Inspection on 02/11/06 for The Haven

This inspection was carried out on 2nd November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

The Haven 22/07/08

The Haven 25/05/07

The Haven 24/01/06

The Haven 07/06/05

The Haven 31/01/05

The Haven 29/06/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE The Haven 191 Havant Road Drayton Portsmouth Hampshire PO6 IEE Lead Inspector Mr Ian Craig Unannounced Inspection 2nd November 2006 09:30 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 The Haven DS0000011671.V314879.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. The Haven DS0000011671.V314879.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Haven Address 191 Havant Road Drayton Portsmouth Hampshire PO6 IEE 023 9237 2356 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) Mrs S M Spencer Mrs T Hall Care Home 20 Category(ies) of Dementia - over 65 years of age (20), Old age, registration, with number not falling within any other category (20) of places The Haven DS0000011671.V314879.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th January 2006 Brief Description of the Service: The Haven is registered with the Commission for Social Care Inspection (CSCI) to provide care and support for 20 elderly persons and is situated in a pleasant residential area of Drayton, a suburb of the City of Portsmouth. A detached property, the home is accessed via a short driveway. There is parking at the front of the home for approximately 8 cars. The home is situated close to the local shopping area and amenities and provides a homely environment for the service users who live there. There are 18 single bedrooms and one double room. All bedrooms provide en-suite facilities. There is a large garden at the rear of the property, which is laid to lawn. A ramp for wheelchair users and steps with handrails, provide further access for service users. The home’s fees range from £380.00 to £421.00 per week. The Haven DS0000011671.V314879.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection consisted of a tour of the building, observations of staff and residents, interviews with residents and staff, discussions with the manager and the owner, plus examination of record and documents. What the service does well: What has improved since the last inspection? What they could do better: Care plans need to be recorded in greater detail to show how personal care needs are being addressed. The Haven DS0000011671.V314879.R01.S.doc Version 5.2 Page 6 Each of the resident’s interviewed felt that it would be beneficial if a larger number of staff were deployed. Comment was also made by each resident that they would like to be offered fresh fruit. The home needs to carry out surveys of residents’ views of the home, which should contribute to an audit and any improvement plans. The hours worked in the home by one of the registered persons need to be recorded on the duty roster. Greater attention is needed to show that each staff member receives supervision. Heating is in need of improvement in one bedroom. Clarification of the security of residents’ finances held in a bank account is needed. 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 Haven DS0000011671.V314879.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection The Haven DS0000011671.V314879.R01.S.doc Version 5.2 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 the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The processing of assessing a potential resident’s needs prior to admission helps ensure that the home only admits those whose needs it can meet. EVIDENCE: It was clear from examination of records and discussion with the manager, and the owner, that any person referred for possible admission has his/her needs fully assessed. A Client Assessment Form is completed detailing the person’s needs in mobility, continence, feeding and other care needs. Where the person is funded by social services a copy of the care manager’s assessment and care plan is obtained, which is also used to assess if the person’s needs can be met by the home. Other assessment pro formas are completed showing that each person’s needs are comprehensively reviewed. The Haven DS0000011671.V314879.R01.S.doc Version 5.2 Page 9 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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Greater detail is needed in care plans to show that personal and health care needs are being met. Residents are treated with dignity and respect. EVIDENCE: Case records were examined four residents. Assessments of need are of a good standard. Care plans, detailing how needs are being provided, are not recorded in sufficient detail for the reader to be able to tell what it is that staff should be carrying out. Entries such as, “needs 1 x carer to wash and bath” and for mobility, “ short distances with assistance of 1x carer,” are too general and do not state what staff actually need to do. Care plans and assessments include manual handling assessments and risk assessments. Residents had recorded their signature at regular intervals acknowledging their agreement to the care plan. The Haven DS0000011671.V314879.R01.S.doc Version 5.2 Page 10 Records also showed that health care needs are addressed with regular appointments being arranged for each person with the optician, chiropodist and general practitioner. Care staff described how the home liaises with specialist health care professionals such as the continence advisor. It was unclear how often dental checks were being carried out and from discussion with the home’s management the inspector concluded that this is something that is arranged when the resident needs treatment, rather than regular checks being arranged. Some of the residents make their own arrangements to see the dentist. Medication procedures were assessed by examination of the recording sheets, checking the medication stocks, discussions with the staff and management. Staff receive training from the supplying pharmacist and from attendance at a course run by a local college. Records of medication administered showed that