CARE HOME ADULTS 18-65
Hamilton Community Home 31-33 Highfield Street Leicester Leicestershire LE2 1AD Lead Inspector
Kim Cowley Unannounced 26 August 2005 12:00 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 C51 C01 S28491 Hamilton Community Home V238377 310805 STAGE 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Hamilton Community Home Address 31-33 Highfield Street Leicester Leicestershire LE2 1AD 0116 2540724 0116 2856539 admin@hamiltonprojects.com Mr Stan Pawluczyk 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 Michelle Allen Care home 19 Category(ies) of MD Mental Disorder registration, with number of places Hamilton Community Home C51 C01 S28491 Hamilton Community Home V238377 310805 STAGE 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 20.01.05 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 to take 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 C51 C01 S28491 Hamilton Community Home V238377 310805 STAGE 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place on a weekday. The inspector talked to five residents, the Manager, and one carer. The premises were toured. Care plans and staff records were examined. The home was commended in two areas. What the service does well:
Hamilton Community Home is an established care home with a friendly and welcoming atmosphere. Many of the residents and staff have been at the home for many years and have built up close and supportive relationships. On the day of inspection some residents were at college/day centres or out and about, and others were relaxing in the home. A resident from another care home was visiting for a chat and a cup of tea. The Manager said ‘I always tell my staff that this is the residents’ home. They can come and go as they please. Their room is their room, and we respect their privacy at all times. They can bring friends round and have them stay for dinner if they wish. We try and give them as much freedom as possible while at the same time offering support when they need it.’ Residents made the following comments about the staff and the home: ‘Michelle (the Manager) is very good and very nice. She fights to keep this place a home not an institution.’ ‘I consider this to be my home.’ ‘Michelle wants this place run like a home.’ ‘I like being here and I’ve got nothing to complain about.’ ‘This is home, in fact it’s better than home.’ ‘I’m happy with the way this home is.’ The Manager said that the home is well established in the local community and local shopkeepers are welcoming and helpful to residents from the home. Staff give them advice on personal safety and training in assertiveness using roleplay. This is commended. Care staff do the cooking and cater for a range of diets including vegetarian and low-cholesterol. Menus are planned in conjunction with residents but are flexible. Those inspected showed a healthy and varied diet being provided with plenty of choice. One resident commented ‘All the food’s good and it’s getting better.’ Hamilton Community Home C51 C01 S28491 Hamilton Community Home V238377 310805 STAGE 4.doc Version 1.40 Page 6 The home is staffed by the Manager, two Assistant Managers (who job share), and the care staff team. There are three to four members of staff on duty during the day, and two at night (although these numbers are increased where necessary). All residents made many positive comments about the staff including, ‘If you feel bad the staff will calm you down’, and ‘Michelle has time to listen to me. She can tell when I’m not well because she’s known me for so long.’ The staff team are commended. The premises are homely, comfortable and clean. The Manager said ‘The residents are involved in all aspects of the home if they want to be. If we’re redecorating they choose the colours. If we’re making any changes to the premises then they’re consulted. We also encourage them to help keep the home clean. Some get involved, others don’t. It’s up to them.’ What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Hamilton Community Home C51 C01 S28491 Hamilton Community Home V238377 310805 STAGE 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Hamilton Community Home C51 C01 S28491 Hamilton Community Home V238377 310805 STAGE 4.doc Version 1.40 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 standard(s) EVIDENCE: These Standards will be inspected at the next inspection. Hamilton Community Home C51 C01 S28491 Hamilton Community Home V238377 310805 STAGE 4.doc Version 1.40 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 standard(s) 6,7,9 Care plans are holistic and contain comprehensive information about residents. Staff encourage residents to be independent, to make choices about their lifestyles, and to take responsible risks. EVIDENCE: Staff produce good care plans in conjunction with residents, where possible. They are holistic and contain information about residents’ social and leisure interests, preferred lifestyle, and goals and aspirations. One resident said ’They’ve got a file about me and I can see it if I want. It’s got my history in it so the staff can find out about me. I don’t mind them looking at it if it helps them understand my illness.’ Residents are encouraged to become independent and to make choices about their lifestyles. The Manager said ‘Sometimes a residents is fairly independent and doesn’t need us for a while. At other times they want very intensive support. As a result we have to be flexible as a staff team.’ A resident commented, ‘The quality of the care here is as good as it gets. Staff are there when you need them and that’s the important thing.’
