Inspection on 09/06/05 for Lister House

This inspection was carried out on 9th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Lister House 26/04/07

Lister House 01/12/05

Lister House 02/11/04

Lister House 22/07/04

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

CARE HOMES FOR OLDER PEOPLE Lister House Lister House 13 Heaton Road Heaton Bradford, BD8 8RA Lead Inspector Sue Dunn Unannounced 9 June 2005 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 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. Lister House J52 S19882 LISTER HOUSE V230170 070605 Stage 2.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Lister House Address Lister House, 13 Heaton Road, Heaton, Bradford, West Yorkshire, BD8 8RA 01274 494911 01274 541359 LHNHBRADFORD@AOL.COM Lister House Limited Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Jacqueline Mitchell Care Home 32 Category(ies) of Physical disability (32), Physical disability over registration, with number 65 years of age (32), Terminally ill (2), of places Terminally ill over 65 years of age (2) Lister House J52 S19882 LISTER HOUSE V230170 070605 Stage 2.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 02/11/04 Brief Description of the Service: Lister House is a large detached Victorian property, which has been extended to provide accommodation for thirty-two people who require personal and nursing care. The home is situated in a quiet area of Manningham on the outskirts of Bradford close to a bus route from the city centre. A small corner shop is nearby.The home is situated in well-maintained attractive gardens and provides off road parking. A safe enclosed courtyard in the centre of the home is accessible from the internal communal areas. The home has twenty-six single rooms, half of which have en-suite facilities, and three shared rooms. The registered providers take a pride in providing a pleasant, domestically furnished environment, which is homely and comfortable for the service users residing in the home.People are encouraged to bring personal possessions into the home. Activities and entertainment are offered.The proprietors are committed to staff training and expect staff to carry out their duties to a high standard and in the interests of the people who live in the home. An NVQ programme is well underway. Lister House J52 S19882 LISTER HOUSE V230170 070605 Stage 2.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection, which was unannounced, was undertaken by one inspector. The inspection started at 10.30am and finished at 5.15pm. The purpose of the inspection was to ensure the home was operating and being managed for the benefit and well being of the residents. The inspector spoke to residents, a visitor, staff members, the proprietor/manager and her partner and the administrator. Records inspected, included resident’s care files and daily progress reports, staff recruitment and training files, and service records. Thirty of the beds were occupied at the time of the inspection. What the service does well: What has improved since the last inspection? The home continues to inspire confidence that residents will be cared for as individuals and will receive good nursing care which keeps them comfortable. The managers continue to examine and re evaluate their practices and procedures. Care files were being reorganised to make it easier to read the records and follow the progress of care. Staff training and the NVQ programme are ongoing. This is keeping pace with any staff turnover. Lister House J52 S19882 LISTER HOUSE V230170 070605 Stage 2.doc Version 1.30 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. Lister House J52 S19882 LISTER HOUSE V230170 070605 Stage 2.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Lister House J52 S19882 LISTER HOUSE V230170 070605 Stage 2.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3,4,5 The home carries out a full assessment of nursing care needs and has a clear criteria for admission based on overriding physical care needs. EVIDENCE: Four care files were examined. Referral information from hospitals was described as ‘very limited’. A discharge coordinator at the hospital carries out an assessment of the type of care required but the home rarely gets a copy of this. A hospital discharge sheet by a named nurse had been completed in the file of one person. This gave up to date information about the individual’s nursing care. The manager spends time during her pre- admission assessment examining the nursing notes at the hospital and talking to the individual and their family to ensure the home has the equipment needed before people are admitted. It was agreed that a further assessment should be carried out if residents have been in hospital to determine any changes in the level of care required. The manager expressed concerns about occasions when people had been returned to the home in the middle of the night because of pressure to vacate hospital beds. Lister House J52 S19882 LISTER HOUSE V230170 070605 Stage 2.doc Version 1.30 Page 9 People are admitted to the home when their nursing care needs outweigh any other condition therefore rely on family and friends to assess the suitability of the home. A relative confirmed that she had received a recommendation from someone familiar with the home and had found the staff very helpful and supportive during the process of admission. Lister House J52 S19882 LISTER HOUSE V230170 070605 Stage 2.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,10 The care plans and progress notes written by the nurses focus purely on how the nursing problems are to be met. This is done well but overlooks any recording of the human element of care which supports peoples’ emotional, social and intellectual needs. This does not do justice to the caring environment and compassion which the home aims to promote. EVIDENCE: The nurse on duty writes a plan of care on the day of admission and gathers background information. The care plans were based on nursing problems and showed how care was to be given. There was nothing to describe retained skills and strengths or to show there had been any involvement or agreement with the individual about how their other needs were to be met. Observation of practices, discussion with some residents and staff and the progress notes written by some staff showed that the staff do provide a very caring environment. Care staff however, who have the most close contact with residents, receive information from the nurse in charge during shift handover meetings but do not contribute to the daily progress notes. This may account for the rather ‘clinical’ and distanced style of recording which only shows a part of the care provided. It was apparent that some staff show more empathy than others. Some nurses recorded the care they gave when people were Lister House J52 S19882 LISTER HOUSE V230170 070605 Stage 2.doc Version 1.30 Page 11 distressed, others simply recorded the behaviour. In one case the response had been inappropriate and was brought to the attention of the manager. A visitor said that the staff were always mindful to preserve peoples dignity and as an example said that screens were always used when catheter bags were emptied. Lister House J52 S19882 LISTER HOUSE V230170 070605 Stage 2.