Inspection on 26/09/05 for Hadrian House

This inspection was carried out on 26th September 2005.

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

Hadrian House 15/07/08

Hadrian House 27/04/06

Hadrian House 28/01/05

Hadrian House 10/12/04

Hadrian House 02/03/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOMES FOR OLDER PEOPLE Hadrian House Garden Street Thurmaston Leicester LE3 8RL Lead Inspector Linda Clarke Unannounced 26 September 2005 09:45am 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. Hadrian House 20050926 Hadrian House X00015 UN Stage 4 V246582 C51.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Hadrian House Address Garden Street Thurmaston Leicestershire LE4 8DS 0116 2694397 0116 2694397 None Leicestershire County Council Social Services 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) Mrs Angela Pauline Horobin Care Home 40 Category(ies) of Dementia over 65 years (20) registration, with number Learning Disability over 65 years (4) of places Mental Disorder over 65 years (6) Old Age (20) Physical Disability over 65 years (12) Sensory Impairment over 65 years (4) Hadrian House 20050926 Hadrian House X00015 UN Stage 4 V246582 C51.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: No person falling within category DE(E) may be admitted to the home when 20 persons who fall within category DE(E) are already accommodated within the home No person falling within category MD(E) may be admitted to the home when 6 persons who fall within category MD(E) are already accommodated within the home No person falling within category LD(E) may be admitted to the home when 4 persons who fall within category LD(E) are already accommodated in the home No person falling within category PD(E) may be admitted to the home when 12 persons who fall within category PD(E) are already accommodated within the home No person falling within category SI(E) may be admitted to the home when 4 persons who fall within category SI(E) are already accommodated within the home Service users between the age of 55-65 years who fall within the above categories and were resident in the care home at the date of registration may continue to reside there To be able to admit the named person of Category A under 65 years of age as identified in correspondence in application number V13681 dated 4:11:04 To be able to admit the named person of category DE who is under 65 years of age as identified in Application Number V17607 dated 23/02/05 Date of last inspection 7th July 2005 Hadrian House 20050926 Hadrian House X00015 UN Stage 4 V246582 C51.doc Version 1.40 Page 5 Brief Description of the Service: Hadrian House is a care home providing personal care and accommodation for forty older persons, which incorporates two beds offering respite facilities. Hadrian House also offers a rehabilitaiton unit, which supports individuals in regaining skills. The forty single bedrooms are without ensuite facilities. The home has a central and surrounding garden, which is well maintained and which is accessible to all residents residing in the home. The premise is owned by the Leicestershire County Council Social Services Department and is situated close to Thursmaston town centre where residents have access to shops, pubs and other amenities. The home is easily accessible by private or public transport. Accommodation is provided over two floors with access between floors being via stairs or a passenger lift. Hadrian House is fully accessible. Communal areas are provided on both floors of the home. Hadrian House 20050926 Hadrian House X00015 UN Stage 4 V246582 C51.doc Version 1.40 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This Inspection took place between 9.45am and 4.00pm. The opportunity was taken to look around the home, spend time with residents, view records which, included viewing the care plans of three residents residing at the home, and one individual accessing the re-ablement unit. The Deputy and Assistant Manager facilitated the Inspection, spending time with the Inspector; the Inspector also interviewed two members of care staff. What the service does well: What has improved since the last inspection? What they could do better: Hadrian House has recently opened the re-ablement unit, however the environmental facilities are inadequate. Facilities need to be improved consistent with the promotion of daily living skills and resident’s comfort. Hadrian House 20050926 Hadrian House X00015 UN Stage 4 V246582 C51.doc Version 1.40 Page 7 The care plans of residents need to be regularly reviewed, and reflect the current needs of residents this will ensure that all staff are aware of residents individual needs, this is particularly important for casual and agency staff. The recording of resident’s participation in activities and trips could be more detailed to encompass as to where the trip took place and any views expressed by the resident. Quality assurance could be further developed if the management team were more proactive in the distribution of relative and resident comment cards supplied by the Commission for Social Care Inspection, which forms part of the Inspection process. The regular supervision of care staff, consistent with the Local Authorities policies and procedures would help promote quality assurance, and consistent care delivery of residents, and provide an opportunity for care staff to discuss aspects concerning their role. 