Please wait

Care Home: Hartcliffe Nursing Home

  • Murford Avenue Hartcliffe Bristol BS13 9JS
  • Tel: 01179641000
  • Fax: 01179641100

Hartcliffe Nursing Home is owned by Methodist Homes for the Aged and provides nursing care for up to sixty-six older people and 10 persons with physical disability under the age of 65 requiring nursing care. It is located in a suburban position and can be accessed by public transport. Transport is needed to reach local shops and amenities. The home itself is purpose built and has now been in operation for six years. 64 bedrooms are for single occupancy and there is one shared room. They are set out over two floors, with the upper floor accessible via 2 1 0 5 2 0 0 9 0 10 0 a passenger lift. Communal space is offered in 4 lounges and there is a spacious dining room on each floor. There is a small garden and parking spaces for visitors.

  • Latitude: 51.409000396729
    Longitude: -2.6099998950958
  • Manager: Mrs Raji Sunil
  • Price p/w: £627
  • UK
  • Total Capacity: 66
  • Type: Care home with nursing
  • Provider: Methodist Homes for the Aged
  • Ownership: Voluntary
  • Care Home ID: 7642
Residents Needs:
Old age, not falling within any other category, Physical disability

Previous Inspections

This may not be the latest inspection for this service as we are having techinical problems updating from CQC - please check directly on the regulators website for the most recent report; bestcarehome hopes to be back to regular updates shortly.

For extracts, read the latest CQC inspection for Hartcliffe Nursing Home.