medication is dispensed as prescribed and that any controlled medication is handled according to pharmaceutical guidelines. Residents described the staff as having a kind approach and that there is support available for emotional issues such as bereavement. The Haven DS0000011671.V314879.R01.S.doc Version 5.2 Page 11 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 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents have opportunities for social and recreational activities and the home tries to maintain links with the local community. EVIDENCE: One resident stated that he/she was satisfied with the level of activities provided by the home, whilst another person felt that this could be improved. The home’s management described how they try to engage residents in a variety of activities including artistic creations, light exercise, bingo and entertainment from visiting musicians. Individual activities for residents are recorded, but the home does not compile a record of ‘group’ activities. This would further demonstrate that residents’ social needs are being addressed. The home’s manager described how residents have been reluctant to go on outings when these have been arranged. Residents’ meetings take place but the last recorded session was in March 2005. The home’s management stated that meetings have taken place since then. The Haven DS0000011671.V314879.R01.S.doc Version 5.2 Page 12 Links with the local community are maintained by the provision of entertainment from singers and musicians. A vicar regularly visits the home. Residents’ described how their relatives are made to feel welcome when visiting. It was clear from discussions with residents that they are able to exercise control over their lives by deciding how they would like to spend the day, what time they go to bed and what food they eat. Residents are asked in advance what they would like to eat for each meal and a record of this is made. The midday meal on the day of the inspection was chicken and mushroom pie, roast potatoes, roast parsnip, mashed swede and cabbage. A staff member took a gravy boat to each resident and asked if they would like gravy. A dessert was also served. Staff assisted residents according to the level of need. A record is kept of the preferred breakfast meal for each person. However, one resident stated that he/she would like a greater variety of breakfast food indicating that the preferences for each person should be reviewed. Each of the residents interviewed stated that they would like fresh fruit to be served more often. This was discussed with the cook. It was not clear how often fresh fruit was offered and at the time of the visit food stocks lacked any fresh fruit. The Haven DS0000011671.V314879.R01.S.doc Version 5.2 Page 13 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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home ensures that there are clear procedures, policies and protocols for dealing with complaints and the protection of vulnerable older persons. EVIDENCE: Each resident is given a copy of the complaints procedure. This was confirmed from discussion with the residents. The home has a logbook to record any complaints made. Training is provided for staff in the principles of protecting older persons from possible abuse. This does not include all of the staff team and the inspector suggested extending this training to each staff member. It was also advised that the home liaises with the local social services training programmes in adult protection. Since the last inspection, the Commission have received two complaints about the home regarding several matters. These are being addressed separately from this report. The Haven DS0000011671.V314879.R01.S.doc Version 5.2 Page 14 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, 20, 21, 22, 24 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home is clean and well maintained offering a range of communal areas. Residents have bedrooms, which they are able to personalise. Equipment is provided to aid the movement of those with mobility difficulties. EVIDENCE: Residents were observed using the communal areas of the home. The lounge and dining room are situated on the first floor, which can be accessed by a passenger lift or the stairs. Several residents’ bedrooms were seen and these were clean and well maintained with personal possessions giving a homely feel. A resident described how he/she likes to keep his/her belongings in his room, which include personal effects. The Haven DS0000011671.V314879.R01.S.doc Version 5.2 Page 15 All bedrooms have an en suite toilet. In addition to this, the home has 3 communal bathrooms, which include a ‘walk-in’ shower and a bath with a hoist. The home also has a number of aids for those with mobility difficulties including a mobile hoist, a stand aid and slings. Staff receive training in moving and handling. It was noted that two residents were transferred by wheel chair and these did not have footrests. One resident’s feet collided with a table leg as his/her legs were outstretched because of the lack of a footrest. This was discussed with the manager. It was noted that one resident’s bedroom was not adequately heated. The resident stated that he/she had been cold the during the night. This was discussed with the manager who was aware of the problem and that the resident had been cold. The home’s heating system had been checked by an engineer and found to be working correctly. The temperature of this room should be checked and supplementary heating provided if necessary. The Haven DS0000011671.V314879.R01.S.doc Version 5.2 Page 16 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 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. It is not clear that the home deploys sufficient staff to meet the needs of residents. Staff are supported to meet residents’ needs by induction and training. Recruitment procedures protect residents. EVIDENCE: The staff rotas were examined. The inspector also discussed the level of staffing in the home with the manager, and with the owner, who both felt that