Care Home: Hartisca House

What the care home does well People who want to use the service are assessed before their admission to the home. There are a number of activities takes place within the home and outings during the year to make sure people do not get bored. The home provides people with a caring, friendly and homely atmosphere. People are provided with a service that is comfortable and staff respect their dignity, privacy and individuality. A relative said " I have no concern about the care given to my mother ." " Staff are always ready to talk to you and help with any concern you may have." People also indicated in the surveys that they alway receive the care and the support they need. Staff said" everybody here work well as a team and pull together, the rooms are well above average." Staff indicated that they get the training they need to look after people. What has improved since the last inspection? The home`s statement of purpose has been reviewed and provide people who may want to move in the home with information they need to make a choice if the home can meet their care and support needs. Care plans have improved and all people care and support needs are identified and staff know what to do to meet their needs. Most staff have had training in infection control. This mean that there is little risk of cross infection. The home has one senior care worker and three staff during the day. To make sure that people have access to enough staff to meet their needs. What the care home could do better: All the required checks for new staff must be carried out and any written information placed in their recruitment files available for inspection. Any action that the home will take as a result of the quality audit, should be available to people, visitors and any others involved in the quality audit process. Key inspection report Care homes for older people Name: Address: Hartisca House Hartwell Road Burley Leeds West Yorkshire LS6 1RY     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: Valerie Francis     Date: 1 9 0 5 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 27 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 27 Information about the care home Name of care home: Address: Hartisca House Hartwell Road Burley Leeds West Yorkshire LS6 1RY (0113)2426919 01132426871 hartiscahouse@schealthcare.co.uk www.schealthcare.co.uk Southern Cross Healthcare Services Ltd Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Yvonne Garbutt Type of registration: Number of places registered: care home 26 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: Date of last inspection Brief description of the care home Hartisca House provides care for older people with dementia. The home was purpose built as a care home, though not specifically designed for the care of people with dementia. Bedrooms meet the minimum size requirements and some have en-suite facilities. The ratio of double to single occupancy rooms is satisfactory. The home is built on two floors with passenger lift to the first floor. Each floor has a lounge and dining area with food and laundry services being provided from a central area on the ground floor. Sixteen people are accommodated on the first floor and ten on the ground floor. The building does not provide an area where residents can wander freely. A decked area to the side of the building has been made into a secure area which can be used during the good weather. The home is situated in the Burley area of Leeds, within walking distance of shops, a day centre, church and park. The city centre is a Care Homes for Older People Page 4 of 27 26 Over 65 0 Brief description of the care home short bus ride away. Because of the vulnerability of the client group external doors are alarmed and the front door can only be opened by staff. Care Homes for Older People Page 5 of 27 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 visit by one inspector who was at the home from 09.30 until 6.45 pm. The purpose of the key inspection is to make sure the home is operating and being managed for the benefit and well being of the people who live there. The inspection process included looking at the information we received about the home since the last key inspection. During the visit we spoke to people living in the home, their relatives, staff and management. We looked at various records relating to peoples care and the running of the home and inspected the premises. During the inspection all of the key standards were looked at to assess the standard of care that people receive. Care Homes for Older People Page 6 of 27 Before the visit we asked the home to complete a self-assessment form. An annual quality assurance assessment (AQAA),, this was returned to us in good time. We also sent surveys to people living in the home and staff. Some relative completed questionnaires on their behalf of their relatives. We also received completed surveys from staff, their comments and information from the self-assessment form are included in this report. Care plans, risk assessments, health care records, minutes of meetings , staff recruitment and training records were looked at. Feedback of the findings of the inspection was given to the manager. The fees for the home range from 450. pounds 40 pence to 542 pounds per week. Chiropody, hairdressing, personal clothing and newspapers are not included in the fees. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use the service are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Care Homes for Older People Page 7 of 27 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 27 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 27 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. People who want to use the service have access to up to date information about the service and they are assessed before they move in. Evidence: The home has a statement of purpose and service user guide which has recently been updated, this gives people who want to use the service good information about the home and the service it provides. The home carries out a care needs assessment and they try to get an up to date core assessment for any one wanting to move into the home. This ensures that the home can meet all the identified care needs of the person. We looked at the care files of two people who had recently moved into the home, and we found that an assessment of their care needs were carried out and also the home had been given up to date assessment information from the referring agency. Care Homes for Older People Page 10 of 27 Evidence: A letter is sent to people after their assessment of needs telling them the outcome and if the home can meet their needs. Care Homes for Older People Page 11 of 27 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 have care plans that are in line with their personal needs and wishes. Peoples medication is handled safely. Evidence: We looked at three peoples care plans and we found that everyone had a care plan which identified their needs. Each persons care file had their photograph, for easy identification. When we spoke to people and their relatives they said that they had been involved in putting care plans together, to make sure they get the care they needed. The manager told us that care plans are reviewed regularly and that people and their