Inspection on 03/06/10 for Hadrian Park

This inspection was carried out on 3rd June 2010.

CQC found this care home to be providing an Good service.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hadrian Park 19/08/10

Hadrian Park 15/07/10

Hadrian Park 25/03/08

Extracts from inspection reports are licensed from CQC, this page was updated on 03/09/2010.

Random inspection report Care homes for older people Name: Address: Hadrian Park Marsh House Avenue Billingham Stockton-on-Tees TS23 3DF two star good service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Valerie Daly Date: 0 3 0 6 2 0 1 0 Information about the care home Name of care home: Address: Hadrian Park Marsh House Avenue Billingham Stockton-on-Tees TS23 3DF 01642566322 01642566744 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Lois Kate Morgan Type of registration: Number of places registered: Conditions of registration: Category(ies) : Southern Cross OPCO Ltd care home 73 Number of places (if applicable): Under 65 Over 65 24 49 dementia old age, not falling within any other category Conditions of registration: 0 0 The maximum number of service users who can be accommodated is: 73 The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia, over 65 years of age - Code DE(E), maximum number of places: 24 Old age, not falling within any other category - Code OP, maximum number of places: 49 Date of last inspection Care Homes for Older People Page 2 of 11 Brief description of the care home Hadrian Park is a purpose-built home opened in 2004. There are 73 beds available, 24 of which are specifically for those suffering from dementia. The dementia unit is separate to the rest of the home, and is built around a courtyard, therefore enabling those who live at the home access to a secure, outdoor space, which has been landscaped. This unit is on the ground floor. The remainder of the home has both ground floor and first floor rooms, which are reached by a lift. All rooms are for single occupancy, and all have en-suite facilities consisting of a toilet and wash hand basin. Residents are able to personalise their rooms, according to preference and taste. Care Homes for Older People Page 3 of 11 What we found: This inspection was a random unannounced inspection. It took place on 3 June 2010 and was completed in one day by two compliance inspectors. At the time of the inspection the current manager of the home was working in another Southern Cross home nearby for a few months, also the deputy manager had been on sick leave for one month. A manager from another Southern Cross home in Northumberland was working in the home for two days a week and another manager form Northumberland for three days. The purpose of the inspection was to look at a range of matters that effect the care, welfare and wellbeing of people living at Hadrian Park and also to follow up the requirements made at the last key inspection of 01/04/2008. During the visit we looked at a number of care records of people living at Hadrian Park, medication administration records, staff recruitment records, staff training records and staff supervision records. We also looked at some maintenance and servicing information along with quality assurance information. We had a look around the home, spoke with people living there, staff and the manager. The care files of four people at Hadrian Park were looked at, two from the dementia care unit and two from the older persons unit. Two of the care records were for people who had been recently admitted to the home. Four care files were examined. They all contained assessments, which had been carried out prior to the person moving in. In general assessments had been completed, however for one person there was no medical history recorded, there were no comments made within the twelve areas of activities of living apart from two. For example; In maintaining a safe environment, the only area ringed was wishes to self medicate? yes/no with the answer being no. This area also relates to falls, tendency to wander/aware of surroundings, none of this was completed. Care plans had been developed from the assessments. However a care plan was not always in place where a need had been identified. For example, on the dementia care unit one persons daily progress reports indicated restlessness, not sleeping, walking around the unit during the night. There were also entries made stating this person had been quite agitated and aggressive during the day. For another person it was commented in their daily progress records that they were often in pain. There were entries in the professional visitors record from Primecare and the persons own GP detailing one pain relieving medication to be given and if that did not help further medication would be prescribed. Whilst medication was given prn, there was not a care plan in place, which could have given a picture of when medication is needed and its effects. One person had a care plan for mobility and personal hygiene which were well written and person centered. For example, when this lady is using the toilet she likes her wheelchair leaving in the toilet with the brakes on so that when she has finished she can sit herself back in the chair using the hand rail to stand. When getting dressed this lady likes to choose her own clothing with help from staff regarding co ordination and colour matching. She wears dentures and at night likes them washing and brushing and then Care Homes for Older People Page 4 of 11 she wears them during the night. Daily progress reports were repetitive and did not always cross reference to the care plan evaluations. For example, for one person on the dementia care unit the personal hygiene care plan stated that he showered himself daily but sometimes needs prompting. There was nothing mentioned in his daily progress reports. However the inspectors found, according to this gentlemans personal hygiene record for May 2010 that he had only received one shower on 5 May 2010. The care plan evaluations for personal hygiene stated he was showering daily. It was stated in the relatives review record that his wife had concerns about his personal hygiene. In three peoples risk assessments for falls, the same generic measures were in place; all pathways to be kept clear, adequate footwear and lighting. One person used a walking stick and a wheelchair for outside use, however this information was not included in the risk assessment. Another persons risk assessment for falls was written, assessed and approved by the same person despite the form indicating another person was to approve the measures. Medication systems were looked at. The temperature in the medication room was too warm at 280 C despite a fan being in use. The temperature records showed that this was the average temperature. The inspectors examined the homely remedies and found that paracetamol tablets were not in boxes, there was just a heap of foil strips in a plastic container in the medication trolley. After paracetamol had been given as a homely remedy to one person it had then been hand written on their medication administration record by a member of staff to be administered for up to 4 X daily. This had not been countersigned and the policy and procedure for Southern Cross was not being followed. The medication administration