the current provision was sufficient to meet the needs of the residents. This consists of 2 care staff from 8am to 10pm with additional catering staff for the midday and early evening meal. Further staff are provided for cleaning. The inspector was concerned that for up to 20 residents, 2 care staff may not be enough to met the needs of the residents especially during the morning when there are no catering staff to assist with the preparation of the breakfast. According to the information supplied by the home most of the residents require assistance with washing, several need help with dressing and 2 with toileting. It was noted that some of the hours being worked by the owner were not recorded on the duty roster. The Haven DS0000011671.V314879.R01.S.doc Version 5.2 Page 17 Each resident spoken to during the inspection commented that the staff are helpful and supportive, but that they considered the numbers of staff on duty was not enough. Training is provided for staff, including the following subjects: medication, dementia, food hygiene, infection control, NVQ level 2 and 3, and skin care. The home has not yet achieved the target, that 50 of staff are trained to NVQ level 2 or its equivalent. At the time of the inspection this stood at approximately 33 . A further 9 staff were undertaking the training at the time of the inspection. Completion of this training will ensure the home exceeds the 50 target. Care staff confirmed the provision of training in NVQ level 2 and 3 in care, as well as other courses. Induction programmes were available for recently appointed staff. Regular staff meetings take place and each staff member has an annual appraisal. Individual staff confirmed that the home’s management is both supportive and approachable. Staff confirmed that appraisals take place but were unsure of formal supervision taking place. This was also reflected in records, where no individual supervision sessions had been held in 2006. Recruitment procedures were examined for recently appointed staff and these showed that appropriate checks were being carried out, including criminal record bureau (CRB) and protection of vulnerable adults (POVA) checks. The Haven DS0000011671.V314879.R01.S.doc Version 5.2 Page 18 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 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home is generally well managed although there are areas that need to be addressed, including greater attention to reflecting residents’ views in how the home runs. Health and safety of residents is promoted. EVIDENCE: The registered manager is a registered nurse and has NVQ level 4 in management. In addition to this, she regularly attends training courses in subjects such as food hygiene, MRSA, health and safety and other related subjects. The home uses several methods of monitoring its own performance including regular checks of the physical environment. There is an annual development plan. Questionnaires have been provided to residents in order to check their The Haven DS0000011671.V314879.R01.S.doc Version 5.2 Page 19 views on the service provided by the home. The frequency of these needs to be addressed as the last questionnaire was completed in November 2004. Feedback provided by service users to the inspector also indicated that the service could be more reflective of the residents’ needs and wishes. Residents’ meetings have been held in the past. The home handles some of the residents’ finances and holds it on their behalf in an account. This is recorded with any transactions, balances, deposits and withdrawals detailed. As this is one collective account, which details each person’s amounts held, the inspector raised the need for the home to ensure that the account is secure for the residents in the event of any possible business insolvency. The manager and owner agreed to follow this up with the relevant bank. The home’s appliances are serviced on a regular basis. Staff receive training in first aid, food hygiene, infection control and moving and handling. The building was found to be free from any risks. The safe use of wheelchairs needs to established. The home’s management need to ensure that the care plans are specific about resident’s needs and that there are sufficient staff on duty. The Haven DS0000011671.V314879.R01.S.doc Version 5.2 Page 20 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 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 3 2 X 3 2 3 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 2 2 X 2 The Haven DS0000011671.V314879.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? N/A 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 Regulation 15 Requirement Care plans must detail how personal and health care needs are being met, including specific actions and guidance for staff to follow. Residents must be offered fresh fruit on a regular or daily basis. Resident’s bedrooms must be adequately heated. Staffing levels should be reviewed to ensure that there are sufficient numbers of staff on duty to meet the needs of the residents. Timescale for action 02/01/07 2 3 4 OP15 OP25 OP27 16(2)(i) 23(2)(p) 18 02/12/06 02/12/06 02/01/07 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 OP33 Good Practice Recommendations Questionnaires should be used to seek the views of residents regarding the service provided by the home, which should contribute to the home’s audit, and future plans. DS0000011671.V314879.R01.S.doc Version 5.2 Page 22 The Haven 2 3 4 OP35 OP36 OP38 The home’s management should obtain clarification that the account used to deposit residents’ finances is secure in the event of insolvency. The home should be able to demonstrate that staff receive supervision at least six times a year. Advice should be sought from appropriately qualified persons regarding the safe use of wheelchairs and footrests. The Haven DS0000011671.V314879.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 The Haven DS0000011671.V314879.R01.S.doc Version 5.2 Page 24 - 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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