Inspection on 03/09/07 for Iris Hayter House

This inspection was carried out on 3rd September 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Iris Hayter House 17/01/07

Iris Hayter House 14/02/06

Iris Hayter House 26/07/05

Iris Hayter House 28/02/05

Iris Hayter House 26/08/04

Iris Hayter House 17/02/04

Iris Hayter House 14/08/03

Iris Hayter House 15/08/02

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

CARE HOME MIXED CATEGORY MAJORITY ADULTS 18-65 Iris Hayter House 43 Sandford Road Littlemore Oxfordshire OX4 4XL Lead Inspector Kerry Kingston Unannounced Inspection 3rd September 2007 10:30 Iris Hayter House DS0000013093.V344392.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 Iris Hayter House DS0000013093.V344392.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 and 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. Iris Hayter House DS0000013093.V344392.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Iris Hayter House Address 43 Sandford Road Littlemore Oxfordshire OX4 4XL 01865 749560 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) info@response.org.uk Response Organisation Mrs Rachel Bronwyn Whitehall Care Home 13 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (13), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (13) Iris Hayter House DS0000013093.V344392.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The total number of persons that may be accommodated at any one time must not exceed 13. 17th January 2007 Date of last inspection Brief Description of the Service: Iris Hayter House is a large bungalow located on the outskirts of Oxford city. The accommodation comprises of a number of communal areas ( lounges and a dining room) with nine single and two double rooms. The home provides 24-hour support to 13 people who have mental health support needs. The majority of residents have been discharged from a hospital setting but continue to require support and accommodation. The staff provide close and continued links with individuals community mental health teams and all relevant professionals, such as psychiatrists, community psychiatric nurses (CPN) and social workers. All residents receive support to develop an individualised care programme. Residents are encouraged to use local community facilities. The fees are £490 per week. Iris Hayter House DS0000013093.V344392.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is a report for the key inspection of the service, which included a routine unannounced site visit. This took place between the hours of 10.30am and 4.30pm on the 3rd September 2007. The information was collected from the previous Inspection report completed in January 2007, surveys which were sent to people who use the service, other professionals and families of residents. 11 surveys were returned to the Commission, two from another professionals, one from a family member, six from people who use the service and two from the General Practitioner Surgeries used by the residents. Discussions with two staff members and the Registered manager took place. Five people who use the service spoke with me during the visit and some observations and further discussions took place throughout the visit. A tour of the home and reviewing residents’ and other records were also used to collect information on the day of the visit. What the service does well: What has improved since the last inspection? The home has looked at the activities and what people do in and outside of the home and are trying to find ways to get people more interested in doing things, to make their life more interesting. Iris Hayter House DS0000013093.V344392.R01.S.doc Version 5.2 Page 6 Staff know how to make sure that the people who live in the home are protected and not treated badly. The home makes sure that it has all the paperwork to prove that staff are safe to work with the residents. 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. Iris Hayter House DS0000013093.V344392.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Individual Needs and Choices Lifestyle Personal and Healthcare Support Concerns, Complaints and Protection Environment Staffing Conduct of Management of the Home Scoring of Outcomes Statutory Requirements Identified During the Inspection Adults 18 – 65 (Standards 1–5) (Standards 6-10) (Standards 11–17) (Standards 18-21) (Standards 22–23) (Standards 24–30) (Standards 31–36) (Standards 37-43) Older People (Standards 1–5) (Standards 7, 14, 33 & 37) (Standards 10, 12, 13 & 15) (Standards 8-11) (Standards 16-18 & 35) (Standards 19-26) (Standards 27-30 & 36) (Standards 31-34, 37 & 38) Iris Hayter House DS0000013093.V344392.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 (Adults 18 – 65) and Standards 1 – 5 (Older People) are: 1. 2. 3. Prospective service users have the information they need to make an informed choice about where to live. (OP NMS 1) Prospective users’ individual aspirations and needs are assessed. No service user moves into the home without having been assured that these will be met. (OP NMS 3) Prospective service users’ know that the home that they choose will meet their needs and aspirations. Service Users and their representatives know that the home they enter will meet their needs. (OP NMS 4) Prospective service users’ have an opportunity to visit and “test drive” the home. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. (OP NMS 5) Each service user has an individual written contract or statement of terms and conditions with the home. Each service user has a written contract/statement of terms and conditions with the home. (OP NMS 2) 4. 