Inspection on 02/05/06 for Hamilton Lodge

This inspection was carried out on 2nd May 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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hamilton Lodge 07/09/09

Hamilton Lodge 03/12/08

Hamilton Lodge 17/12/07

Hamilton Lodge 17/08/06

Hamilton Lodge 20/10/05

Hamilton Lodge 04/05/05

Hamilton Lodge 07/12/04

Hamilton Lodge 30/06/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

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

CARE HOME ADULTS 18-65 Hamilton Lodge Thelma Turner Homes Ltd, Hamilton Lodge Carr House Road Doncaster Lead Inspector Alan Bartrop Key Unannounced Inspection 2nd May 2006 09:00 Hamilton Lodge DS0000042678.V290501.R01.S.doc Version 5.1 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 DS0000042678.V290501.R01.S.doc Version 5.1 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 DS0000042678.V290501.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Hamilton Lodge Address Thelma Turner Homes Ltd, Hamilton Lodge Carr House Road Doncaster 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) 01302 556046 01302 813101 hamiltonvoyage@tiscalli.co.uk Voyage Limited Denise Josephine Annable Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Hamilton Lodge DS0000042678.V290501.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th October 2005 Brief Description of the Service: Hamilton Lodge is a Care Home registered to provide care for people with a Learning Difficulty. The home consists of a main building and a separate house that has been converted into 2 semi-independent living flats. The main building of the home has a good range of communal areas, which include 2 dining rooms and separate lounge spaces. All the bedrooms in the main building are single occupancy and have en-suite facilities. Each of the 2 semi-independent living flats are fully self contained. The home is situated close to a municipal park and local shops. There is a large supermarket close buy and the centre of Doncaster is approximately 1.5 miles from the home. There is a high staff ratio provided and emphasis is put on service users integrating with the community and especially using the local college for education. Hamilton Lodge DS0000042678.V290501.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that started at 10:30 and finished at 15:50. During the inspection records were checked, discussions held with the manager, staff and residents. A partial tour of the buildings and ground, and lunch shared with the residents and staff. Fees for the care offered by the home vary from £1,165.92 to £3,299.53 should any resident require a ratio of 2:1 staffing over 24 hours. Some of the residents remembered me from previous visits to the home and this enabled them to approach me and talk about things that were important to them. The staff were very knowledgeable about the needs of the service users and this enabled them to facilitate the inspection process very well. What the service does well: What has improved since the last inspection? There has been a big improvement in the way that medication is received, stored, and administered. This has been a problem for some time and the improvements in all these areas are to be highly commended. There have been improvements in the way that some service users who were reluctant to go out of the home have gained in confidence so that they are now go out on a much more frequent basis which improves the quality of their lives. Hamilton Lodge DS0000042678.V290501.R01.S.doc Version 5.1 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 Lodge DS0000042678.V290501.R01.S.doc Version 5.1 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 DS0000042678.V290501.R01.S.doc Version 5.1 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 the following standard(s): 2 The quality of this outcome area is good. This judgement has been made using available evidence including a site visit to the service. All the service users have care plans that cover the different aspects of their lives. These are reviewed and updated as necessary. EVIDENCE: There have been no new admissions to the home since the last inspection. All the service users have assessments of need on their personal files and these are used to create the initial care plan. When the service users have been in the home for a time these are reviewed and a longer-term care plan developed. Before there is a major change in the care provided to the service user there is a re-assessment carried out. Hamilton Lodge DS0000042678.V290501.R01.S.doc Version 5.1 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 the following standard(s): 6,7,9 The quality of this outcome area is good. This judgement has been made using available evidence including a site visit to the service. There is good information in the care files to cover different situations that the service users may encounter. EVIDENCE: The care plans of 5 service users were inspected and found to be comprehensive and detailed. Residents said that they were asked about what care they needed and who should do it for them. Residents were able to talk to me about elements in their care plans. The care plans did not detail the types and times that restraint should be used, but there were incidents identified where this would have been appropriate. Hamilton Lodge DS0000042678.V290501.R01.S.doc Version 5.1 Page 10 Where a service user’s freedom or privacy may have to be restricted there are details of when and how this should be done included in the care plan. There are also the reasons clearly stated. Residents were happy with the level of care that they got and the staff was described as being very friendly. Staff were seen to be giving the service users choices where this was appropriate and at a level that they could cope with so that it did not cause undue stress to the resident. Risk assessments were seen on the care files, these covered a wide range of activities and situations. The staff actions to minimise the risk were appropriate. Staff knew what the risk assessments were and could clearly say what action was expected in different situations. Hamilton Lodge DS0000042678.V290501.R01.S.doc Version 5.1 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 the following standard(s): 12,13,15,16,17 The quality of this outcome area is excellent. This judgement has been made using available evidence including a site visit to the service. The staff actively look for both educational and work experience opportunities that the service users can go to. There are several establishments owned by the company that offer different experiences for the residents to use. EVIDENCE: The care files have time tables in them showing different activities that the resident goes on. Most of the residents go out to activities for some days per week and some residents go out most days for the major part of the working day. Work placements and college placements are included in residents programs where appropriate. There is a minibus for the use of the home, and this is used every day to transport service users into the community. Hamilton Lodge DS0000042678.V290501.R01.S.doc Version 5.1 Page 12 All the shopping for the home is done locally and where possible the service users are encouraged to go with the staff to choose the goods. There is a high ratio of staff to service users, which allows for individual activities to be accompanied. Family and friend are welcomed and residents are given the opportunity to see their visitors in private. The staff generally address the residents by their first names, sometimes both names are used, to build the persons self identity. Staff are also addressed by their first names, which develops equal respect between the two groups. The meals are taken communally, in a friendly atmosphere with residents contributing to the experience positively. Where special diets are required these are provided in a sensitive way that does not segregate the service user from those eating different foods. The way that special diets are planned has been changed recently. The present method gives a choice of different menus for each meal on a specific day, the service user is then invited to choose which of the meals they want. The residents say this is a much better way of doing it because it makes the meal choice more exciting. Hamilton Lodge DS0000042678.V290501.