Inspection on 23/04/09 for Hazeldene Nursing Home

This is the latest available inspection report for this service, carried out on 23rd April 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hazeldene Nursing Home 08/05/06

Hazeldene Nursing Home 27/02/06

Hazeldene Nursing Home 03/11/05

Hazeldene Nursing Home 06/09/05

Hazeldene Nursing Home 22/09/04

Hazeldene Nursing Home 03/06/04

Hazeldene Nursing Home 03/03/04

Extracts from inspection reports are licensed from CQC, this page was updated on 15/11/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Hazeldene Nursing Home 84 Poole Road Darnall Sheffield South Yorkshire S9 4JQ     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: Stephanie Kenning     Date: 2 3 0 4 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 24 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Hazeldene Nursing Home 84 Poole Road Darnall Sheffield South Yorkshire S9 4JQ 01142425757 01142421312 none Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : S & S Health Care care home 60 Number of places (if applicable): Under 65 Over 65 60 dementia Additional conditions: Date of last inspection Brief description of the care home 0 Hazeldene is a 60-bed home for older people. It is in a residential area of Sheffield with good access to public services and amenities (e.g. bus services, shops, pubs, etc). It is over two floors both serviced by a lift. All the bedrooms are single and there are a suitable number of lounges and dining rooms. The gardens are landscaped and it has a small car park. A range of information including how to obtain a copy of the last inspection report was available on the notice board in the entrance to the home. The weekly fees are available from the manager of the service. The home charges extra for chiropody, toiletries, clothing, telephone, holidays and hairdressing. Care Homes for Older People Page 4 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced key inspection carried out by Stephanie Kenning, Regulation Inspector. The site visit took place between the hours of 09:30 and 17:15 on the 23rd April 2009. The Acting Manager, Shelagh Bellamy, was present throughout the visit and both the providers attended for feedback at the end of the day. Prior to the visit the service had submitted an Annual Quality Assurance Assessment (AQAA), which detailed what the home was doing well, what changes had been made and plans for improving the service over the next twelve months. Information from the AQAA is included in the main body of the report. Ten completed questionnaires were returned to CQC from people using the service or Care Homes for Older People Page 5 of 24 their relatives, staff working at the home and visiting health professionals. These gave us information about the service from those individual perspectives, and comments and feedback from these have been included in the report. On the day of the visit opportunity was taken to make a tour of the premises, inspect a sample of care records, check records relating to the running of the home, and check some of the policies and procedures. Time was spent observing and interacting with people living at the home and their visitors, and staff members, and they contributed to the findings. The inspector checked all of the key standards and some additional standards, particularly those relating to the requirements outstanding from the homes last inspection in April 2007. We have reviewed our practice when making requirements, to ensure national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this reports recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future if a requirement is repeated, it is likely that enforcement action will be taken. The inspector wishes to thank the people at the home for their time, friendliness and co-operation throughout the inspection process. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 7 of 24 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 24 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service have information about the home and opportunities to visit before they make a decision. Their needs are assessed and planned for before they are admitted. Intermediate care is not provided at this home. Evidence: We wanted to understand peoples experiences when they decide whether to choose this care home, and what it is like for people if they did decide to move there. We spoke to some people already living in the home about their experiences, and to staff and visitors. We looked at comments made on the surveys returned to us, and looked at information the home gives to people and how they assess whether they can meet peoples needs. People were happy with the amount of information given to them before admission, allowing them to consider the best choice for them. Before admission people were Care Homes for Older People Page 9 of 24 Evidence: assessed by a manager or nurse to ensure that the home could meet their needs. The assessment covers all required areas, but we saw some that had not been signed or dated so we do not know when they were carried out. People said that there were opportunities for them to visit the home before choosing, and if they had not been able to visit, usually a relative would visit on their behalf. Care Homes for Older People Page 10 of 24 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People usually receive the personal and health care they need, and medication systems are generally safe. Evidence: We wanted to understand how people had their health and personal care needs met. We spoke to people in the home, observed practices in communal areas such as mealtimes, and looked at records and medication systems. We looked at the information people had put in the surveys they sent to us, including those from other health professionals that visit the home. Most people praised the home and the staff for the care that they give. One person said, very loving and at hand when you need them. Another said, staff try their utmost to do their job well, doing other duties when needed such as cleaning. People also felt that they got good medical attention and assistance for all their health needs from GPs, community nurses and