5. The Commission considers Standard 2 (Adults 18-65) and Standards 3 and 6 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 (3) People who use the service experience good quality outcomes in this area. The home fully assesses prospective residents to ensure that it can meet their needs. The person who may use the service is involved in the assessment process and is able to choose whether they wish to live there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home uses a ‘Combined Assessment Pack’ form. This includes assessment of individuals’ history, personal skills, financial status, personal abilities, mental health needs, and risk. A ‘Needs Assessment Form’ includes information on the person’s likes and dislikes, medication, general health, social needs and social relationships. Iris Hayter House DS0000013093.V344392.R01.S.doc Version 5.2 Page 9 The manager liaises with health and social care professionals as required, the admissions process is activated and a review takes place six weeks after admission to check suitability of placement. The newest person was admitted to the home approximately two weeks prior to the inspection visit, they have been on a waiting list for the service since 2003. A full assessment was completed on the 6th June 2007 and The Community Psychiatric Assessment Care Plan was reviewed in July 07. The home has a transitional/settling in programme, which includes staff from the residents’ previous home visiting once a week, to help with the process. The home has an admission process and procedure that may include visits and tea visits, as are appropriate for the individual. Care plans are written prior to admission or soon after (from the assessments) with the resident and include maintenance of independence, such as going out unaccompanied, risk assessments, a tenancy agreement, service user guide and the amount the resident pays towards fees. Residents, generally retain the support of the Community Psychiatric Nurses and /or their Care managers. People confirmed that they had been involved in the assessment process and their views had been sought, that is five of six surveys, noted that they had visited the home prior to admission, one survey said that they had not been given enough information about the service. The home does not provide intermediate care. Iris Hayter House DS0000013093.V344392.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6-10 (Adults 18-65) and Standards 7, 14, 33 & 37 (Older People) are: 6. Service users know their assessed and changing needs and personal goals are reflected in their Individual Plan. The Service Users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users make decisions about their lives with assistance as needed. Service Users are helped to exercise choice and control over their lives. (OP NMS 14) Service users are consulted on, and participate in, all aspects of life at the home. The home is run in the best interests of service users. (OP NMS 33) Service users are supported to take risks as part of an independent lifestyle. The service users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users know that the information about them is handled appropriately and that their confidences are kept. Service Users rights and best interests are safeguarded by the home’s record keeping, policies and procedures. (OP NMS 37) 7. 8. 9. 10. The Commission considers Standards 6, 7 and 9 (Adults 18-65) and Standards 7, 14 and 33 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6(7), 7(14) and 9. Standard 33 is assessed in Conduct and Management of the Home. People who use the service experience good quality outcomes in this area. The home ensures that they can meet the assessed and changing needs of the people, who use the service, by developing written, individual care plans with them. People are encouraged to be involved in the care planning and review process. Residents are supported to make as many decisions as they can for themselves and are allowed to take risks so that they are able to retain as much independence, as they are able for as long as possible. This judgement has been made using available evidence including a visit to this service. Iris Hayter House DS0000013093.V344392.R01.S.doc Version 5.2 Page 11 EVIDENCE: Three residents care plans were seen, all have a full ‘needs assessment’ which include specific assessments for particular areas of care such as a ‘Bartel’ assessment which identifies the amount of personal care support needed. Health needs assessments and records such as weight charts are completed as necessary. Care plans are developed with residents from initial assessments, monthly evaluations of the plans are discussed with residents and any changes and views from the individual are noted. The care planning process is very inclusive and residents confirmed that they were as involved in it as they wished to be. Other professionals are included in the care planning process, as appropriate. The plans set out any specialist needs that residents may have, such as the monthly support of a community psychiatric nurse. People all have an allocated Key worker. Residents know who their Key workers and care managers are, a survey received from a care manager noted they were ‘very pleased with the care my client receives’. Care plans recognise peoples rights to make their own decisions, five of six surveys noted that people can ‘always make decisions for themselves’ and one said ‘usually’. Residents meetings are held, and four people said