Key inspection report Care homes for older people Name: Address: Hartcliffe Nursing Home Murford Avenue Hartcliffe Bristol BS13 9JS     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: Vanessa Carter     Date: 2 7 1 1 2 0 0 9 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 28 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) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Hartcliffe Nursing Home Murford Avenue Hartcliffe Bristol BS13 9JS 01179641000 01179641100 ruth.andrews@mha.org.uk www.mha.org.uk Methodist Homes for the Aged Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Raji Sunil Type of registration: Number of places registered: care home 66 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: May accommodate up to 66 persons aged 65 years and over requiring nursing care May also accommodate up to 10 persons with physical disability under the age of 65 requiring nursing care Date of last inspection Brief description of the care home Hartcliffe Nursing Home is owned by Methodist Homes for the Aged and provides nursing care for up to sixty-six older people and 10 persons with physical disability under the age of 65 requiring nursing care. It is located in a suburban position and can be accessed by public transport. Transport is needed to reach local shops and amenities. The home itself is purpose built and has now been in operation for six years. 64 bedrooms are for single occupancy and there is one shared room. They are set out over two floors, with the upper floor accessible via Care Homes for Older People Page 4 of 28 2 1 0 5 2 0 0 9 0 10 Over 65 66 0 Brief description of the care home a passenger lift. Communal space is offered in 4 lounges and there is a spacious dining room on each floor. There is a small garden and parking spaces for visitors. Care Homes for Older People Page 5 of 28 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: We have completed an unannounced inspection of Hartcliffe Nursing Home over two days and spent a total of 13 hours in the home. The last full inspection of this service was undertaken in December 2008 and our overall judgement about the quality of the service provided for the people who live in Hartcliffe Nursing Home was that people only received an adequate service. After that inspection we planned to visit again within one year. In the last year we have visited the home on many occasions due to a number of serious concerns that have been raised by families of people who have lived there, health and social care professionals. MHA have worked well with us to address the issues raised and have done everything we have asked of them. Those issues have been referred to in the body of the report. Prior to this inspection the home manager completed the annual quality assurance Care Homes for Older People Page 6 of 28 assessment (AQAA). This is a self assessment document that focuses on how well outcomes are being met. The assessment had been completed in detail and told us about the improvements that have made over the last 12 months and identified those areas where they felt they could do better. We sent out survey forms to people and received 13 back plus one from a GP who has patients in the home. During the inspection we looked at records kept by the home, including care records and those that are kept in respect of the running of the home. We spoke to those staff on duty, the home manager and the newly appointed deputy manager. We observed the interactions between the staff and the people who live in the home. We also spoke to people who live in the home and visiting relatives. At the time of this report the fees for placement in the home range between 516 and 640 pounds per week. Additonal charges may be made for other services and these are detailed in the homes brochure. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? Care planning processes have been improved and each person has a plan of care prepared that meets the persons own individual care needs. The plans are detailed and are generally meaningfully reviewed. The nursing and care staff are ensuring that people get the healthcare support that they need. New arrangements have been made with some GPs who now visit their patients on a twice weekly basis. There are new procedures in place to obtain medications following GP visits and to prevent a delay in treatment. The care team are taking the appropriate measures to prevent the formation of pressure sores. People can now be assured that any concerns or complaints they may have will be listened to and acted upon. Staff are aware of the need to safeguard people from being harmed because they have received additional training. The people who live in this home will be cared for by staff who now have the necessary skills and competencies in order to meet their needs because a rigorous training programme has been put in place. The recruitment of new staff is in line with safe procedures, so only suitable staff will be employed to work in the home. Care Homes for Older People Page 8 of 28 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 9 of 28 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 10 of 28 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 is clear and detailed information available about Hartcliffe Nursing Home that ensures prospective people know what the home has to offer. Pre-admission assessments ensure that placement is only offered to those people whose needs can be met. Evidence: The Statement of Purpose and Service Users Guide (called Weclome to your New Home) both need updating to reflect the changes in management and the Care Quality Commission information. Other than this, both documents provide a clear and detailed picture of what the home has to offer. The welcome pack and a copy of the homes brochure is given to people who enquire about the home and who have been assessed as appropriate for placement. This means that people will have the necessary information to make an informed choice that the home is the right place for them. People will know what to expect when they choose to live at Hartcliffe Nursing Home. Included in the welcome pack is a financial information sheet - this may Care Homes for Older People Page 11 of 28 Evidence: contain out of date information as was prepared in 2005. This document should be updated as it also refers to outdated nursing care contribution arrangements. Each person will be provided with a Residential Care Agreement upon admission and these are prepared by the administrator. Information is included in this agreement about how the charges are determined and who is responsible for which part of the fees. Some people spoken with during the inspection were able to confirm these arrangements whilst others were unsure or commented my family or my social worker sorted everything out. Prior to any placement being offered, a pre-admission assessment will be completed by either the home manager or the deputy manager. We looked at the documentation completed for two people who had recently moved in to the home, we could see that the person had