Care Home: Huntington House Nursing Home

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What the care home does well We were told by the service users that their right to privacy is maintained at all times and the support they receive from care workers is given in a way that maintains their dignity. They told us the home is responsive to their culture, religion, race, age, disability, gender and sexual orientation. They informed us management and staff are competent and knowledgeable about the health care needs of older people including health and safety and that their practise routinely protects and promotes the safety of all who uses the home. New care plans are in place for each service user with their needs outlined with review or evaluation date. Input from the wider health care team is also documented such as visits from GP, dentist, speech and language therapist to help meet their identified needs.Staffing levels are being maintained to ensure that people`s needs are being safely met. The manager is able to demonstrate a clear vision of the home based on the home`s values and corporate priorities. The manager communicates a clear sense of direction, is able to evidence a sound understanding and application of `best practice` operational systems particularly in relation to continuous improvement, customer satisfaction and quality assurance. Equality and diversity and Human rights and person centred thinking are given high priority by the manager who was able to demonstrate best practise and high level of understanding in these areas. What the care home could do better: The home continues to provide excellent service to the people using the service. They are continually exploring ways in which they can improve their service, and listen and act on suggestions from service users and staff. However, we observed that hand gels were placed in bathrooms and toilets but there were no hand gel for visitors entering the home and leaving the home. We observed that Regulation 26 visits were not sent to the manager on a regular basis even though the manager assured us these visits are carried out on a monthly basis. Random inspection report Care homes for older people Name: Address: Huntington House Nursing Home Huntington House Drive Hindhead Surrey GU26 6BG three star excellent service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Mavis Clahar Date: 2 6 0 4 2 0 1 0 Information about the care home Name of care home: Address: Huntington House Nursing Home Huntington House Drive Hindhead Surrey GU26 6BG 01428604600 01428606825 manager@huntingtonhouse.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Katarina Parr Type of registration: Number of places registered: Conditions of registration: Category(ies) : Huntington House Limited care home 41 Number of places (if applicable): Under 65 Over 65 41 old age, not falling within any other category Conditions of registration: 0 The maximum number of service users to be acommodated is 41 The registered person may provide the following category of service Care home with Nursing (N) to service users of the following gender: Either whose primary care needs on admission ot the service are within the following category : Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Huntington House is registered to provide nursing care for up to 41 service users. The service is near Hindhead and is set in 30 acres of well-tended grounds, which provides a peaceful setting. Nursing care is mainly offered in single bedrooms. There are a total of 33 single bedrooms, 26 of which have en-suite facilities and 4 double bedrooms, Care Homes for Older People Page 2 of 11 Brief description of the care home three of which have en-suite facilities. At present one double bedroom is utilised as a single occupancy. There is suitable equipment to provide for the nursing care and safe lifting and handling of service users. The space provided throughout the service is satisfactory. Ample parking is available to the front of service, close to the reception. The service is privately owned and run by Mr and Mrs Hoare the principals.Both principals are closely involved with the day to day operation of the home. Care Homes for Older People Page 3 of 11 What we found: This unannounced site visit, which forms part a random inspection to be undertaken by the Care Quality Commission, (CQC) was undertaken by Mrs. Mavis Clahar on the 26th April 2010 and lasted for four hours; commencing at 09:45 hours and concluding at 13:45 hours. The newly appointed manager of the home assisted on this inspection. The CQC Inspecting for Better Lives (IBL) involves an Annual Quality Assurance Assessment (AQAA) to be completed by the service, which includes information from a variety of sources. This initially helps us to prioritise the order of the inspection and identify areas that require more attention during the inspection process. This document was received by CQC (us) and is referred to throughout the report. The comments received via the pre inspection questionnaires sent to service users and members of staff are also included in this report. The information contained in this report was gathered mainly from observation by the inspector, speaking with a limited number of service users, with the manager and with care staff. Further information was gathered from records kept at the home and from the pre inspection questionnaires returned to us. The manager and staff are aware of the Laws regarding equality and diversity and this was reflected in the staff mix. Service users in this home are mainly British Caucasians service users with some Caucasians from other ethnic minority groups and reflect the population of the area in which the home is situated. We observed a calm and relaxed atmosphere within the home, with service users free to move around the home. The last key inspection of Huntington House was carried out on 13th June 2007 when a star rating of Excellent was awarded. On this visit we looked in-depth at three outcome areas, Health and personal Care, Staffing, Management and Administration of the home. The registered manager of the home has resigned end of February 2010 and the deputy manager has been appointed as manager of the home. She is in the process of sending her application off to CQC for registration as the manager of the home The AQAA informs the home involve service users and their relatives as appropriate in devising their individual care plans which