Inspection on 21/09/06 for Hamilton Rest Home

This inspection was carried out on 21st September 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 Rest Home 16/08/07

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 21st September 2006 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.V298097.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.V298097.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 Mr Eric Walters Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (22) of places Hamilton Rest Home DS0000008403.V298097.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th December 2005 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. Hamilton Rest Home DS0000008403.V298097.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 21st of September 2006. The inspection took place over six hours. The inspection included some discussion with residents, relatives, a tour of the premises, inspection of care and other records maintained at the home and discussion with management and staff. Consideration was also given to responses contained in a preinspection survey of residents, their relatives and visiting health and social care professionals to the home. The home was being appropriately managed and residents were content in their environment and appeared to be well cared for. Residents said they were supported and cared for appropriately and encouraged to make personal choices and retain as much personal independence as possible. Some issues were identified and are detailed below and in the various relevant areas of the report. The home informed us that the current fees at the time of this inspection were; £339.00 to £360.00 a week. What the service does well: What has improved since the last inspection? There have been significant improvements to the lounge, dining room and resident’s bedrooms since the last inspection. Residents and relatives said that these improvements have greatly improved the comfort of the home for residents. Hamilton Rest Home DS0000008403.V298097.R01.S.doc Version 5.2 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 Rest Home DS0000008403.V298097.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.V298097.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3,4,5. Standard 6 does not apply to this service Quality in this outcome area is adequate. 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: Before residents are admitted to the home the manager or deputy 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.V298097.R01.S.doc Version 5.2 Page 9 Prospective residents are encouraged to make trial visits to the home prior to admission and all placements are formally reviewed around 6 weeks after admission. Hamilton Rest Home DS0000008403.V298097.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. The health and personal care residents at the home receive appears to be suitable and appropriate and is meeting the expectations of residents and their relatives. However some areas for improvement have been noted in respect of resident’s care records. EVIDENCE: The care records of four 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, personal and social care needs of residents appropriately and in the main had been evaluated at least monthly – although some had not been evaluated for 2 months. Risk assessments, that seek to protect resident’s health and safety were also in the main recorded within care plans in respect of residents skin integrity (assessing the risk of pressure sores), mobility (including the risk of potential falls and fractures, and nutrition (including weight monitoring) and other relevant areas and these were evaluated in the main monthly but as in the Hamilton Rest Home DS0000008403.V298097.R01.S.doc Version 5.2 Page 11 case of care plans some had not been for 2 months. It is strongly recommended that these should be formally evaluated at least monthly and in a separate form from care plans using a recognised risk assessment format to do so. All residents care records contained written daily statements of resident’s progress. However not all entries were timed. It is recommended that this, in line with good practice, be remedied All residents are registered with a local GP and it was evident that all were enabled to access opticians, chiropodists, district nurses and other specialist services that individual resident’s require. Residents and relatives spoken to (and in pre inspection questionnaire responses) were of the view that they were kept informed of all significant changes in their relation’s health. The procedures 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. However it is recommended that all handwritten transcriptions on residents medication administration records are signed by 2 staff to safeguard against errors being made. Discussion with residents, relatives and staff revealed that residents were treated with respect and that their right to privacy was upheld. Comments made included; ‘the staff look after me well’, ‘I am able to choose what to do with my day’, ‘the staff help me do things for myself as much as possible’, ‘the doctors and district nurses examine all our residents in their bedroom when they come to see our residents’. During the inspection staff were observed to treat residents with respect, protected their dignity and assisted them properly. Residents felt satisfied staff support them appropriately in trying to maximise their health and well being, and treat them decently and with respect. These are all very important areas in resident’s lives and are important measures of their satisfaction (or otherwise) of how effectively a care home is looking after them. Hamilton Rest Home DS0000008403.V298097.