Care Home: Hardriding House

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Hardriding House Hardriding House Bardon Mill Hexham Northumberland NE47 7ET two star good service The quality rating for this care home is: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Carole McKay Date: 0 7 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Internet address www.csci.org.uk Information about the care home Name of care home: Address: Hardriding House Hardriding House Bardon Mill Hexham Northumberland NE47 7ET 01434344330 F/P01434344330 noemail Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Hardriding House Ltd Name of registered manager (if applicable) Mrs Angela Rose Hanking Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 19 0 care home 19 learning disability Additional conditions: The registered person may provide the following category of service only: Care Home only, Code PC. To service users of the following gender: Either. Whose primary care needs on admission to the home are within the following category: Learning Disability, Code LD, maximum number of places 19 The maximum number of service users who can be accommodated is: 19 Date of last inspection 1 5 1 1 2 0 0 6 A bit about the care home Hardriding House provides care to nineteen adults with learning disabilities. Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home How we did our inspection: This is what the inspector did when they were at the care home The Visit: An unannounced visit was made on 6th November 2008. During the visit we: Looked at information about the people who use the service & how well their needs are met. Talked with people who use the service, staff and the manager. What the care home does well People have good relationships with the staff. The home is well run and people live in safe place. The meals are good. What has got better from the last inspection What the care home could do better. Provide staff with up to date and clear procedures for handling medications. Provide staff with up to date local procedures for protecting people from harm. Make sure that there are enough staff for the changing needs of the people who live at the home. Update some of the checks that are made into the background of staff and some of the training they receive. If you want to read the full report of our inspection please ask the person in charge of the care home. If you want to speak to the inspector please contact Carole McKay St Nicholas Building St Nicholas St Newcastle upon Tyne NE1 1NB 01912333300 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People who use this service will make informed choices and have their needs fully assessed. Evidence: People who are considering coming to live at the home are provided with information and opportunities to visit, prior to making a decision. Some of the information is now out of date, but generally it is useful. Any person choosing to come to live at the home will have their needs fully assessed beforehand. The assessment will provide staff with comprehensive information on which to base the care and support they provide to the individual. Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The people who live at the service are consulted and participate in all aspects of life within the home, through managed risk taking that is assessed as needs change. Evidence: The people who live at the home each have a service user plan. These are reviewed regularly, usually every six months or more frequently if necessary. In surveys the people who live at the home confirmed that are usually able to make their own decisions about what they do each day. There is some evidence that restrictions on available day services and staff availability has affected the spontaneity of activity over recent months. Within the home people are encouraged to be independent. During the visit some people spent group time together, whilst others made decisions to spend time alone doing activities that they enjoyed, for example gardening and tidying. The people who live at the home are encouraged to have formal, recorded meetings to discuss the running of the home with the staff. One of these took place the day before the inspection, though the last recorded meeting took place in April 2007. The people who live at the home are supported to be independent and to take manageable risks. Risk assessments and risk management plans are in each persons service user plan. All of these have been reviewed since the last inspection, but the frequency of review varied a great deal from person to person, depending on the amount of change happening in a persons life. This is reasonable but it does not ensure that risks are not being overlooked for people whose lives are more settled. Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The level of activity available to people living at the service is good but somewhat reduced of late by changes in opportunities and abilities. The service is striving to adapt to these changes, to continue to support and meet aspirations. People are offered a healthy diet of home cooked food in a social setting. Evidence: The people who live at the service continue to be supported to enjoy an active life through paid and unpaid work, social activity and creative pastimes. Since the last inspection some people have lost some of their placements at outside daytime activities. The service and the people who are affected by this, are having to adjust to having more time at home. As people age their abilities and needs are also changing . Some staff feel that more could be done to support people with things other than physical needs, if there were more staff. Despite this, the service strives to maintain as individualised and varied range of activity as is possible. Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People who live at the service receive the care and support they need in the way that they prefer. Their physical needs are met and changes in needs are recognised. The medication arrangements are safe and people are supported by trained staff following guidelines that are generally satisfactory. Evidence: People who live at the service have their health needs identified and are supported to gain access to community based services, such as a general practitioner, dentist, optician. Individual needs are respected and as individual needs change the service will support people to stay at the home, as far as it is possible, and to move on if necessary. It does this through staff training, and involvement of other agencies and specialists. Some of the people who live at the service are at, or around, retirement age. Some adaptations have been introduced as necessary. The buildings are not physically adapted to the needs of older people and risk taking and support planning may need to take account of this in the future. Most of the people who live at the service require support to take regularly prescribed medication. The home has secure storage for these. Written procedures for staff to follow are available. Staff have undertaken level 2 training in medication administration. Some specialised support is provided for one person who has epilepsy. There is written guidance for staff to do with the timing of this medication. The method of administration is not described. Staff said that they had received training to do with administering this medication, but there is no clear record of this. The ability of service users to consent to treatment is recorded. Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The people who live at the home are informed about how to raise concerns and feel they can do so. The staff are aware of procedures, but do not have access to recent versions of the local procedures. Evidence: No complaints or concerns about the service have been received by CSCI. The home has not handled any concerns or complaints since the last inspection. The home has an easy to read version of the complaints procedure. Copies of this are posted up in the home. In surveys the people who live at Hardriding House confirmed that they know who to speak to if they are unhappy. And how to go about making a complaint. Staff confirmed that they know how to respond to concerns. The home has its own policy and written guidance for raising concerns and dealing with abuse of vulnerable people. Some of the staff received awareness training in 2005 covering the protection of vulnerable adults. The manager and deputy have taken a two day course in the management of suspected abuse. Local procedures for the reporting of abuse have been revised since 2005, but these are not available. Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The people who use the service live in clean, homely and comfortable surroundings that are suited to their abilities and preferences. The home offers a high degree of privacy for those who are more independent. Evidence: The home offers the people who live there varied accommodation. Some people can live semi independently in cottages or self contained flats, with the benefits of the amenities of the main house nearby. Most of the buildings are old but are well maintained and small structural improvements are planned in one area of the home, where damp is penetrating the window surround. Where people are able to do so they are encouraged to take responsibility for keeping their personal space tidy and clean. A cleaner is employed to maintain the communal areas and some of the personal rooms. The home is clean throughout. Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People who live at the service are supported by a team of staff they have trust and confidence in. Updating recruitment processes and reviewing staffing levels will continue to keep people safe. Evidence: The home is adequately staffed with low staff turnover. The changing needs of the people who live at the home, accompanied by changes in the availability of attendance at outside services all mean that more pressure has been placed on the homes staff of late. People who live at the service speak highly of the staff. There is evidence that staff are supported through induction and further opportunities for training. Though some of the mandatory training is ready for updating. The recruitment process is generally thorough and includes the necessary checks and references, though some of the criminal record checks have not been reviewed for several years. Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The people who live at the service are kept safe in a well managed home. Evidence: The registered manager is qualified, experienced and communicates a clear sense of direction and leadership. The manager is undertaking further qualifications. The home has quality assurance and health and safety systems. These are kept up to date and the building is safe. In particular the home has a good food hygiene record. Other records are held securely and kept in good order. Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action 1 20 13 The registered manager 16/02/2009 must provide clear written procedures describing the method of administration for medication that is administered as necessary for the emergency treatment of epilepsy. Clear written procedures can be referred to at any time and will help avoid errors, keeping service users safe. 2 23 13 The registered manager 30/03/2009 must make arrangements for staff to have updated training in local safeguarding procedures and make copies of these available to staff Staff who are familiar and up to date with the local procedures can better safeguard people using the service from harm. 3 32 18 The registered manager must update the mandatory training for staff. 31/03/2009 This will ensure that staff care practice is up to date and safe procedures are followed. 4 33 18 The registered manager 31/03/2009 must introduce and carry out a regular review of the staffing levels taking into account the dependency needs of the service users. This will ensure that the service can continue to provide good quality care into the future and as needs of service users change. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 1 8 The service users guide should be reviewed to update the information to do with the provider and staffing details. Group meetings of service users should take place at regular intervals and frequency to be effective at including people in the running of the home. Risks should be assessed as part each persons care prior to admission and thereafter at regular intervals within each year, as a minimum. The registered manager should consider introducing age related assessment tools, such as those to do with general dependency and falls. The manager should periodically update criminal record checks for staff. 3 9 4 19 5 34 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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