records for prescribed medication were found to be complete with no gaps in the recording. People spoken to during the inspection were satisfied with the care they received. One person said it is marvelous, I have picked up since I have been here. The staff are very nice. The menu was looked at, which is the standard Southern Cross four week rotational menu, nutritionally balanced. There are choices of meals and alternatives are available if people do not like what is offered. There had been two complaints made since the previous inspection. One related to care practices and the attitudes of some of the staff. Records showed that the complaint was investigated and responded to by the Chief Executive of the organisation. The second complaint was about personal care and whilst this was investigated by the home the complainant was not happy with the outcome. It was then investigated by the Contracts and Commissioning Department of Stockton Council. The complainant was satisfied with the response. Staff training records showed that training in Moving and Handling, COSSH, First Aid and Protection of Vulnerable Adults was not up to date. This was confirmed by staff during interviews. We also examined two accidents books. We found that pages 14 to 54 were in place in Care Homes for Older People Page 5 of 11 Accident book 23, which was dated 14 March 2010. Only 7 of the completed pages included comments regarding investigation and follow up. All of the accident reports in this book had been signed off by the manager on 2 June 2010. In Accident book 22, apart from 3 entries, which were checked on 30 April 2010, 2 March 2010 and 3 March 2010, there was no evidence of any comments regarding investigation and follow up to the accidents reported dated 24 February 2010 to 17 May 2010. All of the accident reports in this book had been signed off by the manager on 2 June 2010. The inspectors found that the accident and incident reports index had been completed and stated checked by area manager in April and May and checked by the manager in April only. Two care records on the dementia care unit were examined. On 10/05/2010 one person had pulled another persons hair. It was explained to her by staff that this wasnt acceptable behaviour and she wouldnt like it if someone pulled her hair and was asked not to pull hair anymore. There was a number of other issues relating to this lady when she has slapped and hit other people. Another person used a walking stick for mobility. It was recorded on 15/03/2010 that he had hit another person in the back with the walking stick. Neither incident had been recorded in the incident book nor had they been referred to safeguarding. Staff were advised that person to person incidents should be reported and not just seen as the persons particular behaviour. Staff were spoken to about staffing levels and they expressed their concerns about low staffing levels on the dementia care unit. They felt that their concerns were not being listened to by management. For example on the recent Bank Holiday there was one senior carer and one carer for a 2-8 shift. They said that one senior and two carers just manage but it depends on how people on the unit are. Also there were people on the unit with challenging behaviour and it was discussed with staff that they did not feel necessarily equipped that training in respect of this was needed. Southern Cross states within their documentation that they send out a number of Client Opinion Surveys on a regular basis. The Administrator told the inspectors that a number of surveys had been sent out to relatives some months ago. A return envelope to Head Office, is included. A report is then sent from Head Office back to the home, however there was no information available to evidence. This is a repeat requirement from the previous key inspection 01/04/2008. A Regulation 26 visit had been carried out on 8 April 2010 by Julie Gray, We were informed that Julie is a General Site Manager for another service. Her report of this visit stated that there was a range of areas identified for improvement, some giving immediate timescales others one week. For example; there was no record of Fire doors being checked in March 2010. There was a gap in recording of water temperatures for March 2010 However there was no evidence to show that any action had been taken in relation to these issues. The previous Regulation 26 visit available to evidence had been carried out on 29 January 2010. Care Homes for Older People Page 6 of 11 Staff formal supervisions were not up to date, this a repeat requirement form the previous key inspection of 01/04/2008. A number of supervisions, for the administrator and senior carers had been carried out on 18 May 2010. However, they were photocopies, containing an explanation of the management structure in place at the home. Handwritten information was how long the member of staff had worked in the home. For the administrator there was slightly more in respect of her workload. What the care home does well: What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 7 of 11 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 33 24 There must be an effective 30/09/2008 quality assurance system, based on seeking the views from people who use the service and others. So that the home can make sure it is meeting the aims, objectives and statement of purpose. (09/04/08 the home informed us, surveys have been sent to people) 2 36 18 Staff must have one to one 31/07/2008 supervision at least six times yearly. Care Homes for Older People Page 8 of 11 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 3 14 Assessment information must be full completed and must contain a good level of information. This will ensure that there is sufficient information to demonstrate that peoples needs can be met. 28/07/2010 2 7 15 Where a need is identified a care plan must be in place. This will ensure peoples needs are being met. 28/07/2010 3 9 13 The management of homely remedies must be reviewed and staff must follow the correct procedure. This will ensure that people are provided with homely remedies inaccordance with the procedure and have their medication reviewed if needed. 28/07/2010 4 18 12 There must be written evidence to show that accidents are investigated 28/07/2010 Care Homes for Older People Page 9 of 11 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action and followed up. This will ensure the health, safety and well being of the people who use the service. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 3 Staff should have the training they need to give them the information they need to safely meet the needs of people living at Hadrian Park. This includes Protection of Vulnerable Adults and Challenging Behaviour. Staff should receive induction training on commencement of employment. 2 3 7 38 Work should continue in developing the care assessments, plans and risk assessments into more person centred ones. Systems should be place to ensure that staff continue to be updated with their mandatory training, including with their mandatory training, including Moving Handling, COSSH and First Aid Care Homes for Older People Page 10 of 11 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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