Care Home: Headingley Hall

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What the care home does well Information about services provided by the home is good, it is available to those people who wishes to use the service and provides enough information for them to be able to decide if the home will be suitable for them. Policies and procedures are in place to promote and protect the health, safety and well being of people who use the home and staff. The home is well managed and people that live and work at the home feel valued and enjoy a friendly and relaxed atmosphere. Comments from people living at the home and/or their relatives included the following "If you have to come and live in a home, it is a very nice one to be in." "Staff see that you have every comfort." "Always clean and tidy." "This is an excellent home, well run." "The staff are so kind, the food is lovely." The home has established close working relationships with other health-care professional to make sure people`s health care needs are met and they have access to the full range of the NHS services. Robust policies and procedure for the smooth running of the home are in place and reviewed regularly. What has improved since the last inspection? Improvement has been made with the administration and recording of medications within the home. Further developments have been made to care management arrangements particularly in respect of ongoing improvements to care planning documentation. `Have your Say` has been introduced, for anyone wishing to make comments, complaints, compliments and suggestions. Each person has the information card and stock of note-lets to use as needed. This new arrangement replaces the comment cards and secure boxes, situated across the home which have not been used. The home now rents a fish tank with a selection of brightly colored fish, this has proved to be very popular with quite a few people. University of 4th Age (U4A), this is a service paid for by the home, that provides for 1:1 visits between a person living in the home and U4A personal visitor. The time spent with each person is determined by the person`s particular interests, hobby, or activity. Over the last 12 months, a number of bedrooms have been fully refurbished. What the care home could do better: The manager should continue to make sure that all members of staff have regular formal one- to- one supervision sessions. This will help to ensure staff are supported to carry out their role. Key inspection report Care homes for older people Name: Address: Headingley Hall 5 Shire Oak Road Leeds West Yorkshire LS6 2DD     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: Frederick Rawlins     Date: 2 3 0 6 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 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) 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 26 Information about the care home Name of care home: Address: Headingley Hall 5 Shire Oak Road Leeds West Yorkshire LS6 2DD 01132759950 01132759950 judith@westwardcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Westward Care (Yorkshire) Limited care home 37 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 37 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 category: Old age, not falling within any other category - Code OP Date of last inspection Brief description of the care home Headingley Hall is a care home that offers care and accommodation to 37 older people. Nursing care is not provided but the home is supported by local health care services and calls on specialist advice where required. The home is a large building that has been extended. It is situated in large grounds that is undergoing extensive development work. There is a small enclosed garden area known as the courtyard to the side of the new building, Shire Oak House. There are attractive garden areas to the front of the older building that was formerly known as Care Homes for Older People Page 4 of 26 Over 65 37 0 Brief description of the care home Headingley Hall. There is outdoor seating available to residents and visitors. Local amenities in Headingley include the Arndale shopping centre; library, public houses, supermarket and other small shops which are within easy access. The Headingley Stadium is also close by. The home is serviced by good public transport links to and from Leeds city centre and more rural areas like Otley. Some off street parking is available in the grounds, to the rear and front of the home. Accommodation is provided on two floors within three distinct areas of the home that are accessible via a link corridor. Each area can be accessed by a passenger lift to the second floor. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The inspection process included looking at information we have received about the service since the last key inspection, as well as this unannounced visit to the home, which was carried out between 09:00 and 17:30 hrs. The methods we used included looking at records, observing staff at work, talking to the manager and looking around the home. We provided some people using the service, their relatives, staff and other professionals with survey questionnaires so that they could share their views of the service with us. The questionnaires returned have been used as evidence in the body of the report. The home had also completed and returned their Annual Quality Assurance Assessment form and the information provided has also been used as evidence in the body of the report. Care Homes for Older People Page 6 of 26 The purpose of the visit was to assess what progress the home had made and the impact of any changes in the quality of life experienced by people using the service. 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 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. Feedback was given to the manager at the end of the visit. The fees for the service currently range from 445 to 560 pounds per week. Details of the exact charge can be obtained by contacting the manager. