Inspection on 13/08/08 for Hampden House

This is the latest available inspection report for this service, carried out on 13th August 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Hampden House 24/01/06

Hampden House 06/09/05

Extracts from inspection reports are licensed from CQC, this page was updated on 08/11/2008.

CARE HOMES FOR OLDER PEOPLE Hampden House 120 Duchy Road Harrogate North Yorkshire HG1 2HE Lead Inspector Jo Bell Key Unannounced Inspection 13th August 2008 10:00 X10015.doc Version 1.40 Page 1 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Hampden House DS0000064477.V369953.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Hampden House DS0000064477.V369953.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hampden House Address 120 Duchy Road Harrogate North Yorkshire HG1 2HE Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01423 566964 01423 562792 lynda.cooper@efhl.co.uk www.efhl.co.uk Elizabeth Finn Homes Ltd Mrs Lynda Cooper Care Home 66 Category(ies) of Old age, not falling within any other category registration, with number (66), Physical disability (66) of places Hampden House DS0000064477.V369953.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users in the category PD must be: i) aged 60 years and over and ii) require nursing care 17th November 2006 Date of last inspection Brief Description of the Service: Hampden House is a purpose built care home, providing personal and nursing services to sixty-six service users. It was refurbished in 1996, with all rooms having en-suite facilities. Each floor is serviced by a lift. Further refurbishment of one wing of the home has just been completed. It is situated in a quiet residential area on the outskirts of Harrogate, has well kept, attractive garden grounds, and is a short walk from open green spaces. The home, which offers support and care for professional people and their families, is owned by the Elizabeth Finn Care, and run by Elizabeth Finn Homes Ltd. The weekly fees range from £680-885. Items not covered by the fee include hairdressing, newspapers and magazines. Information about the home is available in a brochure, which is provided to prospective service users before they are admitted, and a service users’ guide, which is available for them to see at any time. Hampden House DS0000064477.V369953.R01.S.doc Version 5.2 Page 5 SUMMARY 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 Commission for Social Care Inspection inspects homes at a frequency determined by how the home has been risk assessed. The inspection process has now become a cycle of activity rather than a series of one-off events. Information is gathered from a variety of sources, one being a site visit. More information about the inspection process can be found on our website www.csci.org.uk Prior to the visit the information from the following sources was obtained and considered: The annual quality assurance assessment and details in the Annual Service Review. Four surveys from people using the service, two care manager surveys and two health care professional surveys. Notifications (Regulation 37) relating to incidents in the home affecting people using the service. Details of complaints or concerns raised by people connected to the service. Progress of the previous requirements and recommendations made at the last site visit. At the site visit one inspector spent 6 hours at the home. During this time observations of care practices took place. People using the service were spoken with along with some relatives. Discussions with the manager regarding meeting needs, mealtimes, protecting people and the environment took place. The lunchtime meal was observed and time was spent inspecting three care plans, looking at individual rooms and reviewing a selection of health and safety information. Staffing and management issues were discussed and feedback was given to the manager and area manager at the end of the inspection. Hampden House DS0000064477.V369953.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: The records relating to staff training could be more robust. This will help identify which training has taken place and which is due. Hampden House DS0000064477.V369953.R01.S.doc Version 5.2 Page 7 The risk assessments could be clearer and more specific. This will mean people have their risks dealt with appropriately and proportionally. People having access to a menu at mealtimes could improve the dining experience. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Hampden House DS0000064477.V369953.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hampden House DS0000064477.V369953.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 (Standard 6 is not applicable) People who use this service experience good outcomes in this area. People are effectively assessed prior to admission, which helps to ensure individual needs can be met. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: The three pre-admission assessments looked at confirmed that a senior person completes an assessment before an individual moves to the home. This is to check what type of care and support the person needs and whether the staff have the skills and knowledge to provide that care if the individual chooses to move there. The process also reassures the individual and their family that they will receive the right support. Hampden House DS0000064477.V369953.R01.S.doc Version 5.2 Page 10 Assessments are completed if the person has a care manager or is privately funded. These detail health, personal, nursing, social and mental health needs. All the surveys completed by people living there report that people are given enough information about the service and what it provides. This means they can make an informed choice about whether to move there or not. Intermediate care is not offered at Hampden House. Hampden House DS0000064477.V369953.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 People who use this service experience good quality outcomes in this area. People have their health and personal care needs met in a dignified manner. