Inspection on 15/05/07 for Hamilton Lodge

This inspection was carried out on 15th May 2007.

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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hamilton Lodge 15/09/09

Hamilton Lodge 11/06/09

Hamilton Lodge 07/05/08

Hamilton Lodge 20/07/06

Hamilton Lodge 10/02/06

Hamilton Lodge 06/09/05

Hamilton Lodge 25/03/05

Hamilton Lodge 01/11/04

Hamilton Lodge 15/12/03

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Hamilton Lodge Rectory Road Great Bromley Colchester Essex CO7 7JB Lead Inspector Neal Cranmer Key Unannounced Inspection 15th May 2007 09:30 Hamilton Lodge DS0000017841.V341811.R01.S.doc Version 5.2 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 Lodge DS0000017841.V341811.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 Adults 18-65. 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 Lodge DS0000017841.V341811.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hamilton Lodge Address Rectory Road Great Bromley Colchester Essex CO7 7JB 01206 230298 01206 231166 care@hamiltonlodge.org.uk 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) Hamilton Lodge Trust Limited Mr E Curtis-Oram Care Home 40 Category(ies) of Learning disability (40), Learning disability over registration, with number 65 years of age (40), Physical disability (40), of places Physical disability over 65 years of age (40) Hamilton Lodge DS0000017841.V341811.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The home may accommodate 40 persons of either sex under the age of 65 with learning disabilities who may also have physical disabilities The home may accommodate 40 persons of either sex aged 65 years and over with learning disabilities who may also have physical disabilities The total number of service users accommodated in the home must not exceed 40 persons 20th July 2006 Date of last inspection Brief Description of the Service: Hamilton Lodge is a care home registered to provide personal care and support to forty people who have a learning disability and/may also have a physical disability. Registered accommodation is provided in three units, which cater for varying levels of dependency and need. The main residence is the large country manor house, Selbourne Court is a newer, separate, ground floor unit built on a site adjacent to the main house and the third unit is a small cottage where service users experience small group living on a domestic scale. Each unit is staffed separately and led by a home manager. The home is set in vast well maintained grounds, located in the small rural village of Great Bromley, geographically central to the larger towns of Clacton-on-Sea, Colchester and Harwich. Public transport to the towns, however, is minimal, but the home has four vehicles, which include a mini bus with a tail lift for the use of service users. Service users also have access to a taxi or public transport if they wish. There is a standard fee rate charge of £782.50 per week for staying in the home, with no additional charges made, this information was provided during a telephone call on the 10th July 2007 with the registered manager/general manager. Hamilton Lodge DS0000017841.V341811.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report follows a key unannounced inspection of Hamilton lodge, which took place on the 15th May 2007. The inspection was carried out with the assistance of one of the home’s deputy managers, and included discussion with the manager and staff, as well as the sampling of a range of documentary evidence relating to the residents and the management of the home. A total of twenty-four of the forty-three National Minimum Standards were inspected, of these twenty-two Were met, with the remainder being partially met. What the service does well: What has improved since the last inspection? Resident’s contracts of residency have been developed, and are now individualised, and clearly spell out the expectations of each of the relevant parties. The home’s recruitment practice has been improved, and the files sampled all contained the required documentary evidence. Hamilton Lodge DS0000017841.V341811.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. The summary of this inspection report can be made available in other formats on request. Hamilton Lodge DS0000017841.V341811.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Hamilton Lodge DS0000017841.V341811.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents can expect to be provided with the necessary information to enable them to make an informed choice about the home’s ability to meet their needs, and to be provided with a contract of residency upon their admission, which specifies the expectations of each party. EVIDENCE: Three residents care plan records were sampled, and each contained evidence of pre admission assessments, which were comprehensively completed and detailed with sufficient information for the resident’s plan of care to be developed from them. Contracts of residency are now written in an individualised way, and continue to be available in a pictorial format for ease of use by residents. Hamilton Lodge DS0000017841.V341811.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can expect that their care plans will reflect their needs and personal goals, and that they will take account of the need for them to take risks as part of developing an independent lifestyle. EVIDENCE: Three residents plans of care were sampled, all were written in a person centred way, clearly reflecting their individual needs and personal goals, and guidance to staff on how residents liked or needed to be supported were clear and concise. Residents are supported to make decisions about their every day lives, dependant on their individual abilities. All of the plans of care seen contained evidence of risk assessments having been undertaken, which clearly identified the rationale for taking the risk, the nature of the risk, and strategies to be followed to minimise the identified risks. Hamilton Lodge DS0000017841.V341811.R01.S.doc Version 5.2 Page 10 Each of the risk assessments seen had a section in them for the recording of signatures of those signed up to the assessment. Hamilton Lodge DS0000017841.V341811.