Inspection on 05/12/05 for Hamilton Rest Home

This inspection was carried out on 5th December 2005.

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 16/08/07

Hamilton Rest Home 21/09/06

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 5th December 2005 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.V270210.R01.S.doc Version 5.0 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.V270210.R01.S.doc Version 5.0 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.V270210.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th May 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.V270210.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was the home’s second of two annual inspections for the inspection year 2005 to 2006. The inspection took place over three hours. The inspection included discussion with residents, a tour of the premises, inspection of care and other records maintained at the home and discussion with management and staff. The home was being managed well and provided residents with a clean and comfortable environment in which to live. Residents continue to be supported and cared for appropriately and encouraged to make personal choices and retain as much personal independence as possible. What the service does well: What has improved since the last inspection? What they could do better: Whilst it is acknowledged a few resident’s bedrooms have been redecorated and refurbished many are still in need of attention – this was acknowledged by the owner who has devised a plan of action to address this issue. Hamilton Rest Home DS0000008403.V270210.R01.S.doc Version 5.0 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 Rest Home DS0000008403.V270210.R01.S.doc Version 5.0 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.V270210.R01.S.doc Version 5.0 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. Standard 6 does not apply to this service. The home manager uses a method of assessment and social needs that ensures that potential resident’s health can be met by the home. EVIDENCE: Inspection of care records revealed that all prospective residents undergo a formal pre-admission assessment that is conducted by a senior member of staff from the home. Records of assessment revealed that all the relevant activities of daily life were assessed appropriately and any areas of need in these areas identified. Such an assessment ensures that the home identified precisely what prospective needs are and that the home will be able to provide the care that individual needs. Hamilton Rest Home DS0000008403.V270210.R01.S.doc Version 5.0 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. The health and personal care needs of residents continue to be assessed and addressed appropriately. The arrangements for the management of resident’s medicines were appropriate and staff were observed to interact and assist residents sensitively and appropriately during the inspection. EVIDENCE: The health care records of 3 residents were inspected on this occasion. These were found to contain 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 and were formally evaluated at least monthly. Risk assessments, designed to protect resident’s health are incorporated into care plans. However it is strongly recommended that risk assessments for example in respect of mobility, moving and handling, and nutrition should be recorded and evaluated separately from care plans. Inspection revealed that the arrangements for resident’s medicines were secure and appropriately documented. senior staff at the home who are Hamilton Rest Home DS0000008403.V270210.R01.S.doc Version 5.0 Page 10 responsible for managing resident’s medicines have undergone training in the management and administration of medicines. It is also noted that the supplying pharmacy undertake periodic auditing of medicines in the home. Discussion with residents indicated that staff at the home treat them with respect and seek to maintain resident’s dignity and privacy particularly when personal care is being provided. Examples of such comments are ‘ the staff are pleasant and kind’, ‘they care for me well here’, ‘ I can go to the lounge or stay in my room as I choose’, ‘ and my family are able to visit at any time’. Staff were observed to assist resident’s appropriately and sensitively during the inspection. Residents also indicated, and this was supported in discussion with staff and inspection of care records, that residents are enabled to access health care services appropriately. All residents were registered with a local GP. Hamilton Rest Home DS0000008403.V270210.R01.S.doc Version 5.0 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): 12,13,14,15. The home continues to enable residents to exercise as much personal freedom and choice as possible. The routines of daily living appear to be as flexible as is possible in a residential home setting. Menus were varied, balanced and offered choice. Dining areas within the home were clean, and comfortably furnished. EVIDENCE: Discussion with resident’s revealed they were happy with the personal choices and freedom they were able to exercise. They were also satisfied with the activities provided stating that the range of activities and outings available had significantly improved in recent months. The home maintains a record of all activities provided. It is also noted that the activities programme is discussed at resident’s meetings. Residents spoke very positively in respect of the food provided at the home, flexibility of meal times, choice of meals and dining areas provided. Comments made included ‘ the food is very good here’, ‘I can choose something else to eat if I don’t like what is on the menu’. Menus were varied, balanced and provided extensive choice. Staff served and assisted residents appropriately Hamilton Rest Home DS0000008403.V270210.R01.S.doc Version 5.0 Page 12 and sensitively with their lunch on the day of inspection. This was a hot, substantial and well presented meal. Hamilton Rest Home DS0000008403.V270210.R01.S.doc Version 5.0 Page 13 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. Appropriate measures have been taken to provide an environment where residents and their supporters feel comfortable with making a complaint if necessary, and to prevent residents becoming victims of abuse. These are important areas that are crucial to the protection of resident’s in a care home, many of whom are extremely vulnerable. EVIDENCE: Discussion with resident’s indicated that there was a general awareness and appropriate information provided that enabled people to make a complaint if they