Care Home: Huntleigh Lodge Care Home

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What the care home does well People using the service are appropriately assessed to ensure the service can meet their needs and a good standard of information is available to help those thinking about moving into the home to reach an informed decision about it. The health and personal care of people using the service are supported by staff who involve them in decisions about their care and who are well trained to ensure they can meet their needs. The service supports people living in the home to take part in a good range of meaningful activities to ensure they experience a lifestyle that meets their wishes and needs. The concerns of people living in the home are taken seriously and staff training provided to ensure they are safeguarded from harm. The home is clean and well maintained to ensure people using the service have an environment that can comfortably meet their needs. The home is well managed and has very good administrative procedures to ensure the health, welfare and safety of people using the service are promoted and protected and staff are well trained to ensure they can support them appropriately. What has improved since the last inspection? Creams and ointments administered to people living in the home and medication given to them is now recorded more accurately and regularly checked to ensure they are safeguarded from harm and their health needs are appropriately met. Training has continued to be developed to ensure staff have the right skills to do their jobs and a new specialist unit has been developed to ensure the needs of people with more complex behaviors can be more appropriately met. Much of the home has been redecorated to provide a more comfortable environment for those living in the home and a family support group has been started to enable family members to meet and discuss the service and ways to improve it further. What the care home could do better: Recruitment proceedures should be strengthened to ensure full Criminal Records Bureau is received for all new staff before they start working in the home and they are only allowed to start with preliminary Protection of Vulnerable Adults checks in exceptional circumstances. The chef should be more directly involved in consulting with people using the service about their meals in order to enhance the quality of service provided to them. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Huntleigh Lodge Care Home Taylors Avenue Cleethorpes North East Lincs DN35 0LE     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Rob Padwick     Date: 1 1 0 6 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Huntleigh Lodge Care Home Taylors Avenue Cleethorpes North East Lincs DN35 0LE 01472692986 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : manager.huntleighlodge@hica-uk.com Humberside Independent Care Association Limited care home 56 Number of places (if applicable): Under 65 Over 65 56 56 dementia old age, not falling within any other category Additional conditions: 2 0 One further bed for a service user between the ages of 55 years and 65 years with a category of DE (Dementia) Date of last inspection Brief description of the care home Huntleigh Lodge is a care home that is registered to provide residential care for up to fifty-six people, some of whom have varying degrees of memory impairment and dementia. The main part of the home provides accomodation for forty two people in single bedrooms, twenty one of which are situated on the lower floor. Twenty five of the singe rooms have en-suite facilities. The Haverstoe suite is a new self contained unit within Huntleigh Lodge and provides accomodation for eleven people with dementia and associated complex behaviours. The home consists of a large purpose built two storey building, with access to the top floor via a passenger lift. Care Homes for Older People Page 4 of 25 Brief description of the care home Huntleigh Lodge has four lounge areas and a dedicated reminiscence room decorated in the style of 1940s era. The two dining rooms are spacious and set out with individual tables. The courtyard garden provides a safe environment that is accessible to all service users. Accommodation offered is of a high standard in terms of decor, cleanliness, facilities and furnishings. There is ample car parking. The home is situated on a bus route and access to the amenities in the town are within ten minutes walking distance. Huntleigh Lodge is owned by Humberside Independent Care Association, which is a not for profit organisation. The standard fees charged by the home range from £402.69 to £490 with additional charges made for hairdressing, chiropody, toiletries etc. Huntleigh Lodge provides information to residents about its facilities in its Statement of Purpose and Service User Guide. 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: The quality rating for this service is 3 star. This means the people who use this service experience Excellent quality outcomes. 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 people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. This inspection report is based on information received by us since its last key inspection, which took place on 14th June 2007 and includes information gathered during a site visit to the home. As part of the inspection process, we send out a self assessment document that the Registered Person must complete and return to us. This Care Homes for Older People Page 6 of 25 helps us know how well the home is meeting regulations and national minimum standards and what has been done to improve it and what still needs to be done. The self assessment was completed well by the manager and information from this used as part of the inspection process. Other information used, included feedback from people using the service, Professional people who know them well and staff working in the home, together with official notifications sent to us by the home. This information helps us to reach judgments about the service provided. The site visit took place on 11th June 2009 and lasted for 6 hours. The provider was not told in advance when it would take place. The manager was available throughout the period of our site visit, and as well as speaking to her, we talked people living in the home and their relatives and staff who were on duty. We looked round the building, including the bedrooms and shared areas of the home and we inspected the records of peoples care, staff files, health and safety documents and other records kept by the service. 