Care Home: Homefield House Care Home

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What the care home does well People wanting to use the service are holistically assessed prior to admission and this is used as a basis to plan their current care needs. They can tell if the home is suited to their needs by looking at the documentation which supports what services the home provides. Regular reviews take place where each individual or their next of kin is involved in future planning. Where necessary the advice is sought from other health care professionals. A varied programme of activities is available to ensure peoples social, religious and cultural needs are being met. This involves events both inside and outside the home. A 4-week cycle of menus ensures variety and a balanced nutritional diet is on offer. With provision made for peoples special needs, which kitchen and care staff keep track of. The decoration in the home is of a very high standard and care taken to reflect the age and style of the home in communal areas but peoples individual bedroom areas decorated to their personal needs and tastes. Through a thorough auditing and maintenance programme the refurbishment is kept up to date. Staff are always very open and friendly and positive comments are made by people using the home about their caring attitude and how they are cared for as individuals. A robust system of recruitment is in place to ensure they are safe to work with people prior to their commencement of employment and they are then trained and supervised to do their job. A detailed quality assurance system is in place, which takes into consideration the views of people living in the home and ensuring it is a safe place in which to live and work. What has improved since the last inspection? There were no improvements set from the last inspection. What the care home could do better: No improvements have been needed at this inspection. Key inspection report Care homes for older people Name: Address: Homefield House Care Home 11 Welholme Road Grimsby North East Lincs. DN32 0DT     The quality rating for this care home is:   three star excellent 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: Theresa Bryson     Date: 2 4 0 3 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 25 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 25 Information about the care home Name of care home: Address: Homefield House Care Home 11 Welholme Road Grimsby North East Lincs. DN32 0DT 01472341909 01472341306 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Rabindranath Rommel Selliah,Ramesh Dalton Murugupillai Name of registered manager (if applicable) Mrs Carol Ann Kirwin Type of registration: Number of places registered: care home 24 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Homefield House Care Home is a large old house situated in the centre of Grimsby in a residential area and overlooking a large public park. It is in easy reach of all types of amenities and the seaside town of Cleethorpes. The home can accommodate 24 people with problems of old age and dementia. The surroundings are an older house with a modern extension set in mature gardens with some car parking space. Most rooms have en-suite facilities and there are ample other toilets and bathroom and shower rooms. The home also has large sitting and dining areas and has a quiet room for service users to use. Equipment has been supplied to ensure that all acute and Care Homes for Older People Page 4 of 25 Over 65 24 0 Brief description of the care home chronic needs of service users can be met and staff have the necessary equipment, which is regularly maintained. The Company is happy to accept service users who are privately funded as well as those funded through the local authority. Information about the services provided by the home are contained in the service users guide and statement of purpose, which is on display in the main reception area and is sent to all parties interested in using the home. Care Homes for Older People Page 5 of 25 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: three star excellent 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 inspection took place over one day in March 2010. Prior to this we sent out surveys and had returned to us three from relatives, nine from staff and nine from people who use the service. We also looked at the service record CQC keep on this home and tracked the Notifications they had sent to us. The home sent us their Annual Quality Assurance Assessment (AQAA) prior to our visit which told us what they had been doing since their last visit from us, their plans for the future and other statistical data. During the visit we spoke to some people who live there, some visitors and staff. 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 put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Care Homes for Older People Page 6 of 25 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 7 of 25 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 8 of 25 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 have sufficient information given to them prior to admission to ensure they can make an informed decision about using the home. They are then assessed and this tool used as the basis for formulating a fuller care plan. Evidence: The management team of the home had identified on their Annual Quality Assurance Assessment (AQAA) that they were looking into the possibility of revamping their brochure, which is sent with the Statement of Purpose and Service Users Guide. We looked at the present set of documentation which details all the services the home can provide and found the details to be accurate. It is entirely the choice of the service how it presents this information and they were correct in telling us their future plans. The documentation would enable people to make informed choices about using this home as it was very detailed and can be offered in different formats to ensure people are not disadvantaged if they can not read written English. We looked at the admission documentation of the last admission to the home. The Care Homes for Older People Page 9 of 25 Evidence: pre-assessment tool is very detailed and gives an holistic view of the persons needs. The manager is the person to normally undertake this assessment but in their absence two other senior staff can use this tool. The pre-assessment is then used as a basis to see if the home can meet their needs and is used at the planning stage of the care plan formation. People living in the home told us they had found it comforting that staff knew so much about them prior to their admission. Staff told us it is because the pre-assessment tool is used in a positive way to help them complete a fuller assessment on each individual. The home does not provide intermediate care and therefore Standard 6 is not applicable. Care Homes for Older People Page 10 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples assessed needs were regularly evaluated to ensure the documented evidence reflected their current needs. Evidence: Prior to the site visit we sent out a number of surveys to people using the service, relatives and staff. We had a moderate number returned, three from relatives, nine from staff and nine from people who use the