Inspection on 16/08/07 for Hamilton Rest Home

This inspection was carried out on 16th August 2007.

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 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 Rest Home 21/09/06

Hamilton Rest Home 05/12/05

Hamilton Rest Home 17/05/05

Hamilton Rest Home 14/10/04

Hamilton Rest Home 21/04/04

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

CARE HOMES FOR OLDER PEOPLE Hamilton Rest Home 211 Bury New Road Whitefield Manchester M45 8GW Lead Inspector Mike Murphy Unannounced Inspection 16th August 2007 09:30 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 Rest Home DS0000008403.V337587.R01.S.doc Version 5.2 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 Rest Home DS0000008403.V337587.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hamilton Rest Home Address 211 Bury New Road Whitefield Manchester M45 8GW 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) 0161 766 7418 0161 766 2007 Mr Eric Walters Mrs Karen McMahon Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (22) of places Hamilton Rest Home DS0000008403.V337587.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only: Code PC, to service users of the following gender: Either. Whose primary care needs on admission to the home are within the following categories: Old age not falling within any other category: Code OP The maximum number of service users who can be accommodated is: 22. Date of last inspection 21st February 2007 Brief Description of the Service: Hamilton House is a large attractive detached property situated on a main road in Whitefield. The gardens are well maintained and attractive. Hamilton House provides residential care for up to 22 older people. the home is easily accessed by car and public transport. The home informed us that the fees at the time of this inspection were; £355.00 to £380.00 a week. Hamilton Rest Home DS0000008403.V337587.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 16th of August 2007. The inspection took place over seven hours. The inspection included discussion with residents, their relatives, a tour of the premises, inspection of care and other records maintained at the home and discussion with the registered manager and care staff. What the service does well: What has improved since the last inspection? 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 Hamilton Rest Home DS0000008403.V337587.R01.S.doc Version 5.2 Page 6 contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Hamilton Rest Home DS0000008403.V337587.R01.S.doc Version 5.2 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 Rest Home DS0000008403.V337587.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Standard 6 does not apply to this service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. No prospective residents are admitted to the home without their care and support needs being assessed appropriately. EVIDENCE: Prior to residents being admitted to the home the registered manager carries out an assessment of the prospective resident’s needs in consultation with the resident, their relatives and relevant health (for example doctors) and social care professionals (for example social workers). The purpose of such an assessment is to assist the prospective resident (and their relatives) in their considerations of how appropriate a placement at the home would be and enable the person conducting the assessment to judge if the home will be able to meet the prospective resident’s needs appropriately. Hamilton Rest Home DS0000008403.V337587.R01.S.doc Version 5.2 Page 9 3 (recently admitted) residents pre-admission assessments were inspected at this inspection. The records identified that pre-admission assessments had been carried out by the home and were supplemented by assessments conducted by Social Services. Hamilton Rest Home DS0000008403.V337587.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care provided for residents appears to be suitable, well organised, and meets the expectations of residents and their relatives. EVIDENCE: The care records of three residents were inspected. These contained care plans that were initially based on the pre-admission assessment that is referred to earlier in this report. Care plans addressed the health and personal care needs of residents in a clear, organised way and were evaluated at least monthly. Risk assessments, that seek to protect resident’s health and welfare are incorporated into the care plans in respect of residents skin integrity (assessing the risk of pressure sores), mobility/moving and handling, nutrition, (including regular weight monitoring) and other areas of potential risk for individual residents were also assessed at least monthly (for example the need for bed rails to be used). Daily statements regarding resident’s progress are also recorded and these are timed and initialled by care staff. It is recommended that it is good practice for staff to sign the daily statement in full rather than initial them. Hamilton Rest Home DS0000008403.V337587.R01.S.doc Version 5.2 Page 11 All residents are registered with a local GP and it was evident that all were enabled to access dieticians, opticians, chiropodists, dentists, district nurses and other specialist services as individual residents needed. Pre-inspection comment cards completed by relatives and discussion with relatives on the day of inspection indicated that they are kept informed of all changes in their relation’s health. The practices for the receipt, recording, storage, handling, administration and disposal of resident’s medicines were appropriate and safe. Staff responsible for the management of resident’s medicines have all received appropriate training. Medicine records had been completed properly. The inspector was informed the supplying pharmacist had ordered larger storage facilities for controlled medicines as the current arrangements are not appropriate for current needs. Discussion with residents and staff (and responses in Pre-inspection comment cards completed by residents and relatives) revealed that residents were treated with respect and that their right to privacy was upheld. Comments made included; ‘the carers are nice and kind and speak to me properly’, ‘I have never been spoken to out of turn by the management or staff since I came here’, ‘Mum says the staff all treat her decently and with respect and from what I see when visiting that is the case with everybody here’. On the day of inspection staff were observed to interact positively with residents and show them respect, protect their dignity and assist them properly throughout the day. Residents and visitors appeared to have a good relationship with the manager and her staff. Relatives of residents all spoke very positively of the care and attention provided to their relation at the home. Hamilton Rest Home DS0000008403.V337587.