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. The provision of leisure and social activities is of a standard and variety that residents were happy with and residents spoke very positively in respect of food provision at the home. Both are very important to the quality of life experienced by residents. EVIDENCE: Discussion with resident’s revealed they were enabled to make choices in their every day life. In particular they stated that they were able to choose what time they got up and went to bed, whether they wish to participate in activities, to go to their rooms when they choose, where to eat their meals and were also able to choose what they eat and drink, and are able to personalise their rooms. Residents felt that staff encouraged them to retain their independence and individuality. They were also satisfied with the social and leisure activities provided stating that the range of activities available are varied, appropriate and that they are regularly consulted about such activities and that they decide what is good and what needs to be changed. The home maintains a record of all activities and outings provided. Hamilton Rest Home DS0000008403.V298097.R01.S.doc Version 5.2 Page 13 Residents spoke very positively in respect of the food provided at the home, flexibility of meal times, choice of meals and dining areas provided – in which new dining furniture has been provided since the last inspection. Comments about the food provided included ‘ the food is good homely cooking’, ‘I am able to ask for something else if the menu is not suitable’. 4 weekly menus are provided and are varied, balanced and provide choice. Staff served and assisted residents appropriately and sensitively with their lunch on the day of inspection. This was a hot, substantial and well presented meal. Hamilton Rest Home DS0000008403.V298097.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Residents and relatives felt comfortable enough to and knew how to make a complaint if they felt it necessary. Written policies ensure that staff members have a good knowledge of abuse and protection arrangements and safeguards in place to protect the welfare of residents. EVIDENCE: The complaints procedure was prominently displayed in the home. Residents and relatives said that any concerns or worries brought to the manager’s/senior staff’s attention are responded to quickly and rarely become formal complaints. A complaints log/incident log is maintained. Complaints, concerns and incidents are managed appropriately. The home operates protection of vulnerable adults and whistle blowing policies that seek to protect vulnerable people. In addition a copy of Bury’s interagency protection procedure is held on site and complements the home’s procedures in this area. Inspection of training records demonstrated that protection training has been provided in the past but is in need of updating. The registered manager informed the inspector that protection of vulnerable adults training was being planned for the near future. Hamilton Rest Home DS0000008403.V298097.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20, 21,22,24,25,26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home appeared to be structurally well maintained and provides a suitable and comfortable environment for the care of residents. EVIDENCE: Hamilton house care home provides an appropriate setting for residents to receive personal care and accommodation. The home is situated in a residential area in the Whitefield area of Manchester. Structurally the home appears to be appropriately maintained and residents benefit from a large rear garden which they can easily access. At the time of this unannounced inspection all areas of the home were clean, warm, appropriately furnished and residents were of the view that they were provided with a homely and comfortable environment. Hamilton Rest Home DS0000008403.V298097.R01.S.doc Version 5.2 Page 16 The inspector was informed that a programme of redecoration is ongoing. Resident’s bedrooms of which 10 were inspected on this occasion were appropriately/comfortably furnished and very personalised. A number had been redecorated and refurbished since the last inspection. Residents said they were enabled and encouraged to personalise their rooms with their own choice of pictures, items of furniture, ornaments etc. They also said they could access their rooms at any time. Adequate and suitably adapted WC and bathing facilities were provided and these were accessible to all residents. The inspector was informed hot water temperatures, are controlled by a control valve to prevent residents sustaining burns. The home also has a detailed maintenance/refurbishment plan in place. The lounge and the dining room were very clean and have benefited from new easy chairs and dining furniture since the last inspection. A new carpet has also been fitted in the lounge. Appropriate aids and adaptations were in place throughout the home that help to maintain resident’s safety and meet their physical needs. Individual aids and adaptations are provided following referral to the appropriate health care professional. The home was very clean throughout and free of malodour. Appropriate facilities are provided to prevent the spread of infection. And suitable arrangements are in place to ensure the home provides an adequate laundry service. Hamilton Rest Home DS0000008403.V298097.