Inspecting for better lives Key inspection report
Care homes for adults (18-65 years)
Name: Address: Hamilton Community Home 31-33 Highfield Street Leicester LE2 1AD The quality rating for this care home is:
two star good service 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 assessment of the service. We call this a ‘key’ inspection. Lead inspector: Kim Cowley
Date: 3 0 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area.
Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection.
This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home
Name of care home: Address: Hamilton Community Home 31-33 Highfield Street Leicester LE2 1AD 01162540724 Telephone number: Fax number: Email address: Provider web address: michele.allen1@btinternet.com Name of registered provider(s): Name of registered manager (if applicable) Mrs Michelle Allen Type of registration: Number of places registered: Mr Stan Pawluczyk care home 19 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: No additional conditions of registration. Date of last inspection Brief description of the care home 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 and one on the first floor, adjacent to a small kitchenette. At the rear of the home is a garden with a lawn, patio, smoking shelter, and seating areas. Fees start at local authority rates with additional charges dependent on care needs. 19 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 28 Summary
This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home
peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This was a key inspection that included a visit to the home and inspection planning. Prior to the visit, we (throughout the report the use of we indicates the Commission for Social Care Inspection) spent half a day reviewing information relating to the home. During the course of the inspection, which lasted five hours, we checked the key standards as identified in the National Minimum Standards. This was achieved through a method called case tracking. Case tracking means we looked at the care provided to three of the people living at the home by meeting them; talking with the staff who Care Homes for Adults (18-65 years)
Page 5 of 28 support their care; checking records relating to their health and welfare; and viewing their personal accommodation as well as communal living areas. Other issues relating to the running of the home, including health and safety and management issues, were examined. We also talked to two other residents, the Manager, Deputy Manager, and four members of the care staff team. What the care home does well: What has improved since the last inspection? A Moving Forward Programme has been introduced. This is used in conjunction with care plans to identify and support service users who are moving towards independent living. Staff help those on the programme to develop the skills they will need to live in the wider community, for example money management and self-care. A computer room has been set up with two PCs (personal computers), both with Internet access. A tutor comes to the home five days a week to teach IT skills. The Care Homes for Adults (18-65 years) Page 7 of 28 people who live in the home can book individual sessions with him to learn more about computing. There is also a new phone room where the people who live in the home can make free calls in private. This makes it easier for them to keep in contact with families and friends. Some bedrooms and corridors have been redecorated, and an aquarium and new settees have been purchased for one of the lounges The home has become non-smoking. However, at the request of the people who live there, a heated outdoor smoking shelter has been built in the rear garden. The Deputy Manager has achieved her Registered Manager Award (a recognised qualification for people who run care homes) and two staff have completed their NVQ (National Vocational Qualification) Level 3 in Care. This means that 70 per cent of the staff team have achieved NVQ level 2 or above, which gives them the basic skills needed to work in care. 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 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 Choice of home
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is good. People who want to come to the home have their needs assessed to ensure it is suitable for them. This judgement has been made using available evidence including a visit to this service. Standard 2 was inspected. Evidence: People who want to live at Hamilton House first have a written assessment to see if the home is suitable for them. The Deputy Manager, or another senior member of staff, completes this, taking into account their views, and the views of their families and any advocates involved. Health and social care staff who are involved in their care are also consulted. This helps to ensure that the home will be able to meet their needs if they decide to move in. The Deputy Manager told us it is important that new people get on well with the
Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: existing service users. She said, Weve got a really good group of people living here who can turn to each other, as well as to staff. When I carry out assessments its important to consider whether or not the person in question will fit in. At present all the people who live in the home are male and the Deputy Manager said the home is likely to remain single-sex. Both the staff team and service user group are multi-cultural and their skills and experiences help to ensure that people from ethnic minority groups feel at home at Hamilton House. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is good. Detailed care plans and risk assessments help staff to identify and meet the needs of the people who live in the home. This judgement has been made using available evidence including a visit to this service. Standards 6, 7, and 9 were inspected. Evidence: All the people who live in the home have care plans. These help to ensure the care provided fits in with their lifestyles and meets their particular needs. The plans cover the health, personal and social needs of the person in question, and their likes/dislikes and preferred routines. They are evaluated at least once a month to ensure the information in them is up to date. Since the last inspection the home has introduced a Moving Forward Programme. This
Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: is used in conjunction with care plans to identify and support service users moving towards independent living. Staff help those on the programme to develop the skills they will need to live in the wider community, for example money management and self-care. Risk assessments are in place for all the people who live in the home. Those examined were of good quality with clear instructions to staff on how best to support service users when they take responsible risks. In discussion staff also showed a good awareness of the people who live in the home and how they might seem if their mental health starts to deteriorate. This helps to ensure that staff take prompt action if they have concerns about a service users well-being. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is good. Daily living and social activities enable the people who live in the home to lead full lives and grow in independence. This judgement has been made using available evidence including a visit to this service. Standards 12, 13, 15, 16, and 17 were inspected. Evidence: Activities are geared towards each persons individual requirements and interests, although some group activities are organised including meals out, holidays, day trips, and theatre visits. Some of the people who live in the home attend drop-ins and colleges. Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: The home is well established in the local community and the people who live in the home use local shops. They are encouraged to get out and about and staff give them advice on personal safety and training in assertiveness using role-play. There is a new computer room on the ground floor of the home with two PCs (personal computers), both with Internet access. A tutor comes to the home five days a week to teach IT skills. The people who live in the home can book individual sessions with him to learn more about computing. There is also a new phone room where the people who live in the home can make free calls in private. This will make it easier for them to keep in contact with families and friends. 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. Menus are planned in conjunction with the people who live in the home and are flexible. Most of the food is homemade. All the service users we spoke to said they liked the food. They told us there were two or three choices at every meal. Dinner was being prepared during the inspection and consisted of prawns in spicy sauce, or lasagna, or beef pie, with rice and mixed vegetables, and a range of desserts. Hot and cold drinks are available at all times in the dining room, including at meals times, at the request of the people who live in the home. Those who sign up for the homes Moving Forward programme can shop and cook for themselves with the support of staff. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is good. The people who live in the home have their personal and health care needs met in the way they want by staff in the home. This judgement has been made using available evidence including a visit to this service. Standards 18, 19 and 20 were inspected. Evidence: Most of the people who live in the home are self-caring, although a few need some assistance or prompting from staff. Their preferences are set out in their care plans and show they have been consulted about what help they need, and that staff encourage them to be as independent as possible. Care plans relating to their health needs were also examined. They showed that the people who live in the home are registered with local GPS and other health care professionals including opticians, dentists, and chiropodists. All have annual medical reviews through the Care Programme Approach) reviews or GP appointments. Their
Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: mental health is carefully monitored and advice and assistance sought from CPNs (Community Psychiatric Nurses) and consultant psychiatrists where necessary. This helps to ensure that should their mental health deteriorate expert help is sought promptly. Senior carers administer medication, which is kept in a designated medication room. Medications are monitored for side effects and GPS/CPNs/consultants are notified if a problem arises. Two of the people who live in the home self-medicate and staff are building up the amount of medication they can have at one time to prepare them for independent living. Advice should be obtained from the homes contract pharmacist as to whether or not the current medication storage facilities meet the latest relevant legislation, particularly with regard to controlled drugs. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is good. Staff know how to safeguard the people who live in the home and help them express any concerns they might have. This judgement has been made using available evidence including a visit to this service. Standards 22 and 23 were inspected. Evidence: We talked to the people who live in the home about what they would do if there was anything they werent happy about. All said they would tell a member of staff straight away. One commented, If anything was bothering me Id tell the staff. Another said, If I had a problem I would talk to the staff.. There is a written complaints procedure, which is displayed in the home. Staff remind the people who live in the home about this and support them if they want to make a complaint. In addition there is a Suggestions Box, which can be used (anonymously if desired) to comment on the home. Staff said that minor complaints have been posted in here and dealt with promptly. There have been no formal complaints since the last inspection Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: Good written policies and procedures are in place to assist staff in safeguarding the people who live in the home. Staff on duty were knowledgeable about safeguarding and understood the role of social services as lead agency in any safeguarding investigation. Care Homes for Adults (18-65 years) Page 19 of 28 Environment