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. Hadrian House 20050926 Hadrian House X00015 UN Stage 4 V246582 C51.doc Version 1.40 Page 8 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 Hadrian House 20050926 Hadrian House X00015 UN Stage 4 V246582 C51.doc Version 1.40 Page 9 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) 3 and 6. The facilities offered within the re-ablement unit did not meet the needs of its current occupant. EVIDENCE: Hadrian House, within its accommodation has recently opened a re-ablement unit, although planned for four places, due to long term residents occupying part of the re-ablement unit accommodation, there are two beds available. The accommodation is sited on the first floor, with access provided by stairs or a passenger lift. The kitchen area does not provide a washing machine or provision for the ironing of clothing, neither is a cooker provided. Individuals accessing re-ablement are reliant on a two ring electric hob and a microwave. The alternative is that the main kitchen within the residential supplies meals. As part of the Inspection process the records of the first individual to access the re-ablement unit were viewed, which included the assessment undertaken by a Social Worker, which incorporated the goals to which the individual needed to achieve to enable them to return to independent living. Hadrian House 20050926 Hadrian House X00015 UN Stage 4 V246582 C51.doc Version 1.40 Page 10 The current occupant of the re-ablement unit had goals, which included the preparation and cooking of meals and the laundering and ironing of clothing, to enable him to live independently. The facilities offered by the re-ablement unit therefore cannot fulfil the needs of the individual. The individual accessing the re-ablement unit spoke with the Inspector about the accommodation, he expressed concerns as to the lack of facilities, with particular reference to the shower facilities which are located on the ground floor, and are not working appropriately as the water does not drain. The Deputy and Assistant Manager confirmed that shower facilities are to be provided on the first floor within the re-ablement unit, however a date for the commencement of this work has not been agreed. The lounge facility if fully occupied would be cramped, the size of the lounge is compromised by built in wardrobes and shelving. The lounge provides four chairs, covered with throws, a bookcase, sideboard and a television and video. The lighting in the room is dated, and dirty. The individual accessing the re-ablement unit was very complementary of the staff, stating that he was enjoying his stay within the unit. Three members of staff are employed who work specifically within the reablement unit. Hadrian House 20050926 Hadrian House X00015 UN Stage 4 V246582 C51.doc Version 1.40 Page 11 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 and 8. Care plans do not in some instances reflect the current care needs of residents, which are not fully met. EVIDENCE: The care plans of three residents were viewed, two care plans were detailed as to individual’s health care needs and were supported by risk assessments, daily records which recorded residents daily lives reflected within their plan of care, contact with health care professionals, relatives and friends. These two care plans were last reviewed in April and July of this year respectively. The remaining care plan was not dated, nor did it reflect the current needs of the resident, as described within the daily records. Care plans need to be regularly reviewed and reflect the current needs of residents, to ensure that all care staff have a clear understanding of individuals needs, with specific reference to casual and agency staff. The Inspector spoke with five residents, which included the three residents whose records were viewed. Residents were complementary as to the attitude of staff. All felt that staff were always busy and in their view additional care staff are needed. Hadrian House 20050926 Hadrian House X00015 UN Stage 4 V246582 C51.doc Version 1.40 Page 12 One resident said that she was dependent upon staff for a bath/shower, and that she would like to have a bath/shower in access of once a week, however in her opinion this could only be achieved if their were additional care staff, the lady also commented that it would be nice if staff were able to stop and talk as opposed to having rush off to another resident. A resident and their relative were also spoken with, both were