Inspection on 02/05/07 for Hadfield House

This inspection was carried out on 2nd May 2007.

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 08/12/05

Hadfield House 10/05/05

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 Buckley Unannounced Inspection 2nd May 2007 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Hadfield House DS0000005519.V330398.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. Hadfield House DS0000005519.V330398.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hadfield House Address 39/41 Queens Road Oldham OL8 2BA 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) 01616200348 NO FAX Masterpalm Properties Limited Mrs Kathleen Adshead Care Home 28 Category(ies) of Dementia - over 65 years of age (8), Mental registration, with number disorder, excluding learning disability or of places dementia (3), Old age, not falling within any other category (21) Hadfield House DS0000005519.V330398.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 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. 8th December 2005 2. 3. Date of last inspection Brief Description of the Service: Hadfield House is a Victorian detached house, situated one mile from 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 en-suites. An additional eight single bedrooms share an adjoining en-suite and there is one shared room. There are large well-established gardens to the front of the property, which overlook the local park. Seating areas are provided for service users. Fees charged at the time of this inspection were Local Authority rates of £313.18. Hadfield House DS0000005519.V330398.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection site visit took place on 2nd May 2007. The home did not know we were coming. Time was spent talking to seven people who live in the home and three staff regarding their training and care practices. Questionnaires were forwarded to other people in the home and their representatives. Five were returned and all made positive comments regarding the care they received in the home. Comments from the questionnaires are reflected in the body of the report. All key inspection standards were assessed and three case files of people living in the home were examined in-depth following their assessments and care provision from the time of their admission. A selection of other records were examined, including staff duty rotas, medication and staff training records, including observations of care practices. A tour of the home was undertaken, including people’s bedrooms. What the service does well: The home has a low turnover of staff, with many of the staff having been employed over ten years and the shortest time being 2½ years. Staff training is given a high profile and all staff in the home are qualified to NVQ level 2 or above. There was evidence that should a person be admitted to the home with a medical condition which is unknown to the staff, the manager seeks out training and advice immediately to ensure people’s needs can be met and staff understanding is increased. Care plans reflected the assessed needs of people in the home, their likes, dislikes, interest and hobbies, and spiritual needs. People living in the home said, “Staff are marvellous” and “Staff never say anything that makes you feel uncomfortable.” They also said “At first I was scared but they are good to us and make life worthwhile.” One relative said “the home always keeps me informed of any changes like visits to the hospital.” Hadfield House DS0000005519.V330398.R01.S.doc Version 5.2 Page 6 A number of areas of good practice were noted, including the promotion of equality and diversity. This means people are treated as individuals. There was evidence that people in the home are able to voice their opinions and questionnaires were sent to their representatives and professionals asking for their views on the service. Concerns and complaints leaflets are placed in the entrance of the home for people to voice any issues anonymously, enabling the management team to address issues immediately they arise. One person said “I would tell the staff or manager if I was not happy about anything.” 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 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. Hadfield House DS0000005519.V330398.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 Hadfield House DS0000005519.V330398.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 are provided with information on what the home can offer them. This gives an informed choice before making a decision. A professional assessment of need is obtained prior to people entering the home, ensuring their needs can be met. EVIDENCE: People who live in the home are provided with a service user guide and are encouraged to visit the home prior to their admission. A copy of the service user guide is also placed in bedrooms. One of the questionnaires returned said “My daughter had a chat to me about the home so I came for a visit. The staff were very nice and welcoming.” Hadfield House DS0000005519.V330398.R01.S.doc Version 5.2 Page 9 Three files were checked in depth and were found to have a detailed professional assessment of need, ensuring the home could meet their needs. One person said, “At first I was a bit scared but they are good to us and make life worthwhile”. A contract stating rights and responsibilities of each party was held on personal files. The home does not provide intermediate care. Hadfield House DS0000005519.V330398.R01.S.doc Version 5.2 Page 10 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 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Care plans reflected the assessed needs of people living in the home, ensuring their needs would be met. Some care practice observed did not fully support the privacy and dignity of the people living in the home. EVIDENCE: Three care plans were examined, these matched the people’s assessment of need. Staff had sufficient information on which to undertake care tasks. Reviews were held on a regular basis and risk assessments were linked to care planning. Professional visits were recorded making an audit of the care plan process easier to complete. Hadfield House DS0000005519.V330398.R01.S.doc Version 5.2 Page 11 There was evidence that nutritional screening takes place when required and any problems regarding weight loss were discussed with the dietician. Equipment in the home is provided to meet people’s needs, for example, hoist, slide boards, and pressure mattresses. At the time of inspection there was no-one in the home with pressure sores who required a pressure mattress. However, the manager was aware how to obtain these from district nurses should the need arise. Staff training is given a high profile