that they can ‘make decisions and choices for themselves’. The organisation has a residents’ forum which meets every three months but residents from the home do not attend with any regularity. There is information about how to access advocates and advocacy groups on display in resident areas and they are mentioned in the complaints procedure and the Service User’s guide. Residents’ views are sought in the annual survey in which the questionnaire on ‘Living in the Home’ is completed. Risk assessments are in place to maintain independence such as the newest resident continuing to accesses the community independently. Some assessments are not very detailed and there are omissions with regard to some areas where risk assessments may now be appropriate due to peoples’ increasing needs, such as bathing, falling and not leaving the house due to lack of motivation. Iris Hayter House DS0000013093.V344392.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 (Adults 18-65) and Standards 10, 12, 13 & 15 (Older People) are: 11. Service users have opportunities for personal development. 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. (OP NMS 12) Service users are able to take part in age, peer and culturally appropriate activities. 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. (OP NMS 12) Service users are part of the local community. Service users maintain contact with family/ friends/ representatives and the local community as they wish. (OP NMS 13) Service users engage in appropriate leisure activities. 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. (OP NMS 12) Service users have appropriate personal, family and sexual relationships and maintain contact with family/friends/representatives and the local community as they wish. (OP NMS 13) Service users’ rights are respected and responsibilities recognised in their daily lives. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users are offered a (wholesome appealing balanced) healthy diet and enjoy their meals and mealtimes. Service users receive a wholesome appeaing balanced diet in pleasing surroundings at times convenient to them. (OP NMS 15) 12. 13. 14. 15. 16. 17. The Commission considers Standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 10, 12, 13 and 15 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Iris Hayter House DS0000013093.V344392.R01.S.doc Version 5.2 Page 13 12 (12), 13(13), 15, 16(10), 17(15). People who use the service experience adequate quality outcomes in this area. The people who use the service are happy in the home, they pursue a lifestyle that they choose but they could be given more encouragement to participate in activities inside and outside the home. The home is developing activity programmes and opportunities for more community presence. People are encouraged to retain links with friends and families and are offered healthy and nutritious food. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Nine of the 13 residents are aged 70 and above, many people who used to be quite active now choose not to pursue activities that are offered. Three venues/clubs are available to residents three days per week but few people attend. A staff member has been appointed as the activity co-ordinator, which she does alongside her other duties. She has developed an ‘in-house’ activities programme for four days per week, for a few hours per day this includes, knitting, a musical evening, a film night, gentle exercise and quizzes. The home is also attempting to organise trips out but some people have a motivation issue that may need to be addressed with them as individuals. The co-ordinator said that the ‘in house activities’ are slowly becoming more popular and further work is being done with regard to activities and community presence. It was discussed with the manager that more accurate recording of activities offered and participated in may help in the identification of popular activities and whether people had made choices about participation. The home has use of a vehicle, whenever they wish to use it. It is not kept at the home because of security reasons but can be accessed, easily whenever it is required (the organisation has three minibuses available to its’ services in Oxford). Some residents receive the mobility element of the Disability Living Allowance and are able to access taxis and public transport as necessary. Three people said that they have ‘plenty to do, they sometimes enjoy going out but make their own choices’. One resident has just started to attend clubs again and chooses not to join in with ‘on-site’ activities. One resident said that they ‘enjoy things happening in the home’ but another said that they ‘prefer to do their own thing’. Iris Hayter House DS0000013093.V344392.R01.S.doc Version 5.2 Page 14 The home has two televisions, DVD/video players, board games, books and newspapers. People have their own choice of entertainment in their rooms and several said that they prefer to ‘be in their rooms and do what they enjoy’. The Manager confirmed that the work with regard to motivating people and offering further activities will continue with the activities co-ordinator taking the lead in this area. Ten people have links with families or friends, one visits the family home every weekend, and others visit on occasion as well as having visitors in the home. The three people who have no have no personal/social contacts are encouraged to have advocates if they choose. Residents are very positive about the home the six surveys returned had no negative comments, one