been assessed prior to the admission date and a judgement had been made that the home had the necessary facilities (nursing equipment) and the staff team had the necessary skills to ensure that peoples specific care needs can be met. The assessment is recorded upon a comprehensive document (Domiciliary PreAssessment). The assessment covers all aspects of personal, health, emotional and mental health needs, spirituality and religous needs and social care needs. This assessment is then checked through again upon admission and used to form the basis of the care planning documentation. Placements are always arranged on an initial trial basis with a review of how things have gone being completed at the end of this time. This review will be undertaken with the funding authority where appropriate, the person if possible, any family or representatives, and home staff. This trial period can be extended if necessary. Ten of the beds in the home are funded by the local authority and used as rehabilitation assessment beds (5) and interim placements beds(5). People who are looked after in these beds will either receive additional support by physiotherapists and occupational therapists so that their condition improves and they are able to return to their family home, or they are looked after until a place is available in the nursing home of their choice. The home manager/deputy however still have responsibility in saying who is admitted in to these beds. Care Homes for Older People Page 12 of 28 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. Care planning processes now ensure that people receive the specific and individual care and support that they need. The arrangements for monitoring healthcare status have been strengthened so that medical care be provided. Medication procedurs are safe and follow good practice guidelines. Evidence: Each person will have support plans prepared that detail their specific care and support needs and the actions that need to be taken by the care staff to meet those needs. We looked at a sample of six plans, two of these plans were for people who had recently been admitted to the home, one was for a person with wound care needs, and the other three were randomly selected. We found that each of the support plans had been well prepared although there were some minor amendments needed in some areas. These were discussed with the home manager during the inspection. Examples include specific information about where creams need to be applied for one person, exact guidance and parameters in a persons diabetes management, and whether a particular short term care plan was still relevant. Care Homes for Older People Page 13 of 28 Evidence: We looked at the wound care planning documentation for one person. The plan stated what medical products were to be used and how often the dressings needed attending to. An evaluation was recorded each time the dressing was changed. A photograph of the wound had been taken and we were told that this will be repeated on at the most, a monthly basis, so that the status of the wound can be monitored. This person had had several wounds when admitted to the home, and all but one had healed. The support plans need to make it clear when wounds are healed and wound care is no longer required. Support plans also include risk assessments in respects of falls, moving and handling tasks, nutrition and the likelihood of developing pressure sores (waterlow). The moving and handling risk assessment result in a safe system of work being devised those seen needed to record much more detail about the specific equipment that must be used. When people need to be moved using a hoist, the sling size must be recorded. When the likelihood of developing a pressure sore is identified, appropriate equipment is provided. Since the last inspection there has been one occasion where a person was found to be lying on an air mattress that was not working correctly and the care staff had not noticed. We have been working with the home, along with health and social care colleagues to ensure that measures have been put in place to prevent this happening again. Each person will have a falls screening risk assessment and when the likelihood of falls is determined as high, or a person has experienced a number of falls, a further extended falls risk assessment will be completed. This is so that a management plan can be devised to reduce or eliminate the chance of further falls. Monthly falls audits are also completed and this is a good measure in monitoring the frequency of any incidents. All support plans and risk assessments are generally reviewed on a monthly basis. Some of the reviews were completed in depth however others had less detail recorded. We also noted that for each plan, a daily evaluation should be recorded. In some cases entries had not been made for several days. We discussed this with the home manager who advised us that an entry should be made every day, and that the staff team will be reminded of the need for this. Those people we spoke with during the inspection said that they were well looked after and received the care and support that they need. The staff are very kind and thoughtful, I can sometimes be very difficult but the care staff are always helpful and nothing is too much trouble, and I consider that the staff are all my friends now. GP arrangements are provided by two practices and records are kept of all contacts Care Homes for Older People Page 14 of 28 Evidence: with GPs and other healthcare professionals. One GP visits the home twice a week on a planned basis and completes a ward round plus visits will be made as and when necessary in addition. Since the last inspection there have on a number of occasions been difficulties with some of the nurses communicating with the health centres, and getting medical support when people needed it. English language lessons were arranged and are still ongoing, for those staff who need the support. Examples of other healthcare professionals who may visit the home include chirpodists, dieticians, physiotherapists, opticians and dentists. There have also been occasions where district nurses have been called in to perform nursing tasks that the registered nurses did not have the skills to undertake. The home has arranged all the relevant training to ensure that the nursing team have the necessary skills and competencies to meet peoples needs. Medications systems are in general unchanged since the last inspection. However there has been an event when newly prescribed medications were not delivered from the pharmacy in a timely period which meant a delay in starting someones treatment. As a result of this incident, the home now uses a local chemist to obtain urgent prescriptions rather than using their normal medicines supplier. Medication systems are safe and there are robust procedures in place for the ordering, receipt, administration and disposal of medications. Signage is in place where oxygen cylinders are stored and in use. During our time in the home we observed the staff team interacting with the