Inspection on 26/11/07 for Goodwins Hall Care Home

This inspection was carried out on 26th November 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Goodwins Hall Care Home 31/01/07

Goodwins Hall Care Home 14/11/05

Goodwins Hall Care Home 29/07/05

Goodwins Hall Care Home 06/12/04

Goodwins Hall Care Home 15/07/04

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Goodwins Hall Care Home Goodwins Road Kings Lynn Norfolk PE30 5PD Lead Inspector Mrs Geraldine Allen Unannounced Inspection 26th November 2007 09:30 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 Goodwins Hall Care Home DS0000015639.V355540.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. Goodwins Hall Care Home DS0000015639.V355540.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Goodwins Hall Care Home Address Goodwins Road Kings Lynn Norfolk PE30 5PD 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) 01553 777994 01553 777996 annette.white@hallmarkhealthcare.co.uk Hallmark Healthcare (Kings Lynn) Limited Mrs Annette White Care Home 75 Category(ies) of Dementia - over 65 years of age (1), Old age, registration, with number not falling within any other category (65), of places Physical disability (10) Goodwins Hall Care Home DS0000015639.V355540.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Sixty five (65) older people may be accommodated, two of whom, who will be named in the Commission`s records, have a diagnosis of dementia. Ten (10) younger adults, who will be named in the Commisson`s records, may be accommodated. 31st January 2007 Date of last inspection Brief Description of the Service: Goodwins Hall is a care home with nursing, providing personal care and accommodation for 65 older people and 10 people with a physical disability. It is owned by Hallmark Healthcare (King’s Lynn) Limited, which is part of the Hallmark Healthcare group. The home is located on the edge of the town of King’s Lynn, close to shops, pubs and other amenities. The home consists of a 2-storey building, with nursing services provided on the first floor. All the bedrooms are en-suite and the majority are used for single occupancy, however there are two double rooms. There are 2 passenger lifts. There is a large car park to the front of the building and extensive grounds around the building, which are accessible to service users. The home is set in two acres of landscaped gardens with walkways and seating areas among the rose beds. The manager, Mrs White, stated that the current fee range for care and accommodation was between £400:00 & £500:00 for residential clients and between £500:00 & £650:00 for nursing clients. Prospective residents or their representatives are advised verbally of the applicable fee rate at the time of the pre-admission assessment. The fee rate is also included in the contract of residence and residents or their representatives are given full details of any additional charges that apply. Goodwins Hall Care Home DS0000015639.V355540.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place during the day of 26th November 2007. The home manager, Mrs Annette White, completed and returned an Annual Quality Assurance Assessment, together with additional information about the service and its functions. On the day of inspection, further information was obtained by looking at records, speaking with staff, residents and a visitor to the home and also touring the building. A viral infection at the home meant that fewer visitors came to the home. An Expert by Experience, arranged through Age Concern, also took part in the inspection and spent time speaking with residents about their experiences at the home. Comments contained within her report have also been included in this report. There was evidence that people are well cared for and happy at Goodwins Hall. They are able to take part in activities and pursuits that reflect their own choices and preferences. No requirements or recommendations have been made as a result of this inspection. What the service does well: What has improved since the last inspection? Goodwins Hall Care Home DS0000015639.V355540.R01.S.doc Version 5.2 Page 6 Two signatures are now obtained for all financial transactions undertaken on behalf of the residents. This has helped to reduce the risk of possible financial abuse. Written interview notes are now kept for all interviews conducted at the home. This is regarded as best practice and provides a framework for good people management. The new lifestyle care plan is in use and enhances the care plans kept about each resident. The addition of this care plan ensures an holistic approach to each person’s individual care. What they could do better: 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. Goodwins Hall Care Home DS0000015639.V355540.R01.S.doc Version 5.2 Page 7 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 Goodwins Hall Care Home DS0000015639.V355540.R01.S.doc Version 5.2 Page 8 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): 1, 2, & 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People receive sufficient information to help them make an informed choice to move into the home. All people have a full assessment of their needs before they move into the home. EVIDENCE: Mrs White confirmed that all prospective residents and/or their representatives are given a copy of the home’s