said ‘I wouldn’t want to live anywhere else’. On the day of the visit people said ‘staff are very good’, ‘I like living here, it’s a good place to live’. People were seen choosing what to do and when to do it. Staff were observed being sensitive and respectful when dealing with people and responding quickly to requests or when people had personal needs they may not have recognised for themselves. Residents were at all times treated with dignity and discretion. Some people help with clothes laundering and bedroom tidying but due to age many do not. Menus are organised daily as people are given choice about what food to eat, there are always alternatives and people can help themselves whenever they wish. Menus are varied and peoples’ diverse needs are catered for, weight charts if there are any nutritional issues or if they are necessary to safeguard someones’ well-being. One person has had a recent hospital admission because of aspiration, causing a chest infection but the hospital confirmed that this was not an ongoing problem, this was discussed with the deputy manager, who agreed to get some written confirmation of this advice. Three people confirmed that they thought the food was good and they could choose what they wanted to eat and when. A mealtime was observed and people were encouraged to eat at their own pace and were assisted as appropriate. Iris Hayter House DS0000013093.V344392.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 – 21 (Adults 18-65) and Standards 8 – 11 (Older People) are: 18. 19. 20. Service users receive personal support in the way they prefer and require. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users’ physical and emotional health needs are met. Service users’ health care needs are fully met. (OP NMS 8) 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. Service users, where appropriate, are responsible for their own medication and are protected by the home’s policies and procedures for dealing with medicines. (OP NMS 9) The ageing, illness and death of a service user are handled with respect and as the individual would wish. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. (OP NMS 11) 21. The Commission considers Standards 18, 19 and 20 (Adults 18-65) and Standards 8, 9 and 10 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18(10), 19(8), and 20(9). People who use the service experience good quality outcomes in this area. The home ensures people are supported to look after their personal and health care needs, in the way that they prefer and medication is administered safely. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The individual care plans noted peoples likes/dislikes and preferences and staff were seen interacting with people in very individual ways according to their needs and preferences. Equipment is supplied as necessary to meet any diverse physical needs and people were seen to be dressed according to their own choice and taste. Iris Hayter House DS0000013093.V344392.R01.S.doc Version 5.2 Page 16 Healthcare records showed all contacts with the G.Ps, District nurses and other healthcare professionals. Surveys received from two G.P. surgeries and one Community Psychiatric Nurse were positive about the care received by their patients, they expressed no complaints or concerns. Healthcare Charts are kept if necessary such as weight charts, hospital admissions and diabetes checks. The home works closely with the Specialist mental health services, which are accessed through the Community Mental Health Team, and it also used to access podiatry, dentistry and an optician. District nurses are accessed through the GP. Tissue viability nurses and special equipment (such as pressure relieving mattresses) are arranged through district nurses, as necessary. The home liaises with the resident’s GP, district nurses and other healthcare services as required. There have been two deaths since last inspection (natural causes). The home has a policy to guide staff caring for a resident who is dying and in the event of death. Staff have experience of such events and the organisation provides training on loss and bereavement. The medication policy and procedure is robust, medication is administered by two staff, the administration procedure was observed on the day of the visit. All staff are assessed as competent by the manager before they are able to administer medication. Staff work alongside experienced colleagues until they have been assessed as competent, six staff have additionally gained a certificate in medication, all staff will attend this certificated course. All residents take medication, nobody self-administers, and the manager advised that this is noted as part of care plan but she will consider whether risk assessment in this area is appropriate. The manager advised that there have been no medication errors since the last inspection. The home uses the NOMAD system of administration, which is a controlled system used by the pharmacy who offer the service to the home. The pharmacist visits twice a year and completes a report for the home, the manager advised that there have been no issues since the last inspection. Medicines are stored in a portable metal cabinet, which is kept in a locked office when not in use. Medicines requiring cool storage are kept in the fridge in the office in individual containers. The administration records sheets seen were accurate. The home does not have individual guidelines/protocols for the administration of medication that is prescribed to be given ‘as necessary’. One person has some ‘as necessary’ medication to be given for ‘agitation’, there is no description or guidance as to how they present the ‘agitation’. This issue was discussed with the manager, who agreed to address it. Iris Hayter House DS0000013093.V344392.R01.S.doc Version 5.2 Page 17 Iris Hayter House DS0000013093.V344392.