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are being supported by staff to participate in social activities and are able to retain the ability to make personal choices. There was a general satisfaction with meals provision at the home. EVIDENCE: Discussion with residents and relatives (and observations made on the day of inspection) indicate that the routines of daily life in the home are as flexible as possible in a communal setting. Residents stated that they are able to choose what time they get up and go to bed, what activities to engage in and feel that staff inform and consult them about the care and support they need. Clearly this is very important in enabling residents to retain as much control over their life as possible. The arrangements for providing social and leisure activities are satisfactory. Activities at the home are co-ordinated by staff. A varied programme of activities/pastimes (including crafts – assisted by appropriately supervised pupils from a local High School. Some of the craftwork made by residents was exhibited at Bury library as part of a wider exhibition) and outings is provided. Hamilton Rest Home DS0000008403.V337587.R01.S.doc Version 5.2 Page 13 Entertainers are booked on a monthly basis – including a charitable singing group. Residents also periodically attend a local Civic Hall when the ‘Olden Gold Days’ shows are on – a mixture of entertainment and reminiscing. Whilst it is evident that a wide range of social and leisure activities are available and residents are encouraged to engage with the local activities no programme of activities was displayed in the home. Such a programme should be displayed to inform all – including residents relatives how active social and leisure activities are. Residents wishing to maintain their religious links are enabled to do so. The home has an open visiting policy. There are no restrictions on the time people visit. The only time restrictions would be imposed is when requested by residents. Relatives spoken to during the inspection said they were always made welcome at the home and were able to see their relatives in the privacy of their own room or in a quieter communal area. Residents spoken to expressed satisfaction with care provided and organisation of life at the home. Observation of care practice and information in care plans indicated residents are encouraged to make choices. For example what time they like to get up/go to bed. While some residents chose to sit in the lounge a number were observed to spend their time in their own rooms. Meals are cooked on site in the home’s kitchen. Menus are varied and balanced and whilst in practice the home provides a wide choice this was not reflected in printed menus. Meals are served in a designated dining room. This is an appropriately furnished room that provides a comfortable area for residents to have their meals. Residents’ meal times are as reasonable and as flexible as they can be in a communal setting. Lunch was observed on the day of inspection. This was a hot and substantial meal and staff assisted and served residents their meals appropriately. Discussion with residents revealed a general satisfaction with the meals provided. Hamilton Rest Home DS0000008403.V337587.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and relatives knew how to make a complaint if they felt it necessary. Written guidance and training arrangements ensure that staff members have knowledge of abuse and protection arrangements and safeguards were in place to protect the welfare of residents EVIDENCE: The complaints procedure was prominently displayed in the home and included details of how to contact the CSCI – although these now need to be amended to reflect the new contact details of the local office of the CSCI - if it was felt necessary by the complainant. Relatives spoken to on the day of inspection said in the main concerns or worries brought to the manager’s attention are responded to quickly and don’t become formal complaints. Policies and practices aimed at protecting residents from abuse are in place. Also Bury’s inter agency protection procedure is held on site. Staff spoken to confirmed that they had received adult protection training (this was also reflected in training records maintained by the home) and were aware of the whistleblowing policy operated by the home. Training records indicated that approximately half the staff had received recent adult protection training at the time of this inspection. The registered manager stated that plans had been be made for the remaining staff to receive such training in the near future. Hamilton Rest Home DS0000008403.V337587.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 24 and 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home generally provides a comfortable and appropriate environment to accommodate, care for and support residents. However some improvements do need to be made to the environment of the home. EVIDENCE: A tour of the premises revealed that the home was very clean and free of malodour. Discussion with residents and their relatives revealed that the home is regularly cleaned to a high standard. The lounges and dining room provide appropriate and comfortable communal areas for residents. However the paintwork to walls and skirting boards in the dining room is quite marked in places and some plasterwork has been damaged. Most bedrooms were inspected on this occasion – these were clean, warm, suitably ventilated, personalised and comfortable. However some contained furniture that was worn/damaged and needs replacement. Some Hamilton Rest Home DS0000008403.V337587.R01.S.doc Version 5.2 Page 16 require decorating and new floor coverings and it was noted by the inspector that bedroom 2 on the ground floor is particularly in need of refurbishing. The refurbishment of bedrooms must now be a priority. The registered manager informed the inspector that plans were at the advanced stages to commence such work and that bedroom 2 would be the first to be done – within a month of the inspection. A detailed plan will be required to be submitted to the CSCI that indicating what the refurbishment of resident’s bedrooms will consist of and the proposed timescale for completion. Residents are encouraged to bring personal items into the home and this creates a more personalised atmosphere in resident’s own rooms. Appropriate measures to prevent the spread of infection were in place – including adequate hand washing/cleaning facilities, laundry and sluicing arrangements, provision of disposable gloves and aprons for staff, adequate provision of house keeping staff and appropriate arrangements for the disposal of waste. Hamilton Rest Home DS0000008403.V337587.