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents living in the home can expect to be supported to take part in community-based activities, that are age and peer appropriate, and to be supported to maintain links with those important to them. Residents can expect to receive a diet that is healthy and nutritious, however the current arrangements for where resident’s meals are taken is not conducive with a homely environment. EVIDENCE: Residents living in the home are supported by a dedicated day service team, sampling of records indicated that residents were partaking in the following activities: Day trips out Visits to a local farm 1.1 out and about sessions Communication workshops Hamilton Lodge DS0000017841.V341811.R01.S.doc Version 5.2 Page 12 Tending the home’s greenhouse Rambling Bouncability Swimming Attending summer schools Theatre trips and horse riding. Each resident has a periodic lifestyle review, which is presented in a pictorial format, which records activities taken part in, and the outcome. Residents continue to be supported to maintain links with their families and friends, discussion with the manager indicated that the home has an open door policy on the receiving of visitors, with residents free to choose where they receive their visitors. The daily routines of the home promote residents independence, and residents were seen choosing to do various different thing within the home. Residents were seen to have unrestricted access to all areas of the home and its grounds, a number of residents were seen wandering around the grounds at their leisure. Interactions between staff and residents were seen to be positive, and staff spent time talking with the residents, and not exclusively with each other. The kitchen facilities for the home continue to be below standard, due to the age and condition of the home, however extensive work is currently in hand to address this matter. Meals continue to be provided to Selbourne Court from the main house kitchen via heated trolleys, however this system will cease once the new kitchen is built. The current arrangements for residents to take their meals is not adequate, and is not conducive with a homely environment, but once again this will be addressed through the refurbishment programme that is well under way. The meals provided by the home were seen to be varied and nutritious. Hamilton Lodge DS0000017841.V341811.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can expect that their physical and emotional healthcare needs will be met in such a way that preserves and respects their privacy and dignity. EVIDENCE: Observation of interactions seen between staff and residents indicated that residents personal support needs are sensitively met by staff who work with residents in such a way as to ensure that their privacy and is upheld at all times. All residents are registered with a General practitioner, and records relating to residents healthcare needs are well maintained. Records relating to accidents, weight and fluid intake were seen. Records sampled indicated involvement in the home from the following healthcare professionals, General Practitioners, Opticians and Dentists. Each residents care plan contains a Health Action Plan, which is used in all interactions undertaken with healthcare professionals. Hamilton Lodge DS0000017841.V341811.R01.S.doc Version 5.2 Page 14 The home’s medication administration practice was inspected, all medicines are administered from blister packs or individualised named containers. The home does not hold any controlled or invasive medicines. Records sampled were all in order with no omissions; records included photographs of the resident with a written record of how they prefer to receive their medicines. Only senior carers and those more senior administer resident’s medicines, although all staff have been trained to do so. Hamilton Lodge DS0000017841.V341811.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents living in the home can be assured that any concerns or complaints about the home will be listened too and acted upon, and that procedures for protecting them are robust. EVIDENCE: The home’s arrangements for dealing with Complaints and Adult protection issues are robust, and all staff have received training in adult protection, with periodic refresher courses planned. There have been no complaints or adult protection referrals relating to the home since the last inspection. Hamilton Lodge DS0000017841.V341811.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents can expect the home to be generally safe, and maintained to a reasonable standard, they can further expect the home to be kept clean and hygienic. EVIDENCE: Considerable work is currently being undertaken to bring the home up to an acceptable standard, and this work is now nearing completion, with areas of the main house under going complete refurbishment. The unit situated in the ground is also under going significant refurbishment and is designed to enable it to function as a self contained unit. The home’s laundry facility is situated away from areas where food preparation takes place, and in a position whereby it does not intrude upon the residents, the laundry facilities are industrial in nature, but are nevertheless adequate to meet the needs of the number of residents accommodated. The laundry room Hamilton Lodge DS0000017841.V341811.R01.S.doc Version 5.2 Page 17 is equipped with a sluicing facility. On the day of the inspection the home was generally clean and tidy and was free of any offensive odours. During the visit to the unit in the grounds it was noted that the washing powder was maintained in an open container, which was readily accessible to residents, it was mentioned to the manager at the time that provision should be made for the powder to be stored safely and securely. Hamilton Lodge DS0000017841.V341811.