Inspection on 06/06/06 for The Haven

This inspection was carried out on 6th June 2006.

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 28/12/05

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 Key Unannounced Inspection 5th June 2006 10:00 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.V298571.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 DS0000002444.V298571.R01.S.doc Version 5.2 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.V298571.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th December 2005 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 Sleaford and has shops, a G.P. surgery, a church, a library 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 but 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 fees charged by the home are from £335 to £415, depending on the dependency needs of the residents. The Haven DS0000002444.V298571.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced visit was made to the home as part of a key inspection. It started at 15.15 and lasted 3½ hours. Information already held on file was used to plan the visit. The main method of inspection used 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, the care staff and observation of care practices. Two survey forms were received: one from a resident and one from a relative. Both were positive about the level and quality of care given; both ticked that there are activities they can sometimes join in. One ticked that staff usually listen to what residents say and that meals are usually liked. The site visit focused on whether key standards and requirements from previous inspections had been met and how the residents feel about the service provided. Three residents’ assessments and care plans were examined to ensure the health, safety and welfare of the residents is checked and that residents are allowed dignity, autonomy and choice. A partial tour of the home was made and a sample of other records examined. Many residents have relatives who visit regularly although none were available at the time of the inspector’s visit to the home. The inspector spoke with at least thirteen of the twenty-six eight of the residents, including those being case-tracked, and the four staff on duty. The provider/manager was present throughout this inspection and spent time discussing the issues that arise in the running of the home. What the service does well: The home is run by a competent, confident provider and deputy manager and supported by a staff team who are well trained and help to provide a happy atmosphere and a homely and clean environment for the comfort of the residents who live there. The staff were observed by the inspector and visiting healthcare professionals, to be kind and polite when speaking with residents. The provider, who is also the manager, is on-hand on an almost daily basis for the residents and staff. The deputy manager assists the provider closely and is a very valued member of staff. The Haven DS0000002444.V298571.R01.S.doc Version 5.2 Page 6 Residents expressed the view that the staff provide good care and treat them with respect and dignity. No requirements have been necessary at this inspection. What has improved since the last inspection? 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.V298571.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 DS0000002444.V298571.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): 1, 3 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Enough information is provided to prospective residents and a full assessment is done by the home to help each side decide whether the home will be suitable and can meet the individual’s needs. EVIDENCE: An updated copy of the statement of purpose has been produced. A copy of both the statement of purpose and service user guide has been placed in every residents’ room. Care plans examined showed that comprehensive pre-admission assessments are in place for all residents on admission to the home. Where social workers have been involved in placing residents, their assessments were seen in the file. The Haven DS0000002444.V298571.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, 10 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Further improvements made, both in care plans and pharmaceutical practices and good contact with healthcare professionals ensure the safety, health and welfare of the residents at all times. The holistic needs of the residents are clearly defined and met and their privacy and dignity is maintained. EVIDENCE: The inspector examined three care plans covering residents with different levels of need. In all, it was found that further improvement since the last inspection has been made and the assessments were comprehensive and risk assessments identified the residents’ needs and how to manage them. Care plans are reviewed monthly. The manager seeks the advice of health care professionals to ensure the health needs of residents are met, such as physio and occupational therapy, providing specialist equipment and organising for district nurses, the tissue viability nurse, dentists, chiropodists and opticians to come to the home as necessary. The Haven DS0000002444.V298571.R01.S.doc Version 5.2 Page 10 One resident said he was unable to stand or support himself when he came to live at the home but is being helped and encouraged by the staff and with physiotherapy and is now able to stand. The supplying pharmacist supplied a report that stated that all staff who administer medications have been adequately trained, that their medication practices are safe and that their medication systems in place are impressive. Residents say their privacy and dignity is maintained and at previous inspections and at this site visit, the inspector found the staff to be polite, affectionate and pleasant to the residents. One resident said that “even the most intimate care is given with dignity and consideration of the resident’s feelings”. A visiting healthcare professional also found “the staff to interact well with the residents”. Staff and residents agree there is no harassment or discrimination of anyone at the home; all are treated equally and fairly and personal feelings and persuasions are respected. The Haven DS0000002444.V298571.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, 15 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Residents are mostly satisfied with the amount of choice available in their lives although the variety and quantity of activities are limited. EVIDENCE: Activities are not a regular occurrence but most residents spoken with said that, on the whole, what is provided is usually enough to meet their wishes. Two surveys had been ticked that sometimes activities are arranged that they can take part in. Two residents said they “sometimes get a bit bored” but one said she “likes reading so it’s not too bad.” All staff participate in what activities are undertaken, often on a one-to-one basis as a number of the residents want and need, and records are usually kept of what they do. Some staff said that “a lot of the residents aren’t interested in creative work. Thy used to do cards and things but not any longer. They do like the ‘Olde Time Music’ sessions. We don’t have residents’ meetings but those who know The Haven DS0000002444.V298571.R01.S.doc Version 5.2 Page 12 their own minds will say they’re fed up but then they don’t want to be bothered with activities.” Some residents said that staff will accompany them if they wish to go into the village. Creating a more consistent approach to the provision of meaningful, interesting activities for the residents should be sought, possibly including more contact with the community and some organised entertainment. Many residents have relatives who visit regularly although none were available at the time of the inspector’s visit to the home. Residents spoken with said they have choice in all aspects of their lives at the home. The manager states in the pre-inspection questionnaire that a choice of menu is offered and that residents have the facilities to make drinks and snacks. (See Standard 26 for comment on Environmental Health Officer.) At the site visit, residents reiterated from previous inspections that the food is very good. Examination of the food records showed that choice is offered every day and clear records of food consumed by each resident at each main meal are kept. The Haven DS0000002444.V298571.