Inspection on 13/03/06 for Hamilton Lodge Nursing Home

This inspection was carried out on 13th March 2006.

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 Nursing Home 23/08/06

Hamilton Lodge Nursing Home 20/09/05

Hamilton Lodge Nursing Home 01/11/04

Hamilton Lodge Nursing Home 11/06/04

Hamilton Lodge Nursing Home 02/04/04

Hamilton Lodge Nursing Home 16/01/04

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

CARE HOMES FOR OLDER PEOPLE Hamilton Lodge Nursing Home Hamilton Lodge 36 Honor Oak Road Forest Hill London SE23 3RZ Lead Inspector Pam Cohen Unannounced Inspection 13th March 2006 11:00 X10015.doc Version 1.40 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 Nursing Home DS0000007023.V284557.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 Older People. 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 Nursing Home DS0000007023.V284557.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Hamilton Lodge Nursing Home Address Hamilton Lodge 36 Honor Oak Road Forest Hill London SE23 3RZ 020 8699 6080 020 8699 2074 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) Premiere Care (Southern) Ltd Mrs Patricia Jenkins Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40), Physical disability (40), Terminally ill (0) of places Hamilton Lodge Nursing Home DS0000007023.V284557.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 40 patients, frail elderly persons aged 60 years and above (female) and 65 years and above (male), and chronic sick persons aged 40 years and above 4 people may have a terminal illness Date of last inspection 20th September 2005 Brief Description of the Service: Hamilton Lodge is a care home providing nursing and residential care for up to 40 older men and women. It occupies a nineteenth century building that has four floors. There are 22 single and 9 double bedrooms two of which are now in single occupancy. The first three floors are used for resident accommodation and are accessible by lift. The top floor is used for office space. There is a large sloping back garden and a large sun terrace which is being updated for resident use. There is off street parking on the forecourt to the front of the building. The home is situated in a residential area. It is on a bus route which is a few stops from a local shopping centre that has library and rail facilities. Hamilton Lodge Nursing Home DS0000007023.V284557.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place during the day of 13th March 2006. The inspector followed up previous requirements, most of which the manager had met, as well as checking some standards not inspected at the previous visit. She spoke to the manager and the activities organiser, toured the home and had the opportunity of speaking with one relative. She also inspected records. There were two vacancies in the home. What the service does well: What has improved since the last inspection? What they could do better: Care plans should include service users’ emotional and social needs and where possible a life history. All efforts should be made to ensure that any service user, wishing to and capable of, dealing with their own financial affairs, is able to do this. A staff training and development plan is needed, together with induction and foundation training to National Training Organisation standards. Supervision should be provided at least six times yearly and a quality monitoring system and annual development plan put in place. Hamilton Lodge Nursing Home DS0000007023.V284557.R01.S.doc Version 5.1 Page 6 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 Nursing Home DS0000007023.V284557.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hamilton Lodge Nursing Home DS0000007023.V284557.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,4,5. Service users and their families can be assured that the manager works effectively, to assess and meet their needs on admission. They then have the protection of a contract. EVIDENCE: Service users have a written contract signed by both parties. The manager strives to ensure that service users’ needs can be met when they enter the home. She obtains any specialist equipment needed and arranges for any specialist training. Recently the home has started admitting service users needing palliative care and the manager is ensuring that both nurses and carers have the necessary training and understanding for caring for this service user group. When necessary she also calls on specialist guidance as was happening on the day of the inspection. The manager said that relatives are able to visit before admission and a relative confirmed this. However, because most service users are admitted from hospital the manager said that logistical reasons mean that the service users themselves are rarely able to visit before admission. Hamilton Lodge Nursing Home DS0000007023.V284557.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10. Service users health needs are looked after well but staff need to ensure that attention is paid to social and emotional needs. EVIDENCE: Service users all have care plans which deal well with their health needs. However those care plans seen, did not cover the social and emotional needs of service users. They also did not contain life histories which would enable those caring for them to have a fuller understanding of them as people. The care plans are reviewed monthly and since the last inspection the manager has contacted the placing body to request that annual reviews are carried out promptly. At the last inspection it was seen that health care services are accessed well to ensure service users’ assessed health care needs are met. Since that inspection the manager has instigated a review sheet to ensure that any changes in need are recorded at monthly reviews. She has also trained all staff in the use of profiling beds. She has also carried out the requirements made by the commission’s pharmacy inspector and is working with the home’s GP in order to provide full and prompt health care. Hamilton Lodge Nursing Home DS0000007023.V284557.R01.S.doc Version 5.1 Page 10 The inspector saw staff treating service users with friendliness, and in a respectful manner and all personal care was provided behind closed doors. A relative confirmed that staff provide personal care properly to her mother. Hamilton Lodge Nursing Home DS0000007023.V284557.