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 34, 35 and 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can expect to be supported by a competent staff team, who are well supervised and have the necessary training to meet their needs, and are further protected by the home’s recruitment practice. EVIDENCE: During the course of the inspection the home’s recruitment practice was sampled through the viewing of four staff members files, all four of the files were found to contain all of the necessary documentary evidence required to be kept, which is as follows: Application form Two written references Criminal Records Bureau check Record of induction Supervision records Evidence of training and development. Hamilton Lodge DS0000017841.V341811.R01.S.doc Version 5.2 Page 19 The home employs a training needs coordinator who holds responsibility for the training of staff Discussion with the training needs coordinator evidenced that staff have received training in the following areas: Fire training Food hygiene First aid Manual handling Abuse awareness Infection control Communication Dementia awareness Epilepsy awareness Administration of medicines Values and attitudes Recruitment and selection Managing disciplenaries and grievances. Further discussion with the training needs coordinator evidenced that the following training is scheduled: Course on Autism Risk assessments Induction. Discussion with staff during the course of the inspection confirmed that access to staff training within the organisation was very good. The home employs forty care staff, of which twelve are qualified at National Vocational Qualification level two, with a further five working towards the award, six are level three qualified with a further two working towards the award, with a further three being qualified at level four in management and care. Staff during discussion reported that they receive formal supervision every four to six weekly, staff who are responsible for providing supervision to junior staff have received training. Hamilton Lodge DS0000017841.V341811.R01.S.doc Version 5.2 Page 20 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents living in the home can be assured of being supported in a home that is well lead and managed, and which seeks the views and opinions of others, however the home’s safe working practices are not entirely robust enough to ensure that the health and welfare of both residents and staff are fully protected. EVIDENCE: The registered manager/general manager has significant previous experience of working in the care sector, although they are not N.V.Q qualified, however they are supported operationally by two home managers, both of whom are qualified at N.V.Q level four in both management and care. Hamilton Lodge DS0000017841.V341811.R01.S.doc Version 5.2 Page 21 Discussion with members of the staff team indicated that the management ethos of the home is good, being open and transparent, all of the staff spoken with spoke of the home’s management team being approachable, and providing a good sense of leadership and direction. Sampling of records during the course of the inspection indicated that wherever possible the views of residents are sought regarding the running of the home, sampling of the home’s Annual Quality Assurance self Assessment (AQAA) indicated that it has in place all of the relevant policies and procedures. The home’s safe working practices are in need of improvement to ensure that residents and staffs health and welfare are adequately protected, this specifically relates to the need for the home’s electrical safety to be inspected and reported on, the current electrical installation certificate has been out of date for a while. Hamilton Lodge DS0000017841.V341811.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 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 Standard No Score 1 X 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 3 3 x x 2 x Hamilton Lodge DS0000017841.V341811.R01.S.doc Version 5.2 Page 23 Yes 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 YA42 Regulation 23 (b) Requirement All reasonable actions must be taken to ensure service users health and welfare. This relates to the need to ensure that the home has a current certificate for its electrical installation. This is necessary to ensure the health and welfare of both residents and staff. The previous timescales set have not been met. Timescale for action 30/09/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA17 Good Practice Recommendations It is recommended that the service continue to look at ways the environment used by residents to eat their meals could be improved. Hamilton Lodge DS0000017841.V341811.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ National Enquiry Line: 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 © 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 Lodge DS0000017841.V341811.R01.S.doc Version 5.2 Page 25 - 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. 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