Inspecting for better lives Random inspection report
Care homes for older people
Name: Address: Hamilton House West Street Buckingham Buckinghamshire MK18 1HL The quality rating for this care home is: The rating was made on: 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. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Joan Browne Date: 0 7 1 1 2 0 0 8 Information about the care home
Name of care home: Address: Hamilton House West Street Buckingham Buckinghamshire MK18 1HL 01280813414 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Acegold Limited (a wholly owned subsidiary of Four Seasons Health Care Ltd) care home 53 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category 0 Over 65 53 Conditions of registration: That as of the 1st of March 2006, further to a variation application the home is registered to provide care for 1 further service user with Dementia. That this condition applies to a specific service user and should the service user, for whatever reason, leave the home, the home must notify CSCI and this condition will cease to apply. Maximum 53 Nursing 40 years plus Maximum 8 personal care For one resident with dementia, as identified in variation for registration form dated 27 06 05. Date of last inspection Brief description of the care home Hamilton House is situated a short distance from the town centre of Buckingham, a small market town served by local bus networks with a variety of shops and other local Care Homes for Older People
Page 2 of 8 amenities. The home is one of the Four Seasons Healthcare Group. It provides personal care for up to 53 Service Users. Service users are accommodated in one of 39 single or 7 shared rooms, found over 3 floors. The home has 4 dayrooms and 1 dining room. These communal areas provide space for receiving visitors, participation in activities, watching television and dining for limited numbers. The front door to the building is accessed by two steps, and is therefore inaccessible to wheelchair users. Side entrances to the home can be used for wheelchair access. The home has two passenger lifts, which permit access to all levels of the home. Grab rails are found in toilets, bathrooms and bedrooms. There are hoisting equipment to facilitate safe moving and handling practice and a nurse call system in place. The staff team consists of trained nurses, care staff, domestic, catering and laundry staff. Care Homes for Older People Page 3 of 8 What we found:
A routine random inspection was undertaken on 7 November 2008. The inspection consisted of examination of some care documentation and records, discussions with residents, staff and one relative. A tour of the premises was undertaken. We found that the home continues to provide a good level of care to people using the service. As a result of this visit four recommendations have been made. We have summarised our findings under the main outcome areas that were assessed. Health and personal care: We looked at two care plans for two people using the service. The plans examined were well written, comprehensive and had been subject to regular reviewing with accompanying risk assessments such as, moving and handling, falls, waterlow (tissue viability), continence and nutritional in place. The medication administration record (MAR) sheets were examined and there were no unexplained gaps. The control drug register and medication were checked and the register balanced with the medication in stock. We noted some inconsistencies in staffs recording practice. For example, some staff were recording their initials instead of their full signature in the controlled drug register. Handwritten entries on the MAR sheets were not countersigned by a second member of staff to minimise the risk of error when transcribing. To comply with best practice guidelines recommendation have been made for staff to record their full signature and for a second member of staff to countersign all handwritten entries. We observed that a large amount of stock medication was stored on shelves in the area where the medication trolley is stored. Although the door is kept locked in the interest of safety it is recommended that a more appropriate secure shelving is provided. Complaints and protection: The homes complaints folder was examined. Eight complaints had been recorded. Evidence seen indicated that the complaints were investigated appropriately with satisfactory outcomes. The home had notified the Commission of two safeguarding of vulnerable adult incidents, which were still ongoing. Environment: A tour of the premises was carried out. Overall we found all areas of the home to be clean, pleasant and hygienic. The communal areas were found to be pleasantly decorated and furnished. Two bedrooms were examined and they were personalised reflecting the characters of the individuals with family pictures and mementos. The manager told us that there was an ongoing programme of redecoration in place. The home was experiencing some drainage problems which were being investigated. Staffing: The staff were pleasant, polite and co-operated with the visit. They were observed speaking to residents in a respectful manner and having a joke. The staff roster was examined and it was found that sufficient staff were on duty. There were three registered nurses and eight carers covering the morning and afternoon shifts. This number was reduced to two registered nurses and three carers at nights. We were told that training for staff was ongoing. Some of the trained nurses had recently completed training in palliative care. A relative spoken to said that staff were very Care Homes for Older People Page 4 of 8 caring and provided a high standard of care to the people using the service. Management and administration: The home has appointed a new manager and he has started the process to be registered with the Commission. We met with the administrator and discussed the way that the home safeguards the residents financial interests. The home does not manage the residents financial affairs. This is generally carried out by relatives or their representatives. Relatives, hand in money to the home to cover the cost of hairdressing, chiropody treatment and newspapers. A receipt is given to relatives when money is handed in. The money is banked in a central fund. We noted that the home was currently holding money for twenty-eight people. The transaction sheets for these individuals were checked and appeared to be appropriately maintained with receipts in place for all incoming and outgoing payments. We were told that the organisations financial procedure allowed the home to have a petty cash float of 200.00 pounds so that residents can have access to their money as and when required. However, money held in the float on the day of the inspection visit exceeded the 200.00 pounds limit. The actual money held was 280.00 pounds and forty-eight pence. Careful consideration should be given to ensure that the organisations financial procedure is adhered to. We were told that only the manager and the homes administrator had access to the petty cash float and the cash is checked weekly. What the care home does well: 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 2. Care Homes for Older People Page 5 of 8 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set.
No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 6 of 8 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 10 In the interest of safety more secure shelving should be provided to store the stock medication in the medication room. To comply with best practice guidelines staff should sign their full signature in the controlled drug register and not initials. Handwritten entries recorded on the medication administration record sheets should be signed by two staff members to minimise the risk of errors when transcribing. Money held in the home for people using the service should not exceed the organisations financial limit. 2 10 3 10 4 35 Care Homes for Older People Page 7 of 8 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 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 Older People Page 8 of 8 - 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!
