Inspection on 14/10/05 for Hadley House Nursing Home

This inspection was carried out on 14th October 2005.

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

Hadley House Nursing Home 07/06/07

Hadley House Nursing Home 28/02/06

Hadley House Nursing Home 08/03/05

Hadley House Nursing Home 02/11/04

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

CARE HOMES FOR OLDER PEOPLE Hadley House Nursing Home 24/26 Jersey Avenue Stanmore Middx HA7 2JQ Lead Inspector Virginia Allen Unannounced Inspection 14th October 2005 8:00 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 Hadley House Nursing Home DS0000022926.V258128.R01.S.doc Version 5.0 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. Hadley House Nursing Home DS0000022926.V258128.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Hadley House Nursing Home Address 24/26 Jersey Avenue Stanmore Middx HA7 2JQ 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) 020 8907 7047 020 8933 2051 Mr Nalin Joshi Mrs Anila Joshi Mrs Anila Joshi Care Home 14 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (14), Old age, not falling within any of places other category (14) Hadley House Nursing Home DS0000022926.V258128.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The number of people accommodated must not exceed 14. Elderly persons with enduring Mental Health , aged 60 years and over. Minimum staffing notice applies Date of last inspection 8th March 2005 Brief Description of the Service: Hadley House is a home providing nursing care for up to 14 older persons. At the time of the inspection there were 3 vacancies. The owners, Mr and Mrs Joshi, also have a home providing personal care to older persons situated in the same road. Mrs Joshi is registered as the manager of this home. The home is situated in a quiet turning, close to Kenton Lane, on the edge of both Stanmore and Kenton. It is close to local shops and bus routes, with local train and underground links being around thirty minutes’ walk away. Hadley House has off-street parking at the front of the property and there is parking available in the road outside the home. The home consists of two floors and there is a passenger lift to assist movement within the home. There are bedrooms, toilets and bathing facilities on each level of accommodation. Communal space is situated on the ground floor and consists of an open-plan area where there are lounge and dining areas. There is a large attractive garden at the rear of the house. There is one shared bedroom in the home and all other bedrooms are single rooms. Hadley House Nursing Home DS0000022926.V258128.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place on a Friday. The inspector met with the manager, care staff and the activities co-ordinator. She also talked with the service users about their experiences in the home. Records were checked and care practices observed. The inspector thanks everyone at the home for their assistance with this inspection. What the service does well: 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. Hadley House Nursing Home DS0000022926.V258128.R01.S.doc Version 5.0 Page 6 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 Hadley House Nursing Home DS0000022926.V258128.R01.S.doc Version 5.0 Page 7 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 the following standard(s): 2,4,5 Each service user has a written contract. Service users know that the home they enter will meet their needs. Prospective service user and their relatives and friends have the opportunity to visit and assess the quality and suitability of the home. EVIDENCE: The registered manager told the inspector that the home has a contract with the local health authority to provide care and accommodation to service users who are funded by the authority. This is likely to vary in the near future when several beds will become available for private purchase. The service user guide contains the statement of terms and conditions of residency. The inspector viewed the assessments of service users and noted that they were thorough and comprehensive. The manager informed the inspector that only service users whose needs can be met by the home are accepted into the home. Hadley House has a strong commitment to service users who suffer Hadley House Nursing Home DS0000022926.V258128.R01.S.doc Version 5.0 Page 8 with mental illness. The manager explained to the inspector that a Consultant psychiatrist visits the home on a monthly basis. However, psychiatric consultations can be arranged outside of these visits. The community nurse and the GP also support the staff and the service users. The home is sensitive to ethnic minorities and the manager explained that there is currently one service user who prefers treatment with herbal medicine. The manager assists the service user to access this therapy. Prior to admission to the home, the social worker and the home manager assess the service user. They are given the opportunity to spend a day at the home and are advised that they need not make a final decision about permanency until 1-2 weeks after admission. Admission to the home is only after it is agreed with the service user that the home can meet their needs. Hadley House Nursing Home DS0000022926.V258128.R01.S.doc Version 5.0 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 the following standard(s): 7,8,10 Service users health and personal care needs are set out in a plan of care. Their health needs are fully met. Service users are treated with respect and their right to privacy upheld. EVIDENCE: The inspector viewed service user files. Assessments were comprehensive and informed the care plans. Care plans were appropriate and individual. They reflected all