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 set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 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 9 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. The needs of people using the service are appropriately assessed to ensure the service can meet these appropriately and a good standard of information is available to help those thinking about moving into the home to reach an informed decision about it. Evidence: Up to date information was available to help people make an informed decision about moving into the home. This information was of good quality and comprehensively developed in a variety of formats to help people understand it, including use of large print and various photos. The manager told us this information could be provided on audio tape and DVD. The case files belonging to people living in the home all contained assessments about them that the manager had obtained or carried out herself to ensure the service was able to meet their needs. The manager told us she visits people before they move in to gain information about them and help confirm the service is appropriate. A new specialist unit for people with complex behaviours has recently Care Homes for Older People Page 10 of 25 Evidence: opened and the case files of those using this service contained evidence their admission was carefully considered in partnership by both the manager and members of the Community Mental Health team. The manager confirmed the service does not admit people for intermediate care. Care Homes for Older People Page 11 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care of people living in the home are supported by staff who involve them in decisions about the care and are well trained to ensure they can meet their needs. Evidence: People living in the home confirmed staff supported them well with their health and personal care and support plans were available to guide staff and ensure these are delivered in accordance with individual needs and wishes. The support plans we inspected continue to be generally very well maintained and developed, with a good standard of recording and regular reviews. Whilst staff recording in some of the files was not always completed to as high a standard as others, we saw evidence of monthly audits carried out to by senior staff to ensure these are updated when required. People living in the home and their relatives were very positive about the home and told us staff Couldnt do enough and confirmed they involved them in decisions about their support that their views were respected about these. Care Homes for Older People Page 12 of 25 Evidence: The case files belonging to people living in the home contained details about a range of their health conditions, together with regular monitoring and involvement with professionals about these. Comments received from a local doctor were generally positive about the home and confirmed staff contacted him frequently about various issues. Information concerning the management of known risks to using the service were contained in the case files inspected, with details about how staff should support them to take as much responsibility with these as possible. As previously indicated, a new specialist unit for people with complex behaviours has recently opened in the home and we saw evidence of professional advice sought about its design, increased staffing levels and appropriate specialist training. Staff based in the local Community Mental Health Team told us the manager worked well with them and had no concerns about the service and visited it regularly. Policies and procedures are available to support people safely with their medication needs and we saw evidence of appropriate training to ensure staff have the knowledge and skills needed about these. We saw records of regular medication audits carried out by the manager and those inspected were maintained accurately and up to date. We saw evidence staff were now recording promptly any creams and ointments prescribed to people using the service as previously required and the manager told us about a further Vocational Related Qualification on medication that staff are due to start in the near future. 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. The service supports people living in the home to take part in a very good range of meaningful activities to ensure they experience a lifestyle that meets their wishes and needs. Evidence: The home has policies and procedures on the promotion of activities for older people and is a member of a National Organisation for the development of these. Both the main part and specialist unit in the home employ dedicated staff responsible for the ensuring people using the service can participate in meaningful activities and we saw evidence of appropriate training on this. New staff working in the specialist unit had completed a course on the promotion of lifestyle activities for older people before they started working in the unit and relatives confirmed there was Always something going on. We observed people in the main part of the home taking part in a game of group skittles, whilst others in the specialist unit received more intensive one to one involvement with individual board games. There was evidence that a good range of activities were regularly provided, including arts and crafts groups, theme and film nights as well as trips out in the homes minibus. One person told us he regularly took part in a local Age Concern group and was going out later that evening an organised Care Homes for Older People Page 14 of 25 Evidence: walk. The home continues to benefit from a specialist Jubilee room decorated in 1940s style, which is used for reminiscence work with its use extended since our last visit to the home. We observed relatives and friends visiting throughout the period of our visit and were told by them they were actively consulted about decisions affecting the home. People using the service and their relatives confirmed they were able to make active decisions about their lives and could make choices about things like times of getting up going to bed and what to do. A variety of healthy and nutritious meals were included on the homes menus and we saw evidence of appropriate monitoring of aspects of these in the case files inspected. New buffet trays have recently been introduced to supplement the main meals which the manager told us was hoped to lessen the risk of falls and that new dementia menus had increased the availability of finger foods to make eating easier. Whilst people indicated that they liked the meals served, one person told us that further improvements could still be made. A recommendation is made about this to ensure the chef is more directly involved in consulting with people living in the home about their individual nutritional likes and wishes in order to enhance the quality of service provided to them. 