Inspection on 25/01/10 for Hallcroft Care Home

This is the latest available inspection report for this service, carried out on 25th January 2010.

CQC found this care home to be providing an Good service.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Hallcroft Care Home 22/08/06

Hallcroft Care Home 27/07/05

Hallcroft Care Home 05/01/05

Hallcroft Care Home 14/06/04

Extracts from inspection reports are licensed from CQC, this page was updated on 25/04/2010.

Key inspection report Care homes for older people Name: Address: Hallcroft Care Home Croft Avenue Hucknall Nottingham NG15 7JD     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: Lesley Allison-White     Date: 2 5 0 1 2 0 1 0 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 26 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Hallcroft Care Home Croft Avenue Hucknall Nottingham NG15 7JD 01159680900 01159632388 hallcroft@fshc.co.uk www.fshc.co.uk Tamaris Healthcare (England) Ltd Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Type of registration: Number of places registered: care home 40 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 40 The registered person may provide the following category of service only: Care Home with Nursing - Code N, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - OP Date of last inspection Brief description of the care home Hallcroft is a purpose built home, set in a residential area of Hucknall, Nottinghamshire. Hallcroft has forty beds with Nursing care being provided in the home. There are 36 single rooms and 2 double rooms, which all have en-suite facilities. In addition there are 7 toilets 5 bathrooms, one with a parker bath and 1 shower. A passenger lift provides access to both floors. A pleasant garden area is provided. Care Homes for Older People Page 4 of 26 Over 65 40 0 1 0 1 2 2 0 0 8 Brief description of the care home The current fees range from £392.00 to £429.00 per week. Additional cost for hairdressing and podiatry interventions are not included in the fees charged at the home. Care Homes for Older People Page 5 of 26 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: This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The focus of inspections undertaken by the Care Quality Commission (CQC) is upon outcomes for people using the service and their views on the service provided. The last key unannounced inspection was 10th December 2008. Prior to the visit an analysis of the care home was undertaken from information gathered including information from the Annual Quality Assurance Assessment completed by the provider. Care Homes for Older People Page 6 of 26 As most inspections only have one inspector the report is written as what we found as it is written on behalf of the commission. The site visit lasted 5 hours and the main method of inspection used was case tracking which involved looking at the records of two people in detail and tracking the care they received by checking their records and discussing this with them where possible. There were twenty eight people for care in the home. This included nine people for residential care. We spoke with seven other people who either received care or were relatives of people who receive care at the home. The Registered Manager was present at inspection and we spoke with other staff also. We observed care practises to see how staff interacted with people at the home. Care Homes for Older People Page 7 of 26 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 8 of 26 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 26 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. Peoples needs are fully assessed prior to admission so the individual and the home can be sure the placement is appropriate. Evidence: We looked at the records of two people and found that pre-assessments were made. They included a social services assessment of needs and an assessment by the Registered Manager. We saw that case tracking confirmed good practise. The Registered Manager visited prospective people either in hospital or in their homes and carried out a thorough initial assessment of their care needs. People we spoke with were aware of having a copy of their Service User Guide and Statement Of Purpose (information about the care home) and told us that they were invited to visit the home before they made a decision to accept a place at the home. They said that the staff were welcoming and put them at their ease. We saw copies of their contracts and terms and conditions of Care Homes for Older People Page 10 of 26 Evidence: stay on each persons record. We saw that a copy of the fees paid was clearly stated. Comments from people included: I was given the opportunity to look around first and I liked it. Its OK here. Intermediate care is not offered at this care home. Care Homes for Older People Page 11 of 26 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. Peoples health and personal care needs are fully met through careful delivery of care and care planning. Evidence: Health, personal and social needs assessments are in place they include: Moving and Handling, falls, Nutrition and weight , Cognitive ability, emotional and social needs, likes and dislikes. A brief summary of the persons history and life style before they came into the home is also included. This allows the staff to be able to understand the back ground of the person they will care for. An assessment of the skins integrity and pressure ulcer risk is also included. We spoke with four people who they told us that they have contributed to their care plans. They said that they were given the opportunity to contribute if they wanted to. Two of the people we spoke with had short term memory problems but the choices that they were able to make were shown in their care plans such as, making a decision as to what to wear, have bath or what to eat. Staff who spoke with us were also able to say how they assisted people to make choices. Care Homes for Older People Page 12 of 26 Evidence: People at the home felt that they were well supported and cared for although two people