Care Home: Helme View

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What the care home does well People`s needs are assessed prior to them moving into the home and are able to visit the home to establish whether or not it is the right place for them. Staff were observed to be skilled in their approaches with people and gave support with warmth, friendliness and patience, and in the interest of people`s privacy and dignity they were observed knocking on people`s doors before entering. All rooms offer en-suite accommodation and for those who wish and are able, people have a key to their room. One person said that they liked to lock their door. Medication audits are carried out so that any issues can be quickly identified and addressed to ensure that people are kept safe. Meals provided are good and served in a pleasant environment. The majority of staff have had Dementia awareness training and training from the Alzheimer`s Society to ensure that they have the knowledge and skill to care for people who have this disability and records were seen to confirm this. Seventy five percent of care staff have a level 2, National Vocational Qualification in Care (NVQ) in care. Qualified staff have a better understanding of peoples needs. What has improved since the last inspection? This is the first inspection since the owner purchased the home in 2009. The interior of the home has been completely upgraded and refurbished to provide a pleasant environment for people to live. What the care home could do better: Two people were seen to be using inappropriate movement and handling techniques and at lunch time the same two carers did not always interact with people by way of assistance in cutting up food, and explaining the food that had been chosen as it was given to each person. These issues were brought to the attention of the acting manager and appropriate action was taken with the two members of staff on the day. The activities timetable should be written in a format that people are able to understand. The home should have a dedicated activities person so that the staff are not taken away to perform other duties. Staff should record people`s involvement and enjoyment of each activity that they take part in. This will enable staff to evaluate whether the activity should be repeated or not. The patio and garden area should be made into a safe area where people can go. Key inspection report Care homes for older people Name: Address: Helme View Bishops Way Meltham Huddersfield West Yorkshire HD9 4AG     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: Karen Summers     Date: 1 1 0 5 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Helme View Bishops Way Meltham Huddersfield West Yorkshire HD9 4AG 01484851270 01484303804 stablecourt@surfree.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Helme Hall Ltd Name of registered manager (if applicable) Mrs Julie Smith Type of registration: Number of places registered: care home 18 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The maximum number of service users who can be accommodated is: 18 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: Dementia - Code DE Date of last inspection Brief description of the care home Helme View is owned by a small locally owned care company. The home is registered to provide accommodation and care for up to eighteen older people. The establishment is situated in a residential area on the outskirts of the village of Meltham, with easy access by public transport to the town centre of Huddersfield. Care Homes for Older People Page 4 of 27 Over 65 0 18 Brief description of the care home The property, a converted coach house, which has been sympathetically extended, is well maintained throughout and furnished and fitted to a good standard. All bedrooms are for single occupancy and all are equipped with en-suite facilities. Communal areas, that include a conservatory, are spacious and comfortable. Although the building has two floors only staff and service areas are located on the first floor. The ground floor has all the communal facilities for people who live in the home. The garden and courtyard with hanging baskets is an attractive well kept area where people may sit out and relax in the warmer months of the year. The provider informed the Care Quality Commission on the 11th May 2010 that fees range from £525 to £550 Additional charges include hairdressing, private chiropody and newspapers. Information about the home and the services provided are available from the home in the statement of purpose and service user guide. 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 report refers to an inspection, which included an unannounced visit to the service on the 11th May 2010. The home is registered to provide care and accommodation for up eighteen older people who have dementia. Due to the nature of the illness the majority of the people living at the home were not able to communicate their views about living there and the care they receive. The purpose of this inspection was to look at how the needs of people living in the home are being met and we focused on the outcomes of the key standards. During the visit we spoke to visitors, staff and management. We looked at various records including peoples care plans, staff files and training records. We looked around some of the building and we observed staff while they carried out their duties. Care Homes for Older People Page 6 of 27 We did this inspection with an expert by experience who spoke to people living in the home, their relatives and staff. An expert by experience is a person who either has a shared experience of using services or understands how people in this service communicate. They visited the service with us to help us get a picture of what it is like to live in or use the service. This is important because the views and experiences of people who use services are central to helping us make a judgment about the quality of care. We have reviewed our practice when making requirements, to improve national consistency. 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: Two people were seen to be using inappropriate movement and handling techniques and at lunch time the same two carers did not always interact with people by way of assistance in cutting up food, and explaining the food that had been chosen as it was given to each person. These issues were brought to the attention of the acting manager and appropriate action was taken with the two members of staff on the day. The activities timetable should be written in a format that people are able to understand. The home should have a dedicated activities person so that the staff are not taken away to perform other duties. Staff should record peoples involvement and enjoyment of each activity that they take part in. This will enable staff to evaluate whether the activity should be repeated or not. The patio and garden area should be made into a safe area where people can go. Care Homes for Older People Page 8 of 27 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 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 10 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 are assessed prior to them moving into the home to ensure that their needs can be met. Evidence: The care records of two people who use the service were looked at, and they contained a Community Care Assessment carried out by the local authority that funds the placements. Each assessment contained detailed information about the persons