service. All of them made positive comments about the home and how much they enjoyed living there. The attitude of staff and their kindness to individuals was particularly highlighted. During the course of our visit we were able to speak to a further five people currently resident in the home, a visitor and a health professional and five staff. Again very positive comments were made about how peoples needs were being met. People made such comments as staff always speak kindly to me and they ask what I want and are very considerate. Visitors told us that there is always a staff member to see to our needs and staff are friendly. When we walked around the home people looked happy, were well dressed and there was a lot of laughter to be heard. We tracked through three care plans, which were very detailed and appeared to reflect Care Homes for Older People Page 11 of 25 Evidence: peoples current needs. The standard was equal as to that seen on the last inspection, as it had been undertaken by the same inspector. The records included such details as permissions being sought for the use of bed rails. A swine flu assessment had been completed during the winter period to identify which people were most at risk and the home has its own action plan to combat an out break. There was also a document entitled handy hints. The information on this included such detail as what they most like being called (which did not bear resemblance to any of a persons names) and where someone did not like being called love or dear and when someone often stored food which could be a health hazard. Staff told us this helps them to see each person as an individual. There was good follow through and documented evidence to support how people were being looked after and supported with their current needs. For example where it had been identified that someone prior to admission had frequent falls a core care plan was put together and showed regular evaluation. Individual risk assessments were then in place for such events as the use of a walking stick, a persons vision capacity and a falls assessment. There was detailed written evidence to support that other health care processionals such as the falls coordinator and local GP had been involved in the decision making process. Staff had also written when they had contacted family and friends to tell them of events which had been the result of falls. We tracked in this case a number of falls through the accident recording documentation and daily report sheets and found the details to be full, legible and accurate. In another case where a person had been experiencing fits four sections in the core care plan had been more regularly reviewed. This included mobility, continence care, pain and paralysis and weakness. Each section had a goal or aim, a plan of care, permissions in place where required such as bed rail use. The falls assessment had been completed and the manual handling assessment. Both these examples showed good follow through of revised care needs, accurate recording and follow through. Staff when spoken to had a clear understanding of the risks to certain people in the home and were able to tell us how they use the care plan, which followed the policy we had seen in their procedure manual. A new addition to the documentation was an assessment form for people requiring a special assessment under the new Mental Capacity Act. No one, at the time of the visit was under any Mental Capacity Act Authorization. There was also documented evidence that the care plans are reviewed regularly by a senior member of the management team. This ensures someone is checking the quality of each staff members documented evidence as well as whether a persons current needs was reflected in the care plan. This limits the amount of risk and harm a person experiences to enable them to live a full life. We randomly checked the drug administration sheets and found them to be accurately completed. The storage area was small but staff said it meet their current needs and Care Homes for Older People Page 12 of 25 Evidence: was clean and tidy. We observed part of a drug administration round and found that safe practices were in place. Two people were able to self medicate and an assessment had been completed to ensure they could still complete this task. During our visit and when touring the home we saw staff assisting people with a variety of tasks, which they did in a calm manner and encouraging manner and with a great deal of care and attention to detail .Such as ensuring a persons bed room door was closed when they had moved out of the room for a period of time and asking what clothes they would like to wear that day. Care Homes for Older People Page 13 of 25 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. A variety of events ensures people social, religious and cultural expectations and needs are being met. Evidence: In the care plan documentation there was evidence in the ones we tracked that each person had a social needs assessment which was regularly evaluated. This ensures that peoples social, religious and cultural needs are being addressed. The written evidenced supported the comments made by peoples using the service and staff that a variety of events take place for groups and for individuals, both inside and outside the home. This included entertainments, a living service by a local church and games afternoons. The time staff take opportunity to have one to one sessions with service users was also recorded. Two staff have a job share role and undertake facilitating activities each week. This ensures they know the needs of people well and can liaise with other staff to help them.Posters were on display advertising forth coming events both inside and outside the home. We briefly toured the kitchen area as the local Contracting Monitoring Team of the local authority had visited a couple of days before our visit and we liaised with them afterward. There were no issues governing health and safety after their visit. Care Homes for Older People Page 14 of 25 Evidence: We observed that food was being prepared in a clean and safe environment and that all records were up to date and showed regular recording. A senior member of the kitchen staff was able to tell us how they check the safety of supplies coming in and how the 4-weekly cycle of menus are worked out. The kitchen also keeps a likes and dislikes sheet on each individual to ensure their special needs are taken into consideration. People told us how much they liked the meals and made such comments as food is very very good and a good variety is on offer. This ensures peoples dietary needs are being monitored to enable them to have a balance, nutritional diet. Care Homes for Older People Page 15 of 25 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. Staff are trained to recognise an abusive situation and know how to make a referral should the need arise to protect people from harm. Evidence: Since the last inspection there had been no concerns raised to CQC about the home and no safe guarding investigations. In the AQAA returned to us by the home it detailed one complaint which had been handled internally. We looked at this at the site meeting and saw documented evidence to support the homes own policy had been followed. The records