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to the service. Whilst the home was staffed appropriately and resident’s needs were being met the recruitment processes adopted by the home was found to be in need of urgent review. EVIDENCE: Inspection of staffing rotas provided by the home indicated that staffing provision at the home complied with the current minimum Department Of Health requirements that apply to care homes for older people. Discussion with the manager at the home indicated that they were of the view that staffing levels were appropriate to meet the dependency levels of resident’s. Over 50 of the staff employed at the home have achieved an NVQ 2 (or above) qualification in care. Staff who have not already obtained such qualifications have enrolled on appropriate courses to do so. All staff are provided with. induction training on appointment that includes supervision by a senior member of staff. The registered person informed the inspector that the induction training will link to ongoing training that is provided for staff and will meet the requirements of the skills council. Staff are provide with regularly updated training in fire safety, moving and handling, first aid, food hygiene, medicines, and other relevant areas. The registered person informed the inspector that updated Protection of vulnerable adult training will be provided to all staff in the coming months. Hamilton Rest Home DS0000008403.V298097.R01.S.doc Version 5.2 Page 18 However inspection of 3 staff personnel files relating to staff recently employed at the home revealed that; 1 file contained only one written reference instead of 2. 2 files contained no record of a ‘POVA first’ check outcome. These are important omissions as they are intended to help ensure as far as possible that potentially vulnerable residents are cared for by ‘fit and proper people’. Consequently an immediate requirement was issued at the time of inspection requiring the registered person to ensure the appropriate documentation and safeguards were in place before recruits are actively employed within the home. The registered person acknowledged that these deficits required to be remedied swiftly and took immediate action to do so. In view of these findings other staff files were inspected and found to comply fully with the regulations. Hamilton Rest Home DS0000008403.V298097.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,37,38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Hamilton house care home view is being appropriately managed in a way that enables residents, their relatives and staff to feel to feel that they are being supported properly. EVIDENCE: Resident and relatives spoken to were of the view that the manager has adopted an open and positive approach to the management of the home. Both groups stated the manager was very accessible and approachable. And that any concerns were always taken seriously and responded to promptly. The registered manager is very experienced in management of a care home and has completed the Registered Managers Award. He is supported by a deputy manager. Inspection of the arrangements to manage service users Hamilton Rest Home DS0000008403.V298097.R01.S.doc Version 5.2 Page 20 personal allowances, where these are managed by the home, found that these were secure, regularly checked and appropriately documented. The following safety/servicing certificates were inspected at the time of inspection and found to be up to date; servicing of lifting equipment, servicing of fire safety equipment, the fire alarm system and. The registered person/manager informed the inspector that arrangements have been made for the following inspection/servicing to be conducted; NIEIC 5 yearly electrical safety inspection, the annual gas safety check and inspection/servicing of the control of hot water temperatures within the home. Accidents that occur in the home were appropriately recorded and appeared to have been appropriately managed. Hamilton Rest Home DS0000008403.V298097.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 3 3 N/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 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 2 3 3 3 3 X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Hamilton Rest Home DS0000008403.V298097.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 OP18 Regulation 13 Requirement Timescale for action 30/11/06 2 OP29 19 That the CSCI is informed in writing what arrangements have been made to provide staff at the home with protection of vulnerable adults training That staff employed at the home 27/09/06 have had a CRB/POVA First check completed before commencing duty and that the home secured two written references for all staff before they commence duty at the home. This was an immediate requirement made in writing on the day of inspection That the CSCI is informed in writing that the NIEIC 5 yearly electrical check, the annual gas safety check and the servicing/inspection of valves controlling hot water temperatures have been completed That the CSCI is informed in writing that the following safety checks have been completed; 5 year electrical safety inspection, DS0000008403.V298097.R01.S.doc 3 OP38 13 30/11/06 4 OP38 13 30/11/06 Hamilton Rest Home Version 5.2 Page 23 annual gas safety check and the inspection/servicing of the control of hot water temperatures in the home 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 OP8 Good Practice Recommendations That residents care plans and risk assessments are formally evaluated at least monthly. And that risk assessments for example of resident’s mobility, moving and handling needs and nutritional needs are recorded separate from care plans using a recognised risk assessment tool. That all hand written transcriptions to residents medication administration records are signed by 2 staff to safeguard against errors being made. 2 OP9 Hamilton Rest Home DS0000008403.V298097.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG 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. 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