brochure at the initial enquiry. The Statement of Purpose and Service User Guide were seen clearly displayed in the entrance hall. Mrs White said that all residents were given an information folder, containing information about home life and their contract, when they are admitted to the home. Three care plans were looked at and showed that a full needs assessment was completed for each person before they moved into the home. Goodwins Hall Care Home DS0000015639.V355540.R01.S.doc Version 5.2 Page 9 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, 10 & 11 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Resident’s individual plans clearly record their personal and healthcare needs and detail how they will be delivered. Staff respond appropriately and sensitively in all situations involving personal care, ensuring that it is conducted in privacy. The home arranges training on health care topics that relate to the health care needs of the residents. The home has developed efficient medication policy, procedure and practice guidance. Quality assurance systems confirm that policy is put into practice. EVIDENCE: Each care plan was put together following a standardised format. The plans were well constructed and easy to extract information from. The care plans provided good clear information about each person’s needs and how they should be met. There was evidence of regular, timely reviews. Goodwins Hall Care Home DS0000015639.V355540.R01.S.doc Version 5.2 Page 10 Daily records were seen and these provided a good commentary on the experiences of daily living for the person. Care needs to be taken to ensure all entries are legible. The Medication Assessment Record charts for three residents were looked at. These showed that all administrations were signed for and refusals fully recorded. A risk assessment for one resident self-medicating was seen. The records showed the medicines given to the resident. The nurse on duty confirmed that the risk assessment is regularly reviewed to ensure the arrangements were appropriate. The administration of medicines was observed on each floor. In both cases good procedures were seen. Records were only completed after ingestion had been confirmed. A team leader on the ground floor described the arrangements for controlled medicines and the records were looked at. Stock was checked against records and this was correct. The team leader responsible for dispensing medicines in the residential part of the home said she has recently completed advanced medicine training and confirmed that she attends regular update medication training. The opportunity was taken to sit in on the staff handover on the ground floor. The handover was very thorough, with all residents being referred to. There were good discussion taking place, with exchanges of views and opinions being encouraged by the senior staff. Staff demonstrated an excellent knowledge of the individuals, their needs, interests and personality. There was also evidence that staff maintain good contacts with relatives. Evidence was seen that the service refers appropriately to other health professionals and that instructions given were followed. Staff have received training in the Gold Standard Framework for palliative care. Interactions between residents and staff were observed as much as possible although there were restrictions in place due to a viral illness in the home. In all cases, staff spoke with respect. Care was given behind closed doors, ensuring dignity and privacy were protected. Goodwins Hall Care Home DS0000015639.V355540.R01.S.doc Version 5.2 Page 11 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 & 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home has sought the views of the residents and considered their varied interests when planning the routines of daily living and arranging activities both in the home and the community. The routines, activities and plans are resident focused, regularly reviewed, and can be quickly changed to meet individuals changing needs, choices and wishes. Outcomes for people who use the service are positive. Mealtimes are flexible and relaxed, staff are patient and helpful, and allow individuals the time they needed to finish their meal comfortably. EVIDENCE: An expert by experience was present during the day and spoke with those residents well enough. The expert by experience said that residents had expressed general satisfaction with life at the home but were finding the restrictions due to the virus irksome. They told her that they were satisfied with the care they receive and said the food was excellent. Goodwins Hall Care Home DS0000015639.V355540.R01.S.doc Version 5.2 Page 12 During the course of the inspection a Care Dog arrived to spend time with the residents. The dog handler was welcomed to the home and spoke about how much residents enjoyed her visits. The activities organiser was on leave at the time of inspection and, due to the virus, other activities had been cancelled. However, good evidence was seen that real efforts are made to understand each person’s interests and to provide opportunities for these interests to be followed. Good records to this effect were seen. Mrs White gave good examples of how people’s personal choices and preferences are sought and acted upon. She described one persons request to move to