Care Home: Hall Lane Resource Centre

What the care home does well The service was commended for best practice in seven of the National Minimum Standards. People using this service participate in their assessments of need and care plans to ensure that their needs are met in a person-centred way. Staff take a proactive approach to keeping people safe through health promotion and empowering people to assert their rights to valued lifestyles. The staff team are knowledgeable and skilled and recently achieved Manchester City Council`s `Team of the Year` award. The service places a high importance on listening to people`s views and takes action in response to suggestions for improvement. People using the service enjoyed their periods of respite care in the home and participating in the varied range of activities on offer. One person described the experience as `fun` and `invigorating.` People also receive support to participate in the local community and to develop and maintain their relationships with family and friends. What has improved since the last inspection? The three recommendations made at the last inspection had been addressed. Unnecessary items had been removed from the medication cabinet, recruitment records were being held on site and the home was displaying a current public liability insurance certificate. Planned improvements had been made to the environment, such as redecoration, renewal of furniture and refurbishment of the laundry and bathroom. A shower room had been provided to provide people with a choice of bathing facilities. What the care home could do better: One requirement and four recommendations were made at this inspection. A potential risk to people accidentally falling by gaining access to the first floor flat roof must be assessed. Good practice recommendations were made to record preferences in care plans in relation to food, daily routines and religious observance. Furthermore, risk assessments should detail the tasks staff must undertake to keep people safe. Staff should take care to ensure that an accurate record is held of the medicines held in the home. The list of reportable diseases in the health and safety policy should be reviewed to ensure that it is accurate and up to date. CARE HOMES FOR OLDER PEOPLE Hall Lane Resource Centre 157 Hall Lane Baguley Wythenshawe Manchester M23 1WD Lead Inspector Val Bell Unannounced Inspection 13th May 2008 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 Hall Lane Resource Centre DS0000033105.V363448.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. Hall Lane Resource Centre DS0000033105.V363448.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hall Lane Resource Centre Address 157 Hall Lane Baguley Wythenshawe Manchester M23 1WD 0161 945 7609 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) J.Gabrielides@manchester.gov.uk Manchester Children, Families and Social Care James William Gabrielides Care Home 10 Category(ies) of Dementia (0), Dementia - over 65 years of age registration, with number (0), Mental Disorder, excluding learning of places disability or dementia - over 65 years of age (0), Old age, not falling within any other category (0) Hall Lane Resource Centre DS0000033105.V363448.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home provides respite care only for a maximum of 10 service users at any one time within the following categories: old age (OP), older people who require care by reason of dementia (DE(E)), older people who require care by reason of their mental ill health (MD(E)) or adults, aged 60 years and over, who require care by reason of early onset dementia (DE). The Statement of Purpose must be maintained in line with the requirements of Schedule 1 of Regulation 4(1) of the Care Homes Regulations. The Statement must be kept under review and updated. Any changes to the home`s purpose must be agreed with the National Care Standards Commission prior to implementation. The staffing arrangements at the home must be maintained in line with the minimum levels set out in the guidance published by the Residential Forum, `Care Staffing in Care Homes for Older People` . This must be reflected in the Statement of Purpose. The home must be managed at all times in accordance with the guidance and regulations issued in respect of homes for older people by the Secretary of State for Health under Sections 22 and 23(1) of the Care Standards Act 2000. The organisation must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection . The matters detailed in the schedule of requirements attached to the Notice of Registration must be completed within the stated timescales. 27th April 2007 2. 3. 4. 5. 6. Date of last inspection Brief Description of the Service: Hall Lane Assessment/Respite/Outreach (ARO) Unit provides care for a maximum of ten residents at any one time. The unit accommodates older people who suffer from mental ill health. The average stay for each resident is two weeks. Residents in receipt of rotational care are accommodated for approximately 40 nights within a 12-month period. However, this arrangement is flexible to meet the changing needs of those who use the service. One bed is allocated for emergency placements. The unit is located on the first floor of a large two-storey building, which was originally a purpose built residential home for older people. A covered walkway known as the link has been built to connect this building to a large single storey centre for older people, which provide day care facilities for adults with mental health problems, and staff teams who provide a variety of outreach Hall Lane Resource Centre DS0000033105.V363448.R01.S.doc Version 5.2 Page 5 domiciliary services within the community. Residents at Hall Lane have access to the day centre. The Assessment/Respite unit takes up approximately half of the two-storey building. Hall Lane Day Hospital for older people with mental health is also located in the ARO Unit, but this does not directly affect the unit’s services. The centre is located in Baguley, directly opposite a new development of shops and apartments next door to Baguley Hall. The area has a good range of all the usual services, including shops, public houses, health services etc. A large hypermarket is located approximately 35 minutes away. Wythenshawes main shopping centre is 10 minutes drive away. The centre is surrounded by gardens and there are parking facilities for approximately 20 cars. Hall Lane Resource Centre DS0000033105.V363448.