detailed a satisfactory outcome for all parties concerned. The home had been liaising with a trainer to give staff training sessions about the Mental Capacity Act, which nine had already received. Staff training records supported that other training in safe guarding adults and person centered care for example had been recently completed by staff. This ensures that people are protected from abuse and are free from harm. When speaking to staff they were clearly able to tell us about how to make a safe guarding referral, should the need arise. They demonstrated a clear understanding of what constitutes an abusive situation to adequately look after people. People living in the home told us they have every confidence in the management team and staff in dealing with any concerns, should they arise. Care Homes for Older People Page 16 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can live in a safe and comfortable environment suited to their needs. Evidence: The redecoration in the home, in all areas is of a very high standard. The types of furnishings and decoration are in keeping with the style of the building, but in individual rooms they are decorated to suit an individuals needs and tastes. For example in one of the bedrooms we sampled to see, a person had lots of photographs on display, where as in another room it was quite bare of decoration except a persons interest in reading with books, magazines and papers on display. Each room also has its own telephone so staff can put callers directly through to a person. The extension numbers were on display so staff could access people where every they were in the building. In the main sitting rooms there was fruit available for people to eat and a wide variety of magazines and papers to enable people to browse when sitting. The laundry area was clean and tidy and all equipment was in working order. People told us they were happy with the standard of cleanliness of their clothes and how well special items such as woolen cardigans were looked after. All areas of the home were clean and tidy and there were small touches of detail, such as, a jigsaw on a table, next to a chair where people could stop and see if they could contribute to the finished picture. There were several notice boards around telling people of events due to take place but Care Homes for Older People Page 17 of 25 Evidence: also giving them information about library services, information on illnesses and how to contact advocacy services. The home has a small car park and is surrounded by gardens. One person living in the home, at their request, has asked to help with some of the flower borders in the Summer months. During the site visit all areas of the home appeared hazard free and were accessible for those in wheelchairs. Care Homes for Older People Page 18 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A robust system of recruitment is in place and staff are then trained to do their jobs. Evidence: When we were speaking to people who live in the home and on the surveys returned to us people told us that all their needs were being met through a 24-hour period. They said staff go that extra mile and they are very patient. Others told us that they only have to ring their call bell and staff are there immediately day and night. Staff also told us they felt there was sufficient staff on duty to meet peoples current needs and we were assured that the management team keep a close eye on the staffing matrix, copies of which we saw, to ensure this remains so. Times most in need of review at times were lunchtimes (if the manager wasnt in the building) and some hours for the kitchen team. The matrix appeared to be reviewed regularly. We tracked four staff files and there was sufficient evidence to support that robust safety checks had been made prior to their commencement of employment to ensure they were safe to work in the home. Staff were able to tell us what training courses they had attended in the last year and how this had enhanced their care practices. There was documented evidence to support that all mandatory training had taken place and also a cross section of more specific topics. These included, palliative care, falls, infection control and person centered care. The methods were varied such as outside speakers coming to the home, staff going out to courses which they told us they enjoyed going to and mixing Care Homes for Older People Page 19 of 25 Evidence: with staff from other homes. And distance learning courses. The training matrix was on display and showed courses completed, what was planned and when new staff should finish their induction period and training. Each staff member then has their own training folder, which includes their job description. This ensures people are adequately trained to do their jobs and can look after people with the latest information at their finger tips. Care Homes for Older People Page 20 of 25 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. Peoples views are regularly sought to ensure the home is being run for their benefit and auditing processes put in place to ensure the place is a safe one to live and work in. Evidence: The owners of this home do not live locally but there was documented evidence that the local management team speak with them weekly and we saw the monthly Regulation 26 reports which showed regular visits, who they had spoken to including people living there and staff, what records were seen and action required, if necessary. This ensures that the Company is keeping track of the service and appear to take its role seriously on maintaining the home for the benefit of the people living there. To ensure they can monitor the situation more closely regular meetings are held and we saw minutes of those for staff and people living there. The quality assurance folder was seen and the surveys on a variety of topics were there. Such as personal care, health care needs, activities and laundry. Results are collated and any action included Care Homes for Older People Page 21 of 25 Evidence: on the general auditing plan. The views of people living in the home are regularly sought. We tracked three files of peoples personal allowance money and found the entries and money to be correct. These records are open only to a limited number of staff. Funds appeared to be used for personal items of people only. A residents comfort fund has been commenced and funds, it appeared, used for extra social events, according to the documented evidence. The safety certificates for equipment and the general running of the building were looked at and seen to be in order. This ensures it is a safe place in which to live. To ensure staff are safe to work with people living in the home regular supervision sessions take place and the written evidence showed a balance between discussion and observational supervision. Yearly appraisals also take place and all sessions entered on a planner to ensure time is taken for individual sessions and issues. Care Homes for Older People Page 22 of 25 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 23 of 25 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 Care Homes for Older People Page 24 of 25 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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