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Inspection on 28/08/07 for The Haven Residential Home

Also see our care home review for The Haven Residential Home for more information

This inspection was carried out on 28th August 2007.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

This home provides a pleasant, homely and clean environment for residents. Those people spoken to expressed their satisfaction about most aspects of the care provided. Comments received were `the food is very good`, `I can have my meals in my room` and `the staff are good and thoughtful`. One visitor also praised the home stating `I am made welcome when I come here and the carers are friendly and helpful`. The care staff were observed throughout this visit as being competent, kind and polite when speaking to residents. The manager and staff are good at developing positive relationships with each resident. The acting manager monitors the views of residents through a quality assurance system, which enables the home to ensure that continuous improvements are identified and acted upon.

What has improved since the last inspection?

The acting manager stated that she communicates with all those people who are cared for in this home as well as relatives, GPs, district nurses and the commission. She also felt that staff morale has improved and training is now in place, which ensures that all staff can meet the needs of residents. There is no longer regular sick leave by carers and there is only a minimal turnover of staff.

CARE HOMES FOR OLDER PEOPLE The Haven Residential Home 266 Eastgate Louth Lincs LN11 8DJ Lead Inspector Doug Tunmore Key Announced Inspection 28th August 2007 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 Residential Home DS0000061417.V340578.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 Residential Home DS0000061417.V340578.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Haven Residential Home Address 266 Eastgate Louth Lincs LN11 8DJ 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) 01507 604197 01507 601190 Haven HealthCare (UK) Ltd ** Post Vacant *** Care Home 33 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (2), Old age, not falling within any of places other category (31) The Haven Residential Home DS0000061417.V340578.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th May 2006 Brief Description of the Service: The Haven residential care home is located a short distance from the centre of the market town of Louth. The care home consists of a large main building, which was formerly a vicarage, and two detached bungalows. One of these is a modern building, the others being the conversion of a former courthouse. There is a large car park at the rear of the home, which is surrounded by well maintained gardens. The care home is registered to provide care for 33 service users, 31 code elderly and 2 code mental disorder. The home offers long-term care, respite care and holiday stays. All accommodation is provided in single rooms. The fees at the inspection visit on the 28/08/2007 ranged from £348:00 to £431:00, plus chiropody £10:00, hairdressing £6:00 and personal newspapers and magazines. Information about the home can be obtained from the manager of the home. The statement of purpose, service users guide and most recent inspection report are also available from the manager. The Haven Residential Home DS0000061417.V340578.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key visit was announced and took into account any previous information held by the Commission for Social Care Inspection (commission) including the homes previous inspection reports and their service history. The providers Annual Quality Assurance Assessment form has not been received by the commission, which did not enable the commission to send surveys to residents to obtain their views on the care on offer at this home. The site inspection consisted of case tracking a sample of two residents records and assessing their care. The inspector spoke with two of the residents who were being case tracked and joined two other people for lunch, where a general discussion took place about the care on offer at this home. The inspector also spent time with the Provider, manager, the administrator, two carers and one visitor. A partial tour of the home and a review of a sample of the records were also included. What the service does well: What has improved since the last inspection? The acting manager stated that she communicates with all those people who are cared for in this home as well as relatives, GPs, district nurses and the commission. She also felt that staff morale has improved and training is now in place, which ensures that all staff can meet the needs of residents. There is no longer regular sick leave by carers and there is only a minimal turnover of staff. The Haven Residential Home DS0000061417.V340578.R01.S.doc Version 5.2 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 summary of this inspection report can be made available in other formats on request. The Haven Residential Home DS0000061417.V340578.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 Residential Home DS0000061417.V340578.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1, 2,3, 5 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There was information available to enable residents to make a choice as to whether or not to enter the home. People received a care needs assessment, which resulted in their needs being met. EVIDENCE: A previous visit record dated May 06 and evidence seen at this visit in peoples files showed that the home does not admit residents without a care needs assessment being undertaken. Prospective residents are also written to by the home confirming whether they can meet the residents care needs or not. Care needs assessment records also fully documented their care needs. Residents files also contained a current contract setting out the terms and condition of a residents stay: these were signed by the resident or their representative. Two residents commented that ‘yes it was talked over and it The Haven Residential Home DS0000061417.V340578.R01.S.doc Version 5.2 Page 9 looked pretty good’. Another resident stated that she thinks ‘this is a good home’. The acting manager stated that people are encouraged to visit the home prior to admission so that they can make an informed decision. The home does not provide intermediate care. The Haven Residential Home DS0000061417.V340578.