Care Home: Haydon View

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What the care home does well The home provides a good range of information to people thinking of coming to the home, so they can make an informed decision. The home makes a full assessment of a person`s needs before deciding if it can meet all those needs. The home draws up plans to meet the care needs of its service users. Service users health care needs are also fully assessed and properly met. Service users say that staff treat them well and treat them with respect. The staff are working hard to provide a stimulating atmosphere in the home, with appropriate social activities for service users. (But they need to keep records of activities that service users are involved with) Service users are encouraged to keep in regular contact with family and friends. Service users are also encouraged to take as much control over their own lives as they are able, and make their own decisions. Service users were very complimentary about the food, and there is a balanced diet, with service users choice included. Complaints and concerns are taken seriously and are responded to properly. The home is kept clean and hygienic and free from odours. The home has enough staff to meet the needs of service users, and the late shift staff numbers will be increased as the home fills up. The home is very careful as to how it recruits new staff, and runs all the necessary checks on them to protect its service users. The manager is very experienced and is providing positive leadership to the home. The home is being run in the best interests of the service users. Service users finances are protected by the home`s policies and accounting systems. The health and safety of the service users and of the staff are protected by the home`s policies and systems. What has improved since the last inspection? There have been lots of improvements made to the environment since the last inspection visit, these include: new carpets to all the communal areas and somebedrooms. all the communal areas have been decorated, improvements have been made to the kitchen, new garden fencing has been erected, and the majority bedrooms have been decorated. New lighting is in place in the dining room and one of the lounges. The laundry has two new industrial washing machines installed. What the care home could do better: The ground floor bathroom is not used, if this room was refurbished it will provide service users with the number of usable bathrooms needed for the size of the home. The refurbishment of the laundry will provide staff with a more suitable and safe working environment. The controlled drugs for one person were in a locked cupboard, but not in a locked cupboard within a locked cabinet. The home does have the facilities for the correct storage of controlled drugs, and the manager said she will ensure these are adhered to. In order to promote the health and welfare of the service users. if these is an identified need, appropriate assessments must be completed to provide staff with the information they need to fully meet the service users needs. For people with dementia, the service should consider introducing orientation boards and signage that may improve and aid their remaining capacity. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Haydon View North Bank Haydon Bridge Hexham Northumberland NE47 6NA     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jim Lamb     Date: 2 2 0 6 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. 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. 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 Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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: Haydon View North Bank Haydon Bridge Hexham Northumberland NE47 6NA 01434684465 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Kay Care Services Limited care home 27 Number of places (if applicable): Under 65 Over 65 0 15 dementia old age, not falling within any other category Additional conditions: 12 0 The maximum number of service users who can be accommodated is: 27 The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP, maximum number of places: 15 Dementia - Code DE, maximum number of places: 12 Date of last inspection Brief description of the care home Haydon View is a residential care home providing personal care and accommodation for 27 older people. The home is located in a residential area of the village of Haydon Bridge, close to shops, pubs and other local amenities. The home is a detached property and there is lift access. Care Homes for Older People Page 4 of 28 Brief description of the care home The service users have access to landscaped gardens and an external sunroom that has superb views over the valley. All prospective service users have access to information about the home prior to admission. Fees for the home are 454.00 per week. Information about the home, including the service users guide and inspection reports are available in the home. 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 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 services 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. The quality rating for this service is 2 stars. This means that the people who use the service experience good quality outcomes. How the inspection was carried out. Care Homes for Older People Page 6 of 28 Before the visit we looked at information we have received since the last visit, how the service dealt with any complaints and concerns since the last visit, any changes to how the home is run, the providers view of how well they care for people, and the views of people who use the service and their relatives, staff and other professionals. During the visit we talked with people who use the service, relatives, staff, the manager, the area manager and visitors,looked at information about the people who use the service and how well their needs are met,looked at other records which must be kept, checked that staff had the knowledge, skills and training to meet the needs of the people they care for, looked around the building/parts of the building to make sure it was clean, safe and comfortable,and checked what improvements had been made since the last visit. We told the manager/provider what we found. What the care home does well: What has improved since the last inspection? There have been lots of improvements made to the environment since the last inspection visit, these include: new carpets to all the communal areas and some Care Homes for Older People Page 8 of 28 bedrooms. all the communal areas have been decorated, improvements have been made to the kitchen, new garden fencing has been erected, and the majority bedrooms have been decorated. New lighting is in place in the dining room and one of the lounges. The laundry has two new industrial washing machines installed. 