Care Home: Harry Lord House

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What the care home does well The management and staff team had continued to maintain high standards of care and support to the people living in Harry Lord House. It was evident that staff had developed meaningful relationships with the people they cared for. Several people referred to staff as kind and caring. People admitted to the home had received robust assessments of their needs and each person had a structured care plan in place that detailed the support staff would provide in meeting their needs. Risks to the safe delivery of care had been assessed and clear guidelines provided so that staff knew what they must do to keep people safe from accidental harm. We found evidence of varied, interesting and stimulating activities that had regularly been provided to the people accommodated. One person told us that, `There is always something interesting going on here.` Standards had also been exceeded in the area of meals. We found that menus provided people with choice and a person using the service said that they could also request alternatives to the menu as their favourite foods were always made available. The management and staff were good at listening to the views of the people accommodated and used this information to make sure the home was always run in their best interests. What has improved since the last inspection? We made one requirement during our last visit, which was for the home to make sure that new staff were not appointed until all the required recruitment checks had been obtained. One new member of staff had been appointed since our last visit. This person`s records provided evidence that the standard for recruitment had been fully complied with. What the care home could do better: We made one recommendation during this visit. One of the care plans we looked at showed that the person had lost a significant amount of weight over a period of six months, yet no referral had been made to the general practitioner to investigate this. It was encouraging that a senior member of staff contacted the person`s doctor as soon as we pointed this out. None of the other people living in the home had issues with weight loss. Key inspection report Care homes for older people Name: Address: Harry Lord House 120 Humphrey Road Old Trafford Manchester M16 9DF     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: Val Bell     Date: 0 3 0 6 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 22 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 22 Information about the care home Name of care home: Address: Harry Lord House 120 Humphrey Road Old Trafford Manchester M16 9DF 01618724156 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): sue.burrell@trafford.gov.uk Trafford Metropolitan Borough Council Name of registered manager (if applicable) Mrs Susan Burrell Type of registration: Number of places registered: care home 27 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The registered person may provide the following category of service only: Care Home only - Code PC. To service users of the follwing gender: Either. Whose primary care needs on admissions to the home are within the following categories: Old age, not falling within any other category - Code OP, Dementia - DE. The maximum number of service users who can be accommodated is: 27 Date of last inspection Brief description of the care home Harry Lord House is a care home, owned and managed by Trafford Metropolitan Borough Council. It is situated in a quiet residential area close to shops, public park and the Metro link at Trafford Bar. At the time of our visit the number of people accommodated had fallen to 8. The manager told us that this was because the home was being closed. The home is on the top two floors of Harry Lord House. Access to Care Homes for Older People Page 4 of 22 2 1 0 7 2 0 0 9 27 0 Over 65 0 27 Brief description of the care home the first and second floors, where bedrooms and communal areas are located, is by a staircase as you enter the building, or by passenger lift which is situated within the ground floor accommodation. At the time of this visit the top floor was not in use due to the declining number of people accommodated. There are four lounges within dining areas and various bathing facilities, including shower and Parker bath. All bedrooms offer single occupancy. Care Homes for Older People Page 5 of 22 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: This was an unannounced key inspection, which means that the manager was not told beforehand that we were coming to visit. Our visit was just one part of the inspection. We also looked at other information we had about the home, including events that the home had told us bout since our last visit. We spent time with people living in the home and talked to the manager, care staff and the business services officer, cook and handy person. We examined records held in the home, such as care plans, complaints and health and safety records and we looked round the home to assess hygiene, cleanliness and health and safety. The manager submitted a self-assessment called an Annual Quality Assurance Assessment when we asked for it. This gave us good information on how well the Care Homes for Older People Page 6 of 22 manager and staff considered the home to be operating. We also sent satisfaction surveys to the home, although none of these had been returned at the time of writing this report. Care Homes for Older People Page 7 of 22 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 22 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 22 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are systems in place to assess and monitor individual needs, ensuring that a suitable service is provided based on personal needs and preferences. Evidence: There had been no new admissions to the home since our last visit. We looked at two care plans to determine if they had been updated with peoples changing needs. Both care plans had been reviewed on a regular basis and had been appropriately amended as the individuals needs had changed. The plans included individuals preferences for how their personal care should be provided and it was evident that care staff made sure this was respected. This provided evidence that the service continues to meet the personal care needs of the people accommodated. The home did not offer an intermediate care service. Care Homes for Older People Page 10 of 22 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 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 Harry Lord House have their needs met and their care is provided in a manner that protects their privacy and dignity. Evidence: The two care plans we examined had been kept up to date by holding regular reviews. Where changes in individuals needs had been identified during the review process, plans of care had been appropriately amended. There was good evidence to show that people had been involved in developing their care plans, by recording their likes and dislikes, personal histories and preferences for how their care was to be delivered. Daily notes contained good detail to describe the care and support care staff were providing to meet each persons needs. Risks identified during the assessment and review process had been considered and clear guidance had been written down for staff to follow. This meant that people could be confident their care would be provided safely. We found one concern relating to a person who had been identified as at risk of weight Care Homes for Older People Page 11 of 22 Evidence: loss. Nutritional screening and monitoring had been put in place and records for this persons food and fluid intake had been carefully recorded. However, staff had failed to take action when the records showed the person had lost 7 kg in the previous 6 months. When we pointed this out to a senior member of staff, an appointment was immediately made for her to see her general practitioner. This concern should not have been overlooked. There was no evidence to suggest that there had been other similar incidents of weight loss as other people living in the home were either maintaining or gaining weight. We looked at the system in place for administering medication to the eight people accommodated in the home. Staff were operating the Boots monitored dosage system. All medicines held in the home had been securely stored and records had been kept up to date and audited on a regular basis. We found one minor shortfall where a member of staff