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22-23 (Adults 18-65) and Standards 16-18 & 35 (Older People) are: 22. 23. Service users feel their views are listened to and acted on. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted on. (OP NMS 16) Service users’ are protected from abuse, neglect and self-harm. Service users legal rights are protected. (OP NMS 17) Also Service users are protected from abuse. (OP NMS 18) Also Service users financial interests are safeguarded. (OP NMS 35) The Commission considers Standards 22-23 (Adults 18-65) and Standards 16-18 and 35 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22(16 and 23(18). People who use the service experience good quality outcomes in this area. The home ensures people know how to complain and listens to and acts upon their views. People are, generally, protected from all forms of abuse but they need support to ensure they are aware of their overall financial status. The people who use the service feel safe in the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a robust complaints policy and procedure, it is available in the office and the residents’ communal areas. The home retains a record of complaints. No complaints have been recorded or received since the last inspection. Five of six surveys said that people ‘would know who to complain to if they were unhappy’, one said they ‘wouldn’t’. Five people spoken to said they ‘felt safe’ and would ‘know who to tell if they were unhappy.’ The home has a ‘safeguarding adults policy,’ most staff received Protection of Vulnerable Adults Training approximately three years ago but all have either had the training up-dated or are to attend a safeguarding adults training day in Iris Hayter House DS0000013093.V344392.R01.S.doc Version 5.2 Page 19 September. This is to be provided by the Local Authority Safeguarding Adults Co-ordinator. Staff spoken to were confident in the manager and provider to keep residents safe and they gave a clear description of how they would deal with any suspicion of abuse or concerns that residents were not safe. The Commission for Social Care Inspection has received no information with regard to complaints or Safeguarding Adults issues, about this home, since the last inspection. People who use the service rarely display any aggressive behaviour and therefore behavioural guidelines are not necessary. The home does not use physical restraint but staff are taught ‘diffusion’ techniques as part of their induction training. Two financial records were looked at and there was a discussion with regard to receipts for ‘joint’ large expenditure being numbered or identified in some way so that they can be easily cross referenced with individuals personal monies. Peoples’ cash was counted and was accurate, although the figures had to be adjusted. Residents are not provided with clear receipts or information about their care contributions and the manager is not aware of their incoming and outgoing finances, there is some financial information in files but this needs to be matched with financial records, such as the amount that residents contribute to their care costs being reflected by dates when those contributions are made by the individuals. Iris Hayter House DS0000013093.V344392.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 (Adults 18-65) and Standards 19-26 (Older People) are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users live in a safe, well-maintained environment (OP NMS 19) Also Service users live in safe, comfortable surroundings. (OP NMS 25) Service users’ bedrooms suit their needs and lifestyles. Service users own rooms suit their needs. (OP NMS 23) Service users’ bedrooms promote their independence. Service users live in safe, comfortable bedrooms with their own possessions around them. (OP NMS 24) Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Service users have sufficient and suitable lavatories and washing facilities. (OP NMS 21) Shared spaces complement and supplement service users’ individual rooms. Service users have access to safe and comfortable indoor and outdoor communal facilities. (OP NMS 20) Service users have the specialist equipment they require to maximise their independence. Service users have the specialist equipment they require to maximise their independence. (OP NMS 22) The home is clean and hygienic. The home is clean, pleasant and hygienic. (OP NMS 26) The Commission considers Standards 24 and 30 (Adults 18-65) and Standards 19 and 26 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24(19) and 30(26). People who use the service experience good quality outcomes in this area. The home provides a comfortable, clean and pleasant living environment for the people who use the service This judgement has been made using available evidence including a visit to this service. EVIDENCE: On the day of the visit the home was clean and comfortable, people were using both the lounges and their private rooms. Iris Hayter House DS0000013093.V344392.R01.S.doc Version 5.2 Page 21 The home is adequately decorated and in reasonable repair. Some furniture, particularly in the smoking lounge is beginning to look ‘tired’ but is still comfortable. The garden is in need of attention, it looked untidy and