other visiting health professionals. A relative commented, they are good at acknowledging individual needs, and aware of changes Care Homes for Older People Page 11 of 24 Evidence: in medical conditions, with a speedy response when medical intervention is required. Always a friendly welcome for visitors. Some people did want more assistance, one with hearing aids, and another more frequent toileting, which the staff were trying to address by paying more attention to detail, though generally people were satisfied with the care. People living at the home were well presented and mainly appeared calm and content or occupied. Personal care was carried out in privacy and people were observed to be treated with respect. A new care plan system had been introduced during the past 6 months and care plans seemed to be detailed and included the areas of concern identified in assessments. Plans seemed clear, which would be easy for staff to follow, and were very individualised. There were risk assessments linking into individual care plans to improve the safety of people in the home. The daily recordings were not as specific, for example there were many broad statements such as, good diet. There was insufficient evidence within the daily records to say if people had been taken to the toilet sufficiently to prevent accidents, or if someone had been given some attention with a hearing aid. Some statements were more detailed and could be used to illustrate to others how to provide evidence of the detailed care that had been given. Since the introduction of the new plans, families have been invited to be involved in them, where appropriate, and some relatives liked having this involvement as it showed them just what was needed to care for their relative. Staff have received training in care planning and have become more aware of observing people and reporting changes, so that peoples care needs are up to date. Medication is mainly stored, recorded and given safely, with all aspects of medication having been reviewed in recent months. The recording of paracetamol given as required did not have an actual time specified because the space was too small, and was rectified during the visit by putting the time on the back of the chart. This should be reviewed and clarified to ensure people are not given doses too close together. Care Homes for Older People Page 12 of 24 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home have opportunities for socialising and are provided with suitable choices including meals. Evidence: We wanted to understand peoples daily experiences and opportunities for leisure. We observed the routines and the activities taking place and spoke to people living in the home, staff and visitors. We looked at the record of activities, routines and meals, and at the comments made in the surveys sent to us. People were taking part in activities during the visit including a large group doing exercises to music and individual activities. Generally people liked the activities, and wanted more. There are plans for the activity co-ordinator to do training to develop the role, and to recruit to a second post so that someone is available 5 days a week. People expressed their wish for a minibus so that they could go out more often, instead of having to plan and book ahead, particularly as the warmer weather was approaching. Some people also expressed a wish to go on holiday. There are plans to develop a sweet shop and a bar area in the home, and to purchase signs to aid people Care Homes for Older People Page 13 of 24 Evidence: find their way around the home. Relatives felt welcomed and encouraged to participate in activities at the home and on outings. They wanted to have an area where they could spend private time with their relative, and perhaps make a drink. There was positive feedback about the meals with most people usually liking the meals. A small bites menu is on offer helping to supplement people with small appetites or who need extra calories. The home has been awarded 5 stars for their food service from the Environmental Health inspection, showing an excellent standard in food hygiene. Care Homes for Older People Page 14 of 24 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home are protected by the policies and procedures in place. Evidence: We wanted to understand how people were protected from abuse or neglect and how the service responds to complaints. We looked at records, policies and procedures and spoke to people living and working at the home. People generally knew how to make a complaint or who to speak to if they were unhappy about something. Most people said that their problems were sorted out quickly, that staff tried hard to get things right. The complaints procedure was available for people who wished to use it and there had been 4 complaints last year, all of which were upheld. No complaints have been received this year, though there has been a referral through adult safeguarding procedures that was not upheld. Staff have had recent training in awareness of safeguarding issues and further training is planned. Peoples finances are managed safely with clear accounting procedures seen. Care Homes for Older People Page 15 of 24 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home that is safe, comfortable and meets their needs. Evidence: We wanted to understand what it was like to live in the premises and whether they were appropriate for the lifestyles of the individuals living there. We were shown around the premises including some of the bedrooms when people invited us in. We talked to people about the home and looked at comments made in the surveys sent to us. Most people were very happy with the home and their rooms, and felt that it was usually or always clean and fresh. One person said It is nice to live here. A relative said The home is always pleasant. Some rooms had been refurbished including furniture and decor since the previous visit, with more planned and using dementia research to influence choices to help people find their way around, and for calm and stimulating areas. Within the refurbishment of the bedrooms lockable facilities had been provided as required at the previous