Inspection on 28/12/05 for The Haven

This inspection was carried out on 28th December 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

The Haven 06/06/06

The Haven 02/08/05

The Haven 07/01/05

The Haven 12/05/04

The Haven 03/02/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE The Haven The Bungalow 19 Lincoln Road Metheringham Lincs LN4 3EF Lead Inspector Vanessa Gent Unannounced Inspection 29th December 2005 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 DS0000002444.V273891.R01.S.doc Version 5.0 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 DS0000002444.V273891.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Haven Address The Bungalow 19 Lincoln Road Metheringham Lincs LN4 3EF 01526 322051 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 M Dobbs Mrs M Dobbs Care Home 29 Category(ies) of Dementia - over 65 years of age (6), Old age, registration, with number not falling within any other category (23) of places The Haven DS0000002444.V273891.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 02/08/05 Brief Description of the Service: The Haven is a large, extended, chalet-type bungalow set at the end of a shared drive, in the village of Metheringham. The village is on a bus route to Lincoln and has shops, a G.P. surgery and other amenities available. The home is run as a family business; the owner, who is also the manager, is actively involved on a day-to-day basis with the help of a deputy manager. The home provides personal care for up to twenty-nine people of both sexes, over the age of 65 years, some with dementia. The accommodation consists of thirteen single and eight double bedrooms. All bedrooms have hand washbasins; none is ensuite. There is a small car parking facility at the front of the property. The gardens, both in front of the home and surrounded by the bedrooms at the back, are well-tended and colourful. The home’s philosophy of care is “to encourage as much independence as possible and fully acknowledge the rights of the individual residents as to their personal preferences and lifestyles. Whilst ensuring that all care and other support is provided by friendly, caring and suitably trained staff”. The Haven DS0000002444.V273891.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over seven hours. The main method of inspection is called “case tracking”, which involves selecting a proportion of residents, and tracking the care they receive through the checking of records, discussion with them, any visitors, the care staff and observation of care practices provided. The inspector spoke with eight of the twenty-eight residents and four of the staff on duty as well as the manager and deputy manager. What the service does well: What has improved since the last inspection? New carpeting has replaced the worn carpet in the long corridor and all the radiators in communal areas are now covered. Buckets and containers for the soiled linen are kept in the laundry and are used for transporting soiled bed linen and clothing to the laundry for washing. Documents are being updated to provide comprehensive information about the residents, including the pre-admission assessment, which is being re-designed to more comprehensively assess prospective residents and the care plans which are more thoroughly filled in and contain more detail than at the previous inspection to ensure that the residents needs are met. The Haven DS0000002444.V273891.R01.S.doc Version 5.0 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. The Haven DS0000002444.V273891.R01.S.doc Version 5.0 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 DS0000002444.V273891.R01.S.doc Version 5.0 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): 1, 3 The procedure for the admission of new residents is robust to ensure that the home can meet their needs. EVIDENCE: The statement of purpose and service user guide are comprehensive documents that instruct prospective residents on what the home has to offer. The pre-admission assessment has been improved and is now used to assess new residents and ensure that the home can meet their needs. The Haven DS0000002444.V273891.R01.S.doc Version 5.0 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, 10 Improvement has been made in some aspects of documentation and care but some of the medication practices are not in accordance with the Royal Pharmaceutical Society requirements or recommendations to ensure the safety, health and welfare of the residents at all times. EVIDENCE: The care plans show some progress has been since the previous inspection made towards improving their content and format, although there is still room for further improvement. Risk assessments have been carried out and the healthcare needs, wishes and choices of the residents are recorded. Contact with healthcare professionals is now written clearly on separate sheets for easy reading and understanding. One healthcare professional says that the staff cooperate with them and are aware of the residents’ health needs. The district nurse attends one resident daily; staff speak of their co-operation with her in the care of the resident and the care plans satisfactorily monitor the treatment given. The room in which medications are stored is not kept locked and is also used to store wheelchairs. Although most of the cupboards in the room are kept The Haven DS0000002444.V273891.R01.S.doc Version 5.0 Page 10 locked, the cupboard in which tablets, medicines and liquids are stored is not kept locked, as required. Medications, including ‘Prescription only medicines’ were found, left in a plastic carton, unattended, on a ledge in the kitchen, to which the residents have access. The temperature of the room where the medications are stored is not recorded daily, although the temperature of the drugs fridge is. Staff have nearly completed safe administration of drugs training by direct learning with the assistance of the deputy manager, who is a trained assessor. Residents say that their privacy and dignity is respected. All residents were wearing well-laundered, appropriate clothing. Staff say they are taught, from their induction onwards, as confirmed in the ‘first day of induction’ check sheets examined, to respect the residents. The Haven DS0000002444.V273891.R01.S.doc Version 5.0 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, 14, 15 The variety and choice of activities is not sufficient to provide residents with the stimulation they want and need. The limitation in food choice does not prevent the residents from enjoying their meals. EVIDENCE: An activities organiser has been employed for two hours twice a week but residents say they do not get enough or varied activities and some said they sit in the ‘front’ lounge unattended by staff for long periods of time. More staff were seen in the rear lounge than at the previous inspection, keeping company with the residents who have agitated behaviour or poor communication skills. The residents in this area were happy, settled and responded well to the stimulation staff provided. Although meal choices are still limited at lunch, all residents spoken with said they are satisfied with the meals provided, that the food is always fresh, tasty, with plenty of