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. This was a key inspection, which included site visits to the home. The visits were unannounced which means the manager was not informed beforehand that we were coming to inspect. During the visit we spent time talking to people living in the home, three members of staff on duty and the manager. An Annual Quality Assurance Assessment (AQAA), which is a self-assessment document, had been completed and returned to us prior to this visit. Five people using the service and three members of staff completed satisfaction surveys. Relevant documents, systems and procedures were assessed and a tour of the home was undertaken. What the service does well: What has improved since the last inspection? The three recommendations made at the last inspection had been addressed. Unnecessary items had been removed from the medication cabinet, Hall Lane Resource Centre DS0000033105.V363448.R01.S.doc Version 5.2 Page 7 recruitment records were being held on site and the home was displaying a current public liability insurance certificate. Planned improvements had been made to the environment, such as redecoration, renewal of furniture and refurbishment of the laundry and bathroom. A shower room had been provided to provide people with a choice of bathing facilities. 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. Hall Lane Resource Centre DS0000033105.V363448.R01.S.doc Version 5.2 Page 8 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 Hall Lane Resource Centre DS0000033105.V363448.R01.S.doc Version 5.2 Page 9 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): 3 and 6 Quality in this outcome area is good. People using this service have their needs carefully assessed and recorded prior to their admission. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We looked at how thorough the service had been in assessing the needs of three people who were staying in the home. Care manager assessments of need had been obtained and senior members of the staff team had visited the three people to discuss how their needs could be met. It was evident that the people using the service and their relatives had been fully involved in the assessment process. Care had been taken to ensure that the service would not be offered to people whose needs the home would not be able to meet. A good practice recommendation was made to record more details in relation to food preferences and whether the individual wished to attend religious services of their choice. A member of staff confirmed that if a service user wished to attend a religious service support would be provided as necessary. The detail Hall Lane Resource Centre DS0000033105.V363448.R01.S.doc Version 5.2 Page 10 in risk assessments could be improved to clearly describe the action staff should take to keep people safe. The home did not provide intermediate care. Hall Lane Resource Centre DS0000033105.V363448.R01.S.doc Version 5.2 Page 11 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): 7, 8, 9 and 10 Quality in this outcome area is good. People using this service are respected as individuals and have their care and support provided in a safe way. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The three care plans that we examined contained detailed information to guide staff in what action they must take to meet the assessed needs of people using the service. Each person had been asked their preferences on how they would like their care and support to be delivered. This was evidence of good practice in person-centred care. This could be further improved by recording preferences in relation to food, daily routines and religious observance. We asked staff about this and they confirmed that people are encouraged to make informed choices in these areas. Three people told us that staff always treated them with respect and that their care was provided in a private and dignified manner. A relative completing a Hall Lane Resource Centre DS0000033105.V363448.R01.S.doc Version 5.2 Page 12 survey commented, “My mother was very happy with the care and attention she received from the staff and would be happy to stay in future.” Risks had been carefully assessed to ensure that staff would be able to provide care and support safely. We discussed the ways in which risk management plans might be improved by specifying the actual tasks that staff undertake to ensure individual’s safety. Five people spoken to during the site visits said that they felt safe in the home. All staff had undertaken ‘The Managed Care Training Programme’ in medication administration, although two members of staff were awaiting accreditation. This training package, accredited by Keele University has been developed in partnership with Lloyds pharmacy. People had given signed consent for staff to administer their medication. Records were accurate, medicines were safely stored and medicines had been accounted for. A minor shortfall was found in one person’s medication record, as the amount of paracetamol that was received on admission had not been recorded. Hall Lane Resource Centre DS0000033105.V363448.R01.S.doc