of the service users needs, daily routines and actions to be taken. Mental and psychological health issues were addressed in the care plans. Service users or their representative had been asked to sign their agreement to the care plans. The care plans would benefit from expanded documentation of the service user’s likes and dislikes in each section. The manager confirmed that service users are encouraged to attend to their own oral hygiene when they can and care staff assist. None of the service users in the home have pressure areas. Staff are trained to identify early warning signs of pressure and the manager informed the inspector that in this event she would contact the appropriate specialist nurse. Pressure relieving Hadley House Nursing Home DS0000022926.V258128.R01.S.doc Version 5.0 Page 10 cushions were noted in the home. Skin condition was documented in the care plans. The manager informed the inspector that service users are toileted frequently. If a service user becomes incontinent, the home contacts the continence adviser. Psychological and mental health is documented in the care plans along with any action necessary. Every service user is weighed regularly and any change in weight is noted and the GP notified if this continues. An ophthalmologist visits the home 6 monthly and the GP refers to an audiologist if a service user has hearing problems. During the inspection all of the service users were seen to be up and dressed and sitting in the day room. They were encouraged to walk to the dining table to eat and drink. This allowed a degree of passive exercise during the day. Service users are encouraged to attend the exercise class held each day. Ongoing health records were reviewed and included blood pressure and weight. The manager told the inspector that the service users are able to access a pay phone or the phone in the office. In the case of a person being bed ridden, a mobile phone is available. During the inspection it was noted that staff were familiar with the preferred name of the service user. It was recommended that this name also be documented in the care plan. Hadley House Nursing Home DS0000022926.V258128.R01.S.doc Version 5.0 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 the following standard(s): 12,14,15 Services users find the lifestyle they experience in the home matches their expectations and they are helped to exercise choice and control over their lives. Service users receive a wholesome and nutritious diet. EVIDENCE: The home employs an experienced activities co-ordinator. The inspector discussed the activities routine with the co-ordinator. The routine is tailored to the individual needs of the service user and the co-ordinator was aware of the likes and dislikes of each service user. All of the information relating to the activities is documented daily and was viewed by the inspector. During the inspection the service users were seen to enjoy the activities they were engaged in and the interaction between them and the activities co-ordinator was positive and warm. The manager told the inspector that a musician visits the home weekly and the mobile library delivers books. Service users are taken on trips to local areas and are taken shopping. Hadley House Nursing Home DS0000022926.V258128.R01.S.doc Version 5.0 Page 12 Service user finances are supervised. The manager showed the inspector the ledger that is kept for each service user detailing the amount of petty cash and any money spent. Receipts are kept for any money spent. All service users and families are given the leaflet “Care Aware Advocacy Service”. Some service users have availed themselves on the use on an advocate. Those who haven’t have families involved in their care. The manager assured the inspector that everyone has someone. Service users are encouraged to bring with them into the home some of their personal possessions. The inspector noted these items adorning their bedrooms. It helped to make their bedrooms more personal. The kitchen was inspected. It was clean and tidy and the cupboards contained an appropriate store of food. The menu showed a variety of meals that were nutritious. During the inspection lunch was served. It was colourful, plentiful and appetising. The service users were seen to enjoy their meal. Currently three of the service users require diabetic diets. The staff appeared to be well informed about the dietary needs of a diabetic. Currently no service user requires restricted food due to religious conviction. Hadley House Nursing Home DS0000022926.V258128.R01.S.doc Version 5.0 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 the following standard(s): 16,18 Service users know that their complaints will be listened to and acted on and that they are protected from abuse. EVIDENCE: The home has a complaints procedure. The manager discussed the procedure with the inspector and documentation was viewed. All complaints are taken seriously and investigated. The copy of the complaints procedure is on display in the dining area. It showed how to make a complaint. There have been no recent complaints. All staff have attended Protection of Vulnerable Adult training. The home has an Adult Protection and Whistle Blowing procedure, which complies with the Public Disclosure Act and the Department of Health Guidance. This is displayed in a folder and all staff sign to show that they have read this document. The home does not use constraint and there have been no incidents of abuse reported. Any valuables belonging to a service user are stored in the home’s safe. Each service user has a lockable cupboard in their room for the storage of private or valuable items. Hadley House Nursing Home DS0000022926.V258128.R01.S.doc