Care Home: Iris Hayter House

What the care home does well The home provides a safe and secure environment for its residents. It provides trained staff in sufficient numbers to meet the needs of its residents. The home is well managed and supported by the larger organisation. The home compiles a care plan matched to the needs and wants of its residents taking into account any elements of preventable risk. Staff say they feel supported, quality training is available, and that regular supervision takes place. What has improved since the last inspection? The home have reviewed the activities available and made improvements. An activities co-ordinator has been appointed. The home has made improvements to its medications procedures. Residents finances have been reviewed and improvements made to the recording and staff along with residents have a clearer idea of how an individuals money is being spent. The home have reviewed its quality assurance processes and now have the means to assess the residents satisfaction with the service. What the care home could do better: Minor problems with the homes plumbing need to be addressed. The home should keep copies of all concerns, complaints in the home and available for inspection. Key inspection report Care homes for older people Name: Address: Iris Hayter House 43 Sandford Road Littlemore Oxfordshire OX4 4XL     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Andy McGuckin     Date: 2 7 0 8 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 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) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Iris Hayter House 43 Sandford Road Littlemore Oxfordshire OX4 4XL 01865749560 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): info@response.org.uk Response Organisation The registered provider is responsible for running the service care home 13 Name of registered manager (if applicable): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 13 The registered person may provide the following category/ies of service only: Care home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Mental Disorder, excluding learning disability or dementia - MD Date of last inspection Brief description of the care home Iris Hayter House is a large bungalow located on the outskirts of Oxford city. The accommodation comprises of a number of communal areas (lounges and a dining room) with each resident having their own bedroom. The home provides 24-hour support to 13 people who have mental health support needs. The majority of residents have been discharged from a hospital setting and continue to require support and accommodation. The staff provide close and continued links with individuals Care Homes for Older People Page 4 of 25 13 Over 65 0 Brief description of the care home community mental health teams and all relevant professionals, i.e. psychiatrists, community psychiatric nurses (CPN) and social workers. All residents receive support to develop an individualised care programme. Residents are encouraged to use local community facilities. 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: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The Commission undertook a visit to the home to do the inspection. The inspection lasted half a day. We looked at core documentation to evidence compliance with regulation. We had discussions with the management of the home, staff working in the home and informal discussion with residents. We toured the building and with residents permission looked at residents rooms. We made informal observations of the interactions between staff and residents. Fees charged for this service can be obtained directly from the home. 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. The home provides prospective service users with sufficient information on which to make an informed decision. A trial period of assessment takes place to enable both sides to decide if the placement meets the assessed needs of the resident. Evidence: The home provides prospective residents and their families with a Statement of Purpose and a Service User Guide. These documents contain core information as to what the home is able to offer and what is not. The home have recently amended these documents to make them more easily understood by the majority of the homes residents. Informal feedback from residents, relatives and professionals stated that visitors to the home are made welcome at all reasonable times and the home does not set standards times at which visitors can call. A full assessment of the prospective residents is undertaken prior to admission and where appropriate interested professionals and relatives are included in this assessment. Service users are encouraged to visit the home for lunch and short stays. The home has two vacancies Care Homes for Older People Page 9 of 25 Evidence: at present and one prospective resident is in the process of visiting the home prior to a possible admission. The home does not provide an intermediate care service. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health care need of the individual are being fully met and residents are involved with the design of the care plan. Evidence: We looked at six care plans and residents files to establish that the home were involving individual residents in the planning of their care. Evidence was found that the home were supporting residents to take as much control over their life as they are able. The home has developed individual communication methods and continually reviews this to ensure it remains appropriate. Care plans reviewed were written in plain English and evidenced individual involvement in the planning. The home operates a key working system which means staff are responsible for a small number of staff. This enables them to have an in depth working knowledge of the needs and wants of the individual and spent time in one to one sessions. Staff also get to know when a residents needs personal space and privacy. This is included in the care planning. The home undertakes a range of risk assessments to ensure that the individual is enabled to maximise their potential whilst at the same time be protected from harm. Finding the right balance often takes some time and effort and regular Care Homes for Older People Page 11 of 25 Evidence: reviews take place to facilitate this. The care plan also contains comprehensive information about the health and well being of the residents. This information is built up over time and involves consultation with heath care professionals and those who are involved in the life of the resident. The home has robust procedures to ensure the safe administration and recording of medication. Residents who are able to self medicate are encouraged to do so. The care plan is a living document which changes with the needs of the resident, information is regularly reviewed and updated. Residents are aware that information held on them is confidential and will only be shared with those who have a need to know. The home have access to advocacy workers for residents who have no independent person to assist them in their decision making. Care Homes for Older People Page 12 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 home caters for a wide range of residents needs. residents are consulted as to what they would like to do during their time at the home. A range of activities are provided for those who wish to partake. Residents who would prefer to be on their own are not pressured into taking part. Evidence: On the day of the inspection residents were involved in a range of activities. Two residents had gone to a barbecue. Two residents were in the television room watching a black and white movie which they were obviously enjoying. Other residents were socialising over a cigarette. Residents who wanted peace and quiet were given the space to do so. The home has an activities coordinator who discusses with the residents what activities they would like to do. This is usually quizzes, films, gentle exercise or games, a daily walk, sing songs and name that tune are all popular. The home hopes to purchase a karaoke machine. A variety of activities took place during the time of the inspection. Residents are