Inspection on 03/12/08 for Hamilton Lodge

This inspection was carried out on 3rd December 2008.

CSCI found this care home to be providing an Excellent service.

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 17/12/07

Hamilton Lodge 17/08/06

Hamilton Lodge 02/05/06

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 29/01/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Hamilton Lodge Thelma Turner Homes Ltd, Hamilton Lodge Carr House Road Doncaster DN4 5HP     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Valerie Hoyle     Date: 0 3 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Hamilton Lodge Carr House Road Thelma Turner Homes Ltd, Hamilton Lodge Doncaster DN4 5HP 01302556046 01302329049 hamiltonvoyage@tiscalli.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Voyage Ltd Type of registration: Number of places registered: care home 10 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home 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 by 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 people who use the service integrating with the community and especially using the local college for education. Information gained on the 4th December 2008 indicates that the current fees range from 1055 pounds 61 pence to 2100 pounds 34 pence each week. Additional charges include, meals whilst out of the home and personal toiletries. The home provides Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 10 Brief description of the care home information to people who use the service and their relatives prior to admission into the home. Service Users Guides are available in all bedrooms or on request from the manager. The last published inspection report dated 17th december 2007 is available on request from the manager. Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 3 stars. This means that the people who use the service experience excellent quality outcomes. This unannounced inspection of this service took place over 6.5 hours starting at 09:30 to 16:00; this included a partial inspection of the home. Five people who use the service and six staff was spoken to during the visit; their views are included throughout the report. Occupancy at the home remains high with nine of the ten beds occupied. Two peoples support plans were looked at. Policies relating to medication, complaints, Care Homes for Adults (18-65 years) Page 6 of 29 protection of vulnerable adults and handling of peoples monies were looked at. Four staff recruitment and training records were looked at to assess how people were protected. Procedures and risk assessments relating to health and safety were looked at and discussed with the manager. Three CSCI surveys were returned. The information collated and their views are contained within the report. The manager Fiona Birkitt was present throughout the inspection and assisted with the inspection process. The manager had completed and returned the Annual Quality Assurance Assessment on time which demonstrates responsiveness and co-operation. the information gained is included in the report. An Annual Quality Assurance Assessment, AQAA is a self-assessment and a dataset that is filled in once a year by all providers whatever their quality rating. It is one of the main ways that we will get information from providers about how they are meeting outcomes for people using the service. The AQAA also provides us with statistical information about the individual service and trends and patterns in social care. The inspector would like to thank everyone who agreed to be interviewed as part of the inspection process, and the friendliness of staff. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 29 Care Homes for Adults (18-65 years) Page 9 of 29 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service were assessed before moving into the home to ensure their needs could be met. Evidence: Although there had been no recent admissions into the home, the process for admission of people was discussed with the manager. The manager said admissions were not made until a full needs assessment had been undertaken. Where assessments had been undertaken through care management arrangements the manager insists in receiving a summary of the assessment and a copy of the care plan. A blank assessment was looked at, and the manager said the document would be used for all new admissions. The home has one vacancy for a person to live semiindependently in the house attached to the main building. The information provided to people prior to admission was looked at. The Service User Guide should be updated to reflect the changes to the management of the home. Information about how to contact CSCI should also be updated to include the address Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: and contact details of the Newcastle office. Surveys received confirmed people were involved in decisions about moving into the home. People said they had received sufficient information prior to moving and one person said they had made several visits to the home, having tea and meeting other people before moving into the home. Care Homes for Adults (18-65 years) Page 12 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home promotes philosophies to enable people at the home to meet their full potential, with clear support plan instruction and risk assessments to maximise their safety and protection. Evidence: The manager said new person centered plans had been developed for all people who use the service. They were well presented with comprehensive directions to enable staff to support people while helping them maintain their independence. Two support plans were looked at and they follow good practise guidelines to ensure they were person centered. Staff was able to describe in detail the needs of people who live at the home. Keyworkers help people be fully involved in developing their plans and people said they were aware of why support plans were required. Health action plans provided clear information about how people were supported to attend medical