Inspection on 15/08/08 for Hallgarth Nursing and Residential Care Home

This inspection was carried out on 15th August 2008.

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

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

Hallgarth Nursing and... 23/08/06

Extracts from inspection reports are licensed from CQC, this page was updated on 08/11/2008.

CARE HOMES FOR OLDER PEOPLE Hallgarth Nursing and Residential Care Home Hallgarth Street Durham DH1 3AY Lead Inspector Sue Lowther Key Unannounced Inspection 15th August 2008 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 DS0000067011.V370229.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. DS0000067011.V370229.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hallgarth Nursing and Residential Care Home Address Hallgarth Street Durham DH1 3AY 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) 0191 3832244 0191 3832266 hallgarth@schealthcare.co.uk leeminggarth@schealthcare.co.uk Southern Cross (Hamilton) Limited Mrs Joan Williams Care Home 60 Category(ies) of Old age, not falling within any other category registration, with number (65) of places DS0000067011.V370229.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home with nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP, maximum number of places: 65 The maximum number of service users who can be accommodated is: 65 23rd August 2006 2. Date of last inspection Brief Description of the Service: Hallgarth is a care home registered to provide care (including 24 hour nursing care) for persons. It is situated on the outskirts of Durham City. All of the amenities including shops, restaurants and the major tourist attractions, which include the cathedral and castle, are easily accessible. The accommodation consists of 65 single en suite bedrooms located on three floors. The five bedrooms located on the lower floor have en suite shower rooms. There is a passenger lift available. There are various lounge and dining areas located throughout the home on each floor. The home is surrounded by wellmaintained gardens and has ample car parking space available for visitors. Southern Cross (Hamilton) Limited own the home. At the time of this inspection the fees charged were between £417 and £579 per week. Charges for hairdressing, newspapers and dry cleaning are not included in this. DS0000067011.V370229.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This unannounced inspection of Hallgarth Care Home took place on the 15th August 2008. Records were examined and a tour of the building took place. Time was spent talking to staff, the people who live in the home and their relatives. The manager supplied some written information to the CSCI before the inspection. The inspection focussed on key standard outcomes for people who live in the homes and to check whether requirements from the previous report had been met. What the service does well: What has improved since the last inspection? What they could do better: Written care plans should be updated immediately when a need has changed. This is to make sure that staff meet all of the needs of the people who live in the home. DS0000067011.V370229.R01.S.doc Version 5.2 Page 6 Two written references must be obtained before a new member of staff commences duty. During this inspection cleaning fluids were being stored in one bathroom. Alternative arrangements should be made to make sure people who live in the home cannot access these. 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. DS0000067011.V370229.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 DS0000067011.V370229.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): 3. People who use the service experience good quality outcomes in this area. Assessment procedures are in place to ensure that the home can meet the needs of the people who live there. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: People are only admitted after a full assessment of need is carried out by an appropriately trained person. This is usually the manager. This is to make sure that the home can meet the care needs of the people who go to live there. The family of one person who had recently gone to live in the home confirmed that they had looked around the home and had been supplied with all of the information they needed to make a decision about whether or not their relative would like to live there. All of the people who responded to the survey said that they had received enough information about the home before they went to live there. One person said, “We chose this home for my relative because it is ideally situated and has the facilities she needs”. DS0000067011.V370229.R01.S.doc Version 5.2 Page 9 The home does not admit people for intermediate care therefore assessment of standard 6 is not required. DS0000067011.V370229.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. People who use the service experience good quality outcomes in this area. People’s health care needs are well managed by the home. Systems to administer medication are safe and people living at the home say that they are treated well and that the standard of care is good. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The manager said that all of the people who live in the home have care plans so that staff know how to look after people on an individual basis. Three were examined during the inspection. These were comprehensive and contained individual plans of care. However two of the plans indicated that the person should be weighed weekly and this had not happened every week. Written care plans should be updated immediately when a need has changed. This is to make sure that staff meet all of the needs of the people who live in the home. People spoken to during the inspection said that they are happy with the care received and the level of information given. One relative said, “The staff here DS0000067011.V370229.R01.S.doc Version 5.2 Page 11 are second to none. All of them support me and my family. When I visit people are always well dressed and colour co ordinated”. Another relative said that whilst everything was not perfect, they were happy overall with the home. Records examined showed that people receive visits from other healthcare professionals. These include district nurses, doctors, and care managers. One person said, “The manager arranges to get the doctor if I think it is needed”. Medication is administered by qualified nurses . The home has a comprehensive medication policy. Accurate records of all medicines received, administered and those leaving the home are maintained. People spoken to said that staff always treat them with dignity and respect. DS0000067011.V370229.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. People who use the service experience excellent quality outcomes in this area. The activities are varied and provide recreation for most of the people who live in the home. Family and friends can visit at any time and are made to feel welcome. The meals are of a good standard. Menus are varied and people are given a choice. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: Most of the people said that activities are suitable. The activities organiser spends time with people on an individual basis to find out what activities they would like to do. One to one activities take place during the morning and group activities in the afternoon. Regular activities include card and board games, bingo, poetry sessions, horse racing board game and arts and crafts. Outside entertainers visit on a regular basis and a church service is held once per month. People are also taken out and the most recent excursion was a Mystery Tour. One person said, “I like it best when I have a one to one, but I know that a lot of people live here and I have to take my turn”. Another said, “I have DS0000067011.V370229.R01.S.doc Version 5.2 Page 13 asked the activities lady for a special book. I know she will get it for me if she can”. Relatives said that they could visit at any time and that they are always made welcome. One said, “Staff here are really good. They are polite, friendly and always keep me advised if there are any changes I need to know about”. People said that they have a choice about how they like to spend their day. They can also choose what time to get up and go to bed and when they would like to have a shower or bath. One member of staff said, “Choice is the most important thing we do here. People have a choice about when they want to get up, have a shower, where they wish to eat and can have a lie down in the afternoon if they want to”. The lunch looked nice. Staff who were helping people were doing this in a discreet and dignified manner. One person who lives in the home said, “The food is good. There are always two choices available and cook will get you something else if you don’t want what is on offer”. Evidence was seen in care plans to confirm that nutritional needs are assessed and other professionals consulted if required. DS0000067011.V370229.