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Inspection on 06/06/05 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 6th June 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 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

The care home provides both long-term and short-term care to older people in a comfortable and homely environment. Staff respect the privacy and dignity of service users and provide care in a sensitive manner. The home retains its care staff by offering training including NVQ course work. The management team communicate well with all care staff.

What has improved since the last inspection?

There has been an improvement in communication and team work since the last inspection. Care records have been improved. Care plans and risk assessments are now being used as working documents.

What the care home could do better:

Risk assessments were not completed fully. The management of any identified risk had not been transferred onto individual care plans. The quality of individual care plans and risk assessments varied. The care staff interviewed were not fully aware of the needs of all of the service users they were caring for on the day of this inspection. The proprietor of the care home is required to visit on a monthly basis and provide a written report of his review of the services being provided by the home. Only one report has been received since the last inspection in January 2005. The proprietor is required to provide supervision on a formal basis to his acting manager and record this discussion. This has not happened since the last inspection.

CARE HOMES FOR OLDER PEOPLE The Haven Residential Home 266 Eastgate Louth Lincs LN11 8DJ Lead Inspector Ken Hague Unannounced show Solas 6 June 2005 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 Residential Home C04 C53 S61417 TThe Haven 6-6-05 V231703 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Haven Residential Home Address 266 Eastgate Louth Lincs LN11 8DJ 01507 604197 01507 601190 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) Haven Healthcare (UK) Ltd Application to be submitted PC Care Home Only 33 Category(ies) of MD - Mental Disorder - 2 registration, with number OP - Old Age - 31 of places The Haven Residential Home C04 C53 S61417 TThe Haven 6-6-05 V231703 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 24/01/05 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 other being the conversion of the former coachhouse. 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 Haven Residential Home C04 C53 S61417 TThe Haven 6-6-05 V231703 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over a period of nine hours - there were two visits made on 6 June and 13 June 2005. A tour of the premises was conducted and care records were inspected. Two staff and three service users were interviewed. The proprietor of the care home had a detailed discussion with the Inspector on his second visit on the 13 June. The acting manager and deputy manager were actively involved in the inspection, which included a formal interview with both managers. What the service does well: What has improved since the last inspection? What they could do better: Risk assessments were not completed fully. The management of any identified risk had not been transferred onto individual care plans. The quality of individual care plans and risk assessments varied. The care staff interviewed were not fully aware of the needs of all of the service users they were caring for on the day of this inspection. The proprietor of the care home is required to visit on a monthly basis and provide a written report of his review of the services being provided by the home. Only one report has been received since the last inspection in January 2005. The proprietor is required to provide supervision on a formal basis to his acting manager and record this discussion. This has not happened since the last inspection. The Haven Residential Home C04 C53 S61417 TThe Haven 6-6-05 V231703 Stage 4.doc Version 1.30 Page 6 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 Residential Home C04 C53 S61417 TThe Haven 6-6-05 V231703 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 Residential Home C04 C53 S61417 TThe Haven 6-6-05 V231703 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) 2,3&5 The admission process enables service users to make an informed choice about coming to stay at the care home. The initial assessment carried out by the acting manager provides staff with information about the care needs of an individual service user. EVIDENCE: The three service users files inspected during this visit all contained detailed assessment made prior to their admission to the care home. These documents were signed by the assessor and the service user and dated. The statement of purpose was displayed in the care home on the day of the inspection. The service users interviewed confirmed that they have been involved in their initial assessment and that they been issued with a statement of the terms and conditions. The Haven Residential Home C04 C53 S61417 TThe Haven 6-6-05 V231703 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 Service users care needs are recorded with plans of how these should be met on the individual files. A service user can self medicate, after the completion of the risk assessment and consultation with the GP. Staff at the care home respect the right and privacy of service users while carrying out their employment tasks. EVIDENCE: The three files sampled during this inspection all contained initial assessments. The health care needs and social care needs of the service users were recorded on their assessment. All files contained details of health care needs in respect of dental care, eye care and chiropody. All files contained a skin assessment and where medication was required the frequency that medication should be dispensed by staff. Service users personal choices for care was recorded, for example one file stated this service user prefers a shower to bath. The file gave details of the choice of cosmetics and the areas of the body where the service user preferred to wash themselves. Details of the levels of supervision and practical help required in assisting them to bathe were on their individual file. This included the number of care staff required to provide personal care and whether a hoist was necessary. The Haven Residential Home C04 C53 S61417 TThe Haven 6-6-05 V231703 Stage 4.doc Version 1.30 Page 10 A service user stated “staff are very kind and considerate they protect my modesty when helping me to dress or assisting me to have a bath”. All service users spoken to confirmed that their health care needs were being met by the home. The personal files contain details of hospital visits, GP visits and the care being provided by district nurses. The home medication policy meets the National Minimum Standards. A service user confirmed that he did self medicate. The staff confirmed that this was correct and explained how they assisted him by monitoring the medication kept in his bedroom. They had not, however followed the homes medication policy fully by not contacting the GP to obtain his views in relation to the service user been able to self medicate. The Haven Residential Home C04 C53 S61417 TThe Haven 6-6-05 V231703 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) 