Version 5.2 Page 13 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): 12, 13, 14 and 15 Quality in this outcome area is excellent. Staff work hard to promote healthy lifestyles and social inclusion for the people using the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The majority of people that use this respite service also attend on-site day services where a range of health promotion activities is provided. There is evidence that this has improved the health and wellbeing of people using the service, with a marked reduction in falls and improved mobility. Alternative therapies, such as Reiki, are available. The class for this therapy is provided on Saturday mornings. Relatives are invited to join in with the intention that they can continue to provide this therapy when service users return home. Elected members of the service user committee decide the range of activities and day trips to be provided. There is a strong focus on the promotion of social inclusion for older people suffering from mental ill health by involving local schools and the surrounding community. The service also places a great deal of importance on developing and maintaining relationships by involving service users’ relatives and friends in their programmes of support. We visited the day service to ask people their views on the activities provided. Two Hall Lane Resource Centre DS0000033105.V363448.R01.S.doc Version 5.2 Page 14 people said that they thoroughly enjoyed the experience. One person said that she was very isolated at home so she looked forward to being with other people. She said that she attended on four days per week and described the experience as ‘fun’ and ‘invigorating.’ Another person said it provided his wife with a welcome break from caring for him. The excellent standards identified at the last inspection have been further exceeded and this is commended. People using the service have their breakfast, evening meal and supper in the home, while their main meal at lunchtime is provided by the day service. Three people praised the variety of meals available in the home. People can choose from a range of frozen meals that also meet the needs of people on special diets and fresh fruit and salads are also available. Themed nights and barbecues are held in season. One person said that the meals provided by the day service are, “not brilliant, but there is always enough to eat.” At the time of the visit, the Commission’s ‘Highlight of the Day’ report on catering for older people was being implemented in the home. This was identified as an area of good practice. Hall Lane Resource Centre DS0000033105.V363448.R01.S.doc Version 5.2 Page 15 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): 16 and 18 Quality in this outcome area is excellent. People using the service are listened to and positive responses are given to complaints. A proactive response is taken to ensure that staff are vigilant to signs of abuse and that service users are aware of their rights to a safe life. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We looked at how the service deals with complaints. A robust complaints policy and procedure was in place and staff spoken to viewed complaints as opportunities to improve the way the service is provided. People using the service are provided with details, in different formats, on how they can make a complaint and when they can expect a response. One complaint had been received by the service since the last inspection. Records provided evidence of prompt action taken to resolve this to the satisfaction of the complainant. We also looked at what action the service takes to afford protection to the people using the service. Robust policies and procedures were available to guide staff on the action they must take if abuse was suspected or alleged. We talked to three support staff about this. Two of the support staff confirmed that they had received regular refresher training on abuse and they were able to competently explain the correct action to take in safeguarding the welfare of people using the service. The third support worker had not received training but with minimal prompting it was clear that she understood the process. We Hall Lane Resource Centre DS0000033105.V363448.R01.S.doc Version 5.2 Page 16 told the manager about this person’s need for training and he promptly booked her on an appropriate training course. This was evidence of good practice in managing improvement. Proactive action had been taken to inform people using the service of their rights and to improve their knowledge of how to stay safe. This had been achieved by inviting Manchester’s ‘Crucial Crew’ in to talk to service users and members of the local community. This team of people includes experts from the fire service, community police, trading standards and Manchester Local Authority aids and adaptation service. This provided evidence of best practice in promoting the rights and safeguarding the safety of people using the service and this was commended. Hall Lane Resource Centre DS0000033105.V363448.R01.S.doc Version 5.2 Page 17 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): 19 and 26 Quality in this outcome area is good. People using the service are provided with a pleasant, comfortable and safe living environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Significant environmental improvements had taken place since the last inspection. This included extensive redecoration of private and communal space and the provision of new furniture, fittings and flooring. The laundry and main bathroom had benefited from refurbishments and a new shower room had been provided. This provided choice for people in relation to their personal hygiene needs. It was pleasing to note that the manager had conducted regular audits of the