Inspection on 02/06/06 for Hamilton House

This inspection was carried out on 2nd June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Hamilton House 18/05/07

Hamilton House 09/11/05

Hamilton House 26/04/05

Hamilton House 22/02/05

Hamilton House 03/11/04

Hamilton House 16/04/04

Hamilton House 11/11/03

Hamilton House 23/07/02

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Hamilton House Residential Home 23 Houndiscombe Road Mutley Plymouth Devon PL4 6HG Lead Inspector Jane Gurnell Unannounced Inspection 2nd June 2006 10:00 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 Hamilton House Residential Home DS0000003480.V290548.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. Hamilton House Residential Home DS0000003480.V290548.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hamilton House Residential Home Address 23 Houndiscombe Road Mutley Plymouth Devon PL4 6HG 01752 265691 01752 662367 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) Penton Homes Limited Mrs Elizabeth L Glover Care Home 31 Category(ies) of Dementia - over 65 years of age (31), Old age, registration, with number not falling within any other category (31) of places Hamilton House Residential Home DS0000003480.V290548.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered as a care home only (PC), providing care for older people not falling within any other category (OP) over 60 years of age, and also for service users with Dementia over 65 years of age DEE) The home may accommodate up to a maximum of 31 service users at any one time. One named service user under the age of 60 years One named Service user out of category and under the age of 60 years Bedroom 3, on the lower ground floor, can only be used by service users who are ambulant and can safely manage stairs. 09/11/05 2. 3. 4. 5. Date of last inspection Brief Description of the Service: Hamilton House is a large care home owned by Penton Homes Ltd. and situated within walking distance of Mutley Plain shopping precinct. The home can accommodate 31 service users at any one time and can accommodate elderly people who may have dementia. Hamilton House consists of two large houses that have been converted into one. There is a lower ground floor - with two lounges and two dining rooms. Some of these rooms have limited natural light. On the ground floor there is a further lounge. There are bedrooms and bathrooms on all three floors. A passenger lift provides access to all floors however there are a two single steps in the hallway by the dining rooms and this may pose a difficulty for residents with restricted mobility. The home is staffed 24 hours a day, including 2 waking night staff. The current fees for the home range from £327 to £368 a week. Hamilton House Residential Home DS0000003480.V290548.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 3 days; the first visit was unannounced on 2nd June, with announced visits taking place on 6th and 22nd June. Mrs Glover, the Registered Manager was available on all 3 days and she and her staff team assisted the inspector throughout the inspection. The inspector made a tour of the building and spoke to residents, staff and 4 relatives who were visiting at the time. Documentation relating to the care planning process and the management of the home were examined. Prior to the inspection, resident comment cards had been sent to the care home to allow residents to comment upon their experiences. Four cards were returned and no issues of concern were raised. Following the inspection, the inspector contacted a further 5 relatives by telephone to seek their views of the services provided at Hamilton House: all relatives spoken to either in person or over the phone were complementary about the care home. The Community Staff Nurse was visiting the care home at the time of the inspection and reported to the inspector that she has confidence in the care staff and is kept fully informed of the residents’ health care needs. A social worker from Plymouth Social Services Review Team, who has responsibility for those residents funded by the local authority was also consulted as she felt that residents’ needs were being met and that she was kept informed of changing care needs. What the service does well: What has improved since the last inspection? New flooring had been laid in the entranceway, 1st floor hallway and both dining rooms. New carpets had been laid in 3 bedrooms and new furniture purchased for the dining room, conservatory, some bedrooms and the garden. Fencing has been erected in the garden making this a pleasant and safe area for residents. The care plans had been updated since the last inspection and following further advise on the first day of this inspection, improved further. Residents care needs in relation to mental health issues were seen to be recorded in a more respectful manner. Accidents are recorded in more detail and reviewed by the Registered Manager to identify whether residents’ health or mobility needs are changing. Door locks of a type particularly suitable for residents who may suffer from confusion had been fitted to a number of bedrooms since the last inspection. Hamilton House Residential Home DS0000003480.V290548.R01.S.doc Version 5.2 Page 6 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 House Residential Home DS0000003480.V290548.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 Hamilton House Residential Home DS0000003480.V290548.