felt that they were sometimes kept waiting when they needed help. Relatives that spoke with us said that they thought care provided to their relative was good and that they had no concerns about the care. We saw that when people needed to see other health care professionals such as the doctor, the optician, the chiropodist, a specialist nurse or to attend hospital appointments, arrangements would be made and carried out. This means that people can be confident that they will receive the support they need from people who understand their needs. Care Homes for Older People Page 13 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are given the opportunity to participate in social activities that are varied to suit their needs. Meal times are a pleasant unrushed affair with staff readily available to help and support people as required. Evidence: We saw care plans that showed that staff are guided to focus on daily routines and individual activities for people at the home and an activities coordinator is provided for this purpose. People told us that they made friends at the home. We saw families and friends present on the day of inspection who told us that: staff always made them feel welcome and would be offered a drink or a meal if staying for a long while. Two people went out to the local church and said that a multi-faith service is provided at the home also. Family members said that they were happy with the appearance of their relatives when they visited. People told us that they were given choices that included when to have a bath or shower, when they wanted to get up or go to bed and what they wanted to do during the days. Care Homes for Older People Page 14 of 26 Evidence: We observed a lunch time meal. We observed people being moved and handled and noticed that staff spoke with people as they did so and moved people safely from the arm chair to a wheel chair and then into the dining room. Some people were assisted to walk and two or more staff would assist them to do so safely. We heard staff making a point of reminding other staff to ensure that they went off to wash their hands before they assisted with meals. At lunch time the cook served the meals to ensure that people received the correct diet. We saw that special diets were provided such as pureed food. People who were on diabetic diets were given their correct diet by the cook. Menus are offered on a four weekly cycle and a choice of two menus is usually provided. However the cook explained that they are flexible and able to offer people other choices that may not be on the menu and this is recorded on the daily kitchen plans. People who needed assistance were assisted by staff who sat and assisted them at the dining table. The dining area was pleasant, the only noises heard being from the interactions of people dining and the staff who assisted them. People at the home were encouraged to sit with people that they liked and preferred to sit with. We saw that the nurses were present at meal times and sat down to help people with their meals also. Meal time was pleasant, unrushed and well managed. Care Homes for Older People Page 15 of 26 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 managment of complaints is good this has resulted in complaints being acted on and resolved easily to the satisfaction of all parties. Evidence: There have been three complaints and one safeguarding. We are aware of them. At inspection we looked at the complaints book and saw that the complaints had been dealt with in a satisfactory manner. We spoke with relatives who said that they felt able to raise any concerns that they may have through the senior staff at the home and knew that they would be taken seriously and acted on. People said that they knew how to make a complaint. A copy of the complaints procedures is displayed in the entrance to the home and is also available in the Service User Guide kept in each persons bedroom. The Annual Quality Assurance tells us that: a risk monitor report is completed weekly and includes safeguarding issues, weight loss monitoring, pressure area and skin viability monitoring. Staff receive regular training in safeguarding and are clear about referrals to the local authority as part of the local process. We spoke with six staff members, they were able to demonstrate their awareness of safeguarding issues. This means that they would know how to respond if they saw someone at the home being placed at risk. Staff also told us that they were aware Care Homes for Older People Page 16 of 26 Evidence: that if problems were not resolved by the organisation they could alert the external agencies these include the Police, Social Services or the Care Quality Commission with their unresolved concern about care at the home. Care Homes for Older People Page 17 of 26 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. People live in a safe well maintained environment which they enjoy and the environment is maintained to a high standard. Evidence: The door was quickly answered on arrival. Displayed in the foyer is a copy of the relevant certificates, a copy of the menu for the week and an activities planner. A copy of the current inspection report, acknowledgements and a copy of the latest quality assurance customer survey findings is also found in this area. Further into the building there is a board displaying who is in charge of the shift and the first aid person on duty so that people at the home and their relatives have the information that they need on a daily basis. The managers office is shared with the administrator and found at the entrance to the building. A post box is situated outside the office for people to collect their post from it if they have said that they prefer to do so. Five people collect their mail in this way and staff are on hand to assist them should they need assistance with their mail collection. The Annual assessment informs us that : A full time maintenance person is employed who works in accordance with the regional estates manual to ensure that all routine Care Homes for Older People Page 18 