environment as this ensured that the home continued to provide a pleasant and safe living environment for people using the service. However, a potential risk was identified. A fire exit led onto a first floor flat roof, bordered by waist-high railings. Although the exit door was Hall Lane Resource Centre DS0000033105.V363448.R01.S.doc Version 5.2 Page 18 alarmed, staff may not be able to respond in sufficient time to prevent a person falling over the low railings. It is required that this potential risk be reviewed by Manchester City Councils health and safety department. Staff had received refresher training in infection control during the previous twelve months and each member of staff was provided with alcohol-based hand rubs to minimise the risk of cross infection. Hall Lane Resource Centre DS0000033105.V363448.R01.S.doc Version 5.2 Page 19 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): 27, 28, 29 and 30 Quality in this outcome area is excellent. Staff work hard as a team to achieve positive outcomes for people using the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Sufficient staff had been deployed to meet the assessed needs of people using this service. The staff received a commendation for achieving Manchester’s corporate award in good teamwork. A member of staff completing a survey said, “Hall Lane is a dynamic place to work. The staff group have recently won ‘Team of the Year’ for Manchester City Council and are now being entered for a national award. The service users, on the whole, appear to be settled and content. Staff have fantastic relationships with them.” A relative commented, “Staff are very helpful and there is always somebody available to talk to.” Sixteen staff had achieved a National Vocational Qualification (NVQ) at level 2 in care and one of the managers was working towards this qualification at level 4. We looked at the recruitment records for two members of staff. These contained all the required pre-employment checks. A staff member completing a survey said, “It was about two months before I started, which could have Hall Lane Resource Centre DS0000033105.V363448.R01.S.doc Version 5.2 Page 20 been quicker, but checks have to be made.” This afforded protection to the welfare of people using the service. Staff working in the home had access to Manchester City Council’s staff development programme. Training undertaken in the previous twelve months included oral hygiene, safeguarding adults and diabetes awareness. This ensured that staff had the knowledge and skills to understand conditions associated with old age. Hall Lane Resource Centre DS0000033105.V363448.R01.S.doc Version 5.2 Page 21 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): 31, 33, 35 and 38 Quality in this outcome area is excellent. The home is run in the best interests of people using the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Management of this service is open and transparent and is provided flexibly in the best interests of people accommodated. People are asked to complete satisfaction surveys at the point of discharge and their views and suggestions are listened to and acted upon to improve the service they receive. A formal quality assurance system is also used to monitor, audit and review the service. A service user ‘champion’ has been elected to provide support to other service users in expressing their views on the quality of service provided. Empowering service users in this way is commended as an area of best practice. Hall Lane Resource Centre DS0000033105.V363448.R01.S.doc Version 5.2 Page 22 Bedrooms are fitted with lockable cupboards for the safekeeping of personal spending money and valuables. Support is also available with managing money. Records kept for this are accurate and receipts are obtained for expenditure. We looked at a sample of health and safety records and this provided evidence that a safe environment is provided for people accommodated in the home. It is recommended that the list of reportable diseases in the health and safety policy be reviewed to ensure it is accurate and up to date. Hall Lane Resource Centre DS0000033105.V363448.R01.S.doc Version 5.2 Page 23 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 X 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 4 13 4 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 4 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 X X 3 Hall Lane Resource Centre DS0000033105.V363448.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No 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 OP19 Regulation 13 (4) Requirement It is required that the potential risk of falls from the first floor flat roof is reviewed to ensure that people using the service are safe from harm. Timescale for action 22/06/08 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 OP3 Good Practice Recommendations The service provided to people could be improved by assessing and recording preferences and choices in relation to food, preferred daily routines and religious observance. Risk assessments (falls and moving and handling) should contain specific detail on what tasks staff must undertake to keep people safe. Staff should take care to ensure that they can account for quantities of all medication held in the home. 2. OP7 3. OP9 Hall Lane Resource Centre DS0000033105.V363448.R01.S.doc Version 5.2 Page 25 4. OP38 The list of reportable diseases in the health and safety policy should be reviewed to ensure that it contains accurate and up to date information. Hall Lane Resource Centre DS0000033105.V363448.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Manchester Local office 11th Floor West Point 501 Chester Road Manchester M16 9HU 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. 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