Inspection on 10/05/05 for Hadfield House

This inspection was carried out on 10th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Hadfield House 02/05/07

Hadfield House 08/12/05

Hadfield House 04/10/04

Hadfield House 01/06/04

Hadfield House 24/10/03

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

CARE HOMES FOR OLDER PEOPLE Hadfield House 39/41 Queens Road Oldham OL8 2BA Lead Inspector Sandra Bennett Announced 10th May 2005 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 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. Hadfield House Version 1.10 Page 3 SERVICE INFORMATION Name of service Hadfield House Address 39/41 Queens Road Oldham OL8 2BA Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0161 620 0348 Masterpalm Properties Limited Mrs Kathleen Adshead CRH 28 Category(ies) of DE(E) Dementia - over 65 - 8 registration, with number MD Mental Disorder - 3 of places OP Old Age - 21 Hadfield House Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: The home is registered for a maximum of 28 service users to include: up to 3 service users in the category of MD (Mental disorder excluding learning disability or dementia under 65 years of age). Up to 8 service users in the category of DE(E) (Dementia over 65 years of age). Up to 21 service users in the category of OP (Old age not falling within any other category). No service user to be admitted to the home who is under 55 years of age. The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Date of last inspection 4th October 2005 Brief Description of the Service: Hadfield House is a Victorian detached house, situated one ile fro Oldham Town Centre, close to local amenities and public transport. The home is registered to provide care for up to 28 service users in the following categories, Old Age, Dementia and Mental Disorder. Accommodation consists of two large lounges and a lounge/dining room. There are 26 single bedrooms, 17 of which have ensuites, an additional eight single bedrooms share an adjoining ensuite. There are large well-established gardens to the front of the property, which overlook the local park. Seating areas are provided for service users. Hadfield House Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unscheduled inspection took place on 10th May 2005. Time was spent talking to eight service users, three staff and one visitor. The case files of four service users were looked at in detail, looking at their experiences in the home from their time of admission. Records of care were examined, staff duty rotas, personnel files, financial and administration of medication. Quality assurance questionnaires had been forwarded to health and social care professionals, service users and their relatives. Eleven service user questionnaires were returned, confirming they were happy with the care at the home. Two service users reported they would prefer more activities. Four GP’s returned completed forms; all were satisfied with care and communication given by staff. Concerns were raised by one GP over the ordering of medication. Two health care professionals also reported on how well the home communicates with them on the progress of the service users. All relatives interviewed reported that care delivery was good and that staff were thoughtful. At the end of the inspection the home was given advice on how to address any matters highlighted in this report. What the service does well: The home’s manager has a number of years’ experience and holds a NVQ level 4 and the registered manager’s award. Staff turnover is low and they are supported through the supervision process in order to identify their training needs and personal development. Staff training is given a high profile, with over 50 having achieved NVQ level 2. Service users reported they were consulted on developments in the home. Hadfield House Version 1.10 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Hadfield House Version 1.10 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 Standards Statutory Requirements Identified During the Inspection Hadfield House Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3, 4 & 5 The home was aware of service users’ needs prior to their admission. Service users were informed of their rights and responsibilities within the home and encouraged to visit prior to their admission. EVIDENCE: The service user guide provides information on facilities and services in the home. A summary of the results of service user questionnaires was also included. Service users interviewed confirmed they were encouraged to make trial visits and overnight stays in order to assess if the home could meet their needs. Contracts of residency were responsibilities of both parties. in place and stipulated the rights and Assessments of service users are obtained from professional agencies prior to their admission in order to identify if the home can meet the needs of the service user. Hadfield House Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 & 10 The health care and privacy needs of service users were met in-part. There was inconsistency in recording the assessed needs of service users in care planning. The administration system for dealing with medication protects service users. EVIDENCE: The care plans of four service users were examined, most of which reflected the assessed needs of the service users. In one instance, the needs of the service user was not adequately reflected in care planning. The outcome for the service user was not affected, however inconsistencies in recording may result in failure to provide appropriate care if not addressed. There was evidence that service users had been involved in developing their care plans. Hadfield House Version 1.10 Page 10 The accident book showed a number of falls sustained by service users, these had been well documented and had been included in daily reports and updated on care plans if required. There was evidence of nutritional screening on admission and follow up visits from health care professionals with reviews of care planning taking place on a monthly basis. Observation of the administration of medications found them to be administered at the prescribed time with all staff having received training in medication procedures. At interview staff gave examples of how they maintain service users’ privacy and dignity in daily routines of bathing and personal care. Service users felt that staff were sensitive to their needs. Hadfield House Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 & 15 Although service users did have choices in their daily lives, further development is needed in seeking the views of service users on the size of portions provided at meal times. The layout of the dining room needs improvement. EVIDENCE: Residents said that they were able to get up and go to bed when they wished. Some service users were able to go out of the home unaccompanied, others with relatives and friends. Staff were knowledgeable regarding service users preferred routines. An activity co-ordinator had been employed for ten hours a week to provide stimulation for service users, in addition to that undertaken by staff when time allows. There was evidence in the home of church visits in order to provide for the spiritual needs of service users. Hadfield House Version 1.10 Page 12 The inspector joined service users at lunch time and found the meal served was tasty and nutritional. Only small portions were served to