visit. In addition new refuse bins had been provided that had secure lids as required for the health and safety of people in the home. Care Homes for Older People Page 16 of 24 Evidence: Management had carried out an audit on the equipment in the home to ensure that it was up to date and in good working order to help with tissue viability. This had resulted in the purchase of many new profiling beds and mattresses as well as new bedlinen. The use of some rooms, bathrooms and storage areas was discussed and it was agreed that they would be looked at within the refurbishment program and within the plans for care of people with dementia. Care Homes for Older People Page 17 of 24 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by staff who are recruited to thorough procedures and are trained to do their jobs. Evidence: We wanted to understand how staff were recruited and trained to ensure that they could carry out their jobs well. We talked to people living at the home, visitors and staff, including the acting manager and owners. We checked the recruitment files and training records to see if procedures had been followed. We looked at the information provided on the surveys and noted the comments people had made. People at the home liked the staff and felt that they worked hard. One relative said during this time we have observed kindness and commitment from all the staff. We feel this gives us peace of mind knowing that he is not only cared for but loved. Someone living at the home said, the staff are very friendly. One person said, there could be more staff, and they need up to date training in areas such as dementia and manual handling. Another person said, the home is well run now, things are more organised and staff know what they are doing. There are a mixture of nurses and care staff looking after people at the home, some who have been in post many years. The home was busy on the day of the visit and Care Homes for Older People Page 18 of 24 Evidence: some people did comment that there were times when they felt that more staff were required. The staff rota showed that they met their minimum staffing levels, and management explained that they were reviewing staffing levels according to the dependency of people at the home. Recruitment files had been reorganised and showed that all staff have thorough recruitment checks before being employed. People complete an induction program when they start work at the home so that they are familiar with the homes procedures. The files also showed that people had received training in a range of relevant areas during the last 6 months including some dementia and manual handling training. The training matrix identified which members of staff required updates and further training sessions were planned. Over 50 of staff have achieved level 2 NVQ in care or above. Overall the current management felt that they had done a thorough audit on the staffing areas at the home and had identified some areas to work on such as updating training, development of nurses skills in management, and developing the role of the senior care worker. Some areas such as implementing staff meetings, looking at areas of responsibility and accountability, and a structured supervision programme with individuals, was awaiting the start of the newly recruited manager. Care Homes for Older People Page 19 of 24 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed appropriately and people are protected by the systems put in place. Evidence: We wanted to understand how the home was managed and ensuring the quality of service for the people living there. We talked to people in the home, visitors and staff including the acting manager and the owners.We looked at some records and comments from the surveys sent to us. During the past few months there has been a change in management with the previous manager leaving and an acting manager in post awaiting the recruitment of a new manager. Someone has been appointed to the post and is due to start work in the near future. In addition to the acting manager assistance has been sought from a management consultant and from another provider to help to move the home forward. Care Homes for Older People Page 20 of 24 Evidence: A review has taken place of all areas of the homes management and many systems have been revamped and revised. There has been a focus on involving people at the home and their relatives, asking them to complete surveys and encouraging their input. More external health professionals have been used to ensure the health needs of people are being met, and staff have been encouraged to observe and report changes. There are plans to improve many systems and areas in the home and whilst some have been started , others are awaiting the input of the new manager. A quality monitoring system has been put in place for the new manager to follow, and the providers of the service have become more involved in ensuring that the home is running well. Records are kept as required, such as accidents, fire checks, maintenance, and financial. Safe working practices are followed, including fire drills, health and safety training, secure storage of hazardous substances and written procedures to follow. Care Homes for Older People Page 21 of 24 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 22 of 24 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 Arrangements must be put in place to ensure medication records are adequately maintained by a timely entry on the medication administration record including stating the time given for those medicines prescribed to be given as and when needed. This is to prevent medicines being given too close together and will help to ensure peoples health needs are met safely. 31/08/2009 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 2 3 7 Assessments should be signed and dated so that it is clear when they were completed. Daily recordings need to be more specific about what has happened in order to evidence the care given. Care Homes for Older People Page 23 of 24 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 24 of 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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