invited to monthly meetings at which they can have a say in the future activities that will be provided by the home. Residents also are consulted on issues regarding the daily running of the home. The minutes of these meetings are recorded and show a record of good attendance. Many of the residents have very idiosyncratic behaviours around their appearance or how they Care Homes for Older People Page 13 of 25 Evidence: want there room to be. Evidence was found that these behaviours were accepted without judgement. On the day of the inspection residents who did not want to go to the barbecue had a lunch of hot dogs and a beer or soft drink as parity with those who attended the barbecue. The evening meal was being prepared using fresh ingredients and was both wholesome and appetising. A choice was available for those who did not want the main dish of the day. Drinks hot and cold are available throughout the day as is fresh fruit. The cook was aware of the individual needs and preferences of the residents and meets with them to ensure they are getting the food they like. The residents have a takeaway meal once a week which is very popular. Care Homes for Older People Page 14 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 home has clear policies and provides information to residents as to how to comment on the service they provide. The home has policies and procedures to ensure that residents and staff are safe. Evidence: The home encourages residents to make comment both positive and negative about the home. This can be done in a anonymous way or more than often than not at the house meetings. The home has a policy and procedure that informs residents how to make a complaint. The home has recently reviewed and amended it to be more user friendly to residents. Residents can also share there concerns and complaints with their key worker in the one to one sessions that are taking place regularly. Staff have been trained in safeguarding issues and know what to do if a residents is suspected of suffering harm. Staff have been trained on The Mental Capacity Act and its implications for their residents. The home has a whistle blowing policy which is made known to staff at induction. The whistle blowing policy clearly states that staff can make comment about a work colleague without fear or reprisal or repercussion. Staff are aware of the limitations and boundaries with regard to restraint and where any form of restraint is needed to protect residents, this is clearly recorded and agreed by the professionals involved. Care Homes for Older People Page 15 of 25 Evidence: 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The environment whilst not ideal provides a safe, warm and homely environment for its residents. The organisation ensures that it is maintained in good order and that all areas and equipment are safe. Evidence: The home is no longer complaint with the current thinking in the care of residents with mental health issues or those who are considered vulnerable. The organisation hopes to re-provide this service to a new building in the next two years. The current building whilst not ideal is however well maintained and provides a reasonable standard of accommodation. Managers and staff ensure that the home is as comfortable and homely as they can. Residents are encouraged to bring small items of personal possessions with them. Residents are consulted as to how they want there personal areas to be decorated and kept. Evidence of this was found when we were shown around the building. The downstairs shower room was leaking and had caused damp in the hallway and a bath was awaiting a bath seat to be fitted. Both these issues were in hand and the home had adequate alternative arrangements to ensure that residents could bath in safety and privacy. The home ensures that staff knock on residents doors and only enter when invited to do so. The home has a choice of communal areas one smoking and one none smoking. The majority of the residents smoke. Smoking is no longer allowed outside of the designated areas. Where smoking could be considered a risk to a particular resident a risk assessment will be held on file. The Care Homes for Older People Page 17 of 25 Evidence: home has a rolling programme of redecoration and refurbishment and has plans to remodel the garden, removing the pond and replacing it with planted area. The smoking lounge will be fitted with new blinds in the near future. All hot water outlets are temperature controlled and all equipment used in the home is regularly maintained with current certification where required. The home has a sound infection control policy and recently implemented this policy to deal with residents who were suspected of having swine flu. On the day of the inspection the home was clean and free from offensive odour. 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. The home employs staff in sufficient numbers to meet the assessed needs of the residents. Staff are recruited in a manner which ensures they are capable of providing a good standard of care. Staff are supported and trained to do good job. Evidence: The staff rota evidenced that staff are available in sufficient numbers to meet the assessed needs of its residents. Staff numbers are changed to accommodate busy and quiet times. During the inspection staff were seen to spend time in one to one or small group sessions. Lots of activity was taking place and staff were seen to treat people with respect and dignity. Many staff had undertaken external qualifications including the National Vocational Qualification in Care and training in Mental Health issues. Staff files evidenced that staff had accurate job descriptions and that the home was recruiting its staff in a safe and robust manner. Three staff were interviewed and informed us that they felt supported by management and that training opportunities were very good. Staff are encouraged to attend any available training appropriate to the job they do and cover is made available if required. All staff said they enjoyed the job very much. All staff had been with the home for a number of years. Staff supervision records evidenced that staff are being supervised in a supportive way on a regular basis. Supervisions are recorded, have a set agenda, and are given a high priority. Staff meeting take place on a regular basis and minutes seen reflected an agenda which ensured that staff are kept up to date with events in the home and the Care Homes for Older People Page 19 of 25 Evidence: larger organisation. Also staff development opportunities are brought to this forum to ensure all staff are made aware of available training. 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 good 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 with robust procedures for the safe running of the home. The manager is well supported by the organisation, who undertake regular mini inspections to ensure quality is being maintained. Evidence: The registered manager completed her management training two years ago and continues to attend training relevant to the job she does. The registered manager is well supported by the organisation by regular contact with senior management. The organisation has sound financial procedures in place and the home feels it provides value for money. The manager promotes an environment where staff treat residents with dignity ensure they have privacy and confidentiality. The home has a range of policy and procedures to ensure that managers and staff are aware of what is expected of them. These policies are regularly reviewed. The home has health and safety policies which are the responsibility of the organisations heath and safety officer who undertakes regular inspections of the home. The homes managers and care staff have all attended recent training on The Mental Capacity Act and are aware Care Homes for Older People Page 21 of 25 Evidence: of its implications for the homes residents. Staff are aware about the deprivation of liberty safeguards and their implications for day to day practises. No residents are at present subject to this act. 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. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!