appointments. People confirmed staff helped them to visit the chiropodist and doctors and they said staff helped with the ordering and collection of prescriptions for Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: medication. Crisis risk assessments were comprehensively written including behaviour reaction plans, which gave clear instruction to staff. Plans were regularly reviewed and updated as their needs changed. One person said I am aware of the book which describes the support I need to keep me safe when I go out of the home. Care Homes for Adults (18-65 years) Page 14 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service were able to make decisions and choices about their lifestyle and were supported by staff to develop new skills. Social, educational and recreational activities meet individuals needs. Evidence: People who use the service were able to enjoy a full and stimulating lifestyle with a variety of options for them to choose from. Regular house meetings take place to enable people to discuss activities, such as fund raising, outings and leisure activities. People said they enjoyed going out to the local pub for lunch, while others enjoy shopping in the nearby town. One person showed the inspector their bedroom following a trip to purchase a Christmas tree for their bedroom. Staff had helped to decorate the tree which looked very festive. Staff said they were making plans for a Christmas fayre, relatives and the local community were invited to the event. Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: People were encouraged to make choices about holidays away from the home including holidays at caravans and hotels in Blackpool. One person said they wanted to go to Disney Land, but understood that they needed to save up money to pay for the trip. One person was spending time at relatives and a number of people said they were going to stay at relatives for Christmas. People said they were looking forward to going out for a Christmas meal while others said they wanted to go to the theatre. People were encouraged and supported to go shopping for their food. Staff spent time making shopping lists with people to ensure the meals were well balanced. People were encouraged to eat healthy foods and staff helped people to prepare their meals. One person described how they were happy they had lost a considerable amount of weight, with the support of staff. The main meal takes place at teatime when most people were in the home. People said they were having pizza and chips while others were having the healthier option. Care Homes for Adults (18-65 years) Page 16 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy were put into practice. Evidence: People who use the service were encouraged and supported to manage their own health care including visits to the doctors, dentists and opticians. Health action plans were well established providing clear written instructions about what help people may need to attend appointments. Staff members were very alert to peoples changes in mood, behaviour and general wellbeing and fully understood how they should respond and take action. People were supported with appointments with consultants to ensure their mental health needs were met and relatives were encouraged to attend the appointments, with the agreement of the individual. The home has a sustained record of compliance with the administration, safekeeping and disposal of controlled drugs. Support staff have the required accredited training, to Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: ensure people receive their medication safely. The homes policies, procedures and guidance support and inform safe practice. Staff was observed safely administering medication to people and the Medication Administration Record MAR were audited and found to reflect the medication administered. Comprehensive guidelines for all people who use the service was looked at. Staff said they were clear about when to administer as required medication based on signs/indicators in peoples behaviour. Care Homes for Adults (18-65 years) Page 18 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service were able to express their concerns, and have access to a robust, effective complaints procedure. and were protected from abuse, and have their rights protected. Evidence: There was a comprehensive complaints procedure that was available to people who use the service and their visitors. The procedure was also referred to in the Service User Guide, which identified the stages the procedure would follow; this included the time scales to respond to complaints. The address and telephone number for the Commission For social Care Inspection should be updated to include the Newcastle office address. A sample of complaints/compliments were looked at and confirmed there had been one complaint recorded since the last visit to the home. The manager had investigated the complaint within the timescales set out in the procedure. People who use the service said they were confident that the manager would deal with any concerns they may have. Surveys confirmed that people know what to do if they had any concerns, most said they would tell their keyworker or the manager. There was a comprehensive safeguarding adults and whistleblowing policy and staff follow the procedures to those standards. The manager would investigate fully any Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: allegations of abuse and would follow the necessary procedures if any were substantiated. Two safeguarding referrals have been made by the home since the last inspection, although they were still being investigated at the time of writing this report. People said they felt safe at the home, although sometimes they go to their bedroom if other people were having an argument. Staff had a good understanding of safeguarding adults and most confirmed they had received training to recognise the signs of abuse. Two staff said they had not completed the training but would feel confident to report any incidents to the manager. Care Homes