with 100 of staff having achieved NVQ level 2. Several have gone on to achieve NVQ level 3 with two staff undertaking NVQ level 4. Additional training has been provided in Parkinson’s disease, stroke awareness, palliative care, infection control, first aid and moving and handling. People who live in the home said, “Staff are marvellous”, and “Staff never say anything to make you feel uncomfortable”. One relative said, “The home keeps me informed of any changes like a visit to the hospital”, and “My family are very happy with the care in the home”. One questionnaire returned said, “If I have any problems I see staff and they help me; if I do not feel well they will ring my GP”. Observations throughout the day highlighted that one person was moved without footplates on their wheelchair. When questioned, staff reported that the person was more at risk with the footplates on. However, this was not recorded on care planning or risk assessments. Any risk to people in the home must be recorded. It was also observed that staff were cutting one person’s toenails in the lounge. This practice must be conducted in private. Staff at interview had an in-depth knowledge of the people’s needs. The high level of training staff received must be put into practice to ensure privacy and dignity needs are met. The administration, storage and recording of medication were managed appropriately and staff had received training in administering medication. Hadfield House DS0000005519.V330398.R01.S.doc Version 5.2 Page 12 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 good. This judgement has been made using available evidence, including a visit to this service. People living in the home are encouraged to make their own decisions on how they wish to conduct their day, and have the opportunity to participate in activities and feel mentally stimulated. EVIDENCE: The care plans of people living in the home included their social histories, giving staff a better understanding of the person’s previous lifestyle and capabilities. Likes and dislikes were also recorded; for example, preferences in food, interests and hobbies. One care plan stated a person’s religious beliefs and how the home had arranged for them to practice their chosen form of worship. Hadfield House DS0000005519.V330398.R01.S.doc Version 5.2 Page 13 People said they had a choice when they got up in the morning and went to bed. One person said, “I like to get up around 9 o’clock and have a very nice breakfast”. Another person said, “I am bored sometimes, you’re not yourself in a home, but it is the safest thing really”. They went on to say, “Staff are very interesting and helpful”. One of the questionnaires returned said “The staff always find time to listen to me”. Another said, “The food is very good and my bedroom is very well kept”. The home employs two activities co-ordinators. At the time of the inspection, armchair exercises were taking place. One person said, “Some people have been out today, but I didn’t want to go”. There was evidence that one person in the home goes out unaccompanied, whilst another person goes home at weekends. Two visitors called at the home during the inspection, both said the home kept them informed of any changes in care. The inspector dined with people in the home. We were offered a choice of meals, which were steak pie or pork steaks with mashed potatoes and vegetables. The dessert was crumble and custard. People said, “Food is good here and we get good suppers too”. Unfortunately, when drinks were served, milk had been placed in the large teapot. The manager must ensure that staff treat people who live in the home as individuals, asking what their preferences are on each occasion. Those people who are able, should be provided with individual teapots to ensure choices are made. Hadfield House DS0000005519.V330398.R01.S.doc Version 5.2 Page 14 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, 17 & 18. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. People living in the home were comfortable raising any concerns with the manager. Adult protection procedures and staff training provide protection for people living in the home. EVIDENCE: The home’s complaints procedure was displayed in the entrance hallway. A copy of this is included in the home’s service user guide, which is placed in each person’s bedroom. The home maintains a log of complaints, the last recording being in 2005. Complaints or concern leaflets are on display in the entrance of the home, which can be completed anonymously and forwarded to the manager. Local elections were taking place at the time of this inspection and people had received postal votes. One person said, “I would tell staff or the manager if I wasn’t happy with anything”. Hadfield House DS0000005519.V330398.R01.S.doc Version 5.2 Page 15 Staff had all completed training in the protection of vulnerable adults. Policies and procedures were in place giving staff guidance on how to handle a situation of abuse should this arise. Staff, at interview, discussed the different forms of abuse and how they would recognise it. They were also aware of actions to be taken. Hadfield House DS0000005519.V330398.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 23, 24 & 26. Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. Improvements have been made to the environment, however these have not been wholly sufficient to provide the people living at the home with a well maintained and safe place to live. EVIDENCE: Some improvement had been made to the environment. For example, one lounge had been decorated, several failed double glazed units had been replaced and eight bedrooms had new carpets and some new furniture. Hadfield House DS0000005519.V330398.R01.S.doc Version 5.2 Page 17 Since the last inspection the manager has continued to identify maintenance requirements. The list was comprehensive and included numerous cracked sinks with water seeping into vanity units and broken vanity units. Water seepage had caused a hole in the lounge ceiling. Several drawers were broken in bedrooms and had not been repaired. A number of extractor fans were broken. Three bedrooms had broken window restrictors, which would pose a risk to people using the rooms. The carpet in the large lounge was badly frayed and uneven, posing a risk to people in the home, especially to those who need to use a walking frame. Laundry is undertaken in the cellar, the floor of which was flooded at the time of this inspection, posing a health and safety risk. The floor covering in the kitchen had lifted and required repair or replacement. A number of windows had failed double-glazing and, in one person’s room, there was a hole in the en-suite door. Outside of the home the front gardens were well maintained. However, the rear of the property was not maintained to a good standard. The surface was very uneven and dangerous for people to use. The bathroom, in particular, had a badly frayed carpet; the bath handle and door handle were broken. The bathroom blinds were extremely dirty and they were fitted. On the whole, the home was clean and tidy and without odour and people who lived there had personalised their bedrooms, making them homely. Many of the items listed are minor; the high number of issues demonstrates a lack of maintaining the property. The manager had fulfilled their role in bringing these issues to the attention of the owners. Other observations made were that wheelchairs were stored next to the fire exit, causing a blockage and a health and safety risk. Hadfield House DS0000005519.V330398.