Care Home: Harley House Care Home

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What the care home does well There is a very good assessment process in place and people are always visited before they move into Harley House so that their care and support needs can be identified. A visit to the home is also strongly encouraged so that the people interested in living there can see what the facilities are like and the type of service they can expect to receive. Peoples` privacy and dignity is maintained at all times and those we spoke with told us that they were being well cared for and their care and support needs were currently being met. People living at Harley House enjoy the home cooked food which is prepared and cooked by the cook and the kitchen staff. The dining room has tables set out with tablecloths and flower centre pieces, to provide people with a pleasant dining experience and there are bright and airy lounges to relax in. There are good aids and adaptations available to support those living in the home who are more frail, or who have physical disabilities. Recruitment practices ensure that the necessary checks are carried out before a new member of staff commences work. This protects the people living at Harley House from possible harm. The management team is working hard to make sure that staff receive all the training and support that they need. They are approachable and families and friends or those living at Harley House are strongly encouraged to be involved in the life of the home. What has improved since the last inspection? This is the first inspection of Harley House since the new providers were registered on 7th December 2009 What the care home could do better: Make sure that all new staff know what to do if they suspect that someone living at Harley House is at risk of abuse. People need to be appropriately safeguarded and kept from possible harm. Continue with the on going maintenance programme so that further improvements can be made to the accommodation provided. Key inspection report Care homes for older people Name: Address: Harley House Care Home 10-12 Elms Road Leicester Leics LE2 3JE     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Diane Butler     Date: 1 1 0 5 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. that people have said are important to them: They reflect the things 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. Care Homes for Older People Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Harley House Care Home 10-12 Elms Road Leicester Leics LE2 3JE 01162703672 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Pradeep Arvindbhai Patel Name of registered manager (if applicable) Type of registration: Number of places registered: care home 28 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: To be able to admit into Harley House the named person of category (PD) Physical Disability named in variation application number V21304 dated 02/06/05. To be able to admit into Harley House the named person of category Physical Disability (PD) named in the variation application number V24595. To be able to admit the named person of category PD (under 65 years) named in variation application no. V36879 dated 28th November 2006 To limit service user numbers: No person to be admitted to Harley House in categories OP, PD or PD(E) when 28 persons in total of these categories/combined categories are already accommodated in this home. Date of last inspection Care Homes for Older People Page 4 of 26 Over 65 28 0 0 1 Brief description of the care home Harley House is a care home providing nursing and personal care for up to twenty eight people. It is situated in Stoneygate, which is a quiet residential area approximately two miles from Leicester City Centre. The home is close to a bus route and although there are only a few car parking spaces in the grounds of the home there is adequate street parking. There is a large, attractive garden to the rear of the property, which is accessible to all, including those who require the use of a wheelchair. Accommodation is on three floors, with the upper floors accessed by lift or stairs. There are four lounges and a sun lounge available to those living there and a dining room is positioned on the ground floor. There are twenty six single rooms and one shared room. All rooms have a nurse call bell. There is a Registered Nurse on duty at all times. Current charges range from between £345.00 and £750.00 per week depending on care and support needs and additional charges are in place for personal items such as newspapers, toiletries, hairdressing and chiropody treatment. Details of what additional charges people can expect to pay can be found in the Information pack, which is given to everyone when they move into Harley House. A copy of the latest CQC inspection report can be obtained from the registered manager or can be accessed on the CQC website at www.cqc.org.uk Care Homes for Older People Page 5 of 26 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 Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use the service experience good outcomes. As this is the first inspection since the new providers were registered, a 2 star rating is the highest rating possible on this occasion. This key inspection took place over one day in May 2010. We (the Care Quality Commission or CQC) arrived at the home on Tuesday 11th May at 9.05am and completed the visit at 3.15pm. The inspection was unannounced and this means the service was not aware that we were coming. When undertaking key inspections CQC focuses on the outcomes for people receiving a service. In order to do this we case tracked two people receiving care and support. This means we checked records, spoke with them and their relatives, where possible and spoke to the care workers providing the care and support. Care Homes for Older People Page 6 of 26 Where communication was difficult observation was used to evidence whether care needs were being met. Surveys were also sent to some of the people living at the service and some of the staff to gather further views of the service provided. Comments received from people living at the service included: Harley House is clean and they do a good service and good improvement on the food. The care for residents is excellent and the home is run to a high standard. As a staff nurse myself, I feel that the general daily care and nursing care is more than satisfactory. Communication between staff and we, as families is always of high standard. They include residents in daily decisions such as meals etc. Continue to have monthly meetings with staff. Comments received from people working at the service included: The home is well presented and the staff are well supported. Low ratio of staff on Saturdays and Sundays. We have a good working environment, the bosses are always available, we meet regularly with monthly meetings, their door is always open to us. They are doing everything to make the home look better, I am pleased with all they are doing to make our residents feel safe and in a loving atmosphere. Service users feel very homely here because I think they are getting quality care and there is no discrimination. They are looked after according to their individuality. The manager keeps staff up to date with all training which are complusory, eg moving and handling, medication, first aid and many more. Further planning for the site visit included checking the service history of the service and looking through the AQAA document (Annual Quality Assurance Assessment), which was submitted to the CQCcompulsory prior to the visit. The AQAA document is the main way that providers inform us of how well their service is delivering outcomes for the people using it. We checked all the standards that the CQC has decided are key standards during this inspection.The information below is based only on what we checked in this inspection. We have kept details about individual people out of the report to make sure we respected their confidences. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 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 and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. 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 them 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are appropriately assessed before they move into Harley House to make sure that their care and nursing needs can be met. Evidence: We looked at the information available to those interested in living at Harley House. There is both a brochure and an information pack available, which also includes a copy of the service user guide. These documents give people a good idea of what the home has to offer and whether it might be the right place for them. A website is also available for those who have access to a computer so that they can see at a glance what is on offer. People are encouraged to look around the home before making the decision to move in, a tour of the home is provided and they are also shown the rooms that are available to them, this enables them to see what facilities are available and to meet those who already live at Harley House. Care Homes for Older People Page 10 of 26 Evidence: We looked at the records for two people who had recently moved into Harley House and found that the registered manager had completed a pre admission assessment prior to them moving in, to make sure that their needs could be met. The information contained in the pre assessment is then transferred to the persons care plan, which shows the nurses and the care staff working at Harley House the care and support the person needs. Everyone who moves into Harley House is offered a trail period, this provides a time when people can decide whether it is the right place for them. People spoken with told us that their care and support needs were currently being met and they were happy living at Harley House, they told us, They are good to me, this is the best place. I cant grumble at all, like home from home. Treat everyone like family. I think mums being looked after well. Care Homes for Older People Page 11 of 26 Health and personal care 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 health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they 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. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are looked after well, with care and support being offered in a respectful and dignified way. Evidence: We looked at two peoples care plans and talked to them and the care workers on duty. The care plans were thorough and detailed and told the reader the actions they needed to take to meet the persons care and support needs. These were being reviewed on a monthly basis and where changes to the persons needs were identified, the care plans were being updated. We also found that relevant assessments had been completed, to reduce the risks to the persons health and welfare. These included nutritional assessments, moving and handling assessments, pressure area assessments and continence assessments. We looked at the daily records kept and found that relevant professionals were being involved in supporting those living at Harley House, these include the local GPs opticians and chiropodist. Care Homes for Older People Page 12 of 26 Evidence: People told us that they were well looked after, they told us: I have a bath on a Tuesday and a Friday and I have my hair washed as well, the staff arent bad at all. xxxx [care worker] is absolutely brilliant, one lovely lady, looks after mum really well. People living at Harley House are assisted with their medicines to make sure that they get the medication they need. Staff record when they have given someone their medication on the appropriate record sheet and on the rare occasion that medication is refused, this is also recorded. Staff responsible for receiving medication into Harley House ensure that they get a second person to check that the right amount of tablets etc have been received. We checked how medicines are stored and found that storage is safe and secure. People living at Harley House told us that they are treated well and we watched staff supporting them in a dignified and respectful manner. We saw staff asking people what they wanted to eat and what they wanted to drink, we saw them knocking on doors before walking into a persons room and we saw them talking to people whilst helping them with their lunch. Care Homes for Older People Page 13 of 26 Daily life and social activities 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 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. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff enable the people living in Harley House to live the life style they choose. Evidence: We spent the day observing a typical day in the life of those living at Harley House, we also talked with the people who live there, their relatives and staff to find out what it was like to live and work there. We were told that friends and relatives can visit at any time, we were told that people could make choices daily, such as whether to get up early or stay in bed, whether to join in activities or not or whether to spend time in their own room or in one of the lounge areas. We were also told that people could choose what they wanted to eat, one person told us, One day I will just have toast for breakfast, another day I will have a full breakfast, tomatoes, egg, bacon!. People who require special diets such as, diabetic or soft diets are catered for. The cook knows what people can and cant eat and what they like and dislike and makes sure that they get a meal that they require or prefer. She told us xxxx [person living in the home] has meals in her room, she prefers hot puddings to cold, she is a very little eater so as long as not too much is on the plate shes fine. She also explained Care Homes for Older People Page 14 of 26 Evidence: xxxx doesnt like vegetables, but we can get him to eat beans or tomatoes. During lunch time, when Roast Lamb and Roast Pork were on offer, people told us how nice the meal was, one person told us, The lamb was nice, another person told us, It was lovely. An activities leader has been recruited for three days a week and both group activities and one to one sessions are provided. One person told us, They dont make you attend, [activities] but they do like to see you. An outside company also provides one to one support, enabling people to explore new interests or take up old hobbies. Care Homes for Older People Page 15 of 26 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. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. 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 living at Harley House know how to complain and are confident that any concern would be dealt with appropriatley. Evidence: When people move into Harley House they are told what to do if they have a concern of any kind, a copy of the formal complaints procedure is also displayed in the reception area for people to refer to. One person explained, Id talk to matron, I can talk to her. The registered manager told us that she had not received any complaints since the new providers took over in December last year and we, the CQC, have received no concerns regarding Harley House since registration. We spoke with the staff on duty to find out what they would do if they felt someone was at risk of harm. The majority of staff were aware of their responsibilities explaining that they would report any concern to the management team immediately. One person spoken with however, wasnt entirely sure as to what they should do. We looked at the training records to see what training had been provided and found that although some members of the staff team had received training/ refresher training in the Safeguarding of Adults, not all had, including the most recent member of the staff team to be employed. Although they had not been working at Harley Care Homes for Older People Page 16 of 26 Evidence: House for very long, it is vital that they are made aware of what they must do if they suspect any kind of harm or abuse as soon as possible. People told us that they felt safe living at Harley House and they were being well cared for, they told us: I would say she was safe. I feel safe, I would soon say something, I wouldnt leave it. They look after me very well. Care Homes for Older People Page 17 of 26 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, 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. 