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, The quality in this outcome area is adequate. This judgement has been made using the available evidence including a visit to the service. Improvements have been made to the pre-admission process to ensure residents’ needs are clearly identified before admission to the home. EVIDENCE: The Statement of Purpose is a document that describes the aims and objectives of the care home and how the services provided will meet the needs of the residents. This document needs to be amended to meet the requirements of Schedule 1 of the Care Homes Regulations 2001, and include the number and qualifications of care staff, clarification of the roles of the Registered Provider and Registered Manager and how the home supports residents with dementia. The Registered Manager described that she, or her deputy undertake preadmission assessments for prospective residents and meets with them to ensure that their care needs can be met at Hamilton House. Documentation Hamilton House Residential Home DS0000003480.V290548.R01.S.doc Version 5.2 Page 9 relating to these assessments has improved since the last inspection and the one for a newly admitted resident did provide a more detailed description of care needs. The Registered Manager was advised to continue to fully document these assessments as it is important prospective residents are assured that not only can their health care needs be met but also their emotional, social, cultural or religious needs. Since the previous inspection, the Registered Manager has purchased a training manual for the care staff relating to the care of people with dementia. Each member of staff will be individually supported by the Registered Manager to work through this manual to ensure they understand what dementia is and how it effects a person as well as gaining the skills necessary to support residents who may lose their abilities and become frail and who may be anxious or confused. Hamilton House Residential Home DS0000003480.V290548.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 The quality in this outcome area is adequate. This judgement has been made using the available evidence including a visit to the service. The improvements made to the care plans ensure that staff are aware of residents’ needs and will promote consistency in care. EVIDENCE: Hamilton House provides care for residents who may, due to their dementia, require support not only with personal care but also with anxiety and confusion. It is therefore important for residents who are unable to express their needs that care staff have a clear understanding of the residents’ needs both physically and emotionally. Care plans are the documents used to provide this information and as such are important to ensure consistency in care and inform staff of their responsibilities towards the welfare of the residents. Six care plans were reviewed in detail. The Registered Manager had made improvements to these since the last inspection and after further discussion, the care plans format was changed to one that was easier to read and containing a more detailed description of residents care needs and the action Hamilton House Residential Home DS0000003480.V290548.R01.S.doc Version 5.2 Page 11 required by staff to meet those needs. By the 3rd day of the inspection the majority of residents’ care plans had been re-written. The Registered Manager must now ensure that the care plans are kept up to date by reviewing them at least monthly, consulting with the care staff and the resident and/or their relatives. During the inspection, the Community Staff Nurse was visiting the home and reported that she has confidence in the care staff and is kept fully informed of the residents’ health care needs. A Social Worker from Plymouth Social Services Review Team, who has responsibility for those residents funded by the local authority, was also consulted as she felt that residents’ needs were being met and that she was kept informed of changing care needs. Residents spoke highly of the care staff and said that they were being well cared for and were happy living at the home. Those relatives spoken to said they had confidence in the staff and Registered Manager and were kept informed of any changes in their relatives’ needs. Medication is stored safely and the medication records, with the exception of the recorded balance of one controlled drug, were accurate. The mistake with the balance of the controlled drug was traced to an error in the calculation of remaining balance. Senior care staff with the responsibility for medication administration have undertaken training in the safe handling of medicines: these staff must be reminded that the recorded balance and the actual balance of controlled drugs must be in agreement. Any discrepancies must be reported to the Registered Manager or deputy manager immediately. Hamilton House Residential Home DS0000003480.V290548.