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Staff recruitment procedures were robust and provided protection for people living in the home. Training is given a high priority resulting in the staff being well qualified to support the people living at Hadfield House. EVIDENCE: Staffing levels at the time of this inspection were appropriate to meet the needs of people living in the home. Most of the staff team have been employed for a number of years. For example, four staff have worked in the home for 15 years, six staff for over five years and the remaining staff three years. This leads to staff having a good knowledge of people’s care needs, as they demonstrated at their interviews. Unfortunately, this can also lead to complacency in recording people’s needs, as recorded previously in this report. Staff said the manager is constantly researching additional training along with people’s needs. This training included: infection control, palliative care, health and safety and a podiatry course and a podiatry nail cutting course. Hadfield House DS0000005519.V330398.R01.S.doc Version 5.2 Page 19 All staff had completed NVQ training but some practices in the home did not reflect the level of training undertaken, as referred to previously in this report under the sections daily lives and social activities and health and personal care. Policies and procedures in relation to staff recruitment were in place and provided protection for people living in the home. People in the home said “Staff are marvellous” and a relative who visits the home on a regular basis said, “Staff are always nice to people in the home”. Hadfield House DS0000005519.V330398.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36, 37 & 38. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The leadership and management of the home is open and promotes listening to people’s views, their representatives, other professionals and staff, which allows them to influence how care is provided. EVIDENCE: The home’s manager has been in post for 17 years and qualified to NVQ level 4. They have continued their professional development through attending short courses, for example, protection of vulnerable adults, palliative care, and infection control. Hadfield House DS0000005519.V330398.R01.S.doc Version 5.2 Page 21 There was evidence of quality control systems being in place. Questionnaires had been returned from professionals and GP practices. All were positive in the comments made. Complaints and concern forms were in the entrance of the home for relatives or people in the home to complete anonymously if they wished. Staff supervision takes place on a regular basis and is recorded. Work tasks are allocated daily with a record kept of who had been allocated to the task, which enables an audit trail. The home had a number of written policies, such as harassment, bullying and anti-racism. The manager demonstrated an understanding of the needs of people from ethnic minorities and what may need to be implemented should an application for placement in the home be made. Examples were given of dietary and cultural needs. Regular staff and house meetings take place to ensure people in the home have a voice. Minutes of staff meetings included: treating residents with respect and providing choices and staff to ensure report writing is correct and factual. Fire marshals were needed for each shift and training dates had been arranged. The minutes also stated that the manager would be calling in on different shifts as part of the quality monitoring process. Meetings of people who live in the home consisted of a review of menus, preferences of trips out in the community and any concerns. The home does not hold finances on behalf of people in the home. Families or people’s representatives are invoiced for any expenditure. All staff had completed first aid training and there was evidence that checks had been undertaken on electrical and gas equipment. Fire records and tests were checked on a regular basis and recorded. However, the blockage of fire exits with wheelchairs poses a risk to people, which must be addressed. Record keeping needs to be improved to reflect all people’s preferences and needs, as mentioned previously in this report under health and personal care. Hadfield House DS0000005519.V330398.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 2 2 X X X 2 2 2 STAFFING Standard No Score 27 4 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 3 2 Hadfield House DS0000005519.V330398.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP38 Regulation 24 Requirement Fire exits must remain clear at all times, so that in the event of a fire, people living in, working in and visiting the home can access the area and leave the building safely. Any objects placed in front of fire doors must be removed. Timescale for action 25/05/07 Hadfield House DS0000005519.V330398.R01.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 Refer to Standard OP8 OP10 OP14 OP19 Good Practice Recommendations People who are moved without footplates on their wheelchairs must be risk assessed to demonstrate the appropriateness of this practice. The home should ensure that privacy and dignity of people is maintained by undertaking personal care in the privacy of their rooms. The home should ensure people living in the home have choices, especially in relation to drinks at mealtimes where people should be treated as individuals. The home should ensure that people in the home live in a safe and well-maintained environment. Hadfield House DS0000005519.V330398.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Greater Manchester Area Office 11th Floor, West Point 501 Chester Road Old Trafford Manchester M16 9HU 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 Hadfield House DS0000005519.V330398.R01.S.doc Version 5.2 Page 26 - 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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