unattractive but is still used by residents, weather permitting. The shared bedrooms were seen, they looked comfortable and had curtains to allow as much privacy as possible. The manager said that some people like sharing and this is checked with them, on occasion. Staff noted that the home sometimes ‘felt’ a bit small possibly because people do not go out as much as they used to. The smoking room is well used as the majority of residents choose to smoke. Special adaptations and equipment are provided if necessary, to help with peoples’ special and diverse physical needs. There is a piano in the large lounge, which is played by an individual and enjoyed by others. The kitchen was very clean and hygienic on the day of the visit and an Environmental Health Officers’ visit in 0ctober 2006, resulted in no requirements or recommendations. The Laundry is well kept and tidy and residents’ clothes are washed separately to reduce the risk of cross- infection. There is a cross-infection policy in place and lidded bins are supplied as necessary. Iris Hayter House DS0000013093.V344392.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 (Adults 18-65) and Standards 27 – 30 & 36 (Older People) are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users are supported by competent and qualified staff. Service users are in safe hands at all times. (OP NMS 28) Service users are supported by an effective staff team. Service users needs are met by the numbers and skill mix of staff. (OP NMS 27) Service users are supported and protected by the home’s recruitment policy and practices. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users’ individual and joint needs are met by appropriately trained staff. Staff are trained and competent to do their jobs. (OP NMS 30) Service users benefit from well supported and supervised staff. Staff are appropriately supervised. (OP NMS 36) The Commission considers Standards 32, 34 and 35 (Adults 18-65) and Standards 27, 28, 29 and 30 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32(28), 33(27), 34(29) and 35(30). People who use the service experience good quality outcomes in this area. The home has an effective and well- trained staff team who are able to meet the needs of the people who use the service. The provider has the expectation that staff will take up the opportunities offered to them for professional training. The home has the proper records to ensure staff are safe to work there, from their first day. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Iris Hayter House DS0000013093.V344392.R01.S.doc Version 5.2 Page 23 The home has 14 staff, including two part time staff members and two waking night staff. Five staff have NVQ 2 or above and one is half way through her qualification, two staff have just registered for their N.V.Q. course. Several staff members have many years experience and all but one staff member have been working in the home for over a year. Staffing contracts include the clause that staff must register for N.V.Q. within six months of employment, training to N.VQ 2 is now part of the conditions of employment for new staff. The home has no staff vacancies, it is a permanent staff team with experience and knowledge of the residents needs. Staff were observed interacting very effectively and positively with residents on the day of visit. Staff communicated well with each other and with the residents. There are low sickness rates and low staff turnover. The shift pattern is three staff between 8am and 5pm and two between 5pm and 11pm, there is one waking night staff and one person sleeping in. The manager is supernumerary to care staff (generally), additional staffing can be made available for specific activities or special occasions but there were no records of this on the day of the visit. Records for two staff were seen and all the necessary documentation was available in the files. The files had been collected from head office by the manager on the day of the visit, but a checklist of the documentation is kept within the home, the manager sees all the documentation held at head office prior to a staff member starting work in the home. The home has an individual and home training programme, staff are supervised two monthly or more as necessary and training is provided as necessary. Training is provided for the specific needs of individual service users such as diabetes, mental health courses and diversity and equality. All mandatory Health and Safety courses are up-to-date and Safeguarding Adults training is to be completed with the Oxfordshire Safeguarding Adults coordinator in September 2007. Iris Hayter House DS0000013093.V344392.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 (Adults 18-65) and Standards 31-34, 37 & 38 (Older People) are: 37. Service users benefit from a well run home. 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. (OP NMS 31) Service users benefit from the ethos, leadership and management approach of the home. Service users benefit from the ethos, leadership and management approach of the home. (OP NMS 32) Service users are confident their views underpin all self-monitoring, review and development by the home. The home is run in the best interests of service users. (OP NMS 33) 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 homes record keeping, policies and procedures. (OP NMS 37) Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping policies and procedures. (OP NMS 37) The health, safety and welfare of service users are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (OP NMS 38) Service users benefit from competent and accountable management of the service. Service users are safeguarded by the accounting and financial procedures of the home. (OP NMS 34) 38. 