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Medication is safely administered. Residents care plans need to give further detail, promoting their privacy, dignity and respect. EVIDENCE: Care records at a previous visit contained all of the residents assessed care needs identified in the assessment. These included care and social needs and the wishes and choices of each resident. The wishes and choices of individual residents in relation to their personal life were also recorded on their care plans. This visit found that in the case of the two residents being case tracked where a risk was identified, the management of that risk was recorded. Care plans also need to further establish the intimate care needs of residents and what help they require when bathing or toileting or how their privacy and dignity can be maintained. There must be a discussion with individual residents The Haven Residential Home DS0000061417.V340578.R01.S.doc Version 5.2 Page 11 to establish their individual needs. The manager confirmed that this would be addressed with all carers and implemented as soon as possible. Two people who were being case tracked stated that they are visited by the community nurse and their GP when they wanted to see them. The pharmacist visited the home on the 20/06/07. The pharmacist recorded that storage, stock control, a medication review and a spot check of records is carried out appropriately. This visit found that an accurate record is made of medication given to residents. Those people who were being case tracked confirmed that they do not self-medicate. The Haven Residential Home DS0000061417.V340578.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Social activities were varied and provide stimulation and interest for people living in the home. Visitors were made to feel welcome. Meals provided were nutritious and varied. EVIDENCE: A previous visit in May 06 evidenced that residents are helped to exercise choice and control over their lives. Choices and wishes of the residents were recorded on the individual file. The acting manager stated that a lot of work has been undertaken to provide activities for residents. There is an activities annual plan and the manager commented that people would be able to enrol in the Trinity Activities Centre in the near future. The activities available at the centre are flower arranging, chair exercises to music, watercolour painting and local history. No list of activities was available at this inspection. One resident stated that she doesn’t join in with activities she prefers to keep to herself in her room to read the papers. Another resident confirmed that she The Haven Residential Home DS0000061417.V340578.R01.S.doc Version 5.2 Page 13 undertakes activities and outings. Carers stated that activities consisted of music, bingo, DVDs and crafts at Easter and Christmas making seasonal greetings cards. They said that no outings had been undertaken. A visitor stated that she is made welcome by the carers who are open and friendly. The inspector joined residents at lunch and some confirmed that their relatives visit the home and are made most welcome. All those people seen praised the quality of the meals at this home. The inspector found the food to be well prepared, tasty, hot and delicious. The Haven Residential Home DS0000061417.V340578.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints received were treated properly and residents and visitors knew that any complaints they had to make would be addressed and taken seriously. People stated that they feel safe in this home and have no concerns. EVIDENCE: The home has given all residents the homes service users guide, which contains the homes complaint procedures. The home has a detailed complaints procedure and a record is kept of all complaints made. The acting manager stated that she would amend the complaints form to include a space for a complainant to sign and comment on the outcome of their complaint. Previous visits have found that the providers policies and procedures were in place to ensure residents are protected. A previous complaint received by the commission in April 07 regarding this home was discussed with the provider and the acting manager. They confirmed that the complainant had not contacted them in any way and therefore the provider has taken no action. Records in the home showed that no complaint had been received at that time. No vulnerable adults issues have taken place since the last inspection. Staff training records evidenced that adult abuse awareness training has been provided for carers. Two members of staff confirmed that they had received The Haven Residential Home DS0000061417.V340578.R01.S.doc Version 5.2 Page 15 protecting vulnerable adults training and that they were aware of the providers whistle blowing policy. Verbal comments received from residents were ‘ I have no complaints’ and ‘we feel safe here’. Carers also stated that if they became aware of an abusive situation they would report it to the manager. The Haven Residential Home DS0000061417.V340578.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is reasonably well maintained, the standard of the environment and its facilities are appropriate to the needs of residents. The home is clean and had a pleasant smell throughout. EVIDENCE: A previous visit carried out in May 06 found the home is well maintained with well-kept lawns and gardens. Bedrooms had been personalised by the residents or their families with photographs, memento’s and small items of furniture. The Haven Residential Home DS0000061417.V340578.R01.S.doc Version 5.2 Page 17 The home was clean and the acting manager employs domestic staff. The residents commented about how they felt safe and that the home had a good name. A tour of the home found that there was a disparity between the main building and the two detached bungalows with these having a better quality of décor. The provider and acting manager confirmed that there is a refurbishment programme and bedrooms had been decorated. Future plans are for the stair carpet in the main building to be refitted, as it is very frayed. Two carers said that the main building is in need of decorating especially resident’s bedrooms and hallways. The provider stated that further improvements are to be made as part of the yearly maintenance plan. People who were being case tracked confirmed that that their rooms are kept clean. People seen during this visit stated that the home has not had any unpleasant odours. Observations made during this visit were that all staff use disposal gloves and aprons. The Haven Residential Home DS0000061417.V340578.