Inspection on 10/10/05 for Hamilton House Nursing Home

This inspection was carried out on 10th October 2005.

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 Nursing Home 19/06/09

Hamilton House Nursing Home 30/01/08

Hamilton House Nursing Home 14/07/06

Hamilton House Nursing Home 03/05/05

Hamilton House Nursing Home 15/11/04

Hamilton House Nursing Home 01/06/04

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

CARE HOME ADULTS 18-65 Hamilton House Nursing Home The Street Catfield Gt Yarmouth NR29 5BE Lead Inspector Dot Binns Announced 10 October 2005 9.30am 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 House Nursing Home I55 S15643 Hamilton House V246851 101005 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Hamilton House Nursing Home Address The Street Catfield Gt Yarmouth NR29 5BE 01692 583355 01692 583355 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) Prime Life Limited Mrs Stella Evans Care Home 39 Category(ies) of Mental Disorder (39) registration, with number of places Hamilton House Nursing Home I55 S15643 Hamilton House V246851 101005 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Thirty-nine (39) service users who have a mental disorder, excluding learning disability or dementia may be accommodated. 2. One (1) person with a mental disorder over 65 years, who is named on the Commissions file can be accommodated. 3. Maximum number not to exceed thirty-nine (39). Date of last inspection 3 May 2005 Brief Description of the Service: Hamilton House is a registered care home offering nursing care to 39 people who have a mental illness. It stands on the main road through and on the outskirts of the Norfolk village of Catfield. The main large house has been extended and provides 23 single rooms and 1 double room. The rooms in the extension are particularly good with their own shower facilities and French doors to the outside. The accommodation is bright and attractive and has extensive communal space. In addition, a new building in the grounds provides 8 self contained flats, 6 accommodating 2 service users, and 2 for 1 person making 14 in all. These service users are assisted to shop, make their own meals and to be more independent. There is a large garden. Hamilton House Nursing Home I55 S15643 Hamilton House V246851 101005 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine announced inspection of the Home lasting seven hours. During the inspection, five service users were spoken to in private and three staff were interviewed. The records and policies of the Home were examined. Discussions took place with the manager about developments in the home and about the requirements made at the last inspection. A survey was also sent out by the Commission to be given to the service users in the Home. Fourteen replies were received and those views have been taken into account in the report. What the service does well: The Home is an accepting and comfortable place for the service users. They can take their own time, be themselves and are not compelled to do anything they do not want to do. Staff are caring and committed and although some of the group are quite new to the job, nevertheless talk confidently about the service users and want to do the best for them. Overall service users spoke well of the staff and felt listened to and well cared for. The catering especially for the main meal is well received with praise from the service users for the chef. Paperwork about the service users is very good and gives staff a good guide to assisting and understanding the service users. Policies and procedures are in place to provide a framework for how staff work. Health and safety policies are emphasised and maintenance of equipment is regular. The new mews flats are starting to be occupied and provide an attractive facility for the service users allowing more independence and responsibility. Hamilton House Nursing Home I55 S15643 Hamilton House V246851 101005 Stage 4.doc Version 1.40 Page 6 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 House Nursing Home I55 S15643 Hamilton House V246851 101005 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 House Nursing Home I55 S15643 Hamilton House V246851 101005 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) 2 The prospective service users’ needs are well assessed with the home gathering all appropriate information to help them. EVIDENCE: Four care records were selected at random. All four had a detailed assessment by the home of the various needs and abilities of the service user. The assessment was broken down into different areas stating where staff needed to assist and where the service user could be independent. There was also information from hospitals and social worker to enable the home to assess whether they could meet the needs of the person. From this information the care plan was developed and also any details were noted where there might be difficulties or restrictions. Hamilton House Nursing Home I55 S15643 Hamilton House V246851 101005 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 and 9 Service users can be assured that their needs and abilities are well reflected in their individual care and they are maintained to a good standard. Service users are involved in making decisions about their lives as much as possible though some restrictions because of illness or location can limit their participation. Service users are assisted to be as independent as possible