are then updated and reviewed at least monthly or as individual needs change. Review of the care plans on the day of the site visit revealed the care plans consider all needs specific to the individual including the following, communication, eyesight, hearing, personal care to include bathing and washing, dressing, choosing own clothing, oral hygiene, medication administration, memory and mental awareness, mobility, skin care, including waterlow score, elimination, hobbies, social, family and work histories, activities within the home, eating and drinking including likes, dislikes, special needs and any adaptations necessary, and likes and needs of the service user during the day and at night. We observed that Death and dying is also discussed on admission and funeral preferences were also documented. Care Homes for Older People Page 4 of 11 The plan focuses on independence and strives to encourage service users to optimise their abilities to reach their full potential. The AQAA informs service users rights, responsibilities, dignity and privacy are respected in accordance with the homes philosophy of care and we observed that service users received care based on a positive approach to equality and diversity and human rights at the centre of service delivery. We observed from the randomly selected service users care plans reviewed that each service user has a record within their care plan which details their life experiences including family, travel, work, childhood memories, dreams, school and hobbies. These are completed on or soon after admission if the service user agrees, and give the care staff an insight into the past life of a service user to better facilitate individualised care. The AQAA informs and we also observed documentation within service users file that the home operates by the gold standards for palliative care which encourages service users to discuss their end of life care and think about advance directives. We also observed the home utilises the Mental Capacity Assessments and we were told this type of care plan helps the staff to continue to offer seamless care to the service user, in the event of a service user becoming mentally incapable of making certain decisions such as specific clothes they like, hobbies, activities they like to do, places they like to visit. If the service user is incapable of completing this plan information is sourced from family and friends, to build up a comprehensive picture of what the service user would actually want. The care plans are kept in a personal file, which is kept under lock and key to ensure privacy. We were told Service users are able to access their plan at any time. Registered nurses and senior care workers with NVQ L3 have received training in writing care plans. All care staff are encouraged to read the care plans to ensure the care they are giving is person centred. Staff are trained through induction on how to deliver individualised care and treat all service users with respect. Staff are able to extend their supernumerary period if they feel they need more training. Referrals are made wherever needed to members of the multidisciplinary team e.g., speech and language therapist, dentist and hygienist, physiotherapist, dietitian, diabetic nurse, Parkinsons nurse, occupational therapist, wheelchair services. We were told the home has a retained GP who does not always visit weekly and discussions are now taking place to get the GP to increase his visits or the home will take suitable actions. However service users can remain with their own doctor if they prefer. Within the Service users personal file there are risk assessments which cover the following, falls, nutrition, mobility and manual handling, wandering, level of awareness, medication risk, hazards in rooms, use of side rails. Service users also have risk assessments that are specific to them. All service users risk assessments are reviewed at least monthly or more often if required. Side rails are checked more often to ensure they are in full working order. The home has found the use of specific individual risk assessments an excellent way of empowering service users to live their life as they wish. There are also risk assessments for equipment, health and safety general environment and first aid. The AQAA informs service users medication administration records are kept. In discussion with a registered nurse we were told records are kept of medication entering and leaving the home for which a signature of the receiving person is obtained. We were also told service users who are assessed as capable are encouraged and enabled to self administer their medication. The AQAA informs the homes policy and procedure for this Care Homes for Older People Page 5 of 11 action has been recently updated. In discussion with service users they told us they were happy in their home and that the staff were lovely and treated them with respect. When we asked them what is the best thing in the home they responded everything. Staff ensures care is service user led; personal support is flexible, consistent, and is able to meet the changing needs of the service users. Staff respects service users preferences and have expert knowledge about individual personal needs when providing support, including intimate care. The staff response appropriately and sensitively in all situations involving personal care, ensuring that it is conducted in private and at a time and place directed by the person receiving the care. Five completed pre inspection questionnaires were returned to us. Five said they always receive the care and support they need. The staff rota demonstrated the number and grade of staff on duty to provide care and attention to service users for any twenty-four period was good to meet the assessed care needs of the service users. The home has a programme of planned training in place and all members of staff have an individual training record. Under 50 of care workers have attained the National Vocation Qualification at Level 2 Level 3 and above (NVQ L2; NVQ L3) whilst just under 50 of Care workers are currently undertaking NVQ training. Carers are encouraged and enabled to undertake developmental training as well as the mandatory training. . All newly appointed staff undertakes an induction programme. The home ensures that staff undertakes the mandatory training with yearly updates as necessary to maintain their competency to fulfil their duties. This was evidenced