39. 40. 41. 42. 43. The Commission considers Standards 37, 39 and 42 (Adults 18-65) and Standards 31, 33, 35 and 38 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Iris Hayter House DS0000013093.V344392.R01.S.doc Version 5.2 Page 25 37(31), 39(33) and 42(38). Standard 35(OP) assessed in Concerns, Complaints and Protection. People who use the service experience good quality outcomes in this area. The home is well run in the best interests of the service users, who are kept as safely as possible within the home. The home has a robust method of ensuring its’ standards of care are maintained and improved. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered is manager is experienced and well qualified. She has held the post for six years and has acquired NVQ at levels 2, 3 and 4 and the Registered Manager’s Award (RMA). Staff spoken to say the home is well managed and the manager was popular with the residents spoken to, on the day of the visit. The provider carries out an internal organisation wide quality assurance exercise once a year, this year 2007 it is to include families and other professionals for the first time. The survey looks at catering and food, personal care and support, daily living, premises, and management. The results are recorded on a four point rating scale, which range from ‘Very Satisfied’ to ‘Not satisfied at all’. The questionnaire includes space for free text on two questions: ‘Is there anything you don’t like about the service?’ and ‘what can we do to improve the service?’ The results are collated, analysed and reported on by the manager. The results are included in the service user guide and discussed at resident meetings. Residents are consulted through monthly or two monthly house meetings and the organisation hold a quarterly Service Users Forum, the house members do not attend the forum very often. Regulation 26 visits take place and reports are written, the visits are carried out by different members of the board of directors who always make sure that they talk with residents as a major part of their visit. The provider also has staff forums to discuss any issues and listen to staff views. There is an organisational business plan for the next five years but the home does not have its’ own annual development plan, this was discussed with manager. Health and safety checks and maintenance are carried out regularly. There is no electrical wiring certificate but the manager advised that contractors had been and will be re-wiring the building in the near future, the contractors advised her that the wiring is ‘safe’. Iris Hayter House DS0000013093.V344392.R01.S.doc Version 5.2 Page 26 The Fire officer visited in February 2006 and no issues were identified, the home has just completed an on –line fire risk assessment for the fire officer, which he has approved and has not identified any concerns. Staff receive mandatory Health and Safety training, this is up-dated as necessary. There are systems in place for recording accidents and incidents, these are filled in as required. Any hazardous cleaning materials are stored in a locked cupboard when not in use. Iris Hayter House DS0000013093.V344392.R01.S.doc Version 5.2 Page 27 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. Where there is no score against a standard it has not been looked at during this inspection. 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 N/A 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 3 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 X CONDUCT AND MANAGEMENT Standard No Score 37 3 38 X 39 3 40 X 41 X 42 3 43 X 3 3 X 2 X LIFESTYLES Standard No Score 11 X 12 2 13 2 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Iris Hayter House Score 3 3 3 X DS0000013093.V344392.R01.S.doc Version 5.2 Page 28 No 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. 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 YA9 Good Practice Recommendations To review risk assessments to make sure that everyone has those necessary for their current needs and that they are detailed enough to make the resident as safe as possible, whilst allowing them as much independence as possible. To ensure the activities programme continues to develop so that people will have every opportunity to participate and have an interesting lifestyle. To develop guidelines/protocols for the administration of medication prescribed by the G.P to be taken ‘when necessary’ so that it is given consistently and as the G.P intends. To make sure that people know what their overall financial status is, including their income and expenditure so that the manager can assist them to protect themselves from DS0000013093.V344392.R01.S.doc Version 5.2 Page 29 2. 3. YA12 YA20 4. YA23 Iris Hayter House 5. YA39 any form of financial abuse and help them to make. informed choices with regard to their expenditure. To produce an annual development for the home so it is able to measure whether it has effected the changes identified by the Annual Quality Assurance Audit, completed by residents and others,annually. Iris Hayter House DS0000013093.V344392.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU 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. Iris Hayter House DS0000013093.V344392.R01.S.doc Version 5.2 Page 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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