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. The concerns of people living in the home are taken seriously and staff training provided to ensure they are safeguarded from harm. Evidence: Policies and procedures continue to be available to ensure the concerns of people living in the home are taken seriously and they are protected from potential abuse. People using the service and their relatives said they were generally very happy with the home and that staff listened to them should they have any complaints. The people running the home include training on the protection of vulnerable adults as part of their induction for new staff and those on duty who we spoke to indicated appropriate action would be taken should they have any concerns about this. The provider was asked to investigate a complaint we received since the last time we visited and we saw evidence this had been thoroughly followed up. A number of referrals had been made to the Local Authority by the home, for investigating under its duties to safeguard people using the service from harm. There was evidence the manager had acted appropriately on these and had subsequently worked with them well to resolve these. 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. The home is clean and well maintained to ensure people using the service have an environment that can comfortably meet their needs. Evidence: The building provides people living in the home with a comfortable environment that was clean and generally very well maintained throughout, although we noticed some corridor carpets were in need of replacement soon. Since the last time we visited, a new specialist unit had opened for people with complex behaviours and we saw evidence of advice taken on its design with bedroom doors decorated in primary colours and use of wide bright corridors and specialist signs to help those with memory impairments recognise them better. Much of the building has been refurbished since the last time we visited and the lounge areas had been redecorated with new furniture obtained. Corridors were hung with themed photos and posters from years gone by and the service continues to have use of a specialist Jubilee room that we were told can now be used 24 hours a day. Visitors told us they were able to be involved in the decoration of relatives rooms and we saw evidence of regular checks to ensure the building is kept safe and that a new call bell system had been installed. The building was comfortable, clean and tidy throughout with disinfectant hand washes positioned at key points, together with staff training on infection control. Care Homes for Older People Page 17 of 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Whilst the needs of people living in the home are met be staff are who are well trained to do their jobs further recruitment checks would ensure they are better protected. Evidence: Staff were observed working with people using the service in a friendly and professional manner and it was clear they took pride in their work and committed to meeting their needs. Relative comments and those received from people living in the home were overwhelmingly positive and described staff as Wonderful and that they Cant do too much. We observed appropriate staffing levels throughout the home with additional one to one involvement for people with more complex behaviours. Staff told us Huntleigh is a very nice place to work, live and visit and that The training staff receive is extremely good. The people that run the home have a very good training department that ensures staff have the right skills to do their jobs. We saw evidence that new staff had completed a five day induction before beginning work in the home and that this was then followed with a range of specialist and mandatory training. Since the last time we visited, the home owners had further developed training opportunities provided for staff and we saw evidence of new additional Vocational Related Qualification training courses in Medication, Palliative care, Dementia and Nutrition due to start in the near future. Policies and procedures continue to be in place to ensure staff are safe to work with people using the service and whilst staff Care Homes for Older People Page 19 of 25 Evidence: files contained evidence these were generally followed, there was evidence some new staff had been allowed to start working in the home before a full Criminal Records Bureau check had been received for them, although we saw evidence they had been closely supervised and that a preliminary Protection of Vulnerable Adults check had been received. The manager was reminded this should only occur in exceptional circumstances and a recommendation is made about this. 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. The home is well managed and has very good administrative procedures in place to ensure the health, welfare and safety of people using the service are promoted and protected. Evidence: Since the last time we visited the service, the homes manager had returned from working elsewhere and we saw evidence of a considerable amount of work carried out to help develop the home. A new unit had been developed to ensure the needs of people with complex needs are improved and much of the building had been refurbished to ensure they are provided with a more comfortable environment. The manager is appropriately qualified with extensive experience of working with the group of people using the service and staff comments about her were generally positive and confirmed The home is always looking at improving ways to help the clients and that it is Always clean to a high standard with Activities and things always happening although some indicated a wish for more individual time to work with people living in Care Homes for Older People Page 21 of 25 Evidence: the home. Information provided in the homes self assessment was completed to a good standard with good information and the service has a qualified administrator to support the smooth running of the home. We saw evidence of very good systems to ensure the home can monitor its objectives together with regular safety checks carried out to ensure the welfare of people using the service are promoted and protected. A support group for relatives has been developed since the last time we visited and those we spoke to confirmed they were regularly consulted to help improve the home further. People living in the home told us they were generally very satisfied with the service received and their concerns taken seriously. A random check of the monies belonging to those living in the home that we made confirmed accurate records were maintained to ensure their financial interests are appropriately safeguarded. 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 1 15 The Registered Person should ensure the chef is more directly involved in the process of consulting with people living in the home about their meals in order to enhance the quality of service provided to them. The Registered Person should ensure satisfactory Criminal Records Bureau clearance is obtained for all new staff before they start working in the home and that they are only allowed to start with a Protection of Vulnerable Adults check in exceptional circumstances. 2 26 Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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