Care Home: Little Haven Nursing & Residential Home

What the care home does well We reported at the last inspection undertaken on 6th December 2006 that the home was clean and had a relaxed and homely atmosphere. The home had an open and efficient process in place for dealing with complaints, concerns and compliments. The staff team at the home were skilled and received regular training. As we did not assess these areas at this inspection we cannot comment on whether the home is still doing well in these areas. What the care home could do better: Following the last inspection of 6th December 2006 we reported staff were not receiving formal supervision on a regular basis. As we did not assess this area at this inspection we cannot comment on whether this has improved. The home needs to provide everyone with the same opportunities and afford them with equal rights regardless of their needs. People would benefit from having more person centred care plans. Inspecting for better lives Random inspection report Care homes for older people Name: Address: Little Haven Nursing & Residential Home Beaulieu Road Dibden Purlieu Southampton Hampshire SO45 4JF 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 assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. 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: Chris Johnson Date: 1 9 0 3 2 0 0 9 Information about the care home Name of care home: Address: Little Haven Nursing & Residential Home Beaulieu Road Dibden Purlieu Southampton Hampshire SO45 4JF 02380847222 02380847585 aroberts@wilverley.org.uk 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) : The Wilverley Association Limited care home 43 Number of places (if applicable): Under 65 Over 65 43 old age, not falling within any other category Conditions of registration: Date of last inspection Brief description of the care home 0 Little Haven is a registered care home that accommodates forty-three service users over the age of 65 years. The home is the sister home to Forest Oaks and is administrated by the Wilverley Association Ltd, which is a charitable trust, and as such, all members of the governing committee are volunteers. The home was purpose built some years ago located on three floors in pleasant gardens and is situated in a semirural area close to the New Forest. The home is close to shops and other local amenities. Service users are able to go out into the community independently where possible. All 43 rooms are single occupancy with en-suite facilities and have extra facilities within them for storage. The service users who receive personal care furnish those rooms and supply all soft furnishings making each room very individual. The Care Homes for Older People Page 2 of 9 Brief description of the care home home has two passenger lifts installed. The grounds surrounding the home are well maintained. Care Homes for Older People Page 3 of 9 What we found: We undertook this random inspection on 19th March 2009. The reason that we visited the home was that concerns had been raised with us that the home was not meeting the social and emotional needs of some people with nursing care needs. We were told about one person in particular, who was being denied access to the dining room due to the fact that the level of assistance that they required with eating could offend other people living at the home. We were also told that there was an unwritten policy within the home that if people did not have appropriate eating skills then they were not permitted to eat in the dining room with others and that they had to take their meals in their own rooms. Concerns were also raised that some people were not made aware of activities going on in the home and were feeling isolated. We were also told that one person in particular was not receiving support with their personal care needs as described within the care plan. During this visit to the home we looked at the assessment documentation, associated care plan and daily records for the person concerned. We spoke with this person and three other people with nursing care needs. We also talked with four members of staff and the manager. We observed the midday meal and an organised activity. We looked at the homes Statement of Purpose and Service users Guide. We asked the manager whether it was the homes policy that people with eating or swallowing difficulties did not join the rest of the people in the dining room. The manager confirmed this to be the policy. We asked whether there was a written policy regarding this and were told that there was not. From examination of the homes Statement of Purpose and Service users Guide there was no reference to any such restriction. The manager explained that everyone who moves into the home is made aware of the policy verbally. The Statement of Purpose lists one of the homes objectives as To ensure that the care service is delivered flexibly, attentively, and in a non discriminatory fashion while respecting each service users right to independence, privacy, dignity, fulfilment and the rights to make informed choices and to take risks. The manager reported that the dilemma was that the people living at the home who did not need nursing care did not like eating with people who needed assistance. It was established that currently people who use the dining room are served their meals by catering staff. They do not assist people. Those requiring assistance are supported by care staff in own rooms. On the day of the visit a total of eleven people took their midday meal in the dining room. This comprised of six people with nursing care needs and five people without nursing care needs. The manager confirmed this to be the average use of the dining room at midday. None of the eleven people needed any assistance with feeding and this was confirmed by the manager. There were a total of thirty-five people resident on the day of the visit and this comprised of twenty-seven people with nursing care needs and eight non- nursing care. Care Homes for Older People Page 4 of 9 From observation the size and layout of the dining room would not accommodate all of the people living at the home if they all wished to have their meals in there due to insufficient seating and space. The manager reported that this had been discussed with senior management and that they were considering increasing the size of the dining room by knocking through into small television room as this room was hardly ever used. In discussion with people who live at the home we asked whether it was their choice to eat their meals in their rooms and whether they would prefer to use the dining room. Each person said that it was their choice. One person commented that they found it embarrassing that they needed assistance with feeding and preferred this to take place in the privacy of their own room. In discussion with four members of staff they were all of the opinion that everyone who wished to use the dining room at present did so and those that did not, did so out of choice. Each of the people spoken with said that they could take part in activities in the home as they so chose. None felt disadvantaged regarding access to activities. Staff said that people were supported to engage in activities of their choosing and said that they kept people informed of what activities were available and offered them all to get involved.They also said that they had the opportunity to do one to one activities with people and gave several examples. We looked at the daily records in respect of the person whom was the main focus of the concerns. We saw several entries indicating that they had been offered to take part in various activities and that some times they had accepted and at other times declined to join in. On the day of the visit this person was observed to take part in a movement to music session with several other people. This group consisted of people requiring nursing care and those that did not. In discussion with this person their description of their social care support needs were as described within their care plan and as described by staff in discussion. The last issue that we looked at was whether one particular person was receiving the support with their personal care needs that they required. We examined their care plan and discussed this with the person, staff and the manager. The care plan stated that, the person was to be offered a bath or a shower daily and that if they preferred they were to be offered assistance to wash in their room. This part of the care plan had been kept under regular review and no change to this procedure had been recorded. From looking at the daily records over a ten day period there was only one entry recorded to demonstrate that staff were following these instructions. This would suggest that staff are not following the care plan. In discussion with the person concerned however, they told us that that they considered that they were receiving enough support with their day to day personal care needs, that they were offered baths and showers regularly and that they would decline if offered one daily as they did not want one that frequently. We discussed with the manager the importance of maintaining accurate records and the need to ensure that peoples care plans accurately reflect their needs. Care Homes for Older People Page 5 of 9 What the care home does well: 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 6 of 9 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set. No. Standard Regulation Requirement Timescale for action 1 36 18 (2) Staff must receive formal 06/02/2007 supervision at least six times a year. Care Homes for Older People Page 7 of 9 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 1 15 12 Everyone living at the home 30/04/2009 must be given the choice and opportunity to eat in the dining room. People requiring assistance with eating are not given the same choice and opportunity as others. 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 8 of 9 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI 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: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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. 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