needs. In addition to this there was evidence in the records that the home had also carried out an assessment of the persons current needs, this is to ensure the staff are qualified and skilled to meet the needs of the person and the placement will be appropriate. The manager and staff confirmed that prospective people who use the service and their families are encouraged to visit the home and spend some time there meeting the staff, other people living at the home and sample the daily routine. This is to gain Care Homes for Older People Page 11 of 27 Evidence: an insight of how they view the service. Care Homes for Older People Page 12 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. Peoples care plans outline the level of support and care each person requires in ensuring their health and welfare needs will be met. Evidence: Two peoples care plans were looked at, and the records included relevant risk assessments relating to falls, pressure care and nutrition etc. The documentation also included their mental wellbeing, hearing and sight, peoples likes and dislikes, their social, cultural and spiritual needs. There was information in the care records of involvement from peoples doctors, social workers, opticians and other health care professionals where needed. Care reviews had taken place, and the care plans had been updated monthly or as the needs of the person changed and this was with the involvement of health care professionals, and the person or their relative wherever possible. Care Homes for Older People Page 13 of 27 Evidence: Staff were observed to be skilled in their approaches with people and gave support with warmth, friendliness and patience, and they were also observed knocking on peoples doors before entering. However, two carers were observed using inappropriate moving and handling techniques and they did not always explain what they were doing when assisting people. One of the carers was an experienced person and had recently attended a training update in movement and handling. The second person who had not been at the home very long, had been instructed that they must not assist anyone until they had received their training and they had been observed to move people in a safe and appropriate way. Other staff were observed moving and handling people properly and in a safe and dignified way. At lunch time the same two carers did not always interact with people by way of assistance in cutting up food, and explaining the food that had been chosen as it was given to each person. One or two people could have benefited from encouragement thereby avoiding their food going cold. These issues were brought to the attention of the acting manager and appropriate action was taken with the two members of staff on the day. A sample of three peoples medication and records were checked. In each file there was information relating to the drugs that the person was taking and this included the name of the drug, what it is used for and any side effects that the person may experience. This allows the staff to know what medication they are giving and report any side effects to the doctor so that prompt action can be taken where necessary. In one of the medication checked there was a discrepancy between the medication left in the container and what had been recorded on the medication chart. The carer responsible for the medication showed records to suggest that the medication is audited regularly. She said that she would trace back the reason for the medication discrepancy. Medication audits are carried out so that any issues can be quickly identified and addressed to ensure that people are kept safe. Care Homes for Older People Page 14 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. Meals provided are good, varied and served in a pleasant environment. Evidence: On the morning of the visit people were seen to be having cups of tea and sat in various parts of the home. One person was looking at a magazine, and another person was wearing their cleaning apron as they went about their chores and passed the time of day with other people and visitors in the home. Staff were seen to be interacting with people in a friendly and caring manner and friendly banter was observed between some of the people living there. The acting manager confirmed that the home does not have a dedicated activities person; however she did say that there were sufficient staff on duty to provide daily activities and although one member of staff had the responsibility for organising activities, it was the responsibility of all staff to be involved in the activities that take place each day. There was evidence on the duty rota that there are four staff on duty each day and the acting manager is also supernumerary Monday to Friday. When the home is full, Care Homes for Older People Page 15 of 27 Evidence: there is 1 member of staff to 3.6 people living at the home Monday to Friday and the acting manager confirmed this. We discussed with the acting manager and the owner of the care home the benefits from having a dedicated activities person. An activities plan was displayed on one of the walls in the entrance seating area outside of the lounge; unfortunately the writing was not large enough for people to read and taking into consideration the client group people might benefit from a picture format. This was discussed with the acting manager and she said that a more appropriate timetable would be provided in a format that meets the needs of the people living at the home. On the morning of the visit some people were involved in flower arranging and the displays were seen in various parts of the home. Later that day we observed music playing and staff and people dancing together in the conservatory, there was fun and friendly banter being enjoyed by all. The acting manager also said that domestic activities take place for those who wish and this included; folding laundry, dusting, and washing cups in the kitchen. We observed a person wearing an apron with a tea towel in their hand displaying their enjoyment at preparing the tables for lunch. There was evidence in peoples individual care records of the activities that take place each day, and we discussed with the manager that staff should record the persons involvement and enjoyment of each activity that they take part in. This will enable staff to evaluate whether the activity should be repeated or not. The activities were said to be flexible within the day or evening. Outside entertainers are arranged and people commented that they enjoyed when people came into sing. The home had a bookcase and magazines available for people to use. There was also a box containing items of interest however these were not on display and we discussed with the manager that people might benefit from having items of reminiscence on display that they could access at their own will. A hairdresser visited weekly, unfortunately this post has now become vacant and until a new hairdresser is employed, the acting manager said that staff would take on this role. One of the people who were spoken with said that they liked having their hair Care Homes for Older People Page 16 of 27 Evidence: done. Records showed that the Optician visits on a regular basis and was visiting on the day of our inspection. The manager and staff confirmed that a priest visits the home weekly to attend to the spiritual needs of one person, and that all religious denominations can be catered for if they are needed. The home has a daily menu and staff