and part of this process is a consideration of any risk. Hamilton House Nursing Home I55 S15643 Hamilton House V246851 101005 Stage 4.doc Version 1.40 Page 10 EVIDENCE: Three care records were selected at random to see what information they contained. Care plans are generated from the home’s assessment alongside information received from other healthcare professionals. They were very detailed covering all aspects of a person’s care, from their mental health to their ability to be independent. They gave details of what staff need to do to assist the service user and coping mechanisms for difficulties with behaviour or communication. There were references to situations where there were restrictions on choice, for example where the office held the person’s cigarettes, and the reasons for this and what the agreement was. Staff wrote reports every day about the progress or health of each service user and were good at commenting on mood, sleep patterns, and behaviour, all indicators about the mental health of the service user. The care plans were reviewed regularly, at least six monthly though more on some files, and documented to say so. The plans also covered the service users’ activities during the week. The care plans had also been well organised into sections and were easy to read. Overall they were a very good tool for staff. Service users confirmed that they could make some decisions themselves in terms of their routines and whether they leave the premises or participate in activities. The restrictions they experienced were mainly to do with lack of money for bus fares in order to enjoy more activities in the community outside of the small village where the home is located. Or they felt restricted because they felt unwell. Staff and the records indicated that service users were always involved in decision making about their lives as much as they were able and their rights were accepted. One person is on a residency order but this does not restrict his day to day activities. Most of the service users look after their own money, two service users telling the inspector about their bank accounts and how they obtained their money. The manager said that the home does not save money on a service users behalf but just minds it for some. On this occasion the records were not checked. Service users are assessed for any dangers to their wellbeing and risk assessments were seen on handling cigarettes, and on aggressive behaviour. Information from other professionals is used on admission to assess for areas of risk eg self harm. Before a service user looks after their own medication, a risk assessment is carried out. The home has strategies for service users who may go missing with a well defined action plan for one service user as well as a missing persons procedure. Hamilton House Nursing Home I55 S15643 Hamilton House V246851 101005 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) 12,13,14,16 and 17 Service users are not able to participate in many activities outside the home mainly because of their own lack of motivation but also because of access problems. Service users are absorbed into the local community to some extent but this is not always easy. Service users’ rights are in general respected and their decisions accepted. There may be a problem with privacy issues for some service users. Service users are offered a healthy diet and enjoy their main meal in particular. More variety in the teatime menus is recommended. Hamilton House Nursing Home I55 S15643 Hamilton House V246851 101005 Stage 4.doc Version 1.40 Page 12 EVIDENCE: Many of the service users are too ill to find employment or maintain sustained periods of learning. One or two service users attend outside sheltered employment. An adult literacy tutor also comes to the home to teach a group of service users. One service user expressed a wish to attend a day centre in Norwich but was unable to afford the fare. The location of the home does place restrictions in this way. The home has a car but this is not always available or is tied up with taking service users to other appointments. Service users do use the local village facilities, service users saying that they walked up to the shop and post office most days. Staff assist service users to the shops and for those in the mews who have to buy and organise their own food, staff help them with budgeting and shopping. One service user rides her bike everywhere. A church group and the church service are also attended by some of the service users. There have been some difficulties in the relationship with the community in the past though some amends have been made. One service user however said they were not welcome in the local pub and they had to go further afield. The manager has worked hard to liaise with the local community. Staff do organise outings in the car to the wider community and one service user said how he had enjoyed outings to Pleasurewood Hills, Lathams and Norwich. Service users are registered to vote. There has been an increase in the numbers of staff on duty in the evenings and this should allow staff to support service users outside the home more frequently. There are activities provided in the home though the one most remembered by the service users was the bingo. There is a pool table and music is played regularly. The care records record the activities of the service users and outings are referred to and bowling. Service users also help with housekeeping