CARE HOME ADULTS 18-65
Hamilton Community Home 31-33 Highfield Street Leicester Leicestershire LE2 1AD Lead Inspector
Kim Cowley Unannounced Inspection 13th December 2005 14:00 Hamilton Community Home DS0000028491.V271981.R01.S.doc Version 5.0 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 Hamilton Community Home DS0000028491.V271981.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 Adults 18-65. 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. Hamilton Community Home DS0000028491.V271981.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Hamilton Community Home Address 31-33 Highfield Street Leicester Leicestershire LE2 1AD 0116 254 0724 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) Mr Stan Pawluczyk Mrs Michelle Allen Care Home 19 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (19) of places Hamilton Community Home DS0000028491.V271981.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. No additional conditions of registration. Date of last inspection 26th August 2005 Brief Description of the Service: Hamilton Community Home is situated in a multi-cultural area of Leicester close to London Road and Victoria Park. It is registered for up to 19 younger adults with mental health needs. The home comprises of two adjoining Victorian houses with occupancy over three floors. All bedrooms except one are single. There are two lounges on the ground floor, where smoking is permitted. A non-smoking lounge is on the first floor adjacent to a small kitchenette. There is a garden with a lawn, patio, and seating areas. Hamilton Community Home DS0000028491.V271981.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place on a weekday. When undertaking inspections the Commission for Social Care Inspection (CSCI), focuses on the outcomes for residents living in a home. In order to do this, the inspector ‘case tracked’ four residents living at Hamilton Community Home. This means the inspector checked their care records and met with them. In addition the inspector met a further four residents, and spoke to the person in charge and two other members of the care staff team. Further care and other records were examined. What the service does well: What has improved since the last inspection?
Hamilton Community Home DS0000028491.V271981.R01.S.doc Version 5.0 Page 6 Staff are available to run activities every evening from 7pm to 8pm. Care plans showed that some residents had become more independent since being at the home. For example, one resident who would not go out without staff accompanying him, now goes out on his own. 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. Hamilton Community Home DS0000028491.V271981.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hamilton Community Home DS0000028491.V271981.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 A good procedure, including consultation with existing residents, is in place to ensure new residents’ needs are fully assessed prior to admission. EVIDENCE: The home has a standard assessment procedure. The Manager assesses all potential residents, and also takes account of any social work or health care assessments they might have. New referrals are invited to the home for an overnight stay when they have the opportunity to meet existing residents. The person in charge said current residents are involved in decisions about new admissions, as it is important that all the residents get on well together. Hamilton Community Home DS0000028491.V271981.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These Standards were inspected at the last inspection on 26.08.05. Hamilton Community Home DS0000028491.V271981.R01.S.doc Version 5.0 Page 10 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These Standards were inspected at the last inspection on 26.08.05. Hamilton Community Home DS0000028491.V271981.R01.S.doc Version 5.0 Page 11 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Staff support residents who need help with personal care. Residents’ health needs are met by a range of health care professionals. Medication is properly managed and administered by trained staff. EVIDENCE: Most residents are self-caring although a few need some assistance, for example staff run their baths for them, or help them to shave. Water is thermostatically controlled which reduces risk to residents who wash unaided. One resident said ‘The staff remind me when I need a bath or when my clothes need changing.’ All residents are registered with local GPs and records showed their other health needs are met locally. Staff will accompany residents to their appointments where necessary. One resident commented ‘I don’t like going to the doctor’s on my own so staff always go with me.’ A number of residents said staff were good at supporting them if they felt down. One said ‘If I was feeling fed up I’d tell the staff and they’d talk to me.’ Senior carers administer medication, which is kept securely in a designated medication room. All residents on medication are monitored and if side effects are a problem, or if they appear over-medicated, their consultants/GPs are
Hamilton Community Home DS0000028491.V271981.R01.S.doc Version 5.0 Page 12 contacted and staff ask for a review. All care staff have completed a ‘Safe Handling of Medication’ course. One resident commented ‘If I lived on my own I wouldn’t take my medication. Here I do.’ Two residents self-medicate supported by staff Hamilton Community Home DS0000028491.V271981.R01.S.doc Version 5.0 Page 13 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Residents are aware of the complaints procedure, which is readily available. Staff are knowledgeable about protecting residents from abuse. EVIDENCE: There is a written complaints procedure, which is displayed in the home. Staff remind residents about this and support them if they want to make a complaint. In addition there is a Suggestions Box which residents can use (anonymously if they wish) to comment on the home and to give their views about how the service could be improved. Staff said residents regularly use the ‘Suggestion Box’, and the Manager records and addresses all suggestions made. One resident said ‘I’d tell one of the staff if I wasn’t happy about something.’ Another commented ‘I’d use the Suggestions Box if I needed to.’ Good written policies and procedures are in place to assist staff in protecting vulnerable adults. Staff have had in-house training in this area. Staff on duty were knowledgeable about abuse and what to do if they suspected it. Hamilton Community Home DS0000028491.V271981.R01.S.doc Version 5.0 Page 14 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These Standards were inspected at the last inspection on 26.08.05. Hamilton Community Home DS0000028491.V271981.R01.S.doc Version 5.0 Page 15 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 Staff are experienced and competent and all residents interviewed praised them. The home’s recruitment policies and practices are good. EVIDENCE: The staff team consists of the Manager, the Assistant Manager, senior carers and carers. There are three to four members of staff on duty during the day, and two at night. Staffing levels exceed the recommended minimum. The home does not employ ancillary staff so care staff are responsible for cooking and cleaning, helped by residents where possible. All residents interviewed praised the staff team and it was evident that their work in the home is appreciated and valued. The following comments were made: I get on very well with the staff.’ They are easy to talk to and always here for us. You can rely on them 100 .’ ‘The staff are brilliant. No matter how bad you feel they will always listen and try to help.’ ‘Michelle’s lovely. She’s very fair and she gets things done.’ ‘The staff are alright, you can always talk to them.’ ‘The staff are nice and they are not power-crazed.’
Hamilton Community Home DS0000028491.V271981.R01.S.doc Version 5.0 Page 16 The staff team are commended. Staff files were not inspected as they are locked away when the Manager is not in the home. However the home’s written recruitment policies and practices are good. The person in charge said all staff have satisfactory CRB/POVA checks, two written references, and regular supervision sessions. The person in charge said that staff communicate through the home’s ‘Day Book’, which they refer to each time they come on duty. Hamilton Community Home DS0000028491.V271981.R01.S.doc Version 5.0 Page 17 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 The home is run and managed in the best interests of residents by an experienced Manager. Consultation with residents is central to this process. EVIDENCE: The Manager is experienced and runs the home along non-institutional lines with the emphasis being on resident choice. The result is a homely environment with residents who are encouraged to speak out and determine their own care and lifestyles. Residents are consulted at residents’ meetings, which are held approximately every three months. Care staff and the Manager attend where necessary and minutes are taken. Staff also talk to residents on a one to one basis every day. Residents who wish to give their views anonymously can use the home’s Suggestions Box. One resident commented ‘We do get asked for our views here and we are listened to. It’s rare for the staff to do anything without talking to us about it first.’ Hamilton Community Home DS0000028491.V271981.R01.S.doc Version 5.0 Page 18 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X 3 X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X X X X Standard No 24 25 26 27 28 29 30
STAFFING Score X X X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X 4 X 3 X X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Hamilton Community Home Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X X X DS0000028491.V271981.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? N/A 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. Refer to Standard Good Practice Recommendations Hamilton Community Home DS0000028491.V271981.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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