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 The quality in this outcome area is adequate. This judgement has been made using the available evidence including a visit to the service. The introduction of daily activities provides interest and stimulation and will enhance the quality of life for residents. EVIDENCE: The Registered Manager described that since the last inspection a member of staff has been given the responsibility to organise daily activities for the residents. This staff member has consulted with the residents and has developed a weekly timetable for care staff to follow. A record of who has participated is recorded on the activity timetable: the Registered Manager was advised to record each resident’s participation in his or her daily care notes. Attention should be paid to those residents who find it difficult to join in with group activities and for those in frail health. The Registered Manager has purchased specialist activities designed for residents with restricted dexterity and mobility. During the inspection the inspector observed staff facilitating various activities and supporting residents with dementia to join in. The atmosphere within the home was happy, with lots of chatting, singing and laughter between the residents and staff. Hamilton House Residential Home DS0000003480.V290548.R01.S.doc Version 5.2 Page 13 Those relatives spoken to in person and over the phone said that they were satisfied with the care and support provided and were made very welcome. They said that both the Registered Manager and her deputy were very easy to talk to any issues or concerns were dealt with promptly. Two relatives said that it was “one big happy family”. Residents said they enjoy the meals and that there was always a choice. Two residents said that they enjoy a sherry and whisky after their supper and this is provided by the home at no extra cost. Hamilton House Residential Home DS0000003480.V290548.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 The quality in this outcome area is adequate. This judgement has been made using the available evidence including a visit to the service. Residents and relatives can be confident that concerns will be listened to and resolved promptly. EVIDENCE: Those residents able to comment said that they had confidence in the Registered Manager and her staff to deal with concerns. Relatives also had the same confidence. The Registered Manager has an “open door” policy and throughout the 3 days of the inspection the inspector observed residents and relatives meeting with her on numerous occasions. With regard to the use of a “babygate” found at the previous inspection across the doorway to one of the lounge rooms, the Registered Manager acknowledged that albeit used to protect residents, it was inappropriate. The Registered Manager was advised to seek advise from the GP, Community Mental Health Team and the Commission should restrictive measures be necessary to protect the health and safety of a resident in relation to their confusion where they may not recognise their own frail mobility and are at risk from falling. Care staff have received training in the protection of vulnerable adults form abuse. Hamilton House Residential Home DS0000003480.V290548.R01.S.doc Version 5.2 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 24, 25, 26 The quality in this outcome area is adequate. This judgement has been made using the available evidence including a visit to the service. Residents live in a conformable home that is well maintained, the layout of which though may be confusing. EVIDENCE: Hamilton House consists of two large houses that have been converted into one and due to this the layout can be confusing, particularly for residents with dementia who may wander freely around the home and who may become disorientated. Directional signage is used to assist residents to find their way around the home; however, those residents spoken to about the signs had either lost their ability to read and comprehend due to their dementia or did not find them useful as they knew their way around the home. Registered Manager was advised to use a more domestic type of sign with pictures rather than words that may be easier to understand. Hamilton House Residential Home DS0000003480.V290548.R01.S.doc Version 5.2 Page 16 Photographs of residents were displayed on some of the bedroom doors to assist residents to identify their rooms: advise was given to use photographs of the resident when they were younger and also those of family or pets that may be more easily recognisable for residents with dementia who may not recognise themselves as they are today. The home well maintained and decorated. The décor, however, is similar throughout the home it may not be easy to tell one part of the home from another. The use of different colours may be beneficial in differentiating between each floor and identifying areas such as the bathrooms and toilets. New research and advice is available on this subject from dementia care associations such as Dementia Voice and the Alzheimer’s Association. The home was found to be very clean and tidy: a domestic is on duty every day of the week. A portable hoist is now available for the bath identified in the previous inspection report as not being suitable to be used by residents with mobility difficulties. The floor has been repaired in the 2nd floor toilet area now making this area safe, although the shower tray has not yet been installed nor the tiles replaced on the lower part of the wall. The hot water from the baths was found to be very hot despite control valves being fitted to restrict the temperature. These valves are not fail-safe and the maintenance staff should check periodically that they are still functioning as they should to protect residents from scalds. Two bedrooms had low water pressure and the hot water came through very slowly and after some considerable time. The Registered Manager confirmed that a new boiler had been purchased and this should resolve the problem. At the previous inspection it was noted that some of the wash hand basin taps had been changed to those that rotate on a ball and may be difficult for residents to use effectively. The Registered Manager said that the residents