happy with the care, however the relative said she would like her relative to be able to have a bath with greater frequency, and that the bedroom of her relative was not always as clean as she would like. A management team meeting was last held in June 2005; minutes recorded made reference for managerial staff to make daily decisions on bathing, consistent with staffing levels and works loads, but to be mindful that all residents need bathing a minimum of weekly. Reference was also made that managerial staff were to keep on top of care plans and risk assessments. Hadrian House 20050926 Hadrian House X00015 UN Stage 4 V246582 C51.doc Version 1.40 Page 13 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 and 13. Residents experience a homely life style and visitors are encouraged to visit. Various formal and informal activities are made available meeting residents’ recreational needs. EVIDENCE: Records incorporated the participation of residents in activities and trips, the recording of information could be more detailed to include where the trip took place, and any comments expressed by the resident. Various activities are provided, which include musical presentations, bingo, social evenings and coffee mornings, which are held monthly. Future planned trips include Christmas shopping to Loughborough in November, and a trip to Leicester in December to see the Christmas lights. Care plans detailed relative involvement, whilst daily records reflected when residents received visitors. One resident said she went to Church every week accompanied by her husband. Hadrian House 20050926 Hadrian House X00015 UN Stage 4 V246582 C51.doc Version 1.40 Page 14 Two residents said that they prefer not to participate in activities, but instead prefer to spend time in their room, watching television, reading, listening to talking books and embroidering. One lady has brought into residential care with her, her pet budgerigar, which she said staff look after for her. Hadrian House 20050926 Hadrian House X00015 UN Stage 4 V246582 C51.doc Version 1.40 Page 15 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) EVIDENCE: Standards within this section were not inspected on this occasion. Hadrian House 20050926 Hadrian House X00015 UN Stage 4 V246582 C51.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20 and 21. A comfortable and safe standard of accommodation is provided for the resident’s including a garden area, which currently meets the individual and collective needs of residents. EVIDENCE: Environmental improvements have been planned for, which include new flooring in the gentlemen’s toilets, downstairs corridors and stairwell, laundry area and sluice. Carpets of four bedrooms are to be replaced, along with the decorating of six bedrooms. A hydraulic bath is to be installed, and the ground floor shower room flooring which floods is to be rectified. The main lounge is also to be decorated. Dates for the commencement of the work has yet to be agreed. Environmental aspects pertaining to the re-ablement unit have been incorporated within the first section of the Inspection report. Hadrian House 20050926 Hadrian House X00015 UN Stage 4 V246582 C51.doc Version 1.40 Page 17 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 and 30. Recruitment procedures are robust, and staff receive training relevant to residents health and safety, staffing levels provided do not on all occasions meet the care needs of residents. EVIDENCE: Shortfalls in staffing were identified at the previous Inspection, the Deputy and Assistant Manager confirmed that Hadrian House has recruited additional staff, not all of which have as yet commenced their employment, as the Local Authority is awaiting their Criminal Record Bureau clearance. Additional care and ancillary hours have been made available, which will include two additional care staff and two additional ancillary staff. Further care staff are to be recruited to work at weekends. The staff roster for the week of the Inspection reflected that for weekdays there was to be four or five care staff on duty in the mornings and for the afternoon/evening there was to be three to four staff on duty. The roster for the weekend reflected five staff on duty in the morning and three staff on duty in the afternoon/evening. An additional member of staff was also rostered on some occasions to work within the re-ablement unit. Staffing levels currently do not on all occasions meet the needs of residents; staffing levels along with resident views will be followed up at the next Inspection, to establish as to whether resident needs are being met. Hadrian House 20050926 Hadrian House X00015 UN Stage 4 V246582 C51.doc Version 1.40 Page 18 Care staff since the last Inspection have accessed various training sessions, which have included Infection Control and Dementia Care. Future planned training has been scheduled for the Safe Handling of Medication, First Aid and Parkinson’s disease. Records evidenced that