Care Home: The Haven Residential Home

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What the care home does well The home provides a comfortable safe and homely environment for people to live in. There are assessment and care planning processes in place. Residents have detailed care plans which enables staff to know how residents needs are to be met by the resources of the home. Regular residents meetings and care reviews are held where residents comment on the services provided at the home. The home offers, a range of social and leisure activities. A balanced and varied diet is provided. Relatives and other visitors to the home are encouraged to give their views and opinions of the service, which means that they can influence the way the service is run. Resident stated that they felt their needs are being addressed by the care home. They said the home is always clean. There is a training plan in place for staff who are well supported by the management of the home, which helps them to provide a good quality of care. What has improved since the last inspection? The requirements identified at the last key inspection have been met. The registered manager stated that the home is endeavouring to ensure that the regulation requirements continue to be met. All of the homes policies and procedures have been reviewed. There is evidence an improvments in the management of the home. What the care home could do better: The registered manager must ensure that staff on duty are deployed appropriately within the care home to ensure residents needs are always met. Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Haven Residential Home 266 Eastgate Louth Lincs LN11 8DJ     The quality rating for this care home is:   two star good 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: Ken Hague     Date: 0 9 1 0 2 0 0 8 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 24 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 24 Information about the care home Name of care home: Address: The Haven Residential Home 266 Eastgate Louth Lincs LN11 8DJ 01507604197 01507601190 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Haven HealthCare (UK) Ltd Name of registered manager (if applicable) Jane Robertshaw 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 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home The Haven residential care home is located a short distance from the centre of the market town of Louth. The care home consists of a large main building, which was formerly a vicarage, and two detached bungalows. One of these is a modern building, the others being the conversion of a former courthouse. There is a large car park at the rear of the home, which is surrounded by well maintained gardens. The care home is registered to provide care for 33 service users, 31 code elderly and 2 code mental disorder. The home offers long-term care, respite care and holiday stays. All accommodation is provided in single rooms. The fees at the inspection visit on the 28/08/2007 ranged from £348:00 to £431:00, plus chiropody £10:00, hairdressing £6:00 and personal newspapers and magazines. Information about the home can be Care Homes for Older People Page 4 of 24 care home 33 Over 65 0 31 2 0 Brief description of the care home obtained from the manager of the home. The statement of purpose, service users guide and most recent inspection report are also available from the manager. Care Homes for Older People Page 5 of 24 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 inspection took place over 5 hours. The registered manager were given feedback at the end of the inspection. The main method of inspection used was called case tracking which involved selecting three residents and tracking the care they receive through the checking of their records, discussion with them and the staff, and where more appropriate observation of interaction between staff and residents and related care practices. A sample of care records was inspected. Two members of staff were interviewed and the opinions of one resident was sought. An (AQAA) Annual quality assurance assessment was completed by the care home and sent to the Commission for Social Care Inspection prior to this report being completed. This is a self- assessment Care Homes for Older People Page 6 of 24 document completed by the providers of the care home. It sets out evidence from the provider to demonstrate that they are meeting the Care Home Regulations. It is normal procedure to obtain written feedback from residents prior to the site visit using a document called have your say documents There were 14 reports returned from residents and one from a relative. Residents were spoken to do during the site visit their opinions are reflected within the inspection report. 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 24 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 24 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 residents are identified in a detailed assessment which is carried out prior to them being admitted to the care home. This is to ensure residents needs are met. Evidence: The home has an updated statement of purpose and service users guide which sets out the resources of the care home. This enables new residents to decide whether their needs can be met by the care home. The care records for three residents being case tracked were viewed. They all contained a comprehensive detailed assessment which set out the needs of each resident and how they were to be met by the home. Assessments included a risk assessment and where a risk was identified risk management strategies were in place. Assessments were updated and reviewed alongside care plans.Records were signed and dated by the assessor and the resident or relative. The individual residents file containing a contract which stated the room to be occupied, the fee which were payable and the terms and conditions of occupancy. Care Homes for Older People Page 10 of 24 Evidence: The home does not offer a dedicated intermediate risk care service. Care Homes for Older People Page 11 of 24 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. Care plans identify all areas of need and provide detailed care instructions for staff; this enables staff to provide appropriate care and ensures residents needs are met. The homes medication procedure is followed ensuring the safe administration of medication. Evidence: The individual care records for the residents being case tracked all contained an individual service user plan. This had been generated from a comprehensive assessment completed prior to admission. The care plans set out in detail the action to be taken by care staff to ensure all aspects of health, personal and social care needs of the residents were met. The choices and wishes of the residents were recorded within their care plans. The manner in which personal care should be provided to preserve the dignity and privacy of the residents was detailed in care plans. Residents confirmed that they have been involved in the writing of their care plans. There was evidence of ongoing updating of current care plans and formal reviews. All care plans contained risk assessments and risk management strategies where any risk was Care Homes for Older People Page 12 of 24 Evidence: identified. Health care needs were recorded. Care records contained details of visits made by opticians chiropodist and district nurses . There were nutritional assessments in all care files. Residents confirmed that their health care needs were being met. The home has an updated medication policy which