people they were looking after and visitors, in a kind and professional manner. Staff were courteous and polite, and it was evident that the staff genuinely cared about the people they were looking after. There was a lot of friendly banter, and fun being had. As part of the care planning process Final Wishes or end of Life care planning issues will be discussed at the appropriate time. The persons GP will also be involved where people have end of life care needs. People in this situation and their family/representatives will be provided with an explanatory information leaflet so that they can make an informed choice. We saw that decisions are recorded upon a DNR form - of those seen, some made it clear that the person was unable to make a decision and that the family had agreed to course of action with the GP, whilst others did not evidence whether the person was consulted. This was discussed with the manager during the inspection. We expect to see a clear record of who was involved in the discussions and signatures from the person where possible, family, member of staff and the GP who is agreeing the clinical decision. Care Homes for Older People Page 15 of 28 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. There are opportunities for the people who live in Hartcliffe Nursing Home to participate in a wide range of meaningful social and spiritual activities. The support of family and friends is encouraged and welcomed. The standard of catering is high and people will be provided with a well balanced and nutritious diet. Evidence: The home employs a full time Activities Organiser who works mainly during the weekdays however is flexible and covers some evenings and weekends for special occasions. The capturing of peoples life histories is seen as essential in getting to know people and being able to cater for each individuals needs and this is commendable. This process ensures that information is gathered about what people would like to do with their time. A range of different activities are provided and people are able to choose which events they would like to participate in. One person said I am always told what is going on and I choose which events I want to join in with. On day one of the inspection musical entertainment was arranged and 15 people were in the lounge singing along with the singer. A Christmas Fayre was being held in the evening of day two. Other activities that had been planned for this week included a discussion about Bedminster, craft club, a slide show, holy communion, bingo and hairdressing. There is church service held twice a month and a chaplain visits the Care Homes for Older People Page 16 of 28 Evidence: home each tuesday and Friday. The chaplaincy service provides support for people in the home, family and staff members. People are able to have visits from family and friends at any reasonable times. One relative told us that they were regular visitors to the home, that they always found the staff very friendly and were offered refreshements. We saw other relatives who were visiting over the lunch time period so that they could help their relative with their meal. We received a number of our survey forms back that had been completed by relatives and they had the following comments to make - they look after me as well which is very much appreciated and they look after visitors very well. One person who lives in the home said the staff were very flexible about visiting arrangments and would adjust their daily routines to accommodate visitors. Our overall opinion because of observations made during the inspection visit and comments received were that people are encouraged to make their own decisions where possible. People are asked about where they want to spend thei time, what they would like to eat and what time they would like to get up and retire to bed. The home has a rolling menu plan and offers a choice of two midday meals. The menu being served that day is displayed on notices placed on the dining room tables and in peoples rooms. Alternative meals are provided if both choices are not to a persons taste. People spoken with about the meals said that they were very good - Lovely food, the catering is first class and I so look forward to meal times and enjoy the fresh vegetables that are served. We spent time with the hospitality manager who demonstrated a very good knowledge of peoples likes and dislikes. We joined a group of people for lunch and found the meals to be nicely presented and of good proportions. We saw that some people were provided with assistance in eating their meals and this was done sensitively and was unhurried. Drinks and homemade cakes are provided mid afternoon. The kitchens have had a recent environmental health check, a few minor matters were raised and have been addressed and they have been awarded the top five star rating. Care Homes for Older People Page 17 of 28 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. The home has a clear complaints procedure and any complaints people may have will be listened to and acted upon. Staff awareness of safeguarding issues has been raised meaning that people will be protected from being harmed. Evidence: The homes Complaints Procedure is included in the Statement of Purpose and Welcome Pack and is also displayed in the main reception area of the home. Those people who completed our survey forms said that they were aware of how to make a complaint and those spoken with said they would feel happy about raising any concerns. One person said anyone who complains about this place is wrong whilst others said everyone is very thoughtful and do their best for me. I have nothing to complain about. Earlier in the year we received a spate of complaints and safeguarding concerns from families, health and social care colleagues in respect of how people were being cared for. Since this time there has been a great deal of interagency work with the home in raising standards of care and enabling the staff to have the necessary skills and competencies to meet peoples different needs. There have been no further complaints received by the Commission since June 2009. We looked at the homes Complaints Log. The manager has received seven complaints and the records evidenced the actions taken and the outcomes of each complaint. There are no outstanding issues. We are assured that the management of any complaints is now good, people will be listened to and any necessary actions will be taken. Care Homes for Older People Page 18 of 28 Evidence: The home has a protection of vulnerable adults (POVA) policy. Those staff spoken with during the course of the inspection demonstrated good awareness of safeguarding issues and of their responsibilities in protecting the people who live in the home. Staff will receive safeguarding training via an e-learning training programme which will then be repeated on a regular basis by an MHA trainer, to ensure their understanding is maintained. Safeguarding training is included as part of the induction training programme for new staff. In addition to internal training the