Hamilton Community Home C51 C01 S28491 Hamilton Community Home V238377 310805 STAGE 4.doc Version 1.40 Page 10 Since the last inspection risk assessments have been completed for all residents and are on their case files. Those examined were of good quality with clear instructions to staff on how best support residents to take responsible risks. The Manager is in the process of adding photos of residents to all case and medication files. Residents have already had their photos taken for this purpose. Hamilton Community Home C51 C01 S28491 Hamilton Community Home V238377 310805 STAGE 4.doc Version 1.40 Page 11 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 standard(s) 11, 12, 13, 14 15, 16, 17 Leisure activities and opportunities to attend college and drop-ins are provided. Meals are wholesome and varied with choices available. EVIDENCE: Two care staff oversee the activities programme, which is mainly funded by the home. Meals out, pub visits, and day trips are popular. Some residents attend colleges and drops-ins and take classes in art, basic skills, computers, and photography. The Manager said ‘We encourage residents to lead active lives but there is no pressure on them to do anything they don’t want to.’ Residents comments included, ‘I go to Key Circle – it’s a drop-in’, and ‘Twice a week I go to REMIT and do basic skills and ceramics.’ The Manager said that the home is well established in the local community and local shopkeepers are welcoming and helpful to residents from the home. Residents are encouraged to get out and about. Staff give them advice on personal safety and training in assertiveness using role-play. This is commended.
Hamilton Community Home C51 C01 S28491 Hamilton Community Home V238377 310805 STAGE 4.doc Version 1.40 Page 12 Residents’ families and friends are made welcome at the home and are invited to social events held there. Residents are encouraged to help in the home. Some do their own laundry and clean their rooms with staff help where necessary. The home has a central kitchen where main meals are prepared and two small kitchens for snacks/drinks. Care staff do the cooking and cater for a range of diets including vegetarian and low-cholesterol. Shopping in done ‘on line’ with a major supermarket. Menus are planned in conjunction with residents but are flexible. Those inspected showed a healthy and varied diet being provided with plenty of choice. Breakfast is served from 8am to 9am and consists of cereal and toast. At weekends there is a cooked breakfast. A light lunch is served at 12.30pm. Dinner, the main meal of the day, is from 4.30pm to 5.30pm. Supper (hot and cold snacks) is from 8.30pm to 9pm. However the Manager said that all these times are flexible to fit in with residents’ lifestyles and activities. One resident commented ‘All the food’s good and it’s getting better.’ Hamilton Community Home C51 C01 S28491 Hamilton Community Home V238377 310805 STAGE 4.doc Version 1.40 Page 13 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 standard(s) EVIDENCE: These Standards will be inspected at the next inspection. Hamilton Community Home C51 C01 S28491 Hamilton Community Home V238377 310805 STAGE 4.doc Version 1.40 Page 14 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 standard(s) EVIDENCE: These Standards will be inspected at the next inspection. Hamilton Community Home C51 C01 S28491 Hamilton Community Home V238377 310805 STAGE 4.doc Version 1.40 Page 15 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 standard(s) 24,30 The premises are homely, comfortable and clean. Ongoing improvements are carried out and residents are consulted when redecoration takes place. EVIDENCE: The premises are homely, comfortable and clean. There are two lounges on the ground floor, where residents can smoke. A further non-smoking lounge is on the first floor. At the back of the home is a secluded garden with a lawn and a patio with seating. Some residents are involved in tending the garden. A recycling area has been created. The Manager said ‘The residents are involved in all aspects of the home if they want to be. If we’re redecorating they choose the colours. If we’re making any changes to the premises then they’re consulted. We also encourage them to help keep the home clean. Some get involved, others don’t. It’s up to them.’ Since the last inspection the dining room, the first floor kitchen, and all the bathrooms and toilets have been redecorated. The hall, stairs and landings have been redecorated and new carpets laid. Internal doors have been varnished. External parts of the home have been repainted.