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 & 18. People who use the service experience good quality outcomes in this area. The people who live in the home can be confident that their concerns and complaints are dealt with appropriately and sufficient safeguards are in place to protect them from abuse. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: Information about complaints, how and who to make them to, is made available to the people who live in the home and their families through information displayed in the entrance to the home and in the ‘Service Users Guide’. There have been eight complaints recorded since the last inspection. All of these were investigated by the home. One person said, “If I had a problem I would tell one of the senior staff, things usually get sorted straight away”. Another said, “I would tell any of the girls if I was not happy but I have never had cause to complain”. The home had a comprehensive adult protection procedure. This gives staff the support they need to make a referral should this be required. The staff spoken to during the inspection were asked about abuse and what they would do if they saw or heard anything inappropriate. All said that they would tell someone, for example the manager, or make a referral themselves if this was more appropriate. Training is provided for all staff in adult protection. One member of staff said, “I would always report anything straight away”. Another DS0000067011.V370229.R01.S.doc Version 5.2 Page 15 said, “I would never be afraid to tell some one if I saw something even if I was not sure that it would be considered abuse. We are here to protect the people who live in the home”. DS0000067011.V370229.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 & 26. People who use the service experience excellent quality outcomes in this area. The home is clean and well maintained. It is decorated and furnished to a good standard and provides a homely environment for the people who live there. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: During a tour of the building the inspector saw that many of the rooms are decorated to the person’s own taste and there was evidence to confirm that people can take in some personal items when they go to live there. This includes pieces of furniture as well as photographs and ornaments. Since the last inspection the home has been registered for five additional bedrooms. These all have en suite shower rooms and are located on the ground floor. The corridor carpets have also been replaced. A high standard of décor and furniture is now provided throughout the home. DS0000067011.V370229.R01.S.doc Version 5.2 Page 17 There was a range of equipment seen around the home to support people with bathing and mobility. The inspector found the building to be clean, tidy and free from offensive odours. DS0000067011.V370229.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. People who use the service experience good quality outcomes in this area. The home has a settled and well-led staff team, in sufficient numbers to meet the needs of the people who currently live in the home. Training is provided for all staff. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: From the rota supplied at the inspection there was sufficient care staff on duty to meet the assessed care needs of the people who were using the service. People said that staff were usually around and answered the call bells quickly. One person said, “The staff come quickly when I need them”. The home had staff files in place, which provided evidence that the appointment of a new staff member is in the main made through proper recruitment processes. This includes the vetting of staff through the use of references, POVA first checks and Criminal Record Bureau (CRB) checks. However one file seen only contained one written reference. The manager said that she had obtained a verbal reference and was waiting for the written one. There is a commitment at the home to having a trained workforce with most of the staff having an NVQ at level 2 or above. As well as mandatory training, recent training has also taken place in adult protection and health and safety. DS0000067011.V370229.R01.S.doc Version 5.2 Page 19 Staff said that they are also supported with regard to personal training needs. Staff comments in this area were positive. Comments included “There is always plenty of training going on and you can ask for additional training if you want to”. Another said, “I have regular supervision with the manager where personal training needs are discussed”. DS0000067011.V370229.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, 33, 35 & 38. People who use the service experience good quality outcomes in this area. The home’s registered manager provides clear leadership, support and guidance to those living and working at the home. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The manager is a qualified nurse and has completed an appropriate management course. There was an open and friendly culture between the management team and staff working at the home. There was evidence in staff files to show that supervision was taking place and that the staff were being appraised. Staff confirmed that supervision takes place on a regular basis and that they are DS0000067011.V370229.R01.S.doc Version 5.2 Page 21 well supported. People living at the home and visitors who were spoken to during the inspection confirmed that the manager is approachable and that they would go to her if they had any concerns. Staff also confirmed this to be the case. Regular meetings are held and there are a number of systems in place to consult with people living at the home. Relatives and the people who live in the home can approach the staff at any time. The area manager completes a regulation 26 visit monthly. This is an audit which covers all aspects of the environment and the care delivered. The manager said that during this audit staff, the people who live in the home and visitors are consulted about their views. Any suggestions made are considered and improvements made where possible. The manager also carries out regular audits covering all environmental and care aspects which may result in improvements being made. Personal finances are kept in the home for people who request this. Signatures are obtained and receipts are kept to ensure peoples’ financial interests are safeguarded. The company also carry out a regular audit with regard to personal finances. The manager confirmed that all equipment in the home is regularly checked. The maintenance certificates that were seen at this inspection were found to be in order. Health and Safety checks are carried out regularly to safeguard people living and working at the home. However during this inspection cleaning fluids were being stored in one bathroom. Alternative arrangements should be made to make sure people who live in the home cannot access these. DS0000067011.V370229.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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 4 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 DS0000067011.V370229.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 OP29 Regulation Schedule 4 6(c) Requirement Two written references must be obtained before a new member of staff commences duty. Timescale for action 30/09/08 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. Refer to Standard OP7 OP38 Good Practice Recommendations Written care plans should be updated immediately when a need has changed. Alternative arrangements should be made for the storage of the cleaning fluids found in one bathroom. This is to make sure that people who live in the home cannot access these. 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