in the bedrooms fitted with this type of tap are unable to use the sink without supervision and therefore have experienced no difficulty. It was advised that further installation of these taps be avoided as future residents may be able to use the sinks independently. The door to one of the toilets on the lower ground floor was found to be without a lock preventing residents from protecting their privacy. Door locks had been fitted to a number of bedrooms since the last inspection. These locks were of a type that although had to be locked from the inside by turning a knob, did not have to be unlocked as using the door handle as normal unlocks the door. These locks are particularly suitable for residents who may suffer from confusion and can be overridden by care staff in an emergency. Hamilton House Residential Home DS0000003480.V290548.R01.S.doc Version 5.2 Page 17 Not all radiators were covered, posing a risk of burns should residents touch them or fall against them. It was evident that the Registered Provider is committed to maintaining the property in good order and a member of staff is employed to see to day-to-day repairs and redecoration. Since the last inspection new floors had been laid in the main entranceway, the hallway and both dining rooms and new carpets laid in a number of bedrooms. The Registered Manager had taken the advise of the inspector at the last inspection and the flooring and carpets were of a plain design more suitable for residents with poor eyesight. Windows had been replaced in a number of bedrooms: the inspector found that the opening restrictors had not been replaced by the contractors but this was rectified immediately when brought the attention of the Registered Manager and maintenance staff. A lounge room is available for residents who may wish to smoke. New furniture has been purchased for the dining room, lounge rooms, some bedrooms and the garden. Fencing in the garden has been erected making this a pleasant and safe area for residents to enjoy. A passenger lift provides access to all floors however there are two single steps in the hallway by the dining rooms and this may pose a difficulty for residents with restricted mobility. A stair lift is fitted to the stairs in the mezzanine landing only. The front door has been fitted with a video-link entry system allowing staff to view visitors from a monitor adjacent to the dining room on the lower ground floor and allow them entry. Hamilton House Residential Home DS0000003480.V290548.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 The quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. Residents are supported by well-motivated and caring staff in sufficient numbers to meet the needs of those currently living at the home. Recruitment practices protect residents. EVIDENCE: Those staff files examined contained the required pre-employment checks, including Criminal Record Bureau Disclosures, ensuring as far as possible unsuitable staff are not employed. Residents said that they are assisted promptly indicating that there are sufficient care staff on duty each day to meet the residents’ needs. Five care staff are on duty from 7.30am to 9pm, an additional member is on duty from 11am to 7pm. Two waking night care staff work from 9pm to 9am. These numbers do not include the Registered Manager who works 8am to 5 or 6pm five days a week, including weekends. Catering and domestic staff are employed each day. The majority of care staff, 80 , have a NVQ qualification either at level 2 or 3. A further 3 care staff are in training. Training records indicated there is an ongoing training programme to ensure care staff remain up to date in fire Hamilton House Residential Home DS0000003480.V290548.R01.S.doc Version 5.2 Page 19 safety, first aid and manual handling ensuring they have the knowledge and skills necessary to deal with emergencies. The home was been awarded “Investors in People”; an award that recognises the home’s committed to train and develop its staff. One member of care staff described how well she has been supported by the Registered Manager to gain experience and qualifications. She is in training to become a senior member of staff once she obtains NVQ 3 and has undertaken medication training. This indicates that the home takes seriously the responsibilities that come with a senior role and ensures staff are well trained before being promoted. A newly employed member of staff described her induction training and is working through a planned induction programme, indicating again the seriousness the Registered Manager places on training. Hamilton House Residential Home DS0000003480.V290548.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36, 37, 38 The quality in this outcome area is adequate. This judgement has been made using the available evidence including a visit to the service. Hamilton House is a well run home which will improve further as the Registered Manager develops her own skills. EVIDENCE: Mrs Glover, the Registered Manager has been employed at Hamilton House for over 20years and as such has a great deal of experience in caring for older people. She did, however, only take over the role of Registered Manager from Mr Dawson, the Registered Provider, last year. Mrs Glover is developing her own skills and is working hard to ensure that the requirements made at the last inspection are addressed and that the National Minimum Standards are met. As stated in the section for complaints and protection the Registered Manager has an “open door” policy and this is valued