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 standard of the accommodation within Harley House is on the whole good, providing people with a pleasant and homely place to live. Evidence: We looked at the communal areas available within Harley House, there are a number of lounges that can be found throughout the home and there is a large dining area on the ground floor. A number of bathrooms are provided with suitable equipment to enable staff to support the people living at Harley House to bathe safely. The communal areas we saw were well decorated, clean and tidy. Many of the chairs in the downstairs lounges are specially adapted to support people with physical disabilities or who are too frail to use standard equipment, these chairs have been designed to complement a homely environment. We were invited to look at two rooms, both of which included the persons own belongings. We were told that they were able to choose their room and invited to bring their own things in. One of the rooms we looked at was a shared room, we saw that there was a curtain which could divide the room and provide privacy for both people living there. The person who showed us the room told us that the curtain was used to promote their dignity. Care Homes for Older People Page 18 of 26 Evidence: As bedrooms become vacant these are redecorated to a good standard and for those who do not wish to bring in their own furniture, new furniture is purchased. There are some areas of the home which are still in need of work, including a number of door frames on the ground floor, however, an ongoing maintenance programme is in place and work continues to be done to improve the accommodation further. A maintenance worker is employed to regularly check that all equipment used in Harley House is working well and is safe to use. Care Homes for Older People Page 19 of 26 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 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 to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. 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. Staff are appropriately trained and supported to carry out their roles effectively. Evidence: We looked at the recruitment file for the one person that had been employed since the new providers took over Harley House and found that all the necessary checks had been carried out. This is to make sure that people living at Harley House are kept safe from harm. We looked at training records and talked to the staff on duty to find out what training they had received. We were told that the new providers had offered many training courses since taking over in December last year, these include, a tissue viability course, a wound care course, an infection control course and a moving and handling course. A number of other courses have also been booked which will be provided over the next few months. We were informed that 6 staff members had completed their NVQ (National Vocational Qualification) level 2 and 4 staff members had completed their NVQ 3, and it was evident during our visit that the staff on duty were well trained and able to meet the needs of those living at Harley House. We looked at the staff rota and talked with staff on duty to find out whether there Care Homes for Older People Page 20 of 26 Evidence: were enough staff on each shift to properly meet peoples needs. We saw that, as well as the registered manager and/or the deputy manager, there was one registered nurse and four care assistants on during the day and one registered nurse and two care assistants on at night time. Staff told us that that they felt that this was enough to enable them to carry out their work without having to rush the people in their care. As well as the caring staff there is also an activities leader, catering staff, laundry workers, domestic staff and a maintenance worker on duty throughout the week. Care Homes for Older People Page 21 of 26 Management and administration 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 led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate 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. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living and working at Harley House benefit from its leadership and management approach. Evidence: The registered manager is experienced and provides good leadership for the staff working at Harley House. The staff we spoke with told us that they felt supported by the management team and they felt able to talk to them if they needed any help or advice. The new providers have introduced a number of incentives for staff including employee of the month which comes with a financial reward, to show their gratitude for the work that the staff do. Staff are provided with an appraisal every six months and clinical supervision every two months. These sessions provide staff with the support and training they need to enable them to carry out their work to the best of their ability. Care Homes for Older People Page 22 of 26 Evidence: The providers check the quality of the service they provide in a number of ways, these include written surveys, which are completed by the people living at Harley House and/or their relatives, group meetings and one to one meetings for both the people living there and the staff team and the using of feedback from relatives and friends who visit, to make sure that they can provide the best quality care and support that they can. The management team holds pocket money for people who live at Harley House so that they can pay for the hairdresser, and other services and facilities as and when required. We checked the records to make sure that money held on behalf of people was being properly handled, and were satisfied that it was. The health and safety of those living at Harley House and those working at Harley House is very important to the management team and they have employed an outside company to carry out a health and safety audit of the home. Risk assessments for the environment have also been completed and reviewed, to reduce as much as possible any risks identified for those living in or working at Harley House. The records we looked at were current, accurate and well maintained. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R 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 Care Homes for Older People Page 24 of 26 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 Requirement 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 Requirement Timescale for action 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 18 19 The registered provider must ensure that all staff are aware of the actions to take to safeguard those in their care. The registered provider should continue with the ongoing maintenance programme, including addressing the scratched door frames, to further improve the accommodation provided. Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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