said that they assist people in choosing their food preferences each day. The menus take into consideration peoples food preferences and dietary needs and these had also been recorded in the care records. The expert by experience had lunch with people living in the home and she observed that peoples dignity was maintained in protecting their clothing. People were given plenty of time to eat their meal and it was not rushed. A carer was seen to be assisting a person with their meal, however that person may have benefited in using a plate guard to help them eat their meal. This was discussed with the manager at the time. Please refer to the Health and Personal Care section in this report which also refers to the meal time experience. We also discussed with the manager that whilst people were offered hot and cold drinks at breakfast and during the day, at lunch this was not the case. People were observed drinking orange juice and one person was seen to enjoy a glass of lager with their meal. There was a choice of meal and desert at lunch time which people seemed to enjoy. The expert by experience commented that the food taken of the day was very enjoyable and served in a pleasant dining room. Care Homes for Older People Page 17 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. People can be confident that their complaints will be listened to and acted upon. Evidence: The home has a complaints procedure of which a copy was seen in the entrance of the home. The procedure states that complaints will be addressed within 28 days. There was also a Whistle Blowing procedure. There was a complaints log however no complaints had been received since the home opened last year. Staff and the manager showed knowledge of the complaints and whistle blowing procedures. There was evidence in the training records to suggest that staff have had safeguarding (adult protection) training that provides information on how to protect people from abuse, and staff who were spoken with confirmed this. At the time of the visit staff were seen to not be carrying out the correct procedures in relation to movement and handling. Appropriate action was taken by the acting manager and the incident was referred to the Kirklees adult protection team for investigation. Care Homes for Older People Page 18 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. The home offers people a homely, comfortable and clean environment. Evidence: Since the home was purchased by the current owner in 2009, it was closed for a number of months whilst it was refurbished and decorated. The home is decorated to a good standard. As part of the inspection a tour of the home took place, which included the communal areas and a number of bedrooms. People had brought into the home small items of furniture and memorabilia which helps them settle into the home. All rooms offer ensuite accommodation and for those who wish and are able, people have a key to their room. One person said that they liked to lock their door. Now the better weather has come the owner said that he would be upgrading the garden and patio area to provide a safe area for people to go. Discussion was held with the owner about the need for this area to be developed as a matter of urgency as at present some of the people living in the home are showing signs that they want to go out. Following the inspection the inspector was contacted by a health care professional who shared our views that the people living at the home would benefit from being able to go out into a secure garden area. Care Homes for Older People Page 19 of 27 Evidence: The standard of cleanliness throughout the home was good, and systems are in place to control the spread of infection. Care Homes for Older People Page 20 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported and protected by the homes recruitment practices. Evidence: On the day of the visit there were sixteen people in residence. The duty rota was looked at. The manager confirmed and there was evidence to suggest that there were sufficient care staff on duty to care for the number and dependency levels of the people living at the home. Three peoples recruitment records were inspected and the records contained the required information and employment checks. These checks are necessary to help protect people from potentially unsuitable staff. There was evidence in the staff records and staff confirmed that they had induction training when they came to work at the home, which provides them with the knowledge and skill to look after people in their care. The majority of staff have had Dementia Awareness training and training from the Alzheimers Society to ensure that they have the knowledge and skill to care for people who have this disability and records were seen to confirm this. Seventy five percent of care staff have a level 2, National Vocational Qualification in Care Homes for Older People Page 21 of 27 Evidence: Care (NVQ) in care. Qualified staff have a better understanding of peoples needs. Care Homes for Older People Page 22 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. People benefit from the management approach of the home, and the home is run in the best interests of people who live there. Evidence: The managers post has been advertised and until a suitable qualified manager is appointed the Area Manager is acting as the manager to ensure that there is consistency in care and the service being offered at the home. Staff and people spoke positively about the acting manager. The owner of Helme View visits the home a minimum of weekly to give support to the acting manager. On a monthly basis he writes a report on the conduct of the home and this is used to monitor the quality of service and the outcomes for people living in the home. The acting manager said that she had sent out satisfaction surveys to the relatives/ Care Homes for Older People Page 23 of 27 Evidence: friends of people living at the home and the responses have not yet been received. There was also evidence to suggest that residents meeting take place weekly, minutes were seen and staff also confirmed this. There was evidence that staff supervisions have now commenced and staff confirmed this. Staff are supervised to ensure they are competent to do their job. A sample of two peoples finances were checked and found to be correct and receipts were seen of any financial transactions made. Records were also seen of fire alarm and emergency lighting tests. Fire drills and a fire lecture had also been carried out and the staff confirmed that they had regular fire lectures. The manager was aware that more fire drills were needed and she said that she would be contacting the fire safety officer to arrange more training. Care Homes for Older People Page 24 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 25 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 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 12 Staff should record peoples involvement and enjoyment of each activity that they take part in. This will enable staff to evaluate whether the activity should be repeated or not. The home should have a dedicated activities person so that the staff are not taken away to perform other duties. The activities timetable should be written in a format that people are able to understand. The patio and garden area should be made into a safe area where people can go. 2 3 4 12 12 19 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. 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