another room and this room was being deep cleaned and spot decorated ready for the move by the end of the week of inspection. A bird table and feeders were being put in place for her enjoyment. Because of the virus in the home, normal dining arrangements were not in place. Lunch arrangements were discussed with a team leader, who said that at the time of inspection most residents were eating in their rooms although normally 10 residents eat in the dining room on her unit. Support with eating was discussed and the team leader said that support is provided either in the resident’s own room or discreetly in the dining room. One resident was seen being assisted to eat by a carer in her own room. The carer was sitting beside the resident and was talking with her whilst assisting. Goodwins Hall Care Home DS0000015639.V355540.R01.S.doc Version 5.2 Page 13 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 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaints procedure is clearly displayed throughout the service. All complaints made and the actions taken in response to them are fully recorded. A review of the number and nature of complaints made is used as part of the quality assurance procedures in use at the service. Policies and procedures regarding Safeguarding Adults are available to staff and give them clear guidance about what action should be taken. All Staff working within the home are fully trained in Safeguarding Adults and know how to respond in the event of an alert. EVIDENCE: Two complaints have come to the notice of the Commission since the last inspection and both were discussed with Mrs White. In each case, there was evidence that Mrs White had followed the home’s complaints procedure. As a result of one of the complaints, various inspections, including by the fire service, had taken place. This matter has now been rectified. The home’s complaint procedure is displayed and a copy provided to all residents and their relatives at the time of admission. The home has policies in place about safeguarding people and staff know about the whistle blowing procedures. All staff have received safeguarding adults training and this is updated each year. Goodwins Hall Care Home DS0000015639.V355540.R01.S.doc Version 5.2 Page 14 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, 20 & 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The living environment is appropriate for the particular lifestyle and needs of the residents and is homely, clean, safe and comfortable and well maintained. It is fully accessible throughout to people with physical disabilities, adaptations and specialist equipment are designed to fit within the homely environment. The management has a proactive infection control to ensure that infections are minimised. The home is well lit, clean and tidy and smells fresh. EVIDENCE: All areas of the home were seen although occupied bedrooms were not entered. All parts of the home were in a good state of decoration, clean and tidy. There were no unpleasant odours detected. Lighting levels throughout the home were good. All corridors were clear of clutter and fire exit routes Goodwins Hall Care Home DS0000015639.V355540.R01.S.doc Version 5.2 Page 15 unobstructed. All fire doors were functioning properly and held back on magnetic catches. No doors were seen wedged open. Mrs White said the home had recently won the Hallmark National Award for Gardens, judged by RBS. There are views across the gardens from all resident’s bedrooms and communal rooms. The arrangements for residents who wish to smoke were discussed with Mrs White. The designated facilities are located on the 1st floor. However, during the recent diarrhoea and vomiting outbreak, residents living on the ground floor had to use the kitchen garden to smoke. On the day of inspection, the normal facilities were again available. Goodwins Hall Care Home DS0000015639.V355540.R01.S.doc Version 5.2 Page 16 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 & 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The service has a well developed recruitment procedure that has the needs of people who use the service at its core. The recruitment of good quality carers is seen as integral to the delivery of an excellent service. The service employs good staffing levels so that staff are available at all times to support the needs, activities and aspirations of the people using the service. Management prioritise training and support staff to undertake external qualifications beyond the basic requirements. This is in addition to statutory training requirements. The service ensures that all staff within its organisation receives relevant training that is targeted and focused on improving outcomes for people who use services. EVIDENCE: Staff rota’s were provided and showed that the home employs sufficient staff to meet the needs of residents. On the nursing unit, including qualified staff, six staff are employed between 07:00 and 21:00. The residential team employed five staff between 07:00 & 21:00. In addition, ancillary staff are employed in sufficient numbers. Two staff files were looked at in detail. The files were well put together. All required documents were in place and clearly recorded. There was evidence of Goodwins Hall Care Home DS0000015639.V355540.R01.S.doc Version 5.2 Page 17 best practice, for