that the manager had been to assess them prior to them being offered accommodation at the home. DS0000021478.V295349.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 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 excellent. This judgement has been made using available evidence including a visit to the service. Care plans have been reviewed and amended and hold clear detail of all social and heath care need and of how this need will be met. Medication is well managed by people who have full knowledge and understanding of all aspects of medication. EVIDENCE: DS0000021478.V295349.R01.S.doc Version 5.2 Page 12 Staff advised that care plans were available for all residents and are regularly reviewed. Staff revealed the content of care plans were discussed and agreed with each resident and this was confirmed by signatures of each individual. Residents spoken with said they had been involved in the recording of the care plan and had given their agreement for all care and support to be carried out. Residents revealed that they were asked their wishes about what they felt was the care they needed and comments included:“The staff always ask if we are comfortable with the care they give us”, “The staff chat with us all the time to make sure we are OK with the way they look aftre us”, “The staff give us choices of how we want to be looked after,for instance I did not want any help with dressing today so they left me to do it myself”. The level of detail in each care plan was such that it was felt that this standard had been exceeded. Records showed that Health needs were monitored on a daily basis and care plans viewed and discussions with service users confirmed that health needs had been met. Medication systems were good and provided independence for those who wished to deal with their own medication as well as systems for those who rely on staff assistance. Discussion were held with the deptuty manager who had the responsibility for medictaion management at the time of the visit and she displayed excellent knowledge and understadnding of all aspects of mediction to included administration ,recording ,storage and disposal. Staff observed carrying out their duties showed they assisted and supported each resident in a way that maximised independence and retained dignity and residents commnets included:“The staff are kind and really care for us”, “What a great bunch of staff work here”, “They are`always cheerful and make us fell good”, “They are angels,they look after our every need”. . DS0000021478.V295349.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 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. The judgement has been made using available evidence including a visit to the service. Residents are provided with a varied lifestyle, meals are wholesome, menus offer choice and residents generally enjoy their meals. EVIDENCE: Staff advised that activities are provided on a daily basis. These are audited with service users views being gained as to their preferences as well as the standard of activities provided and an activites prograame was seen in the home that held full infmrioan about daily activity input. Discussions with service users noted that they were invited to participate in activities and that they were not compulsory ‘you can either join in or stay in your room as you want’. It was noted that the home had a clear activities programme and staff advised that activities were offered ecah day and at the time of the visit it was noted that some residents were about to undertake an arrnaged outing to The Musuem Of Life at The Albert Dock.Liverpool. Resdinets spoken with said they
DS0000021478.V295349.R01.S.doc Version 5.2 Page 14 sometimes forgot about the arranged activities and as a consequmece “did not turn up for them”. Whilst it was noted that the home had full informaiton of daily activites in the main foyer of the home it is recommended that more informaiton be provived for the resiendts to ensaure that they gain maximum bebfnit from the varied activies provided. This is a good prectaice recommentaion and not seen as a shortfall of the home. Residents said they were encouraged to bring in Personal possessions to make them feel that they could make their own accomodation as home- like as possible.Staff said Advocacy services are also used on a regular basis an d residents spoken wit said they were aware that they could use advociates with one resident revealing that S/he was currently using external advocoay services which had been facilitated by the home. . The provision of food was found to be satisfactory. Service user comments ranged from ‘‘no complaints’, ‘reasonably varied’, ‘excellent’, ‘the chef is good’, ‘food is well presented’ and ‘you put pounds on’. A menu is available. Staff revealed that every effort is made to ensure that meals provided meet the needs and preferences of individuals. DS0000021478.V295349.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 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. The judgement has been made using available evidence including a visit to the service. Staff, receive clear ongoing training in respect of adult protection. Residents know the complaints procedures used by the home and are confident that any complaints made will be listened to, acted upon and quickly resolved. EVIDENCE: The complaints procedure is in place and residnets and thioer representatives spoken with said they knew about the complanits policy and what tp do of they needed to complain.. Staff records showed they receive training in protection of vulnerable adult procedures, have information available to them and are subject to a code of conduct designed to ensure full protection of all the people liivng in the home. DS0000021478.V295349.