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The recruitment, provision and training of staff employed at the home are being managed appropriately. This is important to ensure resident’ are being cared for adequately and appropriately by staff who able to deliver this support safely and competently. EVIDENCE: Inspection of staffing rotas indicated that staffing provision at the home complied with the current minimum requirements that apply to care homes for older people. Discussion with manager and staff at the home indicated that they were of the view that staffing levels were appropriate to meet the dependency levels and needs of resident’s. There is also adequate provision of housekeeping, catering and ancillary staff at the home. Inspection of 3 staff personnel files revealed that these contained an application form (including health declaration), 2 written references, a Criminal Records Bureau check (including a ‘POVA first’ check), proof of identity (however 1 file did not contain a recent photograph of the employee) and evidence of induction training. There is a commitment to NVQ (with over 90 of all care staff having at least an NVQ 2 in care) training, moving and handling, fire safety, first aid, Hamilton Rest Home DS0000008403.V337587.R01.S.doc Version 5.2 Page 18 protection of vulnerable adults and other training provision for all staff at the home. The registered manager has been working in conjunction with Bury adult training to ensure that the induction and ongoing training provided by the home meets the common foundation standards and other requirements of ‘Skills for Care’ (part of the Sector Skills Council). This is to be commended. Hamilton Rest Home DS0000008403.V337587.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was being appropriately managed in a way that enables residents, their relatives and staff to feel that they are being supported properly. EVIDENCE: The registered manager is experienced, has achieved the NVQ Level 4 in care and management and has completed the registered managers award. Discussion with residents, their relatives and staff indicate that the manager operates a management style that is open and accessible. The home was well organised with a clear management structure. Senior carers and a team of care staff support the manager. The registered owner of the home (until recently also the registered manager) is also very supportive of the registered manager and frequently visits the home to do so. Hamilton Rest Home DS0000008403.V337587.R01.S.doc Version 5.2 Page 20 The manager has developed a quality assurance system to measure residents and their relative’s satisfaction, with the level of care and accommodation provided. This is essential as such information will enable a quality improvement plan to be fully developed and implemented to further improve the quality of life for residents. The manager informed the inspector that she intends to further develop the quality assurance system to incorporate the views of visiting doctors, nurses, social workers and others who regularly come to the home. And to develop a system of checks (for example of care records, medicines, social activities, catering, complaints/protection, the home environment, staff training and management processes generally) to ensure practices in the home are of as a high a standard as possible. Measures were in place to ensure that residents’ financial interests are safeguarded. Residents are encouraged to control their own money. However where they are unable (or choose not to) personal allowances are managed by the home. The arrangements for this were secure and appropriately documented. However it is recommended that personal allowances monies/receipts be kept in individual plastic wallets (or similar) to facilitate easier auditing and make the system more transparent. The health, safety and welfare of residents and others is promoted and protected. For example staff are provided with regular training and appropriate equipment to ensure resident’s moving and handling needs are met. An example of this would be for a resident who needs to be safely moved with the aid of a hoist. Fire safety training is regularly provided. Information provided by the home indicates that electrical/gas/other equipment safety inspections/servicing has been carried out. Hamilton Rest Home DS0000008403.V337587.R01.S.doc Version 5.2 Page 21 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 X 3 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 X X X 2 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 Hamilton Rest Home DS0000008403.V337587.R01.S.doc Version 5.2 Page 22 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 OP15 Regulation 16(2)(i) Requirement Timescale for action 30/11/07 2 OP16 22(6)(a) 3 OP19 OP20 OP24 16(2)c 23(2)(d) 4 OP33 24 Confirm in writing to the CSCI that menus have been amended to reflect what choices of meals are available to residents Confirm in writing to the CSCI 30/11/07 that your complaints procedure has been amended reflect the contact details for the CSCI Submit in writing to the CSCI 30/11/07 what refurbishment in the home is planned/has been completed including proposed timescales for completion. Inform the CSCI in writing what 30/11/07 action has been taken to develop the system of quality assurance operated at the home. Hamilton Rest Home DS0000008403.V337587.R01.S.doc Version 5.2 Page 23 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 OP7 OP12 Good Practice Recommendations That staff sign the daily statement within care records in full rather than initial them. Prominently display in the home the programme of social/leisure activities available to residents Hamilton Rest Home DS0000008403.V337587.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Manchester Local office 11th Floor West Point 501 Chester Road Manchester M16 9HU National Enquiry Line: 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 © 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 Rest Home DS0000008403.V337587.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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!