if followed will ensure the safe administration and storage of medication. Staff stated in formal interviews that they have been trained in administration and storage of medication. They confirmed that they follow the homes medication procedure. The registered manager stated that medication is stored in accordance with the homes procedure. A pharmacy visit took place in October 2008 the report states there were no problems identified at this visit and things had improved in respect of the medication practice of the home. Observations made during the site visit provided evidence that staff respect the privacy and dignity of residents. Staff were observed to talk to residents in a quiet sensitive way. They supported a resident who was distressed. At lunchtime a member of staff were seen to be helping the resident who could not feed herself. She was helped in the sensitive manner ensuring that she was not embarrassed or upset. The carer ensured that food did not spill onto her clothes and wiped her mouth after each spoon of food.The resident was observed to be very comfortable and relaxed during this process. All care records instructed staff to ensure the dignity and privacy of the residents is maintained. All care records were written to a high standard easy to follow and filed in a consistent manner. They have greatly improved since last key inspection. The quality of care records exceeded the standard expected. All records were indexed and crossreference. Care Homes for Older People Page 13 of 24 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A range of activities is offered by the home which meets a choice and wishes of the residents. The managers menu offers choices and meets a dietary needs of the residents. The home encourages relatives and friends to visit must maintain residents links with the community. Evidence: A range of activities is offered which meets the choices and wishes of residents.The managers menu offer choices. The home encourages relatives and friends to visit thus maintaining residents links with the community. Residents stated that they found activities enjoyable. Resident meetings minutes provided evidence that activities are discussed with residents and their views acted on. Residents confirmed that their relatives are made very welcome. Residents stated that they go out into the community to attend social activities.A communion service is held at the home by a local minister one Tuesday per month. Residents said we are offered choice in respect of our diet. The likes and dislikes of resident are recorded on their individual care plans including any Special dietary needs. Staff stated that the quality of food is excellent. A resident stated the food is fine I am very happy with it. We are offered choice and it is well presented. Care Homes for Older People Page 14 of 24 Evidence: Care Homes for Older People Page 15 of 24 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. There are good systems in place to protect residents. staff feel are able to use whistleblowing procedures. Evidence: The registered manager stated that staff had been trained in recognition and management of abuse. There have been no investigations carried out on the the adult protection procedure since the last key inspection. Notifications have not raised any concerns. Residents stated they are able to raise any concerned with any member of staff. Staff stated that they would be comfortable using the whistleblowing procedure of the home if they had any concerns. Care Homes for Older People Page 16 of 24 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. Residents live in a clean and comfortable home which meets their social and care needs. Evidence: Improvements were found to have been made to the environment since the last visit. The lounge area and dining area have been decorated. Other areas of the home was seen to be tidier and better organised. One room had been converted to a dedicated training area. The staff rest area was cleaner and well organised. Residents stated they felt safe and were comfortable living in the care home. No health and safety issues were identified. The registered manager stated that staff are being trained in food hygiene and infection control. Staff confirmed this statement to be correct. There is still a need for some ongoing maintenance but there was evidence of financial investment in the building since the last key inspection. Care Homes for Older People Page 17 of 24 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. There are sufficient numbers of staff who are trained to ensure that the current needs of residents are met. Current recruitment arrangements protect residents. Evidence: Staffing rotas demonstrated that the home is meeting the minimum staffing levels with an adequate mix of care staff on duty 24 hours a day. The registered manager stated that extra staff are provided if a need for additional staff is identified. The home provides separate staff for care domestic laundry, catering and maintenance. There were some comments within the have Your say documents that some residents felt staff were not always available to answer their needs. Training records for staff and staff interviews confirmed that training is being provided to all staff including specialist training and NVQ training. The inspection of the file for a new member of staff provided evidence that the homes recruitment procedure is being followed.This ensures that staff are recruited safely.The registered manager stated that supervision and inductions are being provided to all staff. The inspection of the records and discussions with staff supported this statement. staff interviewed stated that they felt there was always sufficient numbers on duty to meet the needs of residents. They were able to describe the medication procedure of the care home. They confirmed that they felt confident in being able to protect residents from any potential abuse. As part of the case tracking process the three residents being case tracked were discussed was Care Homes for Older People Page 18 of 24 Evidence: staff. All staff had the knowledge of needs of each individual residents which would enable them to provide safe care. Care Homes for Older People Page 19 of 24 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 run, with good leadership. The health and safety and welfare of service users is promoted Evidence: Care records have been improved and exceed the National Minimum Standards. All records are comprehensive, detailed and informative. The home was tidier and cleaner than on past visits. Redecoration is taking place. Supervision appraisals have been introduced. The registered manager is providing good leadership and is said by staff to be very supportive. The ongoing quality assurance process is being developed. Feedback from quality assurance questioners seen at the site visit were all positive. No health and safety issues were identified. Recruitment records were excellent. Staff stated they could use the whistleblowing procedure. The registered manager states that she is encouraging staff to report any concerns. Care Homes for Older People Page 20 of 24 Care Homes for Older People Page 21 of 24 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 22 of 24 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 23 of 24 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). 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. Care Homes for Older People Page 24 of 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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