of the twenty-eight care staff employed, eleven have attained a level 2 National Vocational Qualification in Care. Hadrian House 20050926 Hadrian House X00015 UN Stage 4 V246582 C51.doc Version 1.40 Page 19 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) 33, 35 and 36. Systems, which are designed to ensure that care practices are reviewed are not being used to their full advantage, denying residents, relatives and staff the opportunity for comment. EVIDENCE: A relative visiting at the time of the Inspection was asked as to whether she has completed a relative comment care supplied to Hadrian House by the Commission for Social Care Inspection as part of the Inspection process, the relative confirmed that she had never received one. This issue was brought to the attention of the Deputy Manager who stated that were located in the entrance hall of the home, and available for all visitors. It is recommended that the management team are more pro-active in the distribution of these comment cards. Hadrian House 20050926 Hadrian House X00015 UN Stage 4 V246582 C51.doc Version 1.40 Page 20 The management of resident’s financial affairs are recorded within the care plans, a majority of which are managed by relatives. Hadrian House manages ‘spending money’ for some residents, records are available and receipts kept. The Audit department of the Local Authority audits all financial transactions. Resident meetings are held, the most recent taking place in May 2005, resident meetings provide an opportunity for residents to comment on aspects of the home, which affect themselves, and minutes reflected that agenda items, which included activities and entertainment and environmental improvements. The Inspector interviewed two members of staff; one member of staff has been employed at Hadrian House for eighteen months. The member of care staff had a clear understanding of the needs of residents whose records had been viewed as part of the Inspection process. The staff member confirmed training courses she had attended, which included Dementia Care, Infection Control and Moving and Handling. The member of staff when asked as to whether she received supervisions said that if she had any concerns she brought this to the attention of the Manger on duty, however during her eighteen months of employment she had not received a formal one to one supervision, which is inconsistent with the policy and procedure of the Local Authority. A newly appointed member of staff, who works within the re-ablement unit confirmed that she will be looking to undertake relevant training and stated that she had received a formal supervision with the Registered Manager. It is recommended that staff within the re-ablement unit liaise with similar provisions within the Local Authority to observe good practice and working methodologies. Hadrian House 20050926 Hadrian House X00015 UN Stage 4 V246582 C51.doc Version 1.40 Page 21 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x 1 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 x COMPLAINTS AND PROTECTION 3 3 3 x x x x x STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x 3 3 3 3 x x Hadrian House 20050926 Hadrian House X00015 UN Stage 4 V246582 C51.doc Version 1.40 Page 22 No 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. 1. Standard 6 Regulation 16(2)(f,h) 23(d,e,n) Requirement The Registered Person to ensure that facilities offered within the re-ablement unit meet the assessed needs of individuals accessing its services, and are well maintained. The Registered Person to ensure that care plans are regularly reviewed and reflect the care needs of residents. The Registered Person to ensure that residents care needs are delivered consistent with their wishes, with specific reference to the frequency of bathing/showering. Timescale for action 1st December 2005 2. 7 15(2) 1st December 2005 1st December 2005 3. 8 12(2) 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 33 Good Practice Recommendations It is recommended that the management team are more pro-active in the distribution of relative/resident comment cards. 20050926 Hadrian House X00015 UN Stage 4 V246582 C51.doc Version 1.40 Page 23 Hadrian House 2. 3. 36 36 It is recommended that staff receive supervisions consistents with the policies and procedures of the Local Authority. It is recommended that staff employed to support individuals within the re-ablement unit liase with care staff within similar Local Authority provisions to discuss and observe good practice and methodologies. Hadrian House 20050926 Hadrian House X00015 UN Stage 4 V246582 C51.doc Version 1.40 Page 24 Commission for Social Care Inspection 5 Smith Way Grove Park Enderby Leicestershire LE19 1SX 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 Hadrian House 20050926 Hadrian House X00015 UN Stage 4 V246582 C51.doc Version 1.40 Page 25 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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