Inspection on 04/05/05 for Hamilton Lodge

This inspection was carried out on 4th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Hamilton 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 20/10/05

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 Hamilton Lodge Carr House Road Doncaster Lead Inspector Alan Bartrop Unannounced 04 May 2005 08:30. th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. HAMILTON LODGE CS0000042678.V194327.R01.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Hamilton Lodge Address Hamilton Lodge, Carr House Road, Doncaster Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01302 813100 01302 813101 Thelma Turner Homes Ltd Denise Annable Care Home 10 Category(ies) of Learning disability (10) registration, with number of places HAMILTON LODGE CS0000042678.V194327.R01.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 7-Dec-2004 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 CS0000042678.V194327.R01.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out on an Unannounced basis starting as the residents were just finishing breakfast and getting ready to go to their various college and training activities. Discussions of various lengths were held with seven residents and with all of the staff who were on duty. There was also a brief discussion with the site foreman from the building site adjacent to the home. What the service does well: What has improved since the last inspection? There has been a lot of training for staff to enable them to carry out their duties more efficiently and effectively. There is more evidence that the staff are working as a team and that the different roles within the team are better understood by the individual members of the team. HAMILTON LODGE CS0000042678.V194327.R01.doc Version 1.30 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 CS0000042678.V194327.R01.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection HAMILTON LODGE CS0000042678.V194327.R01.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 Both the company and the home put a lot of effort into assessing the needs of prospective clients before the introduction period starts. Once the person has been admitted their assessment continues and a care plan is developed which is individual to the resident. The care plans are reviewed on a regular basis with daily records being kept about the care given. Some of the details entered in the care plans are vague and this makes it more difficult for the staff to offer consistency in the care and also makes it more difficult to record relevant details in the daily notes. EVIDENCE: Every resident has a care plan that is specific to their needs, and from reading a sample of these it was clear that different approaches were deployed with different residents. One resident told me they enjoyed being part of the meeting about them. Where a care plan identified a need for a residents room to be searched by staff it must identify a frequency and the reason why such an action would be implemented. So that consistency and fairness can be monitored. HAMILTON LODGE CS0000042678.V194327.R01.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,9 The residents are regularly asked what they feel about things and if they are happy with their daily program. The residents have differing levels of understanding towards their care plan but all are involved to some degree, and the care of all the residents involves integration with the local community. EVIDENCE: Residents were able to say what care elements of their care plan involved, and how it affects their behaviour. Should there be any disagreement by the resident about elements of the care plan, the matter is discussed and the reasons explained. The care plans are written in clear English and new risk assessments are introduced where there is a new task or activity introduced. This, along with discussion with the residents, gives a good opportunity for the maximum access to the information as possible. The communication between staff and residents was clear and at a level that the resident could cope with, there were also instances where the member of staff was not sure if the resident had understood and they re-worded the point. HAMILTON LODGE CS0000042678.V194327.R01.doc Version 1.30 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 standard(s) 12,17 A good range of activities are provided that are age appropriate and designed to stimulate the resident whilst broadening their experiences. The meals are designed to meet the individual likes of the residents, and any special dietary needs. A general healthy eating regime is followed as god practice, and residents are involved in menu planning as a learning process. EVIDENCE: The activities were age appropriate, three residents said that they enjoyed them and described what they got out of attending. There were risk assessments in the care plans that identified appropriate elements in the activity and approaches to be taken in order to eliminate or minimise such risks. The menus are varied, with residents preferences evident, they generally followed a healthy eating program to aid residents comfort and vitality. The residents are encouraged to take their meals communally within the home and to make them a social occasion. HAMILTON LODGE CS0000042678.V194327.R01.doc Version 1.30 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 standard(s) 18,20 The staff are skilled at addressing personal and health care issues with residents in a way that maintains their privacy and dignity. There have been improvements in the receipt, storage, and handling of medication since the last inspection but there are still concerns that the system is not accurate and that medications could not be accounted for making misappropriation of medication or incorrect administration possible. EVIDENCE: Personal issues that arose regarding the care of residents were dealt with by the staff in private and in a way that did not