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is good. The home is community-based, comfortable, and well maintained. This judgement has been made using available evidence including a visit to this service. Standards 24 and 30 were inspected. Evidence: The premises are spacious, comfortable and clean. There is a good range of communal areas where the people who live in the home can socialise if they wish. All bedrooms except one are single, and the double is occupied by two service users who have chosen to share. At the back of the home is a secluded garden with a lawn and a patio with seating. Records show that the premises have been subject to continual updating and resources have been allocated for this to continue. Since the last inspection some bedrooms and corridors have been redecorated, and an aquarium and new settees have been purchased for one of the lounges. Since the last inspection the home has become non-smoking. However, the request of
Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: the people who live there, a heated outdoor smoking shelter has been created in the rear garden. The service users keep this clean and tidy. The Deputy Manager told us that some of the people who live in the home are allowed to smoke in their bedrooms, subject to a satisfactory risk assessment. She said that although the home doesnt condone smoking, this is in response to the wishes of those that live there. We visited two bedrooms on the invitation of their occupants. Both were homely and personalised. One service user had his own tea-making facilities which he was risk assessed for. He told us, Im happy with my room. Another said, I like to watch the telly in my room. Most of the people who live in the home have keys to their own bedrooms, following a satisfactory risk assessment. A part-time cleaner is employed to look after most of the communal areas. Care staffs, helped by the people who live in the home where possible, are responsible for the bedrooms, the kitchen, the dining room, and the laundry room. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is good. The people who live in the home have their needs met by an established team of friendly and professional staff. This judgement has been made using available evidence including a visit to the service. Standards 32, 34 and 35 were inspected. Evidence: The staff we met were friendly and helpful. We saw they got on well with the people who live in the home. They were observed working closely with them, helping them to make choices, and accompanying them out into the community. The home is wellstaffed so the people who live there have plenty of opportunities to get out and about or take part in activities on the premises. Staff turnover is low which provide continuity of care for service users. We talked to the people who live in the home about the staff team. They all made many positive comments about them including, The staff look after you when youre not very well, I like all the staff. Theyre like friends, and thats what I see them as, and The staff are a good lot. I can talk to them.
Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: All staff are subject to CRB and POVA checks, and references are obtained. Potential staff members meet with the people who live in the home as part of the recruitment process so feedback can be obtained from those they will be caring for. The Deputy told us that staff are recruited taking into consideration the cultural needs and personalities of the people who live in the home. Staff files were sampled and had the appropriate documentation in place. This helps to ensure the people who live in the home are safeguarded. Since the last inspection the Deputy Manager has achieved her Registered Manager Award (a recognised qualification for people who run care homes) and two staff have completed their NVQ (National Vocational Qualification) Level 3 in Care. This means that 70 per cent of the staff team have achieved NVQ level 2 or above which gives them the basic skills needed to work in care. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is good. The home is safe and well managed and the people who live there are involved in the way it is run. This judgement has been made using available evidence including a visit to this service. Standards 37, 38, 39, and 42 were inspected. Evidence: The Registered Manager is still overseeing care at another of the Owners homes, so the Deputy Manager is in charge at Hamilton. She is supported by the Manager who is on call 24/7. While the home is running effectively, it would provide more continuity for the people who live there if a Registered Manager was based on the premises. All the service user we spoke to said they liked the way the home was run. One told us, The Deputy Manager is nice and I have a laugh and a joke with her. Another said, There occasional friction what with 20 men living here, but its mostly OK and if there
Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: is a problem the staff sort it out. Staff meet regularly with the people who live in the home to get their views on how it is running. These meetings tend to be informal, and staff join service users in the dining room after meals and chat to them about holidays, menus, and activities. Occasional formal meeting are held when there is important information to relay, and minutes are taken at these. Annual survey are also given out to service users and their representatives, and anyone who wishes to give their views anonymously can use the homes Suggestions Box. Records showed that the health, welfare and safety of the people who live and work in the home is a priority. Appropriate checks and servicing of equipment has been carried out, as has consultation with the Fire Department and the homes Environmental Health Officer. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R 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, Care Homes Regulations 2001 and the National Minimum Standards
No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 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, Care Homes 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 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 20 Advice should be obtained from the homes contract pharmacist as to whether or not the current storage facilities meet the latest relevant legislation, particularly with regard to controlled drugs. A Registered Manager should be based on the premises. 2 37 Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 28 of 28 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