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 set out 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. Prospective service users are provided with enough information about the service to enable them to make an informed choice about whether this is where they want to live. Evidence: The homes Statement of Purpose and Service User Guide have been updated. These guides contain information that is required to enable people to make an informed choice about where to live. Included in the service users guide are comments that have been made by service users about living at the home. The guide is available in a range of formats on request. Evidence was seen that service users or their representatives have signed a contract with the home, and this included details of the fees to be charged. The manager confirmed that visits to people wanting to use the service always takes place before their admission to the home, to carry out an assessment of needs. Care Homes for Older People Page 11 of 28 Evidence: Four care plans examined contained notes from assessments made on these visits. Also, each persons care plan contained assessments from the placing authority that were responsible for commissioning the service at the home. The home does not provide intermediate care. 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. The care planning system is clear enough to ensure that staff have the information they need to meet the assessed needs of the service users. Medications must always be stored safely at all times. Evidence: Each service user has his or her assessed needs met by an individual care plan. A basic care plan, based on the initial assessment is drawn up so as to be in place when the person is admitted. This is good practice, as is the fact that the staff then draw up more detailed care plans on the day of admission. There was a good match between identified needs (including risk assessments) and corresponding care plans. Care plans are comprehensive, detailed and holistic, in that they cover social, spiritual and emotional needs, as well as their physical needs. In one example seen, staff had accurately identified that an individuals interests included painting, gardening and cooking, and the care plan included helping the service user to Care Homes for Older People Page 13 of 28 Evidence: access all three. Each service user has a monthly re-evaluation of the care plans, to make sure they are still up to date and relevant. A thorough assessment of the physical health needs of each person takes place before/on admission, and monthly, thereafter. However, one service user who is prone to falls did not have a moving and handling assessment completed, therefore staff did not have the information they need to safely assist/transfer this person. Another service user who needs lots of encouragement to eat did not have a nutritional assessment completed. All service users nutritional needs should be routinely assessed. (By the end of the inspection, both assessments were fully completed for the service users concerned). Care plans cover all assessed needs, including health care needs. Mental health needs are assessed as part of the overall dependency assessments, more detailed assessments would be carried out by mental health workers, where necessary. All visits to and/or from health professionals are clearly recorded in the care record. There was evidence of the full range of community health professionals, as well as specialist referrals, as needed. Each service users weight is recorded monthly, and action taken where there is significant weight loss/gain. The home uses the monitored dosage system for its medications. The Medication Administration Records (MAR) was being well completed, with no blank entries. Each persons section in the MAR has a photograph of the person, to make sure that the right medicines are being given out. One persons controlled drugs were not being properly stored in a locked and secured cabinet, within a cabinet. The manager agreed to rectify this immediately. Service users confirmed that they are treated with respect at all times and have their privacy respected by the staff. Staff were seen to treat service users with respect and kindness. Care Homes for Older People Page 14 of 28 Evidence: One service user said,The staff are very kind and caring, nothing is to much for them. This is a wonderful place and i have made lots of friends here. Another said,I have been here for ten months, and i have settled in very well. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service users are offered a good quality lifestyle, which includes varied social contact and activities. Evidence: The home draws up a detailed social history for each person, including hobbies and interests, likes and dislikes, social networks, spiritual needs etc, and there was evidence in the care plans that individual interests are catered for. The manager has plans to display a whole range activities and events in the home. Activities include favourites such as reminiscence sessions, bingo, carpet skittles, quizzes, crafts, baking, dominos and cards. There is a weekly film show and weekly pamper days such as hairdressing and manicures. Keeping records of activities and of those service users that have participated has lapsed. The manager will ensure that detailed records will be recommence. The usual range of festivals and other significant days are celebrated. These include Valentines Day, Shrove Tuesday (pancake tossing), Burns night, Halloween etc. with photos taken and displayed in the home. Care Homes for Older People Page 16 of 28 Evidence: There are occasional trips out. There are monthly entertainers. These have included choirs, singers etc. There are no visiting restrictions. The home continues to be supported by the league of friends who organise fund raising events. Care assessments and care plans showed that service users are encouraged and supported to be as independent as possible. They are free to choose their daily living patterns, in terms of when they get up and go to bed, what to wear, when to bathe, what to eat and when. (The kitchen is never locked). They are assisted to vote, if they so choose. They are also encouraged to comment on the running of the home in their meetings. The menus promote healthy eating. Alternative choices are available for every mealtime, there is provision for individual choice of, omelette, jacket potatoes, soup etc, on request. The menus were drawn up with the help of a dietician. Snacks are available at all times, day and night. Specialist diets will be catered for, but, at the time of the inspection, only diabetic and soft diets were required by service users. There is a suitable budget for the catering staff to work to. The service users said that they always like the meals and confirmed that they are always offered a choice. One service user said,My only complaint about the food is, there is sometimes to much to eat, but it is always good. 