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Appropriate recruitment practices are in place to ensure the safety of residents. Training needs for carers needs are assessed so as to ensure that they can meet the needs of residents. EVIDENCE: The last visit to this home showed that recruitment records had been greatly improved since the last inspection. This visit showed that thorough recruitment practices are undertaken to ensure the safety of those people living in this home. The General Social Care Council Codes of Practice are issued which set out the responsibilities of care workers looking after vulnerable adults. Two carers seen who has worked for ten and four years in the home confirmed that they have a Nationally Vocational Qualification level 2 in caring for the elderly. The training file evidenced that seven carers have a nationally recognised qualification in caring for the elderly and others carers are to undertake training in October 07. The training file also evidenced that training dealing with falls has been undertaken plus dementia care, basic food hygiene and the administration of medication. The rota was seen and evidenced the number of carers, night care staff and domestic workers on duty at any given time. Those people seen during this The Haven Residential Home DS0000061417.V340578.R01.S.doc Version 5.2 Page 19 visit stated that they felt that there were enough staff on duty and that the carers came quickly if they pressed the call bell for attention. Two carers felt that there were enough staff given the number of residents currently being looked after. The Haven Residential Home DS0000061417.V340578.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The acting manage is suitably qualified and experienced to carry out her tasks. Records seen show that residents health and general welfare and safety is promoted. Accurate records are kept of residents monies. The health and welfare needs of people living in the home are not always fully met. EVIDENCE: The acting manager has worked in this home since October 06; she is a qualified nurse with a degree in nursing. She has worked for twenty-five years at various levels in caring for the elderly. The acting manager has not completed a fit person interview with the commission, which is required by regulation. The provider stated that he would make sure that action would be The Haven Residential Home DS0000061417.V340578.R01.S.doc Version 5.2 Page 21 undertaken to meet regulations and ensure that the home has a registered manager. Residents and staff stated that the manager is approachable. Two carers stated that the manager is very supportive and that they are pleased she is returning to work soon. The home conducts a quality assurance report, which includes the views of residents and visitors to the home. The administrator could not remember when the last residents meeting was held. Residents meetings should be held so as to inform the management of their views as to the running of the home and any concerns that they may have. The home only deals with personal allowances of residents, which are kept safe. Past visits have found that the proprietor and manager are not responsible for any residents affairs but residents families handle them. Two residents allowances were checked and an accurate record was kept, with signatures and receipts available for monies spent. The commission has been made aware that bailiffs acting on behalf of East Lindsey County Council have visited the home in relation to unpaid council tax bills. On the 29/08/07 the provider gave the commission permission to talk to the bailiff to confirm that outstanding bills had been paid. The bailiff confirmed that council tax bills had been paid in full. The homes fire log evidenced that fire alarms, fire drills and emergency lighting checks have been undertaken. Care staff also receive fire training as part of the homes initial training and as a regular training event. Up to date certificates were also available regarding the servicing of hoists and the homes shaft lift. One resident was observed being pushed to the bathroom on a ‘chair commode’, with her feet not supported by foot rests. No risk assessments were available in the residents file regarding this practice neither was there a request by the resident to be moved on a commode. The acting manager commented that a risk assessment would be implemented and the residents care plan would address the issues of using a wheelchair with foot rests at all times. The Haven Residential Home DS0000061417.V340578.R01.S.doc Version 5.2 Page 22 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 3 3 x 3 x 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 2 The Haven Residential Home DS0000061417.V340578.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NA 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 OP38 Regulation 13 (4) (5) Requirement Residents must be protected from avoidable risks to their health and safety by ensuring that wheelchairs are used with footplates to move them around the home. Timescale for action 31/08/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Haven Residential Home DS0000061417.V340578.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Residential Home DS0000061417.V340578.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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