of 26 Evidence: checks are on a service schedule and are undertaken in line with company policy. Records are available for inspection at any time. The annual assessment also informs us that three monthly health and safety meetings are held resulting in actions to address any areas of risk. Staff told us that they receive any information for changes through handovers and staff meetings. The AQAA tells us that: there is an annual budget for refurbishment supported by appropriate capital. We saw that the home is kept clean, tidy and safe. The House keeper has a team of staff to ensure that all areas are maintained. We noticed that the lounge area could have more call points for people to use and could be made easier to identify for people at the home and their visitors. We looked at two bedrooms they had personal belongings in them they were clutter free and looked pleasant. Window restrictors were in place to act as safety measures for people at risk from falls from heights. We saw six (hallway, lounge, activities room, dining room, bathroom and toilet area) communal areas they were clean and well presented. Bathrooms and toilet areas had equipment to assist people with mobility problems and had locks on the doors to allow for peoples privacy. There were no unpleasant smells in the home. Care Homes for Older People Page 19 of 26 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 recruitment procedure for staff is good and staff are well trained to provide for the needs of people at the home. Evidence: We saw a copy of the rota and it showed that the shifts were covered by one nurse for the day shift (08:00 hours to 20:00 hours) and four day shift care staff plus three staff on an early shift and two staff on a late shift. Two care staff were on night duty and an agency nurse on nights. Support staff included one Registered Manager, one administrator, one maintenance person, one activity person. On the rota available were two cooks and three catering assistants three domestic staff and two laundry staff. On a daily basis there was one cook and a catering assistant, two domestic staff and one laundry person. The rota showed an over reliance of cover for nights by either bank staff or agency nurses and this could lead to lack of continuity in follow up of care as shown in gaps in medicine sheets although day nurses and the manager also covered night shifts when needed. There is a good skill mix at the home with nurses and well trained care staff who were seen to be responsive to peoples needs. There was no one for terminal care and the need for one to one supervision was not required. At interview staff told us that they had been given thorough training including an induction, health and safety, moving and handling, fire safety, first aid, infection control, vulnerable adults, death and Care Homes for Older People Page 20 of 26 Evidence: dying, challenging behaviour and for some, person centred care and training in specific nursing interventions. Nurses had link roles with the community in infection control, tissue viability and in continence care. We looked at staff records and saw that there has been full and thorough recruitment procedures followed, including waiting for a full Criminal Records Bureau check and induction for staff. When we spoke with staff they told us that they had regular supervisions formally recorded and we saw that this happened at regular intervals. We saw that when staff were late and a pattern was developing the Registered Manager would discipline them with a verbal warning and senior staff would be asked to supervise them more regularly followed by the Registered Managers observations also. Care Homes for Older People Page 21 of 26 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 run in the best interest of the people who live and work there. Evidence: We checked that the Employers Liability insurance and Registration certificate was correct. We checked the finances of two people and they were correct. When money is kept on the premises it is correctly administered and stored. We saw that the organisation creates opportunities for staff, and for the people at the home. We saw a staff group that reflected a variety of different ethnic or cultural backgrounds. We looked at Regulation 26 visit information about the service and saw that quality review monitoring took place each month by senior managers within the organisation. This allows both relatives, visitors and family to have their say on what could be improved at the home. We saw copies of staff and resident meetings where people were free to express their concerns and a copy of the next meeting where concerns Care Homes for Older People Page 22 of 26 Evidence: had been addressed. In this way people can feel confident that their needs will be met and their ideas and suggestions listened to. Health and safety records were kept up to date and we saw copies of the electrical installation certificate, Portable appliance testing certificate, Hoist, passenger and goods lift certificate. Ashfield District Council Food kitchen inspection dated 22/04/2009 made two requirements they were responded to by the Regional Manager for Four Seasons East Midlands on 03/07/2009. People who live at the home and visitors who spoke with us said they were satisfied by the service provided at the home. Since writing this report the Registered Manager has changed her working location and a new acting manager has been appointed who will register with the Commission once her three month probationary period with Four Seasons Health Care is completed. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 9 13 All medication administration 31/03/2010 charts must be completed accurately. This is to ensure there is a clear audit trail of medicines administered and that people receive their medication as prescribed. 01/02/2009 previous date. Care Homes for Older People Page 24 of 26 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 25 of 26 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. 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