through discussion with the manager and care workers and from review of care workers training records and the training planned for the year. The AQAA informs that staff turnover at the home is relatively low. We were told all care workers are Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) checked and two written references are obtained prior to commencing employment plus any gaps in their employment history is explained. They are also in receipt of terms and conditions of employment as evidenced in their randomly selected files. The manager informed us that supervision records were up to date and this was verified during random sampling of care workers files. The manager had shown us her planned programme of improvements and supervision of staff was high on her agenda. The induction process incorporates the six common induction standards. All Staff have a copy of the GSCC code of practises. The manager was knowledgeable about equality and diversity and equal opportunities and how this relates to employment and retention of staff. We evidenced staff have had equality and diversity training and access to a copy of the GSCC code of practises. Five completed service users pre inspection surveys were returned to us. They all said staff are always available when they needed them. Five said staff always listens and act on what the service users wanted. Some comments made by service users about the staff include the following. The staff are interested in you. The staff makes my relatives feel very welcome. Im quite happy here thank you. I feel Im looked after very well. Im genuinely happy with all care and support. The manager has demonstrated that she has kept herself updated on issues relating to care of the service users and staff in her charge. She is a NMC Registered Nurse on Part1 of the register with a diploma in nursing and BSc. (Hons.) in Midwifery. She is currently undertaking NVQ L4 in Leadership and Management. In discussion with the manager it Care Homes for Older People Page 6 of 11 was evident she was knowledgeable about the care needs of the service users and the training needs of the care workers to meet these identified needs. She continues to strive to meet the aims and objectives of the home and is committed to providing service users with an excellent quality of service which meets their needs. She ensures equality and diversity; human rights and person centred care are an every day occurrence within the home through various avenues such as, Staff meetings, suitable and relevant training, support and supervision sessions, appraisals, staff questionnaires and her open door style of management, and by actively promoting and seeking the views of all staff. Service User meetings, care plan reviews, key discussion meetings, service user questionnaires, best interest records ensure the views of service users and their sponsors are actively sought and all these contributed to the development of the homes business and its operational plans. The AQAA informs the home provides suitable and up to date equipment to ensure a high standard of work is carried out by staff and service users can experience a high level of comfort and safety at Huntington House. We were told the senior management of the home believes that effective clinical leadership has a determining influence on the care delivered to service users. Consequently, the management structure of the home has been organised in such a manner as to promote and support a high quality of clinical leadership. An example of this is a deputy manager post has been changed to Assistant Manager to ensure continuity of high quality management of the home is consistent over any twenty four hour period. We were told Quality Assurance questionnaires are carried out to establish feedback from service users and their sponsors, which are evaluated and any areas are actioned by the manager as appropriate. The results of these questionnaires are collated, published, distributed and displayed in all areas of the home. There are clear lines of accountability within the home, each member of staff aware of their role and responsibilities. Equality and Diversity, human rights and person centred thinking are given priority by the manager who is able to demonstrate a high level of understanding and demonstrate best practise in these areas. The way the home is run shows an understanding of peoples needs in respect of the six strands of diversity; gender, including gender identity, age, sexual orientation, race, religion or belief and disability. What the care home does well: We were told by the service users that their right to privacy is maintained at all times and the support they receive from care workers is given in a way that maintains their dignity. They told us the home is responsive to their culture, religion, race, age, disability, gender and sexual orientation. They informed us management and staff are competent and knowledgeable about the health care needs of older people including health and safety and that their practise routinely protects and promotes the safety of all who uses the home. New care plans are in place for each service user with their needs outlined with review or evaluation date. Input from the wider health care team is also documented such as visits from GP, dentist, speech and language therapist to help meet their identified needs. Care Homes for Older People Page 7 of 11 Staffing levels are being maintained to ensure that peoples needs are being safely met. The manager is able to demonstrate a clear vision of the home based on the homes values and corporate priorities. The manager communicates a clear sense of direction, is able to evidence a sound understanding and application of best practice operational systems particularly in relation to continuous improvement, customer satisfaction and quality assurance. Equality and diversity and Human rights and person centred thinking are given high priority by the manager who was able to demonstrate best practise and high level of understanding in these areas. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 8 of 11 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 9 of 11 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, 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 10 of 11 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial 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. 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