Version 5.0 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 the following standard(s): 19,20,22,23,24,25,26 Service users live in a safe, well-maintained environment where they have safe comfortable indoor and outdoor facilities. Service users have the specialist equipment they require. Their rooms suited their needs and were safe, comfortable and personal. Service users live in a comfortable surrounding that is clean, pleasant and hygienic. EVIDENCE: Hadley House is a large freestanding house on three levels. It has a well maintained back garden which can be accessed through the sitting area and has wheelchair access. During the inspection one service user went for a walk in the back garden. Hadley House Nursing Home DS0000022926.V258128.R01.S.doc Version 5.0 Page 15 The sitting area has comfortable chairs. Furnishings are domestic in nature and of a good quality. During the inspection service users sat in the sitting area, they talked amongst themselves and participated in activities. A separate room with a sofa is provided for those who wish to smoke. There is a passenger lift, which allows access to communal areas. The home has wheelchair ramps. There is an equipment storage area and all of the bathroom areas have grab rails. The home has 3 hoists, 2 fixed and 1 mobile. The call bells were located by the inspector next to each bed in the bedrooms and within easy reach of the service user. The manager agreed that regular bell checks are made. The inspector viewed the bedrooms, which were homely and decorated with the service user’s personal items. All of the beds were adjustable. Each bedroom had a hand basin, wardrobe bedside table and cupboard. The floors had carpets and the curtains matched the furnishings. All bedroom doors had locks to allow for privacy. If the service user wishes, the staff look after the key. All central heating was seen to be guarded and of low temperature. Water temperature in the rooms appeared to be satisfactory and the manager reported that this was checked regularly. The inspector was shown the documentation, which showed the temperature to be acceptable. The laundry and sluicing facilities are in a different area of the house and no accessible through the eating areas. The manager showed the inspector the commercial washing machine with a sluicing facility. There was also a commercial clothes dryer. The room was clean and dry. The home has a contract with a clinical waste company for the removal of waste. Hadley House Nursing Home DS0000022926.V258128.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,30 The skill mix of staff meets service users needs and service users are in safe hands at all times. Staff are trained and competent to do their jobs. EVIDENCE: The roster showed that staffing levels are maintained and that the home has a stable work force. On the morning of the inspection there were two care staff, two registered nurses, which included the manager and the activities coordinator. There is a part time domestic. The manager of the home is a general trained and psychiatric trained registered nurse. She has completed NVQ level 4. Two staff have completed NVQ level 3 and one staff is doing NVQ level 3. One person is doing NVQ level 2 and the rest of the staff have completed NVQ level 2. Documentation is kept of in service training. The inspector noted that staff have completed training in safe handling of medications, infection control, dementia awareness, health and safety, fire awareness, first aid and Protection of Vulnerable Adults. Hadley House Nursing Home DS0000022926.V258128.R01.S.doc Version 5.0 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32 Service users live in a home that is run and managed by a person who is fit to be in charge and of good character. The ethos, leadership and management approach of the home benefits service users. EVIDENCE: The owner, who is also co-owner of a residential care home in the same street, competently manages the home. She is a registered general nurse and a registered psychiatric nurse. The manager has completed NVQ level 4. The manager is sensitive to the needs of the service user and spends much of the day going the extra mile to make sure that all of the needs of the service user are met and that the service user is well cared for. Hadley House Nursing Home DS0000022926.V258128.R01.S.doc Version 5.0 Page 18 The manager told the inspector that the ethos of the home is person centred care. All staff employed by the home adhere to this philosophy and the inspector noted that the interaction between staff and service user during the inspection supported this claim. Hadley House Nursing Home DS0000022926.V258128.R01.S.doc Version 5.0 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. 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 X 3 X 4 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 3 X X X X X X Hadley House Nursing Home DS0000022926.V258128.R01.S.doc Version 5.0 Page 20 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. 1 Refer to Standard 6 (6) Good Practice Recommendations The care plans would benefit from more detailed information relating to the likes and dislikes of the service user on most topics in the care plan Hadley House Nursing Home DS0000022926.V258128.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Harrow Area office Fourth Floor Aspect Gate 166 College Road Harrow HA1 1BH 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. Extracts may not be used or reproduced without the express permission of CSCI Hadley House Nursing Home DS0000022926.V258128.R01.S.doc Version 5.0 Page 22 - 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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