tasks and one person bakes bread regularly. One service user looks after part of the garden. One service user thought there were more activities in the past and told how he used to go fishing. He was not able to do so now. Six out of fourteen service users replied to the survey that there were not enough activities. Staff also felt more should be offered. This is an area where improvements have been asked for in the past and again a recommendation is made. The obstacles – the lack of transport, the lack of organisation or ideas, the need to develop the key worker system, should be addressed. Hamilton House Nursing Home I55 S15643 Hamilton House V246851 101005 Stage 4.doc Version 1.40 Page 13 Service users have freedom of movement within the home, using the communal rooms and gardens or staying in their own rooms as they wish. Those service users seen at the inspection endorsed this view and said they were able to enjoy their privacy or choice of activity as they wanted. They hold a key for their rooms and staff use the knocker to gain access. They thought staff were very good and always there to help. The records also indicated that service users’ rights were maintained. Those in the mews flats have a more independent lifestyle and have to take more responsibility for their daily lives, making more decisions themselves. However 5 out of the 14 replies to the survey said that privacy was not respected which might indicate that some work still needs to be done. The chef of the home was seen during the inspection and he confirmed that he worked with fresh ingredients and offered two choices at the main meal. He felt a lot of vegetables were offered each day and that service users ate healthily. Cornish pasties or haddock was being offered on the day of the inspection with apple and blackberry pudding. Three service users with diabetes were given appropriate sugar free dishes. The service users all agreed that the food had improved with this chef and the main meal was very good. The chef confirmed that sandwiches are the main teatime menu and that normally the care staff prepare the tea. Two service users also mentioned that tea was always sandwiches and there was no teatime menu for staff to work from. The service users did mention and seemed to prefer the fact that the day before they had been given pizza and chips which might indicate some changes on the menu are needed. It is recommended that teatime menus are devised to ensure there is variety in what is presented by staff. The service users in the main house eat together in the dining room but those in the flats can suit themselves buying their own food and making their own meals with staff help if required. There are set times for meals in the main house except breakfast which is more flexible. However one service user said that meals will be kept if he is out and comes home late suggesting there is some flexibility in the timing of all meals. Hamilton House Nursing Home I55 S15643 Hamilton House V246851 101005 Stage 4.doc Version 1.40 Page 14 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) 18,19 and 20 Service users are consulted about what support they need and on the whole it works well for them. Service users are monitored by the staff to ensure they are well and outside help is accessed when required. Service users can retain their own medication if it is safe but usually the home looks after medication and controls how this is done with procedures and training. This ensures service users are protected. EVIDENCE: Only one person needs help to move around and the Home does have a hoist to help them. Two or three service users need help with personal care but mainly all are mobile and can handle their own personal hygiene. Service users confirmed they could keep to their own routines and chose their own clothes and hairstyles. They could stay in their room if they liked and rooms reflected their individuality. Those in the mews have more independence and can come and go as much as they are able. Staff gauge with them the level of support they need. 12 out of 14 service users in the survey replied that they felt staff treated them well. Hamilton House Nursing Home I55 S15643 Hamilton House V246851 101005 Stage 4.doc Version 1.40 Page 15 The evidence from the care files showed that service users have access to community healthcare with references to GP visits, annual psychiatrist assessments and community psychiatric nurses and social workers involved in reviewing their care. There were also references to visits to the optician, dentists and hospital appointments. There were specific aspects of the care plans relating to the service users mental health and staff were clearly monitoring each person’s mood, sleep, appetite and behaviour as part of the overall plan (References seen in the daily notes). The medication systems were inspected as requirements had been made at the last inspection. The drug cabinet is locked and located in a locked room. The Home uses the monitored dosage system supplied by the pharmacist. The medication administration records were checked against the tablets in the system and correctly recorded. None of the service users are self medicating at the moment so no risk assessments were seen. However the manager understands these need to be in place should a service user look after his own medicine. The nurses are the main staff to give out medication though the records showed that some care