by residents, relatives and staff and promotes an atmosphere of co-operation and openness. Hamilton House Residential Home DS0000003480.V290548.R01.S.doc Version 5.2 Page 21 A quality assurance system has been developed to consult with residents, relatives and others involved with the home such as GPs and Community Nurses. The Registered Manager has sent surveys to the local GPs asking for their views about the home. At the time of the inspection one had been returned and included positive comments about the home. Once the consultation process has been expanded to include residents and relatives a development plan can be produced identifying the plan for service improvement over the forthcoming year. Each member of staff has had an appraisal to assess their work performance and their training and development needs. The Registered Manager has recently introduced a formal staff supervision process and she and her deputy share the responsibility of supervising all staff. Staff meetings are held every 4-6 weeks and surveys are sent to staff every 6 months asking for their views on the running of the home and the support they receive to do their job. Regular consultation with staff ensures staff can contribute to the running of the home and are aware of the home’s aims and objectives, philosophies of care and promotes consistency and improvement. Money is held for safekeeping for a number of residents and individual records maintained. From examination of these it was obvious that the home subsidises some residents when their funds run out and the Registered Manager says that no resident will go without something they need or would like. Relatives are invoiced each month for the balance. One relative commented upon the generosity of the home towards those residents who have no relatives, particularly at Christmas time. Sampling of records indicated equipment is serviced regularly and maintained in good order. A test of the water system last year indicated that the water is free from legionella, however this assessment is only valid for the time it was taken. A risk assessment relating Legionnaires Disease is required by law and is necessary to ensure that the Registered Provider has taken the necessary control measures to prevent an outbreak: this includes monitoring the temperature of any stored water, both hot and cold and monitoring the temperature of the circulating water in the pipes, particularly at the furthest point form the boiler or hot water tank. The Registered Provider should seek advise from the Environmental Health Department who will provide information about how to undertake the assessment. Hamilton House Residential Home DS0000003480.V290548.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 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 2 2 X 2 2 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 X 3 2 3 2 Hamilton House Residential Home DS0000003480.V290548.R01.S.doc Version 5.2 Page 23 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 OP1 Regulation 4 Requirement The Statement of Purpose must be amended to meet the requirements of Schedule 1 of the Care Homes Regulations 2001. The Registered Manager must ensure that the care plans are kept up to date and reflect accurately the residents care needs in relation to their health and personal care and their mental and emotional wellbeing. Any risks, such as from falls or poor nutrition, are identified and described in full. All toilet doors must be fitted with a lock that can be overridden by care staff in an emergency. The temperature of the hot water must be controlled to approximately 43°C on all baths and those hand wash basins identified through risk assessment as placing residents at risk from scalding. Radiators must be covered to protect residents from the risk of burns. DS0000003480.V290548.R01.S.doc Timescale for action 31/08/06 2. OP7 15 31/10/06 3. OP21 23 31/08/06 4. OP25 13 31/10/06 5. OP25 13 31/10/06 Hamilton House Residential Home Version 5.2 Page 24 6. OP38 23,13 A risk assessment relating to the control of Legionnaires Disease must be completed and implemented, as per guidance from the Health and Safety Executive. 31/10/06 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. 3. Refer to Standard OP12 OP21 OP22 Good Practice Recommendations Residents’ participation in activities should be recorded in their daily care notes. The shower tray should be installed in the 2nd floor toilet area increasing the bathing facilities available for residents. The Registered Manager should consider changing the directional signing to that of a more domestic nature with pictures that may be easier for residents with dementia to comprehend. Consideration should be given to the décor and layout of the home in line with new research from dementia care organisations that may make it easier for residents to find their way around the home. Locks should be fitted to the remainder of the bedroom doors. The Registered Manager should continue with the quality assurance consultation process and expanded it to include residents and relatives. An annual development plan should be implemented. The Registered Manager should continue with the formal staff supervision of staff and should ensure staff are supervised at least 6 times a year. 4. 5. OP24 OP33 6. OP36 Hamilton House Residential Home DS0000003480.V290548.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 Hamilton House Residential Home DS0000003480.V290548.R01.S.doc Version 5.2 Page 26 - 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!