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, 18 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Adequate procedures are in place to protect the residents and keep them safe at all times. EVIDENCE: According to the pre-inspection questionnaire and at the site visit, no complaints have been received by either the home or directly to the CSCI within the past twelve months. The complaints policy is clearly displayed and is in the statement of purpose and service user guide. Both staff and residents say they know who to go to if they have any concerns or complaints. All the residents say they are happy at the home and staff give them caring attention at all times. Staff training for adult abuse awareness has been undertaken by all staff to ensure that residents are safeguarded from the risk of harm. At the last inspection, training in dementia care and managing challenging behaviour had been completed and appreciated by staff, who said it improved their practice in the care of vulnerable people. The Haven DS0000002444.V298571.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, 22, 26 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The home and garden are bright, comfortable, homely and safe for the residents’ well-being and the provider ensures that suitable equipment is available to meet the residents’ needs. EVIDENCE: The home is in the process of an ongoing re-decoration and renovation programme. The three communal lounges and two corridors have been completed and the décor and colour scheme are attractive and summery and appreciated by the residents spoken with. Some residents said they would like their bedrooms decorated next. Specialist equipment is provided in the home including ramps, special mattresses where assessed as necessary and beneficial, grab rails in corridors The Haven DS0000002444.V298571.R01.S.doc Version 5.2 Page 15 and the bathrooms and two hoists, one electric and one manual and bath hoists. The manager was asked, at the previous inspection, to ascertain the views of the Environmental Health Officer (EHO) on residents using the main kitchen to prepare drinks and snacks and other hygiene practices. This was done and the EHO gave the manager a home-assessment book to complete, which the inspector studied at the site visit and found it to be well-used and two-thirds completed. This assists the manager and staff to ensure that they are welltrained to keep residents safe from the risk of harm. The Fire Officer inspected the home in January 2006 and left three requirements, the first of which, on discussion with the deputy manager, was corrected immediately and the others, to do with luminous signs and emergency lighting, are booked for repair and upgrading on 14 June 2006. The provider and manager were also required to carry out a list of risk assessments of any likely hazards in the home, which the Fire Officer would later check on. These risk assessments are seen by the Fire Department as continuous process which the manager must regularly monitor and audit. The Haven DS0000002444.V298571.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, 29, 30 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Residents are in safe hands with sufficient well-trained and caring staff to ensure their comfort and well-being and meet their needs and wishes. EVIDENCE: At the inspector’s visit to the home and in the staff duty rotas examined, there were sufficient and a good skill mix of staff on duty to attend to the residents’ needs, taking into account the dependency levels of the twenty-six residents and the layout of the building. A happy, relaxed atmosphere was evident. A visiting healthcare professional stated, “The Haven is one of the happiest homes I have been in. There were plenty of staff, when I was in the office all I could hear was laughing and chatting, the staff interacting with the residents.” A resident said “I’m very lucky; I’m contented and have no grumbles. The staff are very good, lovely; even the young girls. Everything is done to try and please you.” Staff all said, “it’s a happy home”. The inspector found that the recruitment of new staff is processed comprehensively and staff files examined showed that all documentation was in place. A recently-employed staff member said that her induction has been thorough and the completion of the induction book she was given is still ongoing to support her. She shadowed senior staff in her shifts for several The Haven DS0000002444.V298571.R01.S.doc Version 5.2 Page 17 weeks and has undertaken training to ensure that her practices were adequate to care for residents safely. Staff training is comprehensive and staff said they are encouraged by the provider and deputy manager to keep up-to-date to ensure they can care for the residents proficiently and safely. The Haven DS0000002444.V298571.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): 32, 33, 35, 36, 38 Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to this service. Most of the manager’s and staffs’ practices provide sufficiently consistent care to ensure that the residents’ needs are met and their health, welfare and safety is maintained. However, a lack of staff supervision and monitoring of the service may preclude some improvements in the home being made for the benefit and to meet the wishes of the residents. EVIDENCE: Staff at previous and the present inspections said that the deputy manager is very supportive and helpful and encourages them with training. “If there’s any concerns I’d go to a senior or the manager or deputy. The Haven DS0000002444.V298571.R01.S.doc Version 5.2 Page 19 The provider/manager is at the home on most days and has not considered it necessary to produce documented quality audits for the home, although she says she monitors the service and facilities provided regularly. The deputy manager has produced resident and relative surveys but these have not been given out for some years, so the current wishes of the residents are not fully known. It is recommended that resident and relative surveys are used to gauge what the residents really want in their lives in the home and that the provider regularly audits the service supplied. The provider/manager states in the pre-inspection questionnaire that families have the responsibility for handling residents’ finances and those for whom the home manages their personal allowances, full records are kept to ensure residents’ finances are kept safe. This was confirmed at the inspector’s visit to the home. Staff supervisions have not been held regularly, as is needed to ensure staff are supported to care for the residents appropriately. Health and safety practices such as staff training and the regular maintenance of equipment are adequate to maintain the health and welfare of the residents. However, more regular and efficient staff supervision and auditing of the service would enhance the quality of care provided. The Haven DS0000002444.V298571.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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X 3 X X X 3 STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 3 2 X 3 2 X 3 The Haven DS0000002444.V298571.R01.S.doc Version 5.2 Page 21 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 OP12 Regulation 16(2) Requirement Activities provided must take into account the wishes and needs of the residents and be provided often enough to keep them occupied, as they wish. (Timescale of 30/04/06 not met.) 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 of 30/04/06 not met) Timescale for action 31/07/06 2. OP33 24(1) 31/07/06 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 OP36 Good Practice Recommendations Staff supervision should be held for all staff six times per year. The Haven DS0000002444.V298571.R01.S.doc Version 5.2 Page 22 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.V298571.R01.S.doc Version 5.2 Page 23 - 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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