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14 Service users cannot be sure that every effort will be made to help them to handle their own affairs for as long as they wish and are able. EVIDENCE: Service users’ rooms show that they are able to bring personal possessions into the home. The manager explained that at monthly reviews, she ensures that service users and their relatives are told about their rights of access to records. At the moment however there is no information available in the home about advocacy services that would be available if needed. No service users handle their own financial affairs and the admission process does not include discussion or assessment of the wishes and capabilities of service users to handle their own financial affairs. Hamilton Lodge Nursing Home DS0000007023.V284557.R01.S.doc Version 5.1 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 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 Staff training will complete measures to prevent service users from running the risk of abuse. EVIDENCE: The home has a policy on working with vulnerable adults which ties in with Southwark’s policies and procedures. There is also a whistle blowing policy. The manager has provided a briefing for some staff on working with vulnerable adults, however all staff need proper training in this area. Hamilton Lodge Nursing Home DS0000007023.V284557.R01.S.doc Version 5.1 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,23,26. The home is generally well suited for its purpose except for the provision of assisted bathing facilities. Different floor covering would make communal spaces more homely. EVIDENCE: The home’s location and lay out is suitable for its purpose and it is generally well maintained. On the day of inspection smart new carpet was being laid in the halls and stairs. Communal areas meet the needs of service users but are institutional, with bare floors. Service users’ rooms are in the main, large, light and airy but there are still seven double rooms in use. Toilet facilities for service users are adequate and there are three assisted baths. Plans to provide a shower facility have not as yet been implemented. The home is clean and hygienic throughout and systems are in place for the control of infection. Hamilton Lodge Nursing Home DS0000007023.V284557.R01.S.doc Version 5.1 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 30 A training and development plan is needed to ensure that training is provided to meet the needs of service users. EVIDENCE: The manager delivers much in-house training herself but she does not yet have a training programme which is able to demonstrate that the training needs of the staff have been assessed against the needs of the service users. One clear area where there is not adequate training provision is that of Health and Safety. There is an in-house induction training programme but the manager confirmed that this is not to National Training Organisation level, and foundation training is not yet happening. Hamilton Lodge Nursing Home DS0000007023.V284557.R01.S.doc Version 5.1 Page 15 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33,35,36,38 Good quality assurance initiatives can be developed through analysis and the production of a report. Plans still need to be put into place to ensure that service users can control their own money where they wish to and have capacity. The frequency of supervision sessions need to be increased in line with the national minimum standards. EVIDENCE: The home sends out extremely thorough questionnaires to service users and relatives six monthly and the manager acts on any issues that come up through these questionnaires. The results of these questionnaires need to be analysed and put into report form, annually, for service users and the commission. There is a business plan, which consists of plans for refurbishment . This needs to be expanded into an annual development plan which includes planning, action and review of service outcomes for service users. Hamilton Lodge Nursing Home DS0000007023.V284557.R01.S.doc Version 5.1 Page 16 Plans still need to be put into place to ensure that service users can control their own money where they wish to and have capacity. The inspector also considered that the homes method of recording monies spent on behalf of service users did not give sufficient protection to service users or staff, and she discussed with the manager and activities officer ways in which this might be changed. Staff are receiving annual appraisals and there is a supervision procedure in place. However on inspection this was not being implemented, and supervision sessions seemed to be falling well below the six a year stipulated in the national minimum standards. The staff nurses who are supervision cares have not benefited from full training in this area. The manager has not yet accessed the most recent Occupational Therapy report in order to ensure that the recommendations have been implemented. Hamilton Lodge Nursing Home DS0000007023.V284557.R01.S.doc Version 5.1 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x 3 x 3 3 N/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 2 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 2 3 2 3 x 3 x x 3 STAFFING Standard No Score 27 x 28 x 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x 2 x 2 2 x 2 Hamilton Lodge Nursing Home DS0000007023.V284557.R01.S.doc Version 5.1 Page 18 Are there any outstanding requirements from the last inspection? NO 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 OP7 Regulation 15(1) Timescale for action The registered person must 30/06/06 ensure that service users’ social and emotional needs are detailed in their care plans. The registered person must 31/07/06 ensure that arrangements are in place to enable service users to handle their own financial affairs if they wish and are able. This will include the need for a lockable space in all rooms. The registered person must 30/09/06 ensure that all staff receive full training in preventing service users being abused. The registered person must 30/09/06 ensure that lounges and dining rooms have a floor covering which is homely in character. The registered person must 30/09/06 ensure that a full staff training and development plan is drawn up. The registered person must 30/09/06 ensure that induction and foundation training to National Training Organisation specification is delivered to new staff. DS0000007023.V284557.R01.S.doc Version 5.1 Page 19 Requirement 2 OP14 12(2)(3) 3 OP18 13(6) 4 OP20 23(2)(h) 5 OP30 18(1) 6 OP30 18(1)(a,c) Hamilton Lodge Nursing Home 7 OP33 8 OP36 9 OP38 24(1)(a,b) The registered person must 31/12/06 ensure that a structured quality assurance system and annual development plan are put in place. 18(2) The registered person must 30/09/06 ensure that care staff receive formal supervision at least six times yearly. 23(2)(c) The registered person must ensure that any 31/07/06 recommendations arising from the occupational therapy report of June 2004 have been implemented. Target date of 30/11/05 not met 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 OP5 Good Practice Recommendations It is recommended that the registered manager makes every effort to work with the hospitals to ensure that service users are able to visit the home before they move in. It is recommended that information is provided to service users and their families about local advocacy services. It is recommended that the registered person carries out their intention to provide a shower facilty in the home. It is recommended that the registered person considers whether the provision of seven double rooms meets the needs and aspirations of prospective service users. It is recommended that an auditable trail of paper work is instigated for recording monies spent on behalf of service users. 2 3 4 5 OP14 OP21 OP23 OP35 Hamilton Lodge Nursing Home DS0000007023.V284557.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection SE London Area Office Ground Floor 46 Loman Street Southwark SE1 0EH 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 Nursing Home DS0000007023.V284557.R01.S.doc Version 5.1 Page 21 - 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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