Hamilton Community Home C51 C01 S28491 Hamilton Community Home V238377 310805 STAGE 4.doc Version 1.40 Page 16 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 The staff team are enthusiastic and professional and have good relationships with residents. All residents interviewed praised the staff. Satisfactory recruitment procedures are in place. Staff receive appropriate training. EVIDENCE: The home is staffed by the Manager, two Assistant Managers (who job share), and the care staff team. There are three to four members of staff on duty during the day, and two at night (although these numbers are increased where necessary). Those staff interviewed were enthusiastic and professional and appeared to have good relationships with residents. All residents made many positive comments about the staff including: ‘If you feel bad the staff will calm you down.’ ‘Michelle has time to listen to me. She can tell when I’m not well because she’s known me for so long.’ ‘The staff are good to us. They look after us, feed us, clothe us, and take us to the doctors.’ The staff team are commended. Hamilton Community Home C51 C01 S28491 Hamilton Community Home V238377 310805 STAGE 4.doc Version 1.40 Page 17 Since the last inspection all staff have been put forward for CRB and POVA clearance. The Manager said most checks have been returned and are satisfactory, and the remaining three are being processed. Jobs are advertised in the local paper and the Manager said references are always taken up before a member of staff starts work. In the last 12 months staff have done courses in Drug Awareness, Conflict Management, and Anxiety. Four members of staff are qualified first aiders. NVQs are in progress and two staff have completed Level 2. Others are doing Level 2 and Level 3. Hamilton Community Home C51 C01 S28491 Hamilton Community Home V238377 310805 STAGE 4.doc Version 1.40 Page 18 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 Residents are consulted about the running of the home at residents’ meetings and on a one to one basis. Policies and procedures are in place to maintain health and safety in the home. A Fire Risk Assessment approved by the Fire Officer is in place. The premises are risk assessed every six months. EVIDENCE: Residents’ meetings are held when a particular issue needs discussing. Care staff and the Manager attend where necessary. Minutes are taken and were available for inspection. These meeting give residents to opportunity to contribute to the running of the home. Staff also talk to residents on a one to one basis every day. The Manager said ‘I don’t do anything without consulting the residents first.’ Hamilton Community Home C51 C01 S28491 Hamilton Community Home V238377 310805 STAGE 4.doc Version 1.40 Page 19 There is a range of policies and procedures in place to maintain health and safety in the home. Good records were available to show the home is properly maintained, and in discussions the Manager demonstrated her commitment to maintaining a safe environment for residents and staff. Since the last inspection improvements have been made to the environment with regard to fire safety. On 19.11.04 the Fire Officer carried out an inspection of the home and looked at the Fire Risk Assessment. The Manager said he then confirmed in writing that the home’s arrangements for fire safety were satisfactory. The Manager carried out a health and safety audit of the premises on 14.07.05. She said these are to be carried out every six months with records kept. Hamilton Community Home C51 C01 S28491 Hamilton Community Home V238377 310805 STAGE 4.doc Version 1.40 Page 20 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 x x x Standard No 22 23
ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 3 3 x 3 x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 3 3 4 3 3 3 3 Standard No 31 32 33 34 35 36 Score x x x x 4 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Hamilton Community Home Score x x x x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 3 x C51 C01 S28491 Hamilton Community Home V238377 310805 STAGE 4.doc Version 1.40 Page 21 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 Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Hamilton Community Home C51 C01 S28491 Hamilton Community Home V238377 310805 STAGE 4.doc Version 1.40 Page 22 Commission for Social Care Inspection The Pavilions 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
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