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: The manager should continue to make sure that all members of staff have regular formal one- to- one supervision sessions. This will help to ensure staff are supported to carry out their role. Care Homes for Older People Page 8 of 26 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 26 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with good information that assists them when making their choice about taking a place in the home. They can visit and staff ensure people are properly assessed before they are admitted. Evidence: The information about the service is good and gives people the opportunity to decide whether or not the home can meet their needs. Records show that peoples needs are assessed before they move in to Headingley Hall either in their own home or temporary place of residence. The assessment documents make up part of the care plan documentation that belongs to each person. The preassessment document looked at showed that the dates of these assessments were carried out before each individual was admitted. This is good practice. Surveys returned by health professionals said staff are exceptionally good at Care Homes for Older People Page 11 of 26 Evidence: holistically assessing people as individuals, pro actively plan care to promote health and wellbeing. People said they were able to come and look around the home before they made a choice about taking a place. Some comments made were, We visited on two occasions to look around and the staff were very helpful. I was invited to come and look around and found it was clean. People considering moving in to the home are always supported through the admission process and once admitted care is taken to make sure that they are happy and content in their new environment. Care Homes for Older People Page 12 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health care and personal needs are met in a way that maintains their dignity and independence. Evidence: Care plans are in place and are initially generated from the information of the assessment of needs completed by senior staff. There was some evidence to show that wherever possible people are involved in the care planning process, which means that they are consulted about how they want their care and support to be provided. Each person had their care needs assessed and care plans were written to assist staff with ensuring this care is given. Staff were asked about their involvement with the information kept in each care file. They said they are encouraged to complete the record of what care they have provided to each person on the day they work. Care Homes for Older People Page 13 of 26 Evidence: The care plans provided good person centred care that informed the reader about the exact care needs of each individual. They contained good information about the previous life history of each individual. Evidence was also seen that showed families have also been asked to contribute to these documents. Good evidence was contained within the care planning documentation that showed staff responded quickly to the changing health needs of individuals. Everyone living at the home is registered with a General Practitioner and are supported in having access to full range of NHS services. The input of other health-care professionals is clearly recorded in the documentation available, which shows that staff are seeking advice if they have concerns about individuals health. People were risk assessed in areas such as falls, pressure area care, continence care, manual handling and nutrition. The majority of these documents were reviewed regularly and were up to date. People confirmed that they were happy with the care and support they received and said that staff always treated them with kindness and respect. Comments included you could not wish for kinder staff and we are very lucky to live at Headingley Hall the staff are great. People who work here do their jobs pretty well to say they are always in demand. Im very pleased with the care they give my mother. I am happy that my mum is here. The staff know what she is like with some things. Staff were observed providing the care to people living in the home. There were many examples of good practice seen. Examples of this were, staff getting down to the eye level of people when they were speaking to them, staff providing people with time to answer questions, staff being polite and helpful when interacting with people living in the home. We reviewed the medication system in place and found that medicines are managed safely. Photographs had been taken of all the people, which made sure they are clearly identified on the medication records. Some people take responsibility for their own medication after a risk assessment has been carried out. The medication administration record (MAR) sheets were checked and showed no errors in administration. In the survey returned by the health care professionals they said appropriate use of GP services,good liaison with GPs, families and people. Care Homes for Older People Page 14 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home responds to individual needs and choices and encourages people to exercise control over their daily lives. Evidence: On the day of the visit the atmosphere within the home was very calm and relaxed and staff were observed to interact well with the people in their care. The manager confirmed that the daily routines of the home are flexible and people are encouraged to be as independent as possible and consulted about how they want to spend their time. The home offers people the opportunity to join in a range of social and leisure activities. A weekly social diary is produced and distributed to people who can then choose what they would like to take part in. Activities include, keep fit, sing-a-long, bingo, painting,trips out, games evenings and live music with singers and musicians. During the inspection a keep fit session was organised and we were able to take part with the people living there. The manager is committed to extending the range of activities and outings currently provided and enabling people to lead a full and active life. Care Homes for Older People Page 15 of 26 Evidence: People said that they enjoyed the activities arranged for them and confirmed that special occasions throughout the year including birthdays and anniversaries are always celebrated with a party or entertainment. Feedback from people shows that they are able to see visitors in their own room if they wish to do so and family and friends are always made to feel welcome and offered refreshments. In the returned surveys people said If you have to come and live in a residential home, it is a very nice one to be in. Excellent food. During the visit we observed the lunchtime meal being served in the dining room. The tables were nicely set and people were given the time they required to eat their meal in comfort without being hurried. There were some very positive interactions seen between staff and people who needed assistance. Staff were being helpful and careful. Most staff explained what they were doing when assisting people and most people were given time to swallow mouthfuls before being offered another. Care Homes for Older People Page 16 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are suitable systems in place to make sure that complaints are dealt with appropriately and people are protected from abuse. Evidence: There is a clear complaints procedure in place which is made available to people. It is referred to in the Service User Guide and a copy is included in the welcome pack to the home. People living at the home said that they were aware of the complaints procedure and would have no problem at all in approaching the manager or registered provider if they had any concerns about the standard of care being provided. Adult protection policies and procedures are in place and training records provided by the manager show that most staff have received training in the recognition and reporting of allegations of abuse. Discussions and feedback from staff indicates that they are aware of the homes policy on whistle blowing and knew what to do if they suspected that people were being abused or working practices at the home were not in the best interest of the people living there. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home continues to provide people with a pleasant, safe and comfortable environment in which to live. Evidence: Some extensive development work is going on with a new building that will adjoin Headingley Hall. Completion is due in early 2010, and a range of new and improved facilities are intended. There is an ongoing refurbishment programme for the home which ensures the environment is improved continually. The communal lounges have been furnished and decorated to a good standard, providing comfortable places to sit. The home was clean and tidy. People were happy with their rooms and said that they were kept clean and free from smells. The rooms seen were nicely decorated and furnished. It was clear that people can bring their own belongings, and furniture where possible, to personalise their rooms. Some people hold a key to their bedroom door. Signage and reminder notices are used to good effect, for people with sensory impairments or who have some memory loss. It is apparent when talking to the manager that the registered providers take pride in Care Homes for Older People Page 18 of 26 Evidence: providing people with a high standard of accommodation and have further plans to improve the environment and facilities within the next year. Disposable gloves and aprons are available and there is adequate provision of liquid soap and disposable towels for staff use. This helps to make sure staff follow good infection control practice. People said they were satisfied with the laundry services. Clothes and linens seen were clean, well laundered and ironed. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are sufficient staff employed to make sure peoples needs are met and staff are supported in developing the skills and knowledge they need to care for people properly. Evidence: The home has a through staff recruitment and selection procedure, which includes obtaining at least two written references and a Criminal Record Bureau (CRB) check before new staff start work. This makes sure only people suitable to work in the caring profession are employed. All staff are provided with written job descriptions, which outlines their roles and responsibilities. The manager confirmed that all new staff receive induction training in line with the Skill for Care Common Induction Standards. These are nationally agreed induction standard designed to help new staff get the skills and knowledge they need to care for people. Following induction there is an expectation that staff will study for a National Vocational Qualification (NVQ) at level two or above depending on the post they hold. Currently 53 of the care staff have achieved a NVQ at level two and three staff are studying for a NVQ at level three. Care Homes for Older People Page 20 of 26 Evidence: Feedback from staff indicates that they are generally pleased with the level and standard of training provided and are encouraged to take up training opportunities. The health care professionals in there survey returned said the caring attitude of the staff is excellent and we worked well together as a team recently whilst providing palliative care in two difficult and challenging situations to people and their families. Staff have a very caring attitude. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management structure in place makes sure that the home is well managed and run in the best interest of the people living there. Evidence: Both the registered providers and manager have a positive attitude to the inspection process and have shown a willingness to work with us to maintain and improve standards at the home. The manager confirmed that she is well supported by the providers and there are clear lines of accountability, which makes sure the home is managed affectively and in the best interest of the people living there. To make sure that there are clear lines of communication within the home regular staff meetings are held and the manager operates an open door policy so that people are able to approach her at any time if they have a problem or concerns. Formal oneto-one staff supervision is in place, which gives staff the opportunity to discuss their training and personal development needs. However this has not been happening as regular as it should. The manager said she is working to address this. Care Homes for Older People Page 22 of 26 Evidence: The home looks after some personal monies for some people living there. Receipts are kept for all transactions that are made. We checked a number of transactions and no concern were raised. This means that people can be confident that the system is safe and well managed. One person said I have clean cloths every day and have a bath everyday. Another said this is an excellent home, well run by Judith the manager. The self assessment indicated that there is not yet a formal quality assurance monitoring system in place that cover all aspects of the service provision. The manager is working on this which will help to assess how well the home is meeting stated aims and objectives. The Director of Nursing visit Headingley Hall at least monthly and provide a written report on the conduct of the home. Policies and procedures are in place to ensure the health and safety of people living at the home, visitors and staff, which are audited on a regular basis to make sure that they comply with changes in legislation and good practice guideline. Information provided in the self assessment form shows that all equipment in use at the home are serviced in line with the manufacturers guidelines, which means that people can be sure they are in good working order. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 36 The manager should make sure that all members of staff have regular formal one-to-one supervision sessions. This will make sure that all staff are supported and supervised to carry out their role. Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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. 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