example there were interview notes and a recruitment checklist in use. The staff files provided good evidence of robust procedures. Based on the Monthly Statutory Training Record dated 28/10/07, of the fortyfour care staff employed at the home, twenty-nine have obtained NVQ2 & eight NVQ3. Six are currently working toward NVQ2 and two towards NVQ3. Domestic, kitchen and beauty therapy staff have also achieved NVQ awards. The two remaining kitchen staff are currently working towards the award. The home has achieved 84 NVQ trained staff. All new staff receive induction training. There is an induction day that includes fire, moving & handling and safeguarding adults training. The new member of staff holds the induction training pack. The home uses computer-based training for some elements. The training record also shows that the home has achieved 90 for food awareness, 100 moving and handling, 100 fire safety, 100 health & safety and 87 dementia care. In addition, 70 have completed Control Of Substances Hazardous to Health, 66 1st Aid, Infection control by three nurses and the Gold Standard Framework for palliative care by four nurses. Goodwins Hall Care Home DS0000015639.V355540.R01.S.doc Version 5.2 Page 18 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, 36 & 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The registered manager has the required qualification and experience, is highly competent to run the home and meets its stated aims and objectives. The home has efficient systems in place regarding individual’s money including record keeping. Staff receive regular supervision, training and team meetings. Spot checks and quality monitoring systems provide management evidence that practice reflects the home’s and organisation’s policies and procedures. The home has a comprehensive range of policies and procedures to promote and protect residents’ and employees’ health and safety. Staff are trained, understand, and consistently follows these. There is full and clearly written recording of all safety checks and accidents, including analysis. Goodwins Hall Care Home DS0000015639.V355540.R01.S.doc Version 5.2 Page 19 EVIDENCE: Mrs White is a very experienced and well-qualified manager. She has completed all relevant training to ensure she is conversant with current legislation, Regulations and Standards. The home operates a very robust quality assurance process that includes monthly audits of functions. A full audit is completed every two months, with the company head office doing a satisfaction survey of all residents and their relatives twice a year. Mrs White also speaks regularly with visiting professionals and others to ensure she obtains their views about the quality of the home. She also provides a questionnaire for people who visit the home for short stays so that their views are obtained. Mrs White said a new maintenance manual was being introduced that would include all tasks and the frequency of completing to ensure the quality of the environment is maintained. Personal allowances are looked after by the service for forty-three residents. The records for one resident were checked against the monies held and these were correct. The records show full details of all transactions and two signatures are obtained for each transaction. There was evidence that the records and monies are checked and audited bi-monthly. All staff receive supervision that is fully recorded. Supervision takes place at least six times per year. Staff also attend regular staff meetings, where they are able to exchange views and opinions. Mrs White has completed a two-day health & safety course. The company also employs a health & safety consultant. Mrs White provided sight of a monthly health & safety schedule that checks all areas and functions of the home. There is also a health & safety committee that meets bi-monthly. The minutes were seen. As part of the companies audit procedures, health & safety is audited monthly. The last full audit was completed 6 November 2007, and a copy of the outcomes was provided. This showed a 99 compliance rate. Mrs White also confirmed that all risk assessments are up to date. The last fire training took place 06/11/07 and achieved a 100 attendance. The training was run for five sessions at different times of the day and evening to ensure all staff would be able to attend. Further, six-monthly training takes place using the Computer Based Training system. The last fire officer’s visit was October & November 2007 at Mrs White’s request. Risk assessments were completed for all residents wishing to keep their doors open at night and Door Guards have been fitted where necessary. Goodwins Hall Care Home DS0000015639.V355540.R01.S.doc Version 5.2 Page 20 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 3 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 3 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 4 X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 3 X 4 Goodwins Hall Care Home DS0000015639.V355540.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Goodwins Hall Care Home DS0000015639.V355540.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 Goodwins Hall Care Home DS0000015639.V355540.R01.S.doc Version 5.2 Page 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. 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