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,15 The home provides a good range of activities but allows people to choose to participate or remain in their rooms. There is good contact with family, friends and the wider community. It was apparent that staff had a good knowledge of peoples’ interests but this was not reflected in the care files. The food is good and wholesome and the catering arrangements allow flexibility to provide for individual tastes. Staff should carry out risk assessments and strike a sensible balance between health and safety and quality when serving hot drinks to ensure the drinks are palatable for the residents receiving them. EVIDENCE: Many residents were in their rooms where they were watching TV. Most of the bedroom doors were open so that people did not feel isolated. In one room a childrens’ TV programme was on because the remote control was not working. (There is a system for checking equipment and replacing batteries) A resident confirmed that a telephone is made available if people want to speak to family and friends. The same person complained that some staff do not speak when they bring food and drinks. This was not observed. Staff try to encourage people to join activities in the lounge. There was nothing written in the care plans to show what personal interests and preferences were though the manager was aware of interests and gave an example of a person who liked to listen to ‘The Archers’. Lister House J52 S19882 LISTER HOUSE V230170 070605 Stage 2.doc Version 1.30 Page 13 An aroma therapist was working with people in the lounge with relaxing background music on the afternoon of the inspection. A regular visitor to the home said the staff ‘try very hard’ to provide activities of interest and described a range of ‘nice’ activities such as the piano, potting plants, videos of old films. Everyone received a Christmas present, Easter egg and cards from the staff. The home has a cat, which provides and interest for those who like animals and one person was seen to have a budgerigar in her room. The food was described as ‘beautiful’. Menus are worked out weekly to take advantage of seasonal produce. The daily menu offers two choices and in addition the home provides for any special requests. The proprietor gave an example of tins of asparagus kept in stock as this was a favourite of one of the residents. Staff were seen to assist people who needed feeding in an unhurried way. The system of serving drinks led to hot drinks being served almost cold and there appeared to be a reluctance to acknowledge a residents complaint about this. There should be a satisfactory balance between health and safety and quality. Lister House J52 S19882 LISTER HOUSE V230170 070605 Stage 2.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,18 The proprietors have a very open attitude to complaints brought to their attention and will investigate any complaints to obtain a satisfactory outcome. Care staff and nurses should be prepared to take residents ‘grumbles’ seriously and take action to rectify the cause of any dissatisfaction. All staff should have training in Adult Protection EVIDENCE: There have been no serious complaints since the last inspection as the proprietors try to deal with any concerns as they arise. One person stated that a matter brought to the attention of the managers had been taken seriously and handled well. One person had said he was being got up in the morning too early, but the relative had not brought it to the managers attention as there was no evidence to support this. A member of staff who had worked on nights said that unless people wished to get up early (one resident said he did) staff do not start getting people up before 7am. 24 hour care is provided throughout the night for those who require it. A resident’s complaint about the temperature of the tea would have been overlooked had the inspector not confirmed he was justified in asking for a replacement. Some staff have not had adult protection training. The manager of the home is an adult protection trainer and is to introduce monthly training days for staff in addition to the information they receive as part of their induction and NVQ training. Lister House J52 S19882 LISTER HOUSE V230170 070605 Stage 2.doc Version 1.30 Page 15 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 standard(s) 19,20,22,23,24,25,26 The home is comfortable, clean and well maintained with systems in place to control the spread of infection. People are provided with the equipment they require for their nursing needs. The home has little control over the length of time it takes for people to receive specialist equipment from the NHS, which was restricting the movements of one person People are encouraged to make their rooms ‘homely’ with personal possessions. This is difficult for people in shared rooms. EVIDENCE: Systems are in place for the upkeep and maintenance of the building. Another family member has recently joined the management team and has responsibility for this area. The building has several comfortable communal areas and bedrooms have sufficient space for visitors. A small internal courtyard off the main lounges gives easy access to a safe and private outdoor space. Lister House J52 S19882 LISTER HOUSE V230170 070605 Stage 2.doc Version 1.30 Page 16 The majority of rooms are for single occupancy. A visitor said that they had been encouraged to bring personal possessions into the home. Some people had taken advantage of this opportunity and had made their rooms more ‘homely’ than others. There is less