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 good. The judgement has been made using available evidence including a visit to the service. The manger has systems in place to ensure that residents live in a clean, hygienic safe and well maintained environment EVIDENCE: The home is purpose builit. Service users are able to mobilise around the building. This is assisted by the provison of aids and adaptations. The premises are clean and hygienic throughout. A system of maintenance is in place and this is aided by the employment of maintenance staff. Larger maintenance work is carried out by external contractors. The premises are well-decorated and well-maintained. DS0000021478.V295349.R01.S.doc Version 5.2 Page 17 DS0000021478.V295349.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 excellent. The judgement has been made using available evidence including a visit to the service. Staff, are employed in sufficient numbers and receive ongoing relevant training to ensure that are able to meet the needs of all individuals who live in the home. EVIDENCE: DS0000021478.V295349.R01.S.doc Version 5.2 Page 19 Staffing levels continue to meet previous staffing notices and there is a variety of staff designations that assist with the running of the service. Care Staff are employed with ancillary staff enabling care staff to concentrate on their tasks. Staff recruitment examined during this inspection focussed on recent appointments and the staff files viewed were noted to be in order. Staff spoken with said when they had been appointed, they were subject to a through induction in which they accompanied a senior member of staff for 2 days before they carried out any care practices. Staff files viewed showed that the home had strictly followed their rercuitment and section policy which appeared fair and equal and files held all appropriate checks and references which had been provided prior to appointment. Staff records showed that a structured training programme is in place to ensure that all staff are trained and competent to do their jobs. Records showed that the home manager encourgaes and supports staff to undertake training and staff said they feel valued and empowered by the knowlegde and skills they have gained. DS0000021478.V295349.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 excellent. The judgement has been made using available evidence including a visit to the service. The manager runs the home in the best possible interests of the residents and is totally supported in her task by the deputy and all the staff team. EVIDENCE: The Manager is experienced and qualified for the position and continues to receive training in respect of her role. She has recently obtained the Registered Managers Award. The management structure of the home is supplimented by the addition of a Deputy Manager. The home demonstrates an open philspohy with service users’ views being canvassed on a regular basis through the use of questionnaires in respect of
DS0000021478.V295349.R01.S.doc Version 5.2 Page 21 food, activities and general support,and the provision of regular residents meetings and newsletters in which the residenst are encourged to contribute articles. Staff supervision continues with all staff receving this on a regular basis. Health and safety systems were found to be in order on this visit. At the time of the visit there were twenty eight residents living in Huyton Hey Manor. All resinents were spoken with and they all stated their contentment with the staff and services provided. All service users said they were happy with the service and comments included:‘a marvellous place’ ‘can’t fault it’ ‘you could go a long way to find anywhere as good as this’ ‘staff are helpful’, “very good”. Staff spoken with said they felt the home was well managed by people who “knew what they were doing”. Comments included:“The manager and deputy delegate responsibilites to the staff. This makes us feel valued and part of the team”, “We are supported well by the managers,they are good at what they do and create a good atmosphere for us to work in”. “It is a nice place to work in,we all work together for the good of the residents”. Records show that all heath and safety training is carried out as appropriate and all essential service checks are carried out by people who are competent to do so. DS0000021478.V295349.R01.S.doc Version 5.2 Page 22 DS0000021478.V295349.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 3 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 4 10 4 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 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 X X 3 DS0000021478.V295349.R01.S.doc Version 5.2 Page 24 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. Standard Regulation Requirement Timescale for action 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 OP12 Good Practice Recommendations It is recommended that the manager ensure all residents have daily information of the activity arranged for each day. It was noted the home provides clear details in the foyer in booklet form of all the arranged activities but perhaps this information could also be available in the lift and added to the menu board and tables in the dining area. This would act as a reminder for every resident, and enable him or her to have informed choice in all aspects of their daily living. DS0000021478.V295349.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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