staff had received training on medication. Hamilton House Nursing Home I55 S15643 Hamilton House V246851 101005 Stage 4.doc Version 1.40 Page 16 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) 22 and 23 On the whole service users feel they will be listened to and a structure is in place for dealing with their complaints. Service users are protected from abuse by the Home’s polices but staff training should be more widely offered. EVIDENCE: The complaints procedure is available in the service users guide and includes timescales for action by the Home. There is also a record kept of complaints and the actions taken to investigate and sort them out. No complaints have reached the Commission in the last year and the manager tries to deal with complaints at an early stage. All the service users seen felt they could speak to the staff if they had a concern and 11 out of 14 replies to the Commission’s survey said they knew who to speak to if they were unhappy. The Home has an abuse policy in place (which is copied into the staff handbook which all staff receive) which indicates that any allegation or suspicion of abuse will be reported to the police and social worker in line with local procedures. Not all staff have received training however and it is recommended that local courses are offered to as many staff as possible. Hamilton House Nursing Home I55 S15643 Hamilton House V246851 101005 Stage 4.doc Version 1.40 Page 17 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 The service users live in a bright attractive homely environment which provides a safe place to be. EVIDENCE: The Home has been renovated in the last year and has plenty of communal space that is bright and airy. There are also seven flats in a separate building separately staffed where service users have more independence and are assisted to increase their skills. They have their own living rooms and facilities. The premises are easily accessible to the service users who are all mobile. Furniture and fittings are appropriate and attractive. There is a large landscaped garden. The premises are free from offensive odours. The home is located in a small village a short bus ride away from Stalham. There are only a few village facilities which most of the service users can use but they are not able to access other places very easily. There is a large car belonging to the home but not all staff can drive it. When it is used, the service users enjoy the outings but they would like more. T Hamilton House Nursing Home I55 S15643 Hamilton House V246851 101005 Stage 4.doc Version 1.40 Page 18 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) 32,33,34,35 and 36 Service users are supported by competent staff and training is being encouraged. The service users are well supported by an effective staff team which has new members who are enthusiastic. The levels of staffing are much increased. The recruitment procedures of the home are faulty and do not give as much protection to the service users as they should. Training completed and an overall training plan were more in evidence and this will help to ensure that service users needs are appropriately met. Staff are well supported and the system of one to one supervision is in place, though needs to be more consistent. Hamilton House Nursing Home I55 S15643 Hamilton House V246851 101005 Stage 4.doc Version 1.40 Page 19 EVIDENCE: Staff seen at the inspection were enthusiastic about their work and could see where they could improve it. They felt well supported and had received some training in the Home. They felt the handover meetings and staff meetings allowed them to learn from senior staff. The Home is now making an effort to support staff through the NVQ programme and the manager said that 25 have already completed their NVQ and another 25 are currently studying for it. The target for 50 of staff to be trained by 2005 might almost be there. The rota provided for the inspection showed an increase in staffing which was welcome. As well as a quota of staff allocated to the main house, there were two dedicated staff allocated to the mews between 8am and 8pm where service users are assisted to be more independent. The Home is also contracted to provide a lot of extra hours (196) to several service users who require individual support. One of these was in hospital leaving 140 hours to be found. Extra hours calculated from the rota provided for the week of the inspection showed 140 hours in place, some of these hours being provided by an extra nurse on duty. Clearly staffing levels may have to be reviewed if the numbers of service users increase but on the current numbers staffing was satisfactory and much improved. In addition an extra evening staff had been provided in the main house allowing three staff to be on duty between 8pm ad 10pm. and another one in the mews. This was also welcome and meets the requirement made at the last inspection. Several staff are new to the Home but with support will provide an effective staff team. There are both male and female staff reflecting the gender group of the service users. The only area where staffing could be reviewed is in the provision of catering staff. The current level is good for the weekdays but there are no dedicated catering staff at the weekends and care staff have to provide this. Consideration should be given to extra provision. It should be added that the manager is now supernumerary and can oversee the work in