opportunity for people who are in shared rooms to create a sense of identity in the room or to entertain visitors without compromising the privacy of the other person in the room. Beds, mattresses and hoists were in use according to nursing needs. One persons access to the communal areas of the home was restricted as he was still waiting for a special chair ordered whilst he was in hospital. This delay was a cause of frustration but beyond the home’s control. The home was clean and there were no unpleasant odours. A visitor said that the home is always very clean and people who have spoken with the inspector in the past have commented on the freshness of the environment. Systems are in place to control the risk of cross infection. Lister House J52 S19882 LISTER HOUSE V230170 070605 Stage 2.doc Version 1.30 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29,30 Staff are given training which aims to provide them with knowledge and skills to deliver the high standard of care expected by the managers. The proprietors take an active part in the management of the home and lead by example. Visitors and residents showed an overall satisfaction with the care provided. There was a minor shortfall in the recruitment and selection procedure as people were starting employment before Criminal Record Bureau checks had been received. EVIDENCE: The home has a total of 49 staff plus the two proprietors who take an active part in the management of the home on a day to day basis. There is a strong commitment to developing people through training. An example of this was a catering assistant who had taken advantage of training to a level where she had the skills and knowledge to be promoted to chef. Five care staff have the NVQ award in care at level 2 or over and nine are working towards it. The activity organiser has NVQ in customer care, the catering staff, head housekeeper and all the domestic staff have NVQ. One person, who had worked as a night care worker for six months, had just started an adaptation programme for her overseas nursing qualification. The detailed knowledge she had about the residents care needs was a good indication of the quality of information shared at staff handover meetings. Another care worker confirmed she was doing NVQ and had training in Moving and Handling, Infection control, Hygiene and first aid. She stated that she relied on the nurses for guidance on how each person was to be cared for. Lister House J52 S19882 LISTER HOUSE V230170 070605 Stage 2.doc Version 1.30 Page 18 Any new information relevant to care staff is recorded in a clipboard which staff returning to duty are required to read and sign. This is used as a backup to verbal handovers. The home has experienced difficulties in obtaining CRB checks soon enough to avoid the risk of losing good applicants to other homes. Records showed two staff had been employed before a CRB had been received. The response to one application had been outstanding from October. The managers were not aware that they could apply for a POVA first check in extreme circumstances to ensure suitable people were employed to care for residents. One person had not given the manager of her previous home as a referee and the reason for this had not been checked thoroughly. Lister House J52 S19882 LISTER HOUSE V230170 070605 Stage 2.doc Version 1.30 Page 19 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,38 The home is well managed in the best interests of the residents and their health care needs. Staff are appropriately trained to this end. The documentation should include more detail if the records are to provide a true record of the quality of care. EVIDENCE: The management team of the home have complementary knowledge and skills. The manager has many years of nursing experience, which she keeps updated. The joint proprietor has a catering background and qualifications and the administrator has the office skills and knowledge to handle all the administrative part of the business. All have good people skills and are committed to providing a high standard of care. As stated earlier, the written documentation does not give a full picture of the detailed attention to care but the managers are aware of this and are currently reviewing the care files and other paperwork. Lister House J52 S19882 LISTER HOUSE V230170 070605 Stage 2.doc Version 1.30 Page 20 Staff were able to describe the training they had received for their own and the safety of residents. Fire drills have taken place at a time to include night staff. Lister House J52 S19882 LISTER HOUSE V230170 070605 Stage 2.doc Version 1.30 Page 21 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 x 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 4 4 3 x x x 2 3 Lister House J52 S19882 LISTER HOUSE V230170 070605 Stage 2.doc Version 1.30 Page 22 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 OP7,OP37 Regulation 15 Requirement Carried forward - The care records must provide guidance on more than nursing care and show the involvement of the resident and or their representative in any decisions regarding care Staff must have a satisfactory CRB check or POVA first before they start working with vulnerable adults Timescale for action By 30.09.05 2. OP37 18 By 31.06.05 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. 4. Refer to Standard OP4 OP7 OP15 OP16 Good Practice Recommendations Residents who have been in hospital should be reassesed before they are readmitted to the home to ensure their needs can be met Care staff should be encouraged to record in progress notes the care they have given Risk assessments should be undertaken to ensure that the need for health and safety is not detrimental to the quality of life of residents. All staff should listen to residents views in an open minded way and take action to remedy any cause for complaint J52 S19882 LISTER HOUSE V230170 070605 Stage 2.doc Version 1.30 Page 23 Lister House 5. OP18 All staff should have an update on Adult protection Lister House J52 S19882 LISTER HOUSE V230170 070605 Stage 2.doc Version 1.30 Page 24 Commission for Social Care Inspection Aire House Town Street Rodley Leeds, LS13 1HP National Enquiry Line: 0845 015 0120 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 Lister House J52 S19882 LISTER HOUSE V230170 070605 Stage 2.doc Version 1.30 Page 25 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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