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 complaints management is effective, and this results in the service users being protected from harm and abuse. Evidence: There is a complaints procedure. The procedure is written in a way that ensures service users fully understand its contents. Two service user said that she had been given a copy of the procedure and that staff always listened to any concerns and always dealt with them fairly. The home keeps a record of complaints. The home has a Whistle Blowing policy, the Local Authorities Vulnerable Adults procedures, and a copy of the Department of Healths document, NO SECRETS. Staff are aware of these procedures and have easy access to them. Since the last inspection visit, there has been no complaints received. Safeguarding adults training is ongoing for all staff. Service users can deposit cash for safe keeping and records are kept of accounts. A sample of personal finances records was examined. Transactions were appropriately recorded and had two signatures for each entry. There was plenty of evidence of personal spending. Receipts are obtained for purchases and cross-reference to the Care Homes for Older People Page 18 of 28 Evidence: transaction. Weekly checks of balances and cash are carried out. 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. The home provides a comfortable and safe environment for those living there. Evidence: The home was clean, well decorated and well maintained. The home has an appropriate amount of sitting, recreational and dining space. Service users can see visitors in private in their own rooms. Furnishings and fittings were domestic in design, some of the lounge chairs are worn and need to be renewed. Since the last inspection there have been lots of improvements made to the environment, these include: new carpets in all the communal areas, and some bedrooms, all the lounge areas and the dining room have been decorated, corridors have also been decorated as have several bedrooms. There is new fencing around the superb gardens, and there is a summer house and seating areas for service users to use during the summer months. Lighting was bright and domestic in design. Service users bedrooms have opening windows and restrictors are in place where needed. All bedrooms are spacious, well decorated and personalised. The rooms were Care Homes for Older People Page 20 of 28 Evidence: centrally heated and the heating level could be controlled within each bedroom. Radiators and pipes were guarded. There was emergency lighting throughout the home. Some improvements have also been made to the kitchen, this includes a new industrial oven and extractor fan, a new sink and a tea making area has been incorporated. Water is stored at over 60C. Valves at water outlets ensure water is provided close to 43C to prevent scalding. The home was clean and free from offensive odours. The laundry facilities are small and are in need of refurbishment. However, there are new industrial washing machines now in situ, and the manager said that the laundry will be refurbished during the next year. The washing machine have the specified programme to meet disinfection standards. 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. There is a good match of well-qualified staff, who are appropriately recruited and supervised. Evidence: Staff levels on the day of the inspection met the agreed level for the number of service users. On the day of the inspection there were 20 service users. In addition to the manager, the required numbers of staff were on duty across the day 3 from 8am to 9pm There are 2 carers between 9pm and 8am. There are enough domestic, maintenance, and catering hours. All staff were over 18 years of age and those left in charge were at least 21. The training needs of the staff are identified in supervision and appraisal sessions. The homes training programme meets the National Training Organisation requirements for the first six months. Staff receive at least three days paid training each year. Care Homes for Older People Page 22 of 28 Evidence: All statutory training was up to date and 72 of the staff team has completed NVQ level 2/3. The personnel records of three staff were examined. All three had completed application forms, the dates of employment were clear, making it easy to follow a clear employment audit trail. The manager also completes an audit check list and this ensures that all the necessary checks have been completed prior to commencing employment. All had the required two work references, (crb) criminal record bureau check, documentary evidence of identity, induction and training and development information. The manager confirmed that, if there are any concerns about the content of a CRB disclosure, these are discussed with the proprietor. The service employs a training and development officer, and all staff have an annual training matrix drawn up, this covers all mandatory training needs, and other core training needs, such as Dementia Awareness and Adult Protection. Individual staff members have his or her individual training needs analysis on their personal file. Training for staff also includes equality and diversity. 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. The manager is supported by the organisation in providing good leadership throughout the home, with staff demonstrating an awareness of their roles and responsibilities. Evidence: The registered manager has the required qualifications and experience to run the home. There is a range of quality systems in the home. There is an annual survey of the views of the service users and their families. The findings are collated and an action plan drawn up to address any areas of concern. There are also regular meetings held with both the service user groups and with the staff group. These are minuted and action points listed. Care Homes for Older People Page 24 of 28 Evidence: Both individual and central supervision records were studied. These records show an appropriate bi-monthly pattern of supervision, with an annual work performance appraisal. All staff receive annual health and safety training. This is good practice. Checks of the fire log book showed that all the required checks and tests of equipment and systems take place at the proper intervals, as does fire safety training. The homes accident book is kept up to date and information is fully recorded. Each accident is reviewed after 24 hours to check the outcomes of the accident and any treatment given. There is a monthly audit of accidents, and a detailed audit of all falls. Servicing and maintenance records are comprehensive and well maintained. 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 2 3 7 9 21 Moving and handling and nutritional assessments must be completed as soon as a need has been identified. All controlled drugs must always be stored properly: in a locked cupboard within a locked cabinet. The ground floor bathroom should be refurbished, and this will provide service users with the correct number of usable bathrooms for a home of this size. The laundry needs to be refurbished and this will provide staff with a more accessible, pleasant and safe place to work. 4 26 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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