had signed to say a tablet had been administered, although the tablet was still in the blister pack. It was likely this had been refused by the person and signed for in error. Staff told us that they had received regular training in medication administration and records showed that following their training they had been assessed as competent. We spoke to several people during our visit. One person told us she was sad that the home was closing. She had lived there for a number of years and had been very happy. She said she had found the staff to be wonderful people, very caring and eager to help. This person was moving to a new home the afternoon of our visit. She told us that staff had promised to visit her in her new home. Her key worker was going with her to make sure she settled in and to discuss her care plan with the staff who would be providing her support. The people we spoke to told us that staff always provided their care and support in a dignified and private manner. Care Homes for Older People Page 12 of 22 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. Social activities and meals are managed well and provide daily variation and interest for people living in the home. Evidence: We looked at what had been provided to interest and stimulate the people living in Harry Lord House. We found evidence of varied activities provided both within the home and in the local community. Regular meetings with people using the service and their relatives had been held to listen to views and suggestions for improving the facilities provided. This meant that people had regular access to the things they liked to do on a daily basis. It was particularly pleasing to find that the home had worked closely with local community groups. This enhanced the experiences of people living in the home by providing regular opportunities to make new friends and learn about other peoples lives and cultures. The people we spoke to praised the service in this area. One person said that there was always something of interest going on. This person told us that she was moving to a new home during the afternoon of our visit. She said she was sad to leave as she had been very happy living in the home. Her key worker was going with her to make sure she settled in and to pass on important information about her needs to the new team of carers. She also told us that staff had said they would visit her. This was evidence of the good relationships that had been Care Homes for Older People Page 13 of 22 Evidence: maintained between the staff team and the people they cared for. The people we spoke to confirmed that their friends and relatives were welcome to visit, although they were respectfully asked to avoid mealtimes. We observed visitors coming and going during the time we spent in the home. We joined people in the dining room for the midday meal. The menu provided two choices of main course and dessert. The meal that we ordered had been carefully prepared and attractively presented in accordance with our stated preferences. The person we sat with said that the meals were always good. She told us that kitchen staff always made sure they had a good stock of their favourite foods and that if you asked for an alternative to the menu it would be provided. We observed that there were ample food stocks including a good selection of fresh fruit and vegetables. The cook said that the kitchen was able to cater for the full range of special diets, such as vegetarian and diabetic meals. Care Homes for Older People Page 14 of 22 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. Harry Lord House has good procedures for listening to and dealing with with peoples concerns, to protect their rights and keep them safe from abuse. Evidence: We looked at how complaints had been managed in the home. Records told us that there had been two complaints made in the previous 12 months. Full details of the complaints had been recorded along with the action taken to resolve them. The people we spoke to during our visit knew who to talk to if they had any concerns and they were confident that the appropriate action would be taken to resolve them to their satisfaction. We also looked at procedures used by staff to safeguard the welfare and rights of people using the service. We saw evidence that staff had been trained in how to safeguard people from abusive situations. Clear policies and procedures were in place and a member of staff we spoke to was confident in talking about the action she would take if she suspected a person was at risk of abuse. One person living in the home had been referred for a safeguarding investigation to the local authority in the previous 12 months. The outcome of the investigation found the allegations to be unsubstantiated. Care Homes for Older People Page 15 of 22 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. Harry Lord House provides a clean, hygienic and safe environment for people using the service. Evidence: We walked round the home with the manager. The environment was found to be clean and hygienic and was fresh and airy. We did not find any health and safety issues. Although the environment would have benefitted from re-decoration, it was understandable this had not taken place, as the home was due for closure once the remaining people accommodated had been found alternative accommodation. Good procedures were being used by staff to control the spread of infection and all staff had received appropriate training in this area. Care Homes for Older People Page 16 of 22 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. Staffing arrangements, recruitment and training ensure that people are cared for and supported safely. Evidence: On the day of our visit there were six staff on duty to provide care and support to eight people living in the home. This high staffing level enabled carers to provide the support needed in preparation for people moving to alternative care homes. One member of staff had been recruited in the previous 12 months. We looked at this persons staff file to assess how they had been selected to work in the home. Full prerecruitment checks had been obtained and appropriate induction and ongoing training had been provided. Care staff working in the home had access to training in National Vocational Qualifications in care and most staff had achieved this qualification at level 2 or above. Care Homes for Older People Page 17 of 22 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Harry Lord House is managed well and is run in the best interests of the people who live there. Evidence: From conversations with staff and observations of their interactions with people using the service, it was evident that the home was being managed in their best interests. Excellent relationships had been forged and the manager and staff spoke fondly of the people they cared for. Satisfaction surveys had been completed by people living in the home and their representatives every 12 months. Views expressed in the surveys had been taken into consideration as far as possible, although this was difficult as the home had been earmarked for closure during the past 12 months. A number of people living in the home were receiving assistance to manage their personal finances. We looked at their records and found that they had been kept up to Care Homes for Older People Page 18 of 22 Evidence: date by the business services officer. Regular audits had also been undertaken to ensure that they were accurate and receipts and signatures had been obtained for all items of expenditure. A sample of health and safety and maintenance records that we examined were found to be accurate and up to date. The home was not displaying a current certificate of Public Liability Insurance. The manager explained that they did not always receive a copy of this from their head office, although she confirmed that current insurance cover was in place for Trafford Borough Council workplaces. Care Homes for Older People Page 19 of 22 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 20 of 22 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 8 Prompt action should be taken to make appropriate referrals to health care professionals when significant weight loss is identified. To ensure that the health and welfare of people using the service is not compromised. Care Homes for Older People Page 21 of 22 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. Care Homes for Older People Page 22 of 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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