manager, deputy and registered nurses will be attending Bristol Council safeguarding training in the future. The manager and deputy will also be undertaking mental capacity act (MCA) and deprivation of liberty safeguards (DOLS) training in December and will cascade information to the rest of the staff team until further training is rolled out. These measures will ensure that the staff are able to safeguard people they are looking after and will know what is expected of them when making best interest decisions for those people who lack capacity. Care Homes for Older People Page 19 of 28 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. Hartcliffe Nursing Home is a comfortable and well equipped care home. It is kept clean and fresh. Each bedroom has en-suite facilities and all communal areas are well furnished. Evidence: Hartcliffe Nursing Home is a purpose built two storey care home. It is well maintained and provides private and communal facilities on both floors. Car parking for visitors is available to the left of the home and there is level access into the main reception area. The entrance is secured with a key padded lock and during office hours, visitors are welcomed to the home by the administrator. Access to the upper floor is via a passenger lift, making the whole home fully accessible for people who have impaired mobility. All areas of the home are well decorated and appropriately furnished. There is access out in to the garden and the courtyard from the ground floor lounges - the doors are alarmed so that staff can be alerted to any person wandering out unaided. The garden areas to the front of the home have been revamped this year and there are plans to do the same with the rear gardens in 2010. There are two lounge/dining areas on each floor and in addition one quiet room, used by the chaplain or for consulting with relatives. In the lounges there are a variety of different types of armchairs in order to meet peoples different needs. We discussed the seating provided for one person with the home manager during the inspection as it Care Homes for Older People Page 20 of 28 Evidence: did not appear to provide much comfort. We were assured that this will now be reviewed. Offices for the nursing staff where records are stored have been re-introduced since the last inspection. These arrangements provide better storage for peoples personal records and also provide a place where visiting GPs can consult with registered nursing staff. There are eight communal bathrooms with either an assisted bath, or level access shower installed, located throughout the home, plus toilets near the lounges and dining rooms. There are hoists, stand aids and other items to assist with moving and handling tasks. All beds are specialist profiling nursing beds, and the corridors are wide and fitted with grab rails. Specific items of equipment have been obtained for those people with particular care needs. We were told that where air mattresses are in use the staff will check that it is functioning correctly each time they attend to the person. This measure was put in place following concerns being raised earlier in the year. A nurse call bell system is installed throughout the home. We noticed that in one bedroom there was no call bell and we were advised that this had been removed following a risk assessment, and that there were measures in place to monitor the person. Records evidenced this. There are 64 bedrooms for single occupancy, plus one shared room, however this tends to be used by only one person. Each bedroom is fully furnished, has en-suite facilities of a wash handbasin and toilet. Most of the bedrooms were seen during the inspection - people are encouraged to personalise their rooms and to bring in any small items of furniture and other items. The home was nice and warm on the day of inspection and well lit. The home was clean throughout and fresh smelling. During a tour of the home we noticed that several rooms had dead flowers in vases on display. We discussed this with the home manager and asked that relatives be approached about staff removing the flowers when they have gone over. One relative told us the home is always spotless. Those people who live in the home who completed our survey forms also said the home was always clean and tidy. Care Homes for Older People Page 21 of 28 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. The people who live in this home will be cared for by staff who now have the necessary skills and competencies in order to meet their needs because a rigorous training programme has been put in place. The recruitment of new staff is in line with safe procedures, so only suitable staff will be employed to work in the home. Evidence: For the second year running there has been a significant change in the staff team (registered nurses) although many of the care staff have worked at the home for a number of years. Both the home manager and deputy are new in post although the home manager has been promoted from within the staff team. There have been serious concerns raised about the skills and competencies of the newly appointed registered nurses, including language skills and clinical skills. Because of this rigorous training has been arranged and senior MHA management support has been provided. There are currently a number of staff vacancies and the recruitment process is already underway. Agency staff will only ever be used as a last resort and is usually due to last minute sickness. The home manager monitors how many hours each staff member works and ensures that staff do not do too many and are too tired to undertake their duties. These measures ensure that people who live in this home will be cared for by staff who are able to meet their needs and are familiar with how they want to be cared for. Care Homes for Older People Page 22 of 28 Evidence: We were told that staffing levels are based upon the collective dependency needs of all people in residence and that adjustments are made to numbers of staff on duty when people develop higher dependency levels. We were told that currently for the morning shift there are three registered nurse plus 11 carers, for the afternoon three nurses and eight carers and overnight two nurses and four carers. Those staff spoken with said that although shifts are always busy, the staffing levels were correct. A team of housekeeping, laundry and catering staff are supervised by the hospitality manager, plus there are administrative staff, maintenance and activities staff, employed in sufficient numbers to provide support in meeting peoples daily living needs. Approximately 50 of the care staff have already achieved at least a National Vocational Qualification (NVQ)Level 2 in Care whilst others are working towards the award. All new recruits are expected to undertake NVQ training after they have completed their initial training and probationary period. A personal training log is kept for each staff member. A training matrix is kept on-line and updated on a monthly basis to ensure an overview is kept of training attendance