Inspection on 11/05/05 for The Haven Nursing Home

This inspection was carried out on 11th May 2005.

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 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 Nursing Home 22/05/07

The Haven Nursing Home 26/04/06

The Haven Nursing Home 26/10/05

The Haven Nursing Home 02/11/04

The Haven Nursing Home 28/06/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE The Haven Nursing Home New Road Ash Green Coventry CV7 9AS Lead Inspector Louise Thompson Unannounced 11 May 2005 09:30 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. The Haven Nursing Home E53 S42690 The Haven Nursing Home V226100 110505 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Haven Nursing Home Address New Road Ash Green Coventry West Midlands CV7 9AS 02476 368100 02476 644008 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) Regal Healthcare Homes Ltd Mrs Valerie Lewis N 61 Category(ies) of DE(E) 61 registration, with number OP 61 of places The Haven Nursing Home E53 S42690 The Haven Nursing Home V226100 110505 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 02 November 2004 Brief Description of the Service: The Haven Nursing Home is registered to provide nursing care for up to 61 elderly service users, this includes a specialist registration to provide dementia care.The current owner Regal Health Care Homes Ltd has owned the Haven for a number of years. The home is located on the outskirts of Bedworth, with the City of Coventry close by.The Haven was originally a school; this was converted and extended to provide single storey accommodation for the elderly service user group for which the home caters for. Service user accommodation is provided in 26 single bedrooms and 16 double rooms.Communal facilities include a large lounge diner, a smaller lounge diner, quiet room and a small sitting room at the front entrance to the home. The Haven Nursing Home E53 S42690 The Haven Nursing Home V226100 110505 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over six hours. One additional unannounced visit has been made since the last inspection to investigate a complaint. Letters sent to the registered person following this visit can be obtained from the CSCI office on request. A partial tour of the premises took place and staff, care, and other records were inspected. Five of the staff on duty, seven of the residents and three visitors were spoken to. What the service does well: What has improved since the last inspection? What they could do better: The main lounge area is large, extremely busy and can get noisy at times. Recommended best practice for those with dementia is to provide smaller environments with less noise. The layout of this lounge is being considered with the planned improvements. To ensure that the home is safe and comfortable for people living there the furniture, carpets and furnishings showing signs of wear need replacement. Bath and shower rooms which The Haven Nursing Home E53 S42690 The Haven Nursing Home V226100 110505 stage 4.doc Version 1.30 Page 6 residents are not able to use should be refurbished so that residents are able access the bath/shower safely. Garden areas need weeding and planting to provide a pleasant and safe area for residents to sit outside. The manager must complete all pre employment checks before new staff commences duty to ensure they are suitable people to work with residents. Nursing and care staff must attend training in dealing with difficult and challenging behaviours so that they are able to meet the care of any resident who may need this level of support. 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 Nursing Home E53 S42690 The Haven Nursing Home V226100 110505 stage 4.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 The Haven Nursing Home E53 S42690 The Haven Nursing Home V226100 110505 stage 4.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 Assessment procedures are suitable. Residents’ health and social care needs are assessed prior to entering the home. EVIDENCE: Individual records are kept for each resident and inspection of the records for four of the residents had full assessment information recorded. These included assessments by other health care professionals and the care management assessment and plan for residents supported by local authorities. One recently admitted resident and family members told the inspector of the assessment and how the home was meeting agreed care needs. The Haven Nursing Home E53 S42690 The Haven Nursing Home V226100 110505 stage 4.doc Version 1.30 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 standard(s) 7,8,9,10 There is a suitable care planning system in place, which provides the staff with the necessary information to meet individual resident’s needs. Health needs of residents are met with evidence of liaison with health and social care professionals on a regular basis. Personal support is offered in such a way as to maintain residents’ privacy and dignity. EVIDENCE: Individual care plans are available. Inspection of the records for four of the residents showed that the health, personal and social care needs are identified and planned. Care plans and risk assessments are reviewed on a regular basis. Two residents said that they were unaware of their care plan; care records show that discussions with residents and relatives take place regularly with a large number of consultations taking place in March 2005. Care files viewed showed involvement of members of the multidisciplinary team in assessing and meeting residents’ care needs. Staff from the home are members of a development group which are reviewing and developing care practices in homes. Staff showed the inspector work that had recently been completed on nutrition, pressure area management and continence and how the care practices at the home had changed as a result of this work. The Haven Nursing Home