relatives were involved in the process. This was confirmed by a relative visiting. We found staff to be very aware of the importance of maintaining the privacy and dignity of people in their care. Relatives told us that they felt staff make sure that people are treated with respect at all times. Medications are well managed with good records kept. The home has a safe handling of medication policy in place. Medications are ordered in accordance with the Royal Care Homes for Older People Page 12 of 27 Evidence: Pharmaceutical Society Guidelines. We observed a member of staff taking care with administering medication. The senior care worker has responsibility for ordering and regular monitoring of medication administration records, to make sure people get their medication and that records are signed by staff administering medication. This is to ensure that people are safe. Care Homes for Older People Page 13 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have the opportunity to engage in social and recreational activities and are encouraged and supported to pass time doing what they prefer . A choice of menu is provided with further choice if they wish. Evidence: We saw that people were encouraged to take part in activities in and out of the home. Such as going out for a walk in the grounds. We were also told that there are visiting entertainers who engage people in singing and entertainment. One relative who was visiting told us that her mother was much better now since she moved into Hartisca house, she like to watch the activities rather than join in. We were told that there is a full time activity coordinator, who arrange and plan activities with and for people. This means that people have access to a member of staff who can engage them in meaningful activities, to keep them stimulated. We saw in peoples care file that they had life history information which staff use to plan peoples social activities. It was obvious that people like to join in activities, we saw people having fun and laughing during an activity with staff. One person told us that they had the choice of joining in but preferred not to. Care Homes for Older People Page 14 of 27 Evidence: People told us that they were happy and had no complaint. Relative told us the home provide outings to various place such as the seaside, pubs and parks. Relatives also told us they are very good and this give people time when they need help. During our discussion with the activity coordinator it was appeared that she knew people and their life history and their likes and dislikes. During mealtime we saw that people were given help from staff if they needed it, food was cut up if people needed that level of assistance. People said the food was good and that they were able to have something different if they did not like what was being served. One person told us before lunch that they did not want what was being served but they wanted fish, this was relayed to the chef, and the lady got fish. Nutritional risk assessment are carried out to help identify if people were at risk of malnutrition. people weights are monitored to make sure they keep a health weight and they are not at risk. Care Homes for Older People Page 15 of 27 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 homes complaint and safeguarding procedures and staff training protect people. People and their visitors know that their concerns will be listened to and dealt with. Evidence: The complaint procedure is made readily available and is displayed on the wall in the hallway. The policy was also included in the statement of purpose and the service user guide. The records provided showed evidence that complaints were responded to, showing people and visitors that their complaint and concerns would be listened to and acted upon. From discussion with staff it was apparent that not all staff had received Safeguarding Adult training. The manager said that all staff have half day safeguarding training during their induction and several staff had undertaken a distance learning course for safeguarding. We were told that the organisation is a Dignity in care champion. We saw dignity care folder and leaflets which inform people, visitors and staff about dignity in care and what it means to people being looked after. The home also provides staff training on the Mental Health Act Deprivation Of Liberty, which can affect people living in Hartisca house. Care Homes for Older People Page 16 of 27 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. People live in a homely environment which is being adapted to meet their needs. Evidence: We found that, the sitting areas were seen to be comfortable for peoples use. The furniture and fitments are suitable for the people living there. We saw that people had taken the opportunity to bring with them many of their personal effects. We were told that part of the refurbishment plan is to redecorate and replace furniture and carpet one of the bedrooms monthly . There are signs on bathrooms and toilet to help people to recognise them. Since the last key inspection the communal sitting rooms have been refurbished and there are plans in place to refurbish hallways. In the AQAA we are told that in the next twelve months the home is planing to create a pamper room in the hairdressing room and to develop a quiet room where people can relax and meet with their visitors in private. People have access to the decking sitting area which they can use in the good weather.This is also used as a smoking area by residents. The perimeter fence gives security to people who wish to sit in the garden and the opportunity to use the grounds. There is a ramped access to the front of the building. It was clear that effort was being made to create an atmosphere that would enhance peoples senses and memory. Materials and scarves are hung on rails through out the building for people to interact with. We saw people enjoying touching and wearing Care Homes for Older People Page 17 of 27 Evidence: scarfs. We were told that there are also plans in place for other tactile reminisce objects such a spinning tops placed in a rummage box in the activity room, which is accessible to people, where people can rummage through. This is hoped would enhance peoples memory of their pass life. In the laundry room there is a sluice cycle washing machine and dryer. Peoples clothing appeared to be suitably laundered. Peoples clothing are marked with their names to make sure they wear their own clothing. During the tour of the premises, although we found it to be homely, we saw in some bedrooms and hallways debris and dust . Care Homes for Older People Page 18 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are cared for by staff who are trained to meet their care and support needs. However, the remiss of the required checks for staff could put people at risk. Evidence: There are four care staff available to people during the morning one of which is a senior carer or deputy manager. The availability of the manager to staff and people living in the home was not shown on the rota. Staff told us in the survey the home could employ more care staff, that way the activity person and cleaners would not have to stop their jobs to do care . On the day of the inspection there were five extra staff in the home, four staff had come