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 The quality of this outcome area is good. This judgement has been made using available evidence including a site visit to the service. The health care needs of the service users is planned and where necessary prompt action is taken to ensure that the resident is attended to as soon as possible. There has been a big improvement in the way medication is received, stored, and administered. EVIDENCE: Residents said that they went shopping with staff to choose their own clothes, where the service users choose not to do this the staff choose for them based on what they like to wear. Personal hygiene is maintained in private and the staff were seen to be very sensitive and discrete about the way they initiated this process. None of the service users needed technical aids to help maintain their maximum independence. Hamilton Lodge DS0000042678.V290501.R01.S.doc Version 5.1 Page 14 Health care issues are identified in the service users care plan and from discussion with residents it was clear that they were given as much control as feasible within their risk assessments. There are good relationships with outside health care professionals and evidence that arrangements have been made with them that have improved the quality of life for service users. The medication was inspected in detail and found to be very well organised which indicated that the medication for the service users was handled and administered in a safe and appropriate manner. There is adequate storage for the medications, which is safe and secure. Hamilton Lodge DS0000042678.V290501.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 The quality of this outcome area is good. This judgement has been made using available evidence including a site visit to the service. The service users are able to complain if they think they are being wrongly treated. The staff are aware of the need to protect residents and are aware of what would constitute abuse. EVIDENCE: There is a comprehensive complaints procedure that is accessible to staff, residents, and families so that anyone who wants to complain can have access to it. Residents said that they knew what to do if they were not happy with the care they were getting so that the staff could put things right. There are robust procedures for responding to suspicions or evidence of abuse to residents or their neglect. The staff are aware of what constitutes an abuse of residents either physically or emotionally and what they must do if they have any suspicions that this is going on. There is a whistle blowing policy of the company and staff felt able to express their concerns without retribution. Hamilton Lodge DS0000042678.V290501.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 The quality of this outcome area is good. This judgement has been made using available evidence including a site visit to the service. There is regular maintenance carried out with the result that the home is in a good state of repair and decoration. EVIDENCE: Residents said that they liked their bedrooms and the communal areas of the home. Posters and pictures can be put up by the residents to customise their own bedrooms. The service users are involved in the choice of pictures etc. in the communal rooms. There has been a restricted entrance created to the downstairs flat in the cottage and this needs to be risk assessed for it’s suitability to be used by service users who have either restricted mobility or visual impairment. Hamilton Lodge DS0000042678.V290501.R01.S.doc Version 5.1 Page 17 The areas of the building inspected were well maintained and tidy giving the whole building a homely and cared for feel. Hamilton Lodge DS0000042678.V290501.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 The quality of this outcome area is good. This judgement has been made using available evidence including a site visit to the service. There are a high number of staff on duty to support the service users and the recruitment policies have been found to be satisfactory on a number of occasions. EVIDENCE: Service users approached staff with confidence and were comfortable with their responses so that any questions or information that the residents had were confidently addressed. Staff were aware of situations where service users may need assistance and made a point of being available without being obtrusive so that the residents did ask or discuss things with them as part of a natural process. The staff spoke knowledgeably about the different disabilities and were able to anticipate situations in a way that minimised any disruption to the daily routine of the home. There is a comprehensive training plan that covers a wide range of subjects and addresses the different learning disabilities, but it does not adequately cover the use of restraint techniques or when they should be used. Hamilton Lodge DS0000042678.V290501.R01.S.doc Version 5.1 Page 19 Staff said that training issues were discussed in staff meetings and this enabled the topics to be made very resident specific. Hamilton Lodge DS0000042678.V290501.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The quality of this outcome area is good. This judgement has been made using available evidence including a site visit to the service. The home is well run with the service users welfare being the main concern. There were no immediate health and safety issues to be rectified. EVIDENCE: The registered manager has a lot of experience in working with this client group and she puts that into good practice when running the home. She has autonomy over the daily running of the home, which enables her to maximise the quality of life for the residents. Regular visits are made to monitor the management of the home on behalf of the proprietors with reports of these visits made available for inspection so that all parties know how well the home is progressing. Hamilton Lodge DS0000042678.V290501.R01.S.doc Version 5.1 Page 21 Service users are regularly asked for their opinions with these being used to formulate changes in the daily activities of the home. Safe working practices were observed throughout the inspection. Hamilton Lodge DS0000042678.V290501.R01.S.doc Version 5.1 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 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 X CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 27 28 29 30 STAFFING Standard No 31 32 33 34 35 36 X X X X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 X 17 X Score X 3 X 3 3 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X 3 x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X Hamilton Lodge DS0000042678.V290501.R01.S.doc Version 5.1 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 YA24 Regulation 42 Requirement An assessment be made of the suitability of the access to the ground floor flat in the cottage for service users who have mobility difficulties or visual impairment Ensure that all staff have received up to date restraint training that covers all the aspects identified in the residents care plans Timescale for action 01/08/06 2. YA32 3,24 01/08/06 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. Refer to Standard YA42 Good Practice Recommendations Keep entrance and driveway clear and clean Hamilton Lodge DS0000042678.V290501.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Doncaster Area Office 1st Floor, Barclay Court Heavens Walk Doncaster Carr Doncaster DN4 5HZ 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 Lodge DS0000042678.V290501.R01.S.doc Version 5.1 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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