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Inspection on 18/02/09 for Hatton Court

Also see our care home review for Hatton Court for more information

This is the latest available inspection report for this service, carried out on 18th February 2009.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The manager and her staff like to find out what people living in the home like to do and try to make sure that they can do it. They find out what they like to eat and try to make sure that is what they get. If a person is ill they make sure that they get the right treatment. If a person doesn`t like something they can complain to the manager and will be listened to. The staff are cheerful, friendly and helpful and encourage people to enjoy themselves but also try to make sure that they are safe and well looked after. Relatives and people who use the service are very complimentary about the care experienced. They find the staff helpful and friendly and they feel listened to.

What has improved since the last inspection?

The assessment and use of bed rails has improved so that if people need to use them they are assured that it is done with safety in mind. The recording of assessments and care delivery has significantly improved. Care plans are very thorough, clear and people are involved in the development of them. Staff have a clearer indication of the care needs of individuals living at the home. The premises have benefited from redecoration and replacement of old furnishings. The garden has new features such as gazebos and planters. People surveyed are very satisfied with their care and feel they can air any concerns with the manager. Staff recruitment has been successful and continuity of staff on duty is better. Daily activities are progressing well and the organizers are committed to finding new ways of providing a better service to those with dementia.

What the care home could do better:

The service should review the storage of equipment in resident areas. The service could make the home safer by risk assessment and providing suitable areas for storage of large items such as hoists and trolleys. There should be evidence of at least annual quality monitoring of the service. The manager could implement her own audit in areas such as medication and infection control taking the findings of external audits into account. This is so the service itself can ensure compliance with policies and procedures.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Hatton Court Whitchurch Road Cold Hatton Telford Shropshire TF6 6QB     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: Pat Scott     Date: 1 8 0 2 2 0 0 9 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 23 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 23 Information about the care home Name of care home: Address: Hatton Court Whitchurch Road Cold Hatton Telford Shropshire TF6 6QB 01952541881 Telephone number: Fax number: Email address: Provider web address: hatton.court@hotmail.co.uk Name of registered provider(s): Type of registration: Number of places registered: Springcare (Hatton) Limited care home 64 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommdated is: 64 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) 64 Dementia (DE) 34 Date of last inspection Brief description of the care home Hatton Court is a purpose built single storey property which is situated near the village of Cold Hatton near Telford and was built in 1992. The home has 52 single rooms and 6 twin rooms, having a total of 64 beds. There are large gardens and car 34 0 Over 65 0 64 Care Homes for Older People Page 4 of 23 Brief description of the care home parking. Fees charged range from a minimum of £390 to £650 per week. The latest inspection report is available from the home. Care Homes for Older People Page 5 of 23 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: We, the commission, looked at all the information that we have received, or asked for, since the last key inspection or annual service review. This included: The annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. Surveys returned to us by people using the service and from other people with an interest in the service. Information we have about how the service has managed any complaints. What the service has told us about things that have happened in the service, these are called notifications and are a legal requirement. The previous key inspection and the results of any other visits that we have made to the service in the last 12 months. Care Homes for Older People Page 6 of 23 Relevant information from other organisations. What other people have told us about the service. 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 23 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 23 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home understands the importance of having information about their service so that people can choose a home that will meet their needs and preferences. The admission process is personalised so that people are given consideration to their individual needs, concerns and anxieties before moving into care. Evidence: The service has developed clear information in large print format to help people understand what services the home can provide. This is in the form of an information pack which includes photographs of the premises, the statement of purpose, service user guide and fee information. People do not come into the home until a full needs assessment has been undertaken, usually by the manager. Records viewed show that this is done with the involvement of the individual and their family. Emergency admissions are sometimes accepted but only if full information is provided beforehand by the Authority placing the person in the home. Care Homes for Older People Page 10 of 23 Evidence: Surveys returned state that people had information prior to making the choice to live at the home. Other comments made said that the home had been recommended by word of mouth and that they would also feel happy to recommend to others. Care Homes for Older People Page 11 of 23 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 care needs and risk assessments are set out in their individual plans of care which ensures that all care needs have been addressed and will be fully met. The manager understands the need to comply with safe medication systems and staff training ensures that the homes procedures are complied with and that residents health matters are safely addressed. The actions of staff and their approach to care ensures that people are treated with respect and their right to privacy is upheld. Evidence: People have a plan of care that has been agreed with them. The care plans have significantly improved and those seen are easy to understand and look at all aspects of a persons life. People can talk to a primary nurse (a qualified nurse) and a keyworker (a care worker) who will work with them on a one to one basis to support and encourage them in everyday life. Care plans viewed contain information about assessment, how they keep safe, their aims and hopes, choice in social activity as well as detailed clinical information about their health and personal care. People have the aids and equipment they need which Care Homes for Older People Page 12 of 23 Evidence: are well maintained to support them and staff in daily living. The staff record how they consult people about their choice and satisfaction with care and the service generally. This is done through the care plan reviews, preference questionnaires, communication sheets and the opportunities to complete surveys. Medication is safely handled and the Primary Care Trust has recently completed an audit. Regular management checks by the service should be implemented and recorded to monitor compliance. Staff records show that appropriate training is provided. Comments from peoples families demonstrate a high level of