desired. Certainly residents and relatives spoken to expressed the view that they felt comfortable enough to raise concerns with the home’s management if they needed to and equally importantly were confident that any issues raised would be dealt with appropriately. Clearly such an approach by the home management means that the vast majority of concerns raised can be dealt with before they escalate into major issues – this can only be of benefit to residents at the home. A detailed and accessible complaints procedure was in place and prominently displayed in the home, which included details of how complainants could contact the CSCI if desired. Hamilton Rest Home DS0000008403.V270210.R01.S.doc Version 5.0 Page 14 Inspection of policies and procedures operated at the home and discussion with staff indicated that staff were aware of the importance of protecting resident’s from potential abuse and how to communicate any concerns they may have in this area. Staff training has been provided in respect of protection of vulnerable adults. Hamilton Rest Home DS0000008403.V270210.R01.S.doc Version 5.0 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): 19,20,21,22,23,24,25,26. The home appeared to be structurally well maintained and to provide an appropriate environment for residents to receive personal care and accommodation. EVIDENCE: An ongoing programme of refurbishment and redecoration was in operation at the time of this inspection. All areas of the home designated for resident’s use were accessible to them – including a substantial well-maintained rear garden. Adequate and suitable WC and bathing provision was accessible to service users. 12resident’s bedrooms were inspected on this occasion – these were clean, appropriately furnished and some were very personalised. Although it was evident that a number of resident’s bedrooms were in need of redecoration and refurbishment. The inspector was informed a plan had been developed to address these issues. Also not all rooms were provided with a Hamilton Rest Home DS0000008403.V270210.R01.S.doc Version 5.0 Page 16 lockable space or door lock. The inspector was informed that lockable spaces were eventually going to be provided in all rooms as furniture was replaced, however one would be supplied on request if desired. The inspector was also informed that an appropriate door lock would also be provided if desired. The arrangements regarding lockable spaces and door locks should be clearly detailed in the service users guide provided in the home and individual residents preferences noted in their care records. It was also noted that the floor covering in both the dining room had been replaced since the last inspection. The communal lounge floor covering was still in need of replacing – the inspector was informed that this was to be fitted within the week following this inspection. The home was clean and free of odour at the time of this unannounced inspection. Hamilton Rest Home DS0000008403.V270210.R01.S.doc Version 5.0 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. The home provided adequate and appropriate staff to meet the assessed needs of resident’s who reside at the home. Staff were subject to an appropriate recruitment process and it was evident staff received a wide range of appropriate training – including NVQ training. EVIDENCE: Inspection of staffing rotas provided by the home indicated that staffing provision at the home complied with the current minimum requirements that apply to care homes for older people. Discussion with the manager and his deputy indicated that they were of the view that staffing levels were appropriate to meet the dependency levels of resident’s. Inspection of 3 recently employed 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 and evidence of induction training. Inspection of training records demonstrated that staff at the home were provided with appropriate training in care and related issues – including protection of vulnerable adults, dementia care and NVQ training. The inspector was informed that updates in staff training have been planned. Hamilton Rest Home DS0000008403.V270210.R01.S.doc Version 5.0 Page 18 Hamilton Rest Home DS0000008403.V270210.R01.S.doc Version 5.0 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 The home was being appropriately managed at the time of this inspection. This is important as residents need to have confidence in and access to competent managers. EVIDENCE: Residents and their relatives were positive about the manager and senior staff being accessible and approachable. They were of the opinion that any issues they raised were addressed promptly and in a way that made them feel comfortable in expressing their views and concerns. Discussion with staff, inspection of staffing records, and inspection of staff supervision and training records indicated that staff were properly supervised whilst caring for residents. Hamilton Rest Home DS0000008403.V270210.R01.S.doc Version 5.0 Page 20 Records in respect of fire safety equipment, fire drills (including fire safety training), electrical safety, lifting equipment (including the chair lift), gas safety, clinical waste removal, and the regulation of water temperatures were inspected. These were found to be satisfactory. Hamilton Rest Home DS0000008403.V270210.R01.S.doc Version 5.0 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 3 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 3 3 3 3 3 X 2 3 3 STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X X 3 3 Hamilton Rest Home DS0000008403.V270210.R01.S.doc Version 5.0 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 24 Regulation 16, 23. Requirement That a written plan detailing the proposed refurbishment/redecoration of resident’s bedrooms (including the provision of new commodes where required) is submitted to the CSCI. This plan should include proposed dates of completion. That the CSCI is informed in writing that the lounge floor covering has been replaced Timescale for action 31/01/06 2 20 16(2)c 31/01/06 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 8 Good Practice Recommendations It is strongly recommended that risk assessments for example in respect of resident’s mobility, moving and handling, and nutrition should be recorded and evaluated separately from care plans Hamilton Rest Home DS0000008403.V270210.R01.S.doc Version 5.0 Page 23 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. Extracts may not be used or reproduced without the express permission of CSCI Hamilton Rest Home DS0000008403.V270210.R01.S.doc Version 5.0 Page 24 - 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!