E53 S42690 The Haven Nursing Home V226100 110505 stage 4.doc Version 1.30 Page 10 Systems and procedures for the management and administration of medications are satisfactory with only minor improvements to the MAR sheets necessary. A number of residents are prescribed psychotropic medications. The manager said that the Consultant Psychiatrist visits monthly to monitor and review this. Residents and relatives said that they were happy with the care provided by the home. Two recently admitted residents and their families said that they had settled well into the home, the staff are helpful and that their privacy is maintained. The Haven Nursing Home E53 S42690 The Haven Nursing Home V226100 110505 stage 4.doc Version 1.30 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 standard(s) 14 Residents are enabled where possible to exercise choice and control over their life. EVIDENCE: The manager said residents manage their own financial affairs with help from family or legal representatives. Information on advocacy services is available in the Service User Guide and a copy of this is in provided each resident’s room. Two service users have accessed local advocacy services with the advocate visiting at the time of the inspection. Records are maintained on care files of personal possessions brought into the home. Residents said that they could choose how they spend their day and take part in the social activities if they wish to. One resident said that she liked to get up early in the mornings and staff helped her get ready. Residents were observed enjoying an afternoon’s music and movement session followed by a holiday reminiscence. Choices are available at mealtimes; menus have recently been reviewed following consultation with residents and families. These have been given to the dietician to check nutritional content before being introduced. The manager said photographic menus for the new dishes will be provided to assist resident choice at mealtimes. The Haven Nursing Home E53 S42690 The Haven Nursing Home V226100 110505 stage 4.doc Version 1.30 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 standard(s) 18 Arrangements for responding to any suspicion or allegation of abuse are satisfactory. The policies and practices for dealing with physical and verbal aggression need further development to ensure the health, safety and welfare of residents. EVIDENCE: A procedure for responding to allegations of abuse is available staff spoken to were aware of this and told the inspector the action to be taken should they suspect/witness abuse. Concerns raised with social services over bruising to a resident were investigated. The investigation found the bruising clearly documented on admission to the home and consistent with accident records. Difficulties with meeting the residents care needs due to challenging and difficult behaviours were identified and the resident admitted to hospital for assessment. The manager and staff dealt this with promptly. Since these concerns were raised all staff have attended refresher training on adult abuse and whistle blowing. Newly appointed staff attended a dementia care study day, which included dealing with challenging behaviours. Further 3day dementia care training programme has been arranged for November 2005. The Haven Nursing Home E53 S42690 The Haven Nursing Home V226100 110505 stage 4.doc Version 1.30 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 standard(s) 19, 20, 21,23, 24, Improvements to the décor are ongoing. Future plans to provide more single room accommodation and redesign communal space will significantly improve the facilities available and provide safe comfortable surroundings. EVIDENCE: Since the last inspection the home has continued with the decoration programme with the majority of bedrooms being redecorated. Work continues on the redecoration of corridor areas. Planning permission has been obtained to provide additional single rooms and communal areas. This will enable the home to reduce the number of shared rooms and to redesign the large lounge to better meet the needs of all residents particularly those with dementia. The larger of the two lounges is used daily by a large number of residents with varying care needs. Staff have arranged furniture to provide discreet sitting areas. During the inspection television was being watched by a small group of residents in one area, music was being played in another area of the lounge at the same time. The lounge area was very busy and noisy with a large number of interruptions and distractions. The Haven Nursing Home E53 S42690 The Haven Nursing Home V226100 110505 stage 4.doc Version 1.30 Page 14 Carpeting throughout the home is a stained and showing sign of wear, as does some of the furniture and furnishings. The manager said that carpets are cleaned regularly, however carpets and furnishings will be replaced once the building works are completed. The owner said that he was aiming to commence the work around September 2005. The upper lounge is being redecorated and residents said that they thought it was looking much lighter and they approved of the redecoration. Not all of the bathrooms are used, as many residents are unable to access the bath. This means that the majority of residents use the two assisted bathrooms, which are situated, in one part of the home. Plans include the provision of a further assisted bathroom. Garden areas to the back and side of the home need attention so residents have a pleasant, safe area to sit outside. The Haven Nursing Home E53 S42690 The Haven Nursing Home V226100 110505 stage 4.doc Version 1.30 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 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, 29, 30 After a period of instability in staffing there is now a good complement of staff reducing the need for use of agency staff and offering a greater consistency of care within