all the service users in the home. The inspector acknowledges that staff offered additional helpings at the end of the meal, however this does not account for those service users who may be reluctant or find it difficult to ask. The more vulnerable service users interviewed were too confused to discuss this issue, therefore appropriate assessments of service users’ dietary needs should be undertaken and recorded on care plans. No alternative choices were offered or reflected on the menus. Whilst there was no evidence that service users had lost weight, issues about food does have an impact on the quality of life for service users. The congeniality of meal times could be improved by the use of tablecloths, napkins and individual teapots for service users. Hadfield House Version 1.10 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, 17 & 18 Service users had their legal rights protected and safeguards were in place to ensure their protection from abuse. Service users were confident that their complaints about the home would be addressed. EVIDENCE: The home’s complaint procedure stipulates timescales for action. At interview service users were aware of whom they should complain to. A record is kept of complaints made, outcome and any action taken. Neither the home nor the CSCI had received a complaint since the last inspection. Adult protection and whistle blowing policies were in place. Staff at interview were aware of these procedures and their responsibility in reporting any such event. Training had been provided in the protection of vulnerable adults. Hadfield House Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 23, 24, 25 & 26 The home is clean, well maintained and without odour, some refurbishment has taken place. Additional refurbishment is required in the dining areas and lighting. Service users’ rooms were personalised and provided with aids to promote their independence. Suitable bathing and toilet facilities are provided throughout the home. EVIDENCE: Garden areas outside of the home are well maintained and provide seating for service users. To the rear of the property Groundwork Trust has completed a mural of a landscape, which the service users said they enjoyed. The home was clean and tidy and free from odours. Many of the service users had personalised their bedrooms, providing a homely appearance. Hadfield House Version 1.10 Page 15 Certain areas of the home had long life low wattage bulbs that gave a dim light. A number of service users in the home have poor eyesight, therefore this issue must be addressed for their safety and comfort. The home has continued with their planned refurbishment programme with some carpets being replaced and bedrooms redecorated. There are two lounge/dining rooms and an additional lounge. The lounge to the rear of the property and the large front lounge have a less homely appearance and an institutional feel, with chairs being arranged round the walls. A dining table is available in the large lounge, offering the choice of seating to service users. The chairs to the table were wood and without cushions, making it uncomfortable for service users. A small TV is provided, with service users saying they were not interested because they could not always see the TV. There is a need for the lounges to be included into the home’s refurbishment plan. Bathroom and toilets were provided with sufficient aids to promote the independence of service users. Hadfield House Version 1.10 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 & 30 Staffing levels in the home were sufficient to meet the needs of service users. Staff recruitment and training were not robust enough to provide adequate protection for service users. Staff employed received training and supervision in order to meet the needs of the service user group. EVIDENCE: The manager provided evidence that a range of training had been provided for staff, including infection control, dementia care, protection of vulnerable adults and basic foods hygiene. Each staff member has a personal training file. Over 50 of the staff have undertaken training to NVQ Level 2. Interviews with staff provided evidence that they are supervised on a regular basis, both on care delivery and their professional development. An established staff team provide consistency of care for service users. Criminal Records Bureau checks had not been requested for two members of staff prior to commencement of employment. References were not in sufficient detail and, in one instance, had not been requested till after the staff member had started work. Hadfield House Version 1.10 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 34, 35, 36, 37 & 38 The home is well run in the best interests of service users by a competent well managed staff team. Service users are safe and the finances are protected. Service users do have a say in how the home is run. EVIDENCE: The manager is qualified to NVQ level 4, registered manager’s award, and has a number of years’ experience in the care of the elderly. There is little changeover of staff. Staff are well supported through the home’s supervision process. It is company policy to undertake regular checks of the environment and equipment in respect of health and safety. Hadfield House Version 1.10 Page 18 Staff were observed using safe working practices. Service users and staff confirmed that regular meetings took place in order to involve them and take on board their views on developments in the home. Four service users take responsibility for their own finances with most finances being managed by families. Records were examined of those monies the home retains and were found to be accurate and corresponded with monies held on behalf of service users. Quality assurance questionnaires had been sent out by the home to family’s service users and health professionals. Hadfield House Version 1.10 Page 19 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. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 2 3 3 3 3 3 2 3 STAFFING Standard No Score 27 3 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 3 3 3 3 3 2 3 Hadfield House Version 1.10 Page 20 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 7 Regulation 15 Requirement The registered person must ensure that all aspects of service users needs are included on care plans. The registered person must ensure that individual nutritional assessments are undertaken to include the views on those service users who wish to have small portions of food. The registered person must ensure that a choice of meals must included on the menus which are displayed for service users to peruse. The registered person must ensure that Criminal Bureau Record checks and referances are obtained prior to staff commencing duty. Timescale for action immediate 2. 7, 15, 37 13 30/9/05 3. 29 19 immediate 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 Hadfield House Version 1.10 Page 21 1. 2. 25/19 25 The registered person shoulds ensure that the use of low wattage lighting in communal areas is reviewed. The layout of chairs and furnishings in the lounge areas should be reviewed to prove a less institutional feel. Hadfield House Version 1.10 Page 22 Commission for Social Care Inspection 2nd Floor, Heritage Wharf Portland Place Ashton under Lyne OL7 0QD National Enquiry Line: 0845 015 0120 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. 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