to the home to under take Health and Safety training. There were four staff available to people including a senior carer. The proposed deputy and the manager was also on duty. We were told and we saw records that staff had undertaken mandatory training such as moving and handling and infection control. The training matrix showed that staff had undertaken courses such as customer care, dementia awareness, challenging behaviour, pressure care, safe handling and administration of medication and nutrition. A number of staff have had some updated training such as: moving and handling with plans in place for other to undertake these training. The manager told us that there is ongoing training to make sure that staff practices provide people with a good standard of care. Care Homes for Older People Page 19 of 27 Evidence: Communication systems are in place for sharing information. At the end and the beginning of shifts there is a hand over, when staff pass on information of what had happened during their shift. During the visit we observed staff interaction with people and visitors and found them to be friendly but not overly friendly. Staff told us that despite there is shortage of staff they work together as a team for the good of the people who live in the home. The home has a training plan in place, and staff files showed that they had attended several courses and receive updated training. We were also told by staff training is an important part of my role.I can gain knowledge and keep up to date. The home have exceed targets set in the National Minimum Standards for the numbers of staff who should achieve a (NVQ) National Vocational Qualification. It is acknowledged that there is a good induction programme for new staff. In the AQAA we were told that staff receive bi-monthly supervision and annual appraisals. Staff personal development files are audited at the manager monthly meeting with line management to the home. The home told us they hope to enable all care staff to obtain an NVQ level 2 qualification. They also assist all staff in their training and development needs through internal and external training. The organisation training plan is for all staff to obtain the( YTT) Yesterday, Today & Tomorrow dementia training, with refresher courses for those already completed the course. It would appear that staff are trained and have experience to meet the needs of people living in the home. We looked at the recruitment files of three staff one had recently been employed. We saw information that all the required checks were completed before they started working in the home. However, we saw that two members of staff work permit had expired and three other staff file did not have a copy of their work permit or visa. We were told that these were been followed up by the home administrator. Two additional staff did not have a work permit; these staff were presently off on sick leave and had been contacted about the permit. However, they had not responded, to any communication made from the home, and we were told that plans were in place for these staff employment to be terminated. We saw that all staff have had a POVA (Protection of Vulnerable Adults) first and CRB (Criminal Record Bureau) checks, and the receipt of two written references had been obtained. We were told that the organisation carries out further CRB check. To make sure staff are still safe to work with vulnerable people. All other recruitment records were checked and found to meet the standards. We were told by visiting health care professionals staff ask for help and act on the Care Homes for Older People Page 20 of 27 Evidence: advice given and over the years the care for people had improved. Visitors told us, staff are friendly helpful and caring and always wiling to help. Care Homes for Older People Page 21 of 27 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. The management of the home has peoples interest in mind. However, some of the homes management practice put people at risk. Evidence: The manager has been employed in the home since January; she is supported by two senior care workers. There were plans in place for deputy manager who was assisting with the running of the home on the day of the inspection to join the staff team at Hartisca House. The operational manager visit the home on a regular basis and monthly reports are made at the visit on the conduct of the home. The manager and the propose deputy manager spoke with knowledge of the home and the people living there. There are good systems in place to protect people. The homes financial procedure protect people, we saw a good audit trail of peoples money. We were told that the organisation give people access to any money kept on their behalf via a cash float. We were told that the home do not handle peoples financial affairs, this is done by people, relatives, advocates or solicitors. Care Homes for Older People Page 22 of 27 Evidence: People, their relatives and health care professionals are able to comment on the service provided at the home. For example: in house meetings, involving people and relatives in their care and through taking part in the annual quality audit. Questionnaires are sent to people, relatives and professionals involved in the home. We were told that the outcome is displayed in the home in a graph format, which gives all involved access to the result. However, there are no comments of any action to be taken for improvements that may be needed as a result of the audit. Staff are trained in health and safety, infection control, safe handling of people and food safety. There are systems in place for recording and monitoring accidents, so that any possibility of accidents can be recognised and an arrangement put in place to reduce the potential risk. We found that regular checks are carried out of the fire equipments, and all staff take part in fire safety training. The maintenance records we looked at were up to date and showed that equipments are maintained and serviced at the required intervals. Risk assessments were in place for the building and other potential generic risk to people and staff. This is to make sure people and staff are safe at all times. Care Homes for Older People Page 23 of 27 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 27 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 1 29 18 All the appropriate check for staff must be carried out. To make sure they are safe to work with people and the home comply with the countrys legal systems 29/06/2009 2 37 19 All the required checks for new staff must be carried out and any written information placed in their recruitment file. To make sure that people living in the home are not at risk. 03/07/2009 3 38 19 All the required checks for new staff must be carried out and any written information placed in their recruitment file. To make sure that people living in the home are not at risk. 03/07/2009 Care Homes for Older People Page 25 of 27 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 33 The action to be taken as a result of the homes quality audit should be made available to people, visitors and any others involved in the quality audit process. Care Homes for Older People Page 26 of 27 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). 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