draw attention to the persons needs. Discussions with one resident revealed that they had cream applied by staff in an appropriate manner. Records of tablets were examined and they indicated that tablets had been received into the home, not administered, and not returned to the pharmacist. A search of the medication storage could not find the tablets which meant that no one could know what had happened to them. A general practitioner had prescribed “1 or 2” tablets, the administration records stated that only 2 had been given without reasons stated. HAMILTON LODGE CS0000042678.V194327.R01.doc Version 1.30 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 standard(s) 23 The procedures for responding to allegations of abuse and neglect are robust and link in with Doncaster Metropolitan Borough Council Adult protection procedures. The staff were able to deal with verbal and physical aggression in an appropriate manner. EVIDENCE: The procedures have been inspected on several occasions and they cover all the elements needed to provide a good quality of protection should an allegation be made. There was an incident during the inspection which was handled appropriately both at the time and through follow up with the resident. Residents were able to say who they spoke to if they were unhappy about something and they knew what they expected to be done about it. Residents were seen approaching members of staff and discussing things with them in a way that indicated they were comfortable about taking issues to staff and confident that they would get an appropriate response. HAMILTON LODGE CS0000042678.V194327.R01.doc Version 1.30 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 standard(s) 24,30 The land at the side of the home has been turned into a building site and this along with the line of the temporary fencing reduces the level of safety for residents within the grounds. EVIDENCE: The feet of the temporary fencing have been seen obstructing a fire exit in a way that caused a tripping hazard. The fencing near the entrance to one of the flats has been erected so that it leave an access of approximately 700mm width, and there is a deep drop at the other side, making night access to the flat dangerous. There was a heavy earth moving machine seen operating across the drive entrance to the home which meant that the residents had to be kept inside when it was a bright sunny morning. The boundary to the home has been moved closer to the building than had been indicated at Registration which affects the garden space and accesses for the residents. HAMILTON LODGE CS0000042678.V194327.R01.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 The staff were working as a team. Each member of staff had responsibilities for specific residents, and they were aware of aware of the responsibilities of the other members of the team and to specific residents requests. The Staff all have job descriptions and access to training in both general care issues and specific identified needs either for their own development or to meet the needs of the client group. EVIDENCE: When a resident asked a member of staff if they could negotiate part of their care plan they were referred to their key worker in order that consistency in approach could be maintained. The staff confirmed that they had job descriptions and that they knew who the senior on duty was and the kind of issues that should be referred to them. There has been a lot of training provided since the current manager took up her post to provide the staff with the tools necessary to carry out their duties effectively and efficiently. HAMILTON LODGE CS0000042678.V194327.R01.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 Generally the way the home is run promotes safe working practices, however lapses can occur without constant monitoring. There is a problem at the moment with the building work and the changes to the boundary line which needs specific attention. EVIDENCE: The building work is leaving the entrance driveway muddy and uneven which causes concern as residents walk to the local shops as part of their care plan and this situation raises the level of risk for some people. A member of staff has been seen painting in the kitchen whilst residents and staff have been preparing a meal. This practice in unhygienic and may cause contamination of the food. HAMILTON LODGE CS0000042678.V194327.R01.doc Version 1.30 Page 16 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 2 x x x Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 2 Standard No 11 12 13 14 15 16 17 x 3 x x x x 3 Standard No 31 32 33 34 35 36 Score 3 x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 HAMILTON LODGE Score 3 x 1 x Standard No 37 38 39 40 41 42 43 Score x x x x x 2 x CS0000042678.V194327.R01.doc Version 1.30 Page 17 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. 2. Standard 2 20 Regulation 12 13 Requirement The frequency of and reason for instigating bedroom searches must be accurately recorded The stock control system must accurately record the number of tablets received, held, administered and returned When there is a choice of giving one or two tablets to a resident, the reason for the decision of how many to give must be recorded Details of the boundary changes from those indicated at Registration must be provided Timescale for action 1st June 2005 1st June 2005 1st June 2005 3. 20 13 4. 30 37 1st June 2005 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 42 42 Good Practice Recommendations Keep entrance and driveway clear and clean Staff carry out local risk assessments when doing maintenance work HAMILTON LODGE CS0000042678.V194327.R01.doc Version 1.30 Page 18 Commission for Social Care Inspection First Floor Barclay Court Heavens Walk 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 CS0000042678.V194327.R01.doc Version 1.30 Page 19 - 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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