for Adults (18-65 years) Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The physical design and layout of the home enables people to live in a safe well maintained and comfortable environment, which encourages independence. Evidence: The home had a warm, homely and friendly atmosphere, and people were encouraged to see the home as their own. People were happy to show the inspector around the home and they were happy with their choice of decoration and private bathing facilities. All bedrooms were individualised to their taste including posters of their favorite pop stars and football teams. The home was clean, tidy and well maintained. People were encouraged to assist with daily routines including tidying their bedroom and doing their laundry. Surveys confirmed that the home was always clean and tidy and staff helped to keep it that way. Care Homes for Adults (18-65 years) Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff in the home were trained, skilled and sufficient in numbers to support people who use the service, in line with their terms and conditions, and supports the smooth running of the home. Evidence: Staff rotas were looked at, they confirmed there was sufficient numbers and skill mix to meet the complex needs of people who live at the home. The atmosphere created by everyone involved at the home, makes it a homely place for people to live. People said they liked living at the home, and enjoyed being independent. Training records looked at, show staff have the required skills and competencies to deliver a good service. Discussion with the manager and staff confirmed that there had been a number of changes to the staff group, although some staff had worked at the home for a good length of time. Staff said they enjoy working at the home, and feel supported by seniors and managers. There was a robust induction and probationary package, which was service specific. A number of staff inductions looked at had not been fully completed, although the manager said courses had been completed but were awaiting certificates. One staff Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: member said they had not completed the computer programmes although was aware that they must be completed to be confirmed in post. The manager only confirms permanent employment when satisfied that competence and progress has been shown to be satisfactory against their high standards. Information received on the Annual Quality Assurance Assessment (AQAA) confirmed that ten of the twenty-eight (permanent) staff employed at the home held NVQ Level 2 or above, while other staff were working towards an NVQ award in care. There were robust recruitment and selection procedures that ensure people who use the service were safe and protected. A number of staff recruitment files were examined, and there was evidence that all the required employment checks had been undertaken prior to commencing work at the home. Evidence confirmed all staff had a Criminal Records Bureau check. The manager said that hard copies of the references and CRB checks were kept at the organisations head office. The recruitment file for a new member of staff was not available. The manager must ensure that information is on site prior to the person commencing employment. The manager should check the date on all existing CRBs as good practise suggests that a new CRB check should be carried out every three years, to ensure the information is up to date. Care Homes for Adults (18-65 years) Page 23 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service were protected by sound management practises, and their views were actively sought to improve the service. Evidence: The manager has over 27 years of experience in health and social care. She holds the relevant management qualifications and is also a qualified mental health nurse. She was appointed to the position of manager in March 2008, although she has not yet submitted an application to CSCI to be the registered manager. The ethos at the home promotes team working and all staff were involved in making decisions about the way they want to support people, to be as independent as possible. The organisation is keen to develop ways of gaining the views of people who use the service. The appointment of a quality assurance manager demonstrates a commitment to driving the service forward. The outcome from the most recent quality assurance Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: surveys was looked at and confirmed positive outcomes for people who use the service. Regular residents meeting take place and people said they were comfortable talking to the manager or their keyworker if they had a problem. Procedures were in place for the management and servicing of appliances and equipment, promoting and protecting the health, safety and welfare of staff and people who use the service. Information received in the AQAA confirmed the dates that equipment had been serviced. Care Homes for Adults (18-65 years) Page 25 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 34 18 Evidence that all recruitment 02/02/2009 checks have been completed must be available at the home before staff commence employment. To ensure the safety and protection of people who use the service. 2 35 18 Staff must complete training 02/02/2009 in areas of safeguarding adults and fire. To ensure they have the required skills and competencies to keep people safe. 3 35 18 New staff must complete the 02/02/2009 homes induction programme, within the first six weeks of employment. To ensure they have the skills and competencies meet the needs of people who use the service. Care Homes for Adults (18-65 years) Page 27 of 29 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 1 The Service User Guide should be updated to reflect the changes to the management. the correct contact details for CSCI should also be updated. 50 of all staff should achieve NVQ level 2 The manager should submit her application to CSCI to be the registered manager. 2 3 32 37 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!