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: People were observed looking clean and well cared for throughout the home. Three care plans were looked at during this visit. These describe the care and support people need to stay in charge of their own lives as much as possible. The plans looked at contained a lot of information, so that an unfamiliar carer could look at them and would be able to work out how much support they needed. The General Manager and Clinical Care Manager audit a minimum of ten care plans per month. Hampden House DS0000064477.V369953.R01.S.doc Version 5.2 Page 12 There were written assessments as to whether people were at risk of developing pressure sores, of losing weight because of poor appetite, a health problem, needing help with moving and handling and the use of bed rails. Those identified as ‘at risk’ had a care plan in place describing how that risk was to be managed. However, some of the risk assessment information was unclear and repeated. The scoring of risk assessments was not completed correctly, and in some cases this was evaluated on the day of admission, which is not appropriate. One person had a risk assessment for the prevention of pressure sores, staff had identified that a pressure relieving mattress was needed, but had immediately reduced the overall score without waiting for a week or a month to review this. Some risks for falling were unrealistic with staff always scoring the worst-case scenario (for example death). One person’s assessment stated there was a risk of drowning, though when this was discussed the person needed two people to assist in the bathroom and this person would never be left alone and no previous concerns had be raised. More training is needed to ensure staff understand risk assessments and how they are best completed. To this help the individual to have their current needs met. The home reports accidents and injuries and information in the care plans showed that the home has a good rapport with Doctors, nurses, mental health staff and social services. Surveys from health care professionals generally confirmed that people with complex needs are cared for, though one comment was that staff need more training in ‘psychiatric needs’. People spoken with felt that their health needs were met. One person said she sees her Doctor, and the chiropodist visits. Staff understand that people who need ‘residential care’ will seek treatment from the District Nurses rather than the nurses in the home. The medication system was inspected. Staff receive training in administering medication. Medication charts were fully completed and accurate. Staff know how to store, record and dispose of medication. This includes Controlled Drugs. A fridge is available to store medication, which needs to be stored below a certain temperature. For example some eye drops, and antibiotics. A medication audit takes place, which helps identify if any errors have occurred. Staff are clear when they need to use codes on the medication charts and regular stock balances are in place. Staff were observed treating people in a dignified manner. People were addressed in a pleasant manner by either their full name or first name. Staff were observed knocking on bedroom doors prior to entering, and people using the service had a good rapport with nursing and care staff. Hampden House DS0000064477.V369953.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People who use this service experience good quality outcomes in this area. People participate in a range of activities and visitors are welcomed. Staff encourage autonomy and choice, and people enjoy dining in pleasant surrounding with appealing food. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: People can participate in a range of activities, which are facilitated by an organiser. These include, monthly special event meals. For example the Beijing Olympics are taking place so meals representative of this have taken place. The theme for this year is well known films with a showing of the film. This has included ‘The Sound of Music’. There are exercises and movement to music three times a week. Church services take place twice a month, and there is a weekly quiz. People discussed having access to a bar for pre- lunch drinks. There is also a monthly library and an In house shop for sweets and essentials. For people who prefer to be outside there is Gardening in the Hampden House DS0000064477.V369953.R01.S.doc Version 5.2 Page 14 raised flowerbed. Activities can be recorded within the care planning system that allows coordination between the social organiser carers and nurses, with a fully detailed and evaluated care plan. Activities participated or declined can be recorded within the system. Surveys completed stated that there are enough activities and people spoken with discussed their favourite activities to participate in. Staff encourage autonomy and choice, the daily routine varies depending on the individual’s needs. Visitors are welcomed and the visitor’s book confirmed people arrive in the home at different times during the day. The lunchtime meal was observed. People can dine in the communal areas or in their own room depending on their preference. A varied and appealing choice of food is offered. The menu is on display in the entrance area to the dining room though people spoken with were unsure what they were having for lunch. It may be beneficial having menus on the tables. People were given assistance in a dignified manner, though a full explanation of the food offered was not always given. A range of diets were catered for which included soft and pureed, diabetic or normal diet. Portion sizes were appropriate and staff understood how to care for people who were under-nourished or over-weight. The dining experience was pleasant and people were observed chatting and enjoying their lunch. Hampden House DS0000064477.V369953.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People who use this service experience good quality outcomes in this area. People have their concerns listened to and acted upon, and people feel safe and protected from harm. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: A complaints policy is available and the home operates an open door policy, where people can speak with the manager any time to discuss anything about the home. Surveys confirmed that people know how to raise concerns, though one comment was made that “the manager never comes round the home”. No complaints have been raised through the Commission. People have the opportunity to speak to staff on a one to one basis or through the residents/relatives meetings. Staff spoken with knew about abuse and how they must immediately report any incident that causes them concern, to the manager. The manager was also clear about her need to report incidents promptly to the Local Authority, as required by the North Yorkshire policy. Previous safeguarding issues have been identified and these have been dealt with appropriately. Awareness by all staff about safeguarding adults helps to keep people safe. Hampden House DS0000064477.V369953.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People who use this service experience good quality outcomes in this area. People live in a comfortable and clean environment. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: The home is large and spacious with plenty of communal areas and a garden for people to enjoy. The home is well maintained, though the manager is aware that certain areas need re-painting. For example some bedroom door entrances, and corridor areas. It would be beneficial if the corridors were wider so chairs could be placed along this area for people who are mobile to have a rest or sit and chat with other people using the service. Some corridors are very long which makes it difficult for people to walk all the way at once without needing to rest. The home has disabled access and is kept secure. There is a Hampden House DS0000064477.V369953.R01.S.doc Version 5.2 Page 17 range of areas for those people with nursing needs or residential needs. Currently these areas are not named, though the manager discussed plans for reviewing this. This would help people using the service; visitors to the home and staff identify different areas. Staff were observed wearing protective aprons and clothes to prevent crossinfection. The home has sluice rooms and an effective laundry system. People were observed wearing clean and well-ironed clothes. Staff confirmed they receive infection control training, which helps them understand how to prevent the spread of infection in the home. Hampden House DS0000064477.V369953.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People who use this service experience good quality outcomes in this area. People are cared for by staff who are competent, well trained and recruited and in sufficient numbers to meet individual needs. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: The home currently has fifty people using the service. People have nursing and personal care needs. There are enough nurses and carers to look after the current client group. The annual quality assurance assessment states that “the Clinical Care Manger and Head of Care have an additional supernumerary day per week, and the induction programme for nurses has been updated”. This was confirmed when speaking with the Clinical Care Manager. This means that the care and nursing staff are well supported in the home; this ensures good standards are maintained. During the visit call bells were answered promptly, people did not have to wait long for assistance and the atmosphere was calm and relaxed. Eighteen out of the thirty-three care staff employed have achieved an NVQ Level 2 in Care. There is a robust induction programme, which all-new staff go through when Hampden House DS0000064477.V369953.R01.S.doc Version 5.2 Page 19 they start working at the home. This goes through care practices and customer care. Staff meetings are held regularly including night staff meetings. The recruitment process was discussed with the manager and administrator. Three staff files were inspected, these contained two written references and a police check along with a protection of vulnerable adults check. This helps to identify if people are suitable to work with vulnerable adults. There are checks in place to confirm if registered nurses have up to date registration, which allows them to work as a nurse. The home does not employ staff who are under eighteen and there is an equal opportunities recruitment process in place. Hampden House DS0000064477.V369953.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35,37 and 38 People who use this service experience good quality outcomes in this area. The home is run in the best interests of the people using the service. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: The registered manager is competent and skilled at managing the home. She has completed a management course and is deemed fit to run the home by the Commission. The manager is supernumerary and is well supported by an Area Manager and the Clinical Care Manager. Hampden House DS0000064477.V369953.R01.S.doc Version 5.2 Page 21 A quality assurance system is in place; whilst there is no overall annual development plan a system of regular audits is in operation. These include the environment, complaints, accidents, care plans and medication. Questionnaires are sent out to people and resident and relatives meetings take place. This helps to identify if people like living in the home and how the home can develop to improve people’s daily life. People can have their personal monies dealt with by the home. Individual accounts are in place and detailed accounts for three people were examined and found to be accurate. Invoices are in place for hairdressing, chiropody, newspapers or any extras. The home have up to date insurance regarding the amount of money that can be kept in the home. People have access to an advocacy service and some people have power of attorney to deal with their finances. There are a range of health and safety policies and procedures in place. The manager says that safe working practices are in place and staff are provided with training in first aid, fire, food hygiene, infection control and safe moving and handling techniques. Staff confirmed this mandatory training takes place, though records were unclear. The computer system had not been updated and whilst a training matrix was in place this was not up to date. Individual training records showed some certificates but training completed was not consistently recorded in individual files. However, the person responsible for training discussed training dates and was very clear regarding the training needed and the action taken if this does not take place. The home has a fire risk assessment and regular fire alarm testing and fire drills are in place. Water temperatures are checked monthly and a sample of water temperatures were tested and found to be within the expected range. The home have an electrical wiring certificate and evidence that gas safety checks are in place. This shows that the home is safe for people to live in. Information in the annual quality assurance assessment regarding policies and procedures being updated for health and safety also confirm this. Hampden House DS0000064477.V369953.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x 2 3 Hampden House DS0000064477.V369953.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 13 Requirement People must have clear risk assessments in place. This should identify the actual risk, the action to be taken and an evaluation of the risk. Timescale for action 13/09/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP19 OP37 Good Practice Recommendations Consideration should be given to re-painting the bedroom door entrances, which have chipped and scuffed areas. Clear record regarding mandatory training for staff need to be in place. This will help identify when training has been completed and when it is due. Hampden House DS0000064477.V369953.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Hampden House DS0000064477.V369953.R01.S.doc Version 5.2 Page 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!