the home. Staff training and development is structured and planned equipping staff to meet the needs of residents. The procedures for the recruitment of staff need review and potentially leave residents at risk EVIDENCE: Since the last inspection the manager has recruited into the vacant posts and reduced the use of agency staff. Duty records showed that the previously agreed staffing levels were being met with an additional carer provided on the morning shift. The number of residents with dementia is increasing at each inspection visit. At the time of this visit 40 residents with varying degrees of dementia were being cared for by the home. The home is a training placement for student nurses with two students on night duty who remain supernumerary. Training records viewed show that good opportunities are made available for staff to attend training both in house and externally. Training is planned yearly. Courses planned for 2005/6 include a 3-day dementia care course. Staff said that they had the opportunity to attend regular training and had recently attended training in dementia, abuse and enteral feeding. Induction records were seen for the two most recently appointed staff members and are based on Croners induction package. The Haven Nursing Home E53 S42690 The Haven Nursing Home V226100 110505 stage 4.doc Version 1.30 Page 16 An examination of staff records identified that two recently appointed staff members had provided a criminal records bureau disclosure from a previous employer. The home had requested a further disclosure and POVA check but these had not been received prior to the staff member commencing duty. The Haven Nursing Home E53 S42690 The Haven Nursing Home V226100 110505 stage 4.doc Version 1.30 Page 17 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) 33 and 35 The manager regularly reviews aspects of the home’s performance through a programme of self-review and consultations, which include seeking the views of the residents, relatives and staff. Residents’ financial interests are safeguarded. EVIDENCE: A questionnaire has recently been sent to residents and relatives the manager is in the process of reviewing those returned and compiling the report. Comments received on those returned were positive and include: “ I and my family are satisfied with the care you are giving my uncle. He always looks happy and well cared for I appreciate this.” “ I find your home excellent and really enjoyed the Christmas party.” One relative has conducted a survey with residents and relatives as a result of this new menus have been developed and are about to be introduced. The Haven Nursing Home E53 S42690 The Haven Nursing Home V226100 110505 stage 4.doc Version 1.30 Page 18 The manager regularly audits other areas within the home and includes: • Annual audit of service using the Blue Cross Quality audit tool. • Monthly audit of accidents/incidents • Weekly health and safety checks • Regular care plan audits. Future plans include a survey of stakeholders in the community e.g. GP’s, district nurses etc. Procedures for the management of residents’ pocket money accounts and any valuables handed in for safe keeping are satisfactory. Records for three residents money were checked and were found to be correct. Advocacy services are accessed for residents should they require/request this with the advocate visiting at the time of this visit. The Haven Nursing Home E53 S42690 The Haven Nursing Home V226100 110505 stage 4.doc Version 1.30 Page 19 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 x x x 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 x 13 x 14 3 15 x COMPLAINTS AND PROTECTION 2 2 2 x 3 2 x x STAFFING Standard No Score 27 3 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 2 x x 3 x 3 x x x The Haven Nursing Home E53 S42690 The Haven Nursing Home V226100 110505 stage 4.doc Version 1.30 Page 20 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 9 Regulation 13 Requirement The MAR sheet must indicate the reason for administration for those medications which are prescribed as PRN. MAR sheets must be dated and signed when medications have been reviewed and changes made to the medication. Nursing and care staff must attend training on the management of difficult and challenging behaviours. The manager must provide a timed action plan to the Commission for the proposed building works. This must include a timed plan for the replacement of carpets, furniture and furnishings once the building work is completed. A timed action plan for the refurbisment of bathroom facilities must be provided to the Commission. The manager must ensure that CRB and POVA checks are completed before new staff commence duty. A copy of the completed questionairre report and analysis must be forwarded to the Timescale for action 30/6/05 2. 16 18 30/11/05 3. 19 16, 23 30/07/05 4. 22 16, 23 30/07/05 5. 29 19 Schedule 2 24 11/05/05 6. 33 31/07/05 The Haven Nursing Home E53 S42690 The Haven Nursing Home V226100 110505 stage 4.doc Version 1.30 Page 21 Commission. The results must be made available to residents. 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. Refer to Standard 27 33 Good Practice Recommendations The inspector recommends that the manager regularly review the dependency levels of residents and increase staffing levels accordingly. The inspector recommends that the manager consider the use of dementia care mapping as a tool to monitor the quality of the care to those residents with dementia. The Haven Nursing Home E53 S42690 The Haven Nursing Home V226100 110505 stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Imperial Court Holly Walk Leamington Spa CV32 4YB 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 Nursing Home E53 S42690 The Haven Nursing Home V226100 110505 stage 4.doc Version 1.30 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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