Inspection on 20/10/05 for Hamilton Lodge

This inspection was carried out on 20th 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 found no outstanding requirements from the previous inspection report, but made 3 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 02/05/06

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 Unannounced Inspection 20th October 2005 12:45 Hamilton Lodge DS0000042678.V263950.R01.S.doc Version 5.0 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.V263950.R01.S.doc Version 5.0 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.V263950.R01.S.doc Version 5.0 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 813100 01302 813101 Voyage Limited Denise Josephine Annable Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Hamilton Lodge DS0000042678.V263950.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th May 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.V263950.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that included a partial tour of the building, talking with staff and service users, reading of records, and discussions with the manager. The inspection was carried out over a 4.5 hour period during the afternoon so that the service users who returned from college could be seen and given the opportunity to put their views forward. The residents talked about the different subjects especially the different activities that they did and were also able to say how they told the staff what they wanted in their care plan. What the service does well: What has improved since the last inspection? The residents continue to develop skills that they can use either within the home or during college courses. The control of the disruption caused by the building work has been reduced although it is still acknowledged that there is a problem here. Hamilton Lodge DS0000042678.V263950.R01.S.doc Version 5.0 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.V263950.R01.S.doc Version 5.0 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.V263950.R01.S.doc Version 5.0 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): 1,3,4,5 There is an improved Service User Guide that is due to be converted to Wigit as well as plain text. There have been no admissions of service users to the home since the last inspection. EVIDENCE: The service user’s guide has been rewritten and made clearer for prospective service users. The guide is in plain English at the moment but there are plans to adapt it to Wigit so that it will be more user friendly for people with learning disabilities. Inspection of care files proved that all the residents have been in the home since the last inspection, there have been no new admissions. Hamilton Lodge DS0000042678.V263950.R01.S.doc Version 5.0 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): 8,10 The service users are encouraged to make as many decisions as possible when deciding what they want to do with their lives. The information about service users is held appropriately. EVIDENCE: Service users said that they were asked what they wanted to do during the day and evening. Residents confirmed that they were party to the meetings that decided the college courses they would attend. Where work placements are arranged the service users are fully involved in the finding of the placement and the request that they be taken on. Care files are kept in the office and access is restricted to appropriate staff from the home or other agencies. Hamilton Lodge DS0000042678.V263950.R01.S.doc Version 5.0 Page 10 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): 13,15,16 The residents use the local facilities and are an integral part of the community. The staff are aware of the need for residents to make appropriate relationships and facilitate this when appropriate. The rights of the residents are preserved. EVIDENCE: Care files indicate that the service users have used local shops and colleges, some with the aid of the home’s transport. The residents confirmed that they often went for walks in the area and used Enfield Park for recreation. Residents are encouraged to make appropriate relationships and there are details in the care plans that state how these should be achieved. The staff are aware of the dangers of some relationships and the signs to indicate that it may be best for the resident to move on. Hamilton Lodge DS0000042678.V263950.R01.S.doc Version 5.0 Page 11 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): 19,20 The care plans address the emotional and physical needs of the service users and state how these should be dealt with. The receipt, handling and disposal of medication is improving but there are still serious concerns about the level of competency within the staff group. EVIDENCE: Care plans contain monitoring sheets where medical needs have been identified and progress with meeting the targets set can be audit trailed. Emotional needs are recorded and there are good records to show what the service users current needs are so that they can be addressed consistently. The tablets that were prescribed as PRN (as required) had not been taken out of the blister packs in a consistent manner. There were gaps identified in the medication administration record & request that could not be accounted for. Medication counted against the medication administration record & request did not tally with what should have been there. Hamilton Lodge DS0000042678.V263950.R01.S.doc Version 5.0 Page 12 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 The service users do have their views taken into account by the staff and these views are acted upon to enhance their experiences. EVIDENCE: The residents said they have their views listened to and they are able to tell the staff what activities they want to do. Staff were heard asking the residents what they wanted to do and these requests were facilitated. The staff have been quick to react when a resident has made a request regarding an activity so that the goals of their care plan can be maximised. The complaints procedure is part of the new Service User Guide that is being produced using Wigit. The residents were able to explain how they would complain if they were not happy. Where complaints are made there is evidence in the file to show that they are acted upon quickly so that the resident gets a response in a short space of time. The residents confirmed that if they wanted to complain they could talk to staff and some could say where the complaints procedure is kept. Hamilton Lodge DS0000042678.V263950.R01.S.doc Version 5.0 Page 13 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): 30 The home was clean and hygienic, and the service users are encouraged and helped to maintain their own bedrooms. EVIDENCE: Service users said that they cleaned their bedrooms and that the staff helped them and reminded them when they needed to do it. A partial tour of the building proved that the home has been kept clean and tidy. The laundry is large enough to meet the needs of the service users and it was clean with all the equipment working properly. Hamilton Lodge DS0000042678.V263950.R01.S.doc Version 5.0 Page 14 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): 35 There is in house staff training available and the staff are able to demonstrate that they understand the different care needs of the service users and were able to explain how they should deal with the different behaviours. EVIDENCE: Staff files contained records of the training courses they had attended and those that had been identified for the future. Staff said how they had benefited from the training they had attended. The manager had a plan for future training and had identified staff who were to attend the different courses. Work is being done with a training agency to provide courses on the subjects that are specific to the needs of the current resident group. Residents confirmed that they were involved in some of the training courses that staff attended. Hamilton Lodge DS0000042678.V263950.R01.S.doc Version 5.0 Page 15 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): 39,42 There are quality assurance systems in place that let the company directors know how the home is being run on a day to day basis. There were safe working practices, with the exception of medication practices, observed throughout the inspection. There is still concern that the building work on the adjacent site cause a potential hazard to service users and visitors. EVIDENCE: There are visits made to the home on a monthly basis to ensure that Hamilton Lodge is being operated in accordance with company policy, copies of these reports are routinely sent to the Commission For Social Care Inspection. There is a duty on the senior care staff to ensure that practices within the home are compatible with good working practices and the senior staff confirmed that they were aware of this duty. Hamilton Lodge DS0000042678.V263950.R01.S.doc Version 5.0 Page 16 Medication practices again cause concern but this has been dealt with under a different section of the report. There is a considerable amount of debris caused by the building work on the adjacent site and this restricts the resident’s free use of the garden area. The temporary fencing that has been erected and the use of the front of the home by the builders vehicles needs constant monitoring to ensure service user safety. Hamilton Lodge DS0000042678.V263950.R01.S.doc Version 5.0 Page 17 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 3 3 3 3 3 Standard No 22 23 Score 3 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 3 3 X 3 Standard No 24 25 26 27 28 29 30 STAFFING Score X X X X X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 3 14 3 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X X X X 3 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Hamilton Lodge Score X 3 2 x Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X 2 x DS0000042678.V263950.R01.S.doc Version 5.0 Page 18 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 YA20 Regulation 13 Requirement The stock control system must accurately record the number of tablets received, held, administered and returned There must be no gaps in the medication administration record & request. The building work must be monitored to ensure that the debris or vehicles do not cause a hazard to the service users. Timescale for action 01/12/05 2 3 YA20 YA42 13 13 01/12/05 01/12/05 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 Refer to Standard YA42 YA20 Good Practice Recommendations Keep entrance and driveway clear and clean Medication practices be monitored on a frequent basis and this monitoring be recorded. Hamilton Lodge DS0000042678.V263950.R01.S.doc Version 5.0 Page 19 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.V263950.R01.S.doc Version 5.0 Page 20 - 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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