and MHA can then identify when refresher training is needed. A range of training is arranged for both care staff and registered nurses. Mandatory training includes moving and handling, health and safety, COSHH, fire and safeguarding awareness. Clinical training has been arranged for registered nurses following the recent concerns, and this included medication management, care planning, syringe driver, diabetes, wound care, risk assessment, catheter care and venepuncture. There has been a great deal of time and effort invested by Methodist Homes since the last inspection, in training staff and ensuring that they have the necessary skills to meet peoples needs. This must however be continued to ensure that the staff team maintain the necessary skills. We looked at six recuitment files to check the procedures that are followed before new staff are employed to work in the home. We found that the procedures are robust. Each prospective employee has to complete a written application form, and attend for a face to face interview. Two written references are obtained with at least one from a previous employer. CRB and POVA1st clearance is obtained before start dates. These measures will ensure that only suitable staff are employed to work at Hartcliffe Nursing Home. Care Homes for Older People Page 23 of 28 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. This home is well managed and run in the best interests of the people who live there. Their views will be sought to ensure that people receive the care and support that meets their expectations. Peoples health and safety will be promoted because of safe working practices. Evidence: There has been a change in the management personell of this home since the last inspection. Mrs Raji Sunil has been the acting manager since April and was officially appointed as the home manager in November 2009. She has recently been successful in completing the registered manager process with the Care Quality Commission. Mrs Sunil is a registered nurse and was previously the deputy manager at Hartcliffe for many years. During the last couple of months along with support from other MHA home managers and the newly appointed deputy manager, she has worked diligently in addressing the shortfalls. One staff member said she has such high standards and expects the same from all of us. Care Homes for Older People Page 24 of 28 Evidence: Regular meetings are held with the staff teams,and people who live in the home, and relatives. Records evidence that the opinions of others are sought and acted upon where possible. The manager has an open style of management and holds regular Relatives Clinics. Her office is located at the entrance to the home and she regularly walks the floor to see what is going on. She has a clear idea of what is happening in the home. A Standards and Values Assessment is completed by MHA on an annual basis and will be undertaken again in January 2010. In the AQAA they told us that they have amended this assessment to incorporate new legislation and standards, with the aim of raising the level of service provided. Regulation 26 reports are undertaken by managers from other MHA homes. We looked at those that had been completed for the last year. Most of the reports were only sparsely completed and did not evidence a robust analysis of how things were in the home. We would recommend that these monitoring visits are completed in greater depth and include an overview of staffing issues and staff training. These visits should also be carried out on a monthly unannounced basis. In addition to these arrangments regular audits are completed in respects of accidents/incidents, complaints, care planning documentation and the environment. The home provides safe keeping arrangements for personal monies and have good administrative procedures in place to safeguard peoples money. All transactions in to and out of the accounts are logged and receipts kept where required (for example hairdressing and foot care). We checked a sample of accounts and the records tallied the amount of money held. We were told about the arrangements in place for staff supervision and monitoring of work performance. The records evidenced that staff have regular formal supervision with a senior. There is a cascade system of supervision shared between the manager, the deputy, nurses and the hospitality manager. Those staff spoken with during the inspection confirmed that they have regular supervision and that they are well supported. We were also told that registered nurses monitor what care staff are doing on a daily basis. Safe working practices ensure the safety of both the people who live in the home and the staff team. We would suggest that some of the safe systems of work devised from manual handling risk assessments are revisited and fuller details recorded about specific moving and handling equipment needed. All the necessary environment and equipment checks are completed regularly by the maintenance man, the fire log evidenced that the alarm system and fire fighting equipment is tested regularly and water temeratures are monitored. The home is well maintained throughout and no health and safety concerns have been raised as a result of this inspection. Care Homes for Older People Page 25 of 28 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 26 of 28 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 1 Review and update the information in the Statement of Purpose, Service User Guide and financial information leaflet. Ensure that a clear record is kept in end of life care planning documentation, when the person themselves, is unable to be involved in the decision making process. A reason for this is to be recorded to make it clear. Dead flowers should be removed once they have gone over, in order to maintain peoples bedrooms in good order. Regulation 26 reports should be completed in greater depth to ensure that the quality of service provided is monitored more robustly. Safe systems of work devised following manual handling risk assessments must include explicit instructions for staff so that they know what equipment must be used. 2 11 3 4 24 33 5 38 Care Homes for Older People Page 27 of 28 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. Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!

The Provider has not yet updated their profile and added details of the services and facilities they offer. If you are the provider and would like to do this, please click the "Do you run this home" button under the Description tab.

The Provider has not yet updated their profile and added details of the services and facilities they offer. If you are the provider and would like to do this, please click the "Do you run this home" button under the Description tab.

Promote this care home

Click here for links and widgets to increase enquiries and referrals for this care home.

  • Widgets to embed inspection reports into your website
  • Formated links to this care home profile
  • Links to the latest inspection report
  • Widget to add iPaper version of SoP to your website