fresh locally-grown vegetables and fresh fruit always available and that staff know their likes and dislikes and always provide food to suit them. The Haven DS0000002444.V273891.R01.S.doc Version 5.0 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Adequate procedures are in place to protect the residents and keep them safe at all times. EVIDENCE: The complaints policy is publicly displayed and is in the statement of purpose and service user guide and contains the information necessary should a resident or relative wish to make a complaint. No complaints have been received by the manager or directly by the Commission within the past twelve months. Residents, staff and healthcare professionals say that the manager and deputy manager are open, approachable and supportive and they could take any issues to them and know they would sort them out satisfactorily. Some staff have already undertaken training in the prevention of adult abuse and the rest are booked to complete this training within the next three months. Training to understand and care for people with dementia and challenging behaviour has been completed and appreciated by staff who say it has helped to improve their practice for the vulnerable people in their care. The Haven DS0000002444.V273891.R01.S.doc Version 5.0 Page 13 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, 25, 26 The home is comfortable, homely and most areas are hygienic although some practices in the kitchen do not always safeguard the residents from harm or the risk of infection. EVIDENCE: Residents’ rooms are pleasantly decorated and kept clean and tidy. The decorations in the communal areas are shabby, with some corridors and the lounges poorly lit and still in need of re-decoration. The carpeting in the main corridor has been replaced, the radiators in the communal areas are now all covered, and the radiators in the rooms of residents case-tracked have lowsurface temperatures. The hot water in residents’ sinks has been attended to by the plumber and was felt to be of a safe temperature. Soiled bed linen and clothing is carried to the laundry in buckets or net panniers and is sluice-washed by machine at the appropriate temperature for the material. The Haven DS0000002444.V273891.R01.S.doc Version 5.0 Page 14 The kitchen is open-plan, giving access to residents and visitors, who use it to make hot drinks and food, as well as the staff. Staff now appropriately wear aprons when preparing food for the residents. Although there was a kitchen cleaning schedule record, the cook had not recorded food temperatures during cooking procedures, saying that no food probe was available. It was suggested that the manager should approach the Environmental Health Officer for advice on safe and hygienic practices for the kitchen. Training for both cooks in food hygiene and health and safety are up-to-date. The Haven DS0000002444.V273891.R01.S.doc Version 5.0 Page 15 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, 29, 30 Although staff on all shifts have appropriate training and managerial support and are in a good skill mix, staff are not always in sufficient numbers to safeguard the health and safety of the residents at all times. EVIDENCE: At most times, staff work in sufficient numbers and skill mix to ensure that the residents are safe and well-cared for. However, in the evenings, between 18.00 and 20.00, there are not enough staff on duty to observe, monitor and protect residents still in the lounges and communal areas whilst other residents are being taken to bed. Staff say and staff records confirm that the induction process is satisfactory and that new staff are given ample time to get used to the routines before being given responsibilities in the care of the residents. One staff said that the deputy manager is very supportive and helpful. Staff training is encouraged and ensures that staff are able to care for the residents with adequate knowledge and good practice. The Haven DS0000002444.V273891.R01.S.doc Version 5.0 Page 16 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): 32, 33, 36, 38 Most but not all the practices of the home provide sufficiently consistent care to ensure that the residents’ needs are met and their health, welfare and safety is always promoted or safeguarded. EVIDENCE: A healthcare professional spoken with says that the manager “is wellrespected, co-operative and cares deeply for the residents”. Staff respect and residents are very fond of the manager and her deputy. Although the provider lives ‘on the doorstep’ and is at the home most days, documented monitoring of the service provided does not take place; resident and relatives surveys and questionnaires have not been completed for over two years. The deputy manager has produced a quality audit form and says she intends to circulate this and a current questionnaire to monitor resident satisfaction to be completed and analysed within the next three months. The Haven DS0000002444.V273891.R01.S.doc Version 5.0 Page 17 Health and safety practices are mostly adequate to maintain the health and welfare of the residents: staff training, staff supervision and the regular maintenance of equipment. However, the home’s environment and practices, such as for medication and in the kitchen, may not always protect the residents. Staff supervision has been commenced and staff say they are getting more regular. They say that the manager and the deputy manager are open and approachable and they would take any problem to one of them. The Haven DS0000002444.V273891.R01.S.doc Version 5.0 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 X X X X 3 2 STAFFING Standard No Score 27 3 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 3 2 X X 3 X 3 The Haven DS0000002444.V273891.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? Yes 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 OP9 Regulation 13(2) Requirement Medications must be safely stored, recorded and administered by appropriately trained staff. Activities must be provided to take into account the wishes and needs of the residents and be provided often enough to keep them occupied, as they wish. All communal parts of the home must be kept in a reasonable decorative state for the comfort of the residents. The registered person must consult with the Environmental Health Officer concerning the hygiene practices in the kitchen, and these practices must comply with health and safety regulations to safeguard the welfare of the residents. Residents’ views must be obtained and quality assurance measures must be in place to ensure that the home is run in the residents’ best interest. Timescale for action 31/03/06 2 OP12 16(2) 30/04/06 3 OP19 23(2) 30/04/06 4 OP26 13(4) 28/02/06 5 OP33 24(1) 30/04/06 The Haven DS0000002444.V273891.R01.S.doc Version 5.0 Page 20 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 36 Good Practice Recommendations It is recommended that formal supervision takes place six times a year for each staff. The Haven DS0000002444.V273891.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 DS0000002444.V273891.R01.S.doc Version 5.0 Page 22 - 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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