the home much more effectively. This is a huge improvement since the last inspection. Hamilton House Nursing Home I55 S15643 Hamilton House V246851 101005 Stage 4.doc Version 1.40 Page 20 Recruitment files of three new staff were examined and found to have references, identity checks and criminal record checks. However the dates of starting work were earlier than the receipt of the POVA first checks and the criminal records checks. This is not giving enough protection to service users. It is accepted that the Home needed to recruit quickly and new staff were shadowing experienced staff. However all references and the POVA check must be in place prior to recruitment. The Home does provide induction training and completed workbooks were seen though one new staff had not yet completed it four months into the job. There was also evidence of training on first aid, fire awareness, coshh and food hygiene. Medication and moving and handling was also provided. Staff confirmed that they had received the training and shadowed an experienced member of staff during their first week. In terms of mental health training this is not yet standard and new staff confirmed they learned through reading the files and listening to more experienced staff. There has been some mental training for more experienced staff and this is to be encouraged. A training summary of each member of staff’s training was in evidence and allowed the manager to see where the need for further training lay. In terms of one to one supervision sessions for staff this has started to improve and a plan of what had already taken place was seen. There were still a lot of gaps however though it was clear that the manager is working hard to ensure supervision is provided systematically. Improvements still are needed however. Hamilton House Nursing Home I55 S15643 Hamilton House V246851 101005 Stage 4.doc Version 1.40 Page 21 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) 39 and 42 To ensure the service users’ views underpin the development in the home, the quality assurance system should be reviewed. The health and safety of the service users is protected well by policies, training and regular maintenance of equipment. EVIDENCE: The Home has some parts of a quality assurance system though up to date information was not in place at this inspection. There are questionnaires given out to service users and staff though in the past these have been limited in the information produced. There was at this inspection no analysis of the surveys. There is an audit carried out every year on the building as part of the quality monitoring system though more standards by which to measure quality would serve the system better, for example whether all staff have received supervision six times in the year, whether all care plans have been reviewed, all complaints attended to etc as well as the surveys for staff and service user views. Overall the quality assurance system should be reviewed. Hamilton House Nursing Home I55 S15643 Hamilton House V246851 101005 Stage 4.doc Version 1.40 Page 22 There are policies and procedures in place to ensure that safe working practices are complied with. Staff are given a handbook with the policies in it. Compulsory training at the start of employment is provided on moving and handling, fire awareness, food hygiene and Coshh (seen in staff files and training plan). Records for checking electrical and gas systems were seen as was a record of water temperatures. Fire records were inspected and showed alarms and equipment were checked regularly and drills carried out. Risk assessments were carried out and the accident record is properly kept. Hamilton House Nursing Home I55 S15643 Hamilton House V246851 101005 Stage 4.doc Version 1.40 Page 23 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 3 x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x 3 Standard No 11 12 13 14 15 16 17 x 2 3 2 x 2 2 Standard No 31 32 33 34 35 36 Score x 3 3 1 3 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Hamilton House Nursing Home Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 2 x x 3 x I55 S15643 Hamilton House V246851 101005 Stage 4.doc Version 1.40 Page 24 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 34 Regulation 19(1)(b) Requirement The registered manager shall not employ a person to work in the Home until he has received all the information required. The registered manager must ensure that staff are appropriately supervised. Timescale for action 31.10.05 2. 36 18(2) 30.11.05 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. 4. 5. 6. Refer to Standard 12 14 16 17 23 39 Good Practice Recommendations It is recommended that opportunities for sheltered work or attendance at day centres are created. It is recommended that more activties and outings are organised. It is recommended that issues of privacy are reviewed with staff. It is recommended that menus are organised for the teatime meal so a greater choice is offered. It is recommended that staff receive training on adult protection provided by the local authority. It is recommended that the quality assurance system is reviewed and fuller surveys developed. Hamilton House Nursing Home I55 S15643 Hamilton House V246851 101005 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection 3rd Floor, Cavell House St Crispins Road Norwich NR3 1YF 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. 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