13,14 &15 Relatives and friends of service users are made welcome to the home. The home provides a choice of menu which meets the needs of all service users including those with special dietary requirements. EVIDENCE: The care staff were asked to give details of family members for the service users whose files had been studied by the Inspector. Staff described all family members and confirmed the importance of the relationships being maintained. staff were asked to answer a question in relation to a second service user, “what do you believe is the most important need this person has which must be met to maintain his quality of life? The answer was “frequent contact with his family but particularly his partner”. The records provided evidence that this statement was correct. Service users files contained details of their personal wishes and choices, for example one record stated “she wishes staff to only wash the parts of her body which she is unable to reach herself.” There were details of her choice of activities recorded on her care plan. All service users likes and dislikes in relation to food were recorded. In the case of one service user it was recorded “she dislikes tomatoes and strawberries has a small appetite and does not like foods which contains seeds”. The Haven Residential Home C04 C53 S61417 TThe Haven 6-6-05 V231703 Stage 4.doc Version 1.30 Page 12 Staff formally confirmed that service users are shown the menu for the following day at teatime. Their choice for the following day is then passed on to the kitchen. Staff confirmed alternatives are always available. The service users confirmed this to be the case. All four service users spoken to during this inspection confirm their satisfaction with the choice quality and quantity of food provided by the home. The Haven Residential Home C04 C53 S61417 TThe Haven 6-6-05 V231703 Stage 4.doc Version 1.30 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 standard(s) Not inspected EVIDENCE: The Haven Residential Home C04 C53 S61417 TThe Haven 6-6-05 V231703 Stage 4.doc Version 1.30 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 standard(s) 19,20,23,24,25&26 The service users live in a comfortable and homely environment. The standard of decoration and furnishing is good, providing a safe and clean environment The home has a continuous rolling maintenance programme. EVIDENCE: Areas of the home have been decorated since the last inspection in January 2005. The gardens are well maintained and all lawns were being cut on the day of this visit. All furnishings were found to be of a good standard, service users spoken to confirm their satisfaction with the facilities provided in their individual bedrooms. A service user stated that she was moving to a new bedroom by choice as she had decided to stay long-term at the care home. A number of the rooms were viewed as part of the tour of the home, they were seen to be furnished in accordance with the National Minimum Standards. All areas of the home was found to be clean and free from any offensive odour. No health and safety issues were identified as part of this inspection. Staff stated that the home is a safe environment in which to work. The Haven Residential Home C04 C53 S61417 TThe Haven 6-6-05 V231703 Stage 4.doc Version 1.30 Page 15 The Haven Residential Home C04 C53 S61417 TThe Haven 6-6-05 V231703 Stage 4.doc Version 1.30 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 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) 28,29,30 The home has a stable staff group. The management team employs sufficient staff to meet the needs of service users. There is a staff training programme in place. The acting manager is following the recruitment policy of the home EVIDENCE: The acting manager stated there has been very few changes in staff employed by the home since the last inspection. The inspection of records for new staff confirmed that the recruitment policy of the home is being followed. The individual files for new staff contained all the information required under the Care Home Regulations. Staff stated there are always sufficient numbers on duty to meet the needs of the service users. They stated that they are given sufficient warning in relation to future shifts. The homes training plan was seen, which included details of NVQ training. The acting manager confirmed that she expects 50 of the staff to obtain NVQ two in care by the end of 2005. The Haven Residential Home C04 C53 S61417 TThe Haven 6-6-05 V231703 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) 31,32,33,36,38 The Acting manager and deputy manager are supportive to all care staff. The care records have improved as a direct result of work being carried out by the new management team. Service users are able to raise any concerns with the management of the home. The proprietor has failed to supply the Social Care Inspection with section 26 reports. Supervision for the acting manager has not been provided. EVIDENCE: The inspection of care records provided evidence that since the last inspection the filing process for care records has been reorganised. Information is now filed in a consistent manner; all files contained a standard index. The quality of the recording was found to have improved since January with greater inclusions of choices and wishes of service users being recorded. All requirements identified at last inspection have been met. Staff confirmed that they had been provided with annual appraisals and that supervision is being provided at least six times a year on a one-to-one basis. The Haven Residential Home C04 C53 S61417 TThe Haven 6-6-05 V231703 Stage 4.doc Version 1.30 Page 18 The acting manager stated that she had only received one supervision in 2005. The home was unable to produce copies of section 26 reports which is a requirement under the Care Home Regulations. The proprietor agreed in his discussions with the Inspector that supervision had not been provided to the acting manager. He confirmed section 26 visits have been made, but reports had not been completed. The Haven Residential Home C04 C53 S61417 TThe Haven 6-6-05 V231703 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 3 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 x x 3 3 3 3 STAFFING Standard No Score 27 x 28 3 29 3 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 3 3 3 x x 2 x 3 The Haven Residential Home C04 C53 S61417 TThe Haven 6-6-05 V231703 Stage 4.doc Version 1.30 Page 20 no 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. 2. Standard 7 18 Regulation 13-2 26 Requirement The registered person must make arrangements for the safe administration of medication The registered proprietor must visit the care home in accordance with regulation 26 and supply a report to the Commission for Social Care Inspection supervision must be provided for the Acting Manager Timescale for action immediate 31 August 05 3. 4. 36 31 August05 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 none Good Practice Recommendations The Haven Residential Home C04 C53 S61417 TThe Haven 6-6-05 V231703 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection 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 Residential Home C04 C53 S61417 TThe Haven 6-6-05 V231703 Stage 4.doc Version 1.30 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. 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