satisfaction with their care. We had peace of mind knowing that he was being looked after. Care and kindness. Loving care and attention in his final days made him more comfortable. Kindness and friendships. Really excellent care and attention. His passing was peaceful and without pain. Care Homes for Older People Page 13 of 23 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 provided with social activity and can keep in contact with family and friends. Social, cultural and recreational activities meet peoples expectations through assessment, consultation and choice. Residents receive a healthy diet according to their assessed requirement and preference. Evidence: People are able to enjoy their preferred lifestyle with a variety of activities to choose from. The homes assessment process identifies what leisure pursuits and hobbies the person likes. Residents meetings are starting to take place which the manager stated would become a regular feature. Recent events enjoyed include: crafts, cards, Pat a dog, exercise, movies and trips out. The activity organiser is involved in the Shropshire Activity Group, which emerged from attending courses with Shropshire reminiscence. This group meets regularly to discuss ideas for activities, which can be brought to the resident meetings. The service is working on designing activities specifically to help people with dementia. The menus show that a well-balanced and nutritional diet is provided. The service has achieved a five star quality rating for food from the Environmental Health Office. Staff were seen to assist people to eat their meals during the lunchtime with sensitivity and dignity. Care Homes for Older People Page 14 of 23 Evidence: Survey results showed that people are very satisfied with the quality of the food. People say they are happy with the amount of activity provided and some enjoyed the opportunity to have trips out whilst others preferred to be entertained at the home. Both of these are catered for at Hatton Court. The service helps people maintain links with their family. A relative recently commented: Thankyou for taking the phone to him every Sunday in order that I could have a few words with him. Care Homes for Older People Page 15 of 23 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 service has a complaint procedure which is accessible so that people who use the service have information of how to make complaints about the home. Training is provided so that service users are protected from abuse and have their legal rights protected. Evidence: People surveyed state that they would go to the manager or one of the staff if they had a problem. All expressed confidence that issues would be dealt with. Records show that concerns spoken about by residents had been promptly dealt with and a satisfied outcome reached. Staff through training understand how to deal with complaints from people and are also clear when information needs referring through safeguarding processes. The manager states that complaints are treated as a learning process so that similar issues do not occur. The person centred approach by the manager and staff have given people the confidence to air their concerns. The use of bed rails is a form of restraint and staff have worked hard to involve people in the decision making process to use them. Full individual risk assessments were seen to be in the care plans detailing others consulted. Care Homes for Older People Page 16 of 23 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The physical design and layout of the home has improved so that people live in a better-maintained and comfortable environment. Evidence: The manager spoke of the refurbishment improvement plan which has been achieved and of the further work in progress. All areas seen around the home are clean and rooms personalised and decorated according to the wishes of those people occupying them. This has been welcomed by those living at the home and many favourable comments were made in surveys. Appropriate signage is in place to assist those people with dementia to identify rooms and lavatories. However, there is a lack of storage space for trolleys and hoists which are at present stored in bathrooms and corridors which could pose a hazard depending on the assessment of risk. The service should review storage facilities. Care Homes for Older People Page 17 of 23 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. Staff in the home are trained and are in sufficient numbers to fill the aims of the home and meet the changing needs of residents. Evidence: Staffing rotas are in place and assistance to achieve National Vocational Qualifications (NVQ) is provided. Staff files kept in the home evidence the induction process provided for new starters. Initial training such as infection control, manual handling, first aid and medication are provided. After induction, candidates are assessed for suitability to move onto NVQ training. Staffing in the home has improved through successful recruitment. Continuity of care is better. The residents know the staff very well and observation showed that they provide a personal and professional service. Staff are seen to attend to people discreetly. Visitors are welcomed into the home. Comments from surveys relayed satisfaction with the care from all staff. Care Homes for Older People Page 18 of 23 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 management of the home is based on openness and respect. The service has quality assurance surveys in place so that people are assured that the overall conduct of the home is taking into account their views. Peoples opinions are more central to how the home develops and reviews its practice, and the service is developing appropriate ways of making sure they get things right. So, people have confidence in the care home because it is run and managed well. Evidence: The manager holds the required qualifications and through experience is more confident to manage the service. She is supported by the organisations management structure to plan business and monitor the quality of care provision. She finds out what people like by talking to them, involving them in their care and holding resident meetings so that any issues can be discussed. The manager is aware of the importance of making people safe and has improved the assessments for use of bed rails. The AQAA contains clear information that is supported by evidence and informs us of Care Homes for Older People Page 19 of 23 Evidence: changes made to the service to make improvements. The organisation monitors itself through monthly visits by the area manager, quality audits (last one seen dated 2007), surveys to relatives and residents. External audits are conducted by the Primary Care Trust for medication and infection control. Elements of these could be incorporated into a regular managers quality audit of the service to ensure staff practice complies with policies and procedures. People are supported to manage their own money and good records are kept. People who use the service say that they trust the staff and feel safe in the home. One stated about the management The home is run efficiently and Consistently offers good care. Care Homes for Older People Page 20 of 23 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 21 of 23 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 1 19 To risk assess the storage of equipment in bathrooms and corridors. To review the storage provision of these items in the home. The service should provide evidence of an annual quality audit by the provider. The collation of survey results should be formally recorded and an action plan developed to feed back to people who use the service. 2 3 33 33 Care Homes for Older People Page 22 of 23 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. 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 23 of 23 - 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!