Inspection on 12/12/05 for Hamiltons Residential Home

This inspection was carried out on 12th 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

Hamiltons Residential Home 16/10/08

Hamiltons Residential Home 16/10/07

Hamiltons Residential Home 04/01/07

Hamiltons Residential Home 18/07/05

Hamiltons Residential Home 16/11/04

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

CARE HOMES FOR OLDER PEOPLE Hamiltons Residential Home 26 Island Road Upstreet Canterbury Kent CT3 4DA Lead Inspector Wendy Gabriel Unannounced Inspection 11:30 12 December 2005 th 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 Hamiltons Residential Home DS0000061038.V250521.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. Hamiltons Residential Home DS0000061038.V250521.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Hamiltons Residential Home Address 26 Island Road Upstreet Canterbury Kent CT3 4DA 01227 860128 01227 860128 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) MGL Healthcare Ltd Mrs Kerry Louise Mullens Care Home 17 Category(ies) of Old age, not falling within any other category registration, with number (17) of places Hamiltons Residential Home DS0000061038.V250521.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18/07/05 Brief Description of the Service: Hamiltons is a large detached property situated by the main road in the village of Upstreet and is registered to provide care for up to seventeen elderly residents. Currently there are twelve residents living there and the Registered Provider stated that they would not take more than fourteen residents as the three double bedrooms are currently used as single occupancy. All bedrooms have colour television, telephone and a call system facility. There is an attractive garden to the rear of the premises with a wide flat pathway, suitable for wheelchair users. There is some parking to the front of the property. Canterbury and the seaside towns of Whitstable and Herne Bay are within thirty minutes drive away. The home does not have its own vehicle but there is public transport from the village. Hamiltons Residential Home DS0000061038.V250521.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place when the Registered Providers and Director were in the home during their weekly visit. The Registered Manager was not on duty at the time and the senior carer in the home undertook an escorted tour of the premises with the Inspector. The Inspector was pleased to find that the requirements made at the previous inspection had been met. On the day of the inspection, the cooker had broken down and whilst the home was waiting for a service visit, the cook and staff had rallied round and provided a cooked meal for the residents using various, small cooking appliances in the kitchen. The Inspector noted that the meal provided was fulsome and looked appetising. Some maintenance had been identified and the Registered Provider confirmed that they were waiting for the work to be carried out. This included a new bath panel and some grouting to one bathroom. The proposed redevelopment of some of the home has been delayed, the Registered Provider said, until probably the end of 2006 and that in the meantime, decoration and some refurbishment was to be undertaken. The Registered Manager has redesigned the format for references for new staff applicants and these had successfully been put into use. Further staff training has been undertaken, the most recent in November 2005. The Registered Provider was unable to state how many staff were now undertaking NVQ but added that finance and a suitable provider had now been sourced. The medication administration storage system has been secured suitably and robustly and a lockable fridge for medications requiring a certain temperature has been purchased. The Inspector was pleased to be told by the senior carer on duty of the secure medication administration procedures employed routinely in the home. The home was warm and cosy at the time of the visit with no unpleasant odours. Residents were dressed in an age appropriate manner and suitable for the time of year. What the service does well: The Registered Provider and Registered Manager act positively to maintain suitable administration procedures. Medication administration practices meet Hamiltons Residential Home DS0000061038.V250521.R01.S.doc Version 5.0 Page 6 the National Minimum Standards. Staff said the staff team worked well together and that both the Registered Provider and the Registered Manager were approachable and friendly and would listen to any requests for further training or for anything that would benefit the residents. Communication between the Registered Provider and staff was noted to be friendly and relaxed. 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 contacting your local CSCI office. Hamiltons Residential Home DS0000061038.V250521.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 Hamiltons Residential Home DS0000061038.V250521.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): These standards were not inspected during this inspection. EVIDENCE: Hamiltons Residential Home DS0000061038.V250521.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 9 10 11 Residents know their individual needs will be identified, risk assessed and recorded. Medication administration is well managed for the safety of residents. Residents know their privacy will be upheld. Residents know that at the time of their death staff will treat them with due care. EVIDENCE: Guidance in care plans enables staff to support residents to achieve maximum control over their lives. Risk assessments are regularly reviewed and identify staff actions to enable them to support individual residents needs. Medication is robustly secured within a locked environment. Since the previous inspection, the home has purchased a lockable fridge for storing medications that may require a certain temperature. Competency training is undertaken to manage oxygen for a particular resident. The senior carer was able to clearly explain the medication administration system employed by the home to maintain safe procedures. Bedrooms have locks and these may be overridden in an emergency. The home cares for dying residents whenever possible, with support from the District Nurse and Doctor, unless Health Care professionals advise that hospital care is required. Hamiltons Residential Home DS0000061038.V250521.R01.S.doc Version 5.0 Page 10 Hamiltons Residential Home DS0000061038.V250521.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 Residents know their favoured choices are recorded, although recreational activities are limited due to the lack of motivation shown by the current residents. Residents know their families and friends will be welcomed into the home. Residents know their religious preferences are recorded and enabled. Residents’ dietary needs are assessed and catered for and meals taken in a comfortable setting. EVIDENCE: The owners of the home stated that the residents currently living in the home were able to make their wishes known. Two members of staff said that they gradually got to know the likes and dislikes of residents especially regarding meals. But that they were also offered choices wherever possible. Residents all have their breakfast in bed or in their rooms and choice of getting up and coming into the day areas of the home is their own. Communication between staff and residents was observed to be friendly. A vicar visits the home regularly. Staff and the Registered Provider said that motivating residents was very difficult as they often expressed a wish to be left alone ‘with my newspaper’ or watching tv in their own rooms. Some entertainments are arranged such as parties and ‘themed’ nights and relatives are also invited to these. Hamiltons Residential Home DS0000061038.V250521.R01.S.doc Version 5.0 Page 12 Although the home does not have its’ own transport they will hire a vehicle for outings if enough residents are interested. As indicated in the summary, the staff had rallied around to provide a hot meal for the residents on the day of the unannounced inspection because the cooker had broken down. Despite the obvious upheaval this had caused, the kitchen was clean and tidy. The cook maintains an up to date, recorded cleaning schedule for the kitchen. Food choices are recorded and the daily menu is also written on a small notice board in the dining area for the residents. The cook and the senior member of staff confirmed that a choice is available at any time. The senior carer also confirmed that snacks were available between mealtimes and through the night if required. Alcoholic drinks are available at mealtimes and were seen in some bedrooms by residents’ armchairs. Although there are set times for drinks such as tea and coffee or soft drinks, they are also available throughout the day and night. The Registered Manager has previously commented on the importance of ensuring residents receiving adequate fluids throughout the day. The dining area is at one end of a large day space and is cosy and comfortable. The tables were attractively set with cloths and placemats in readiness for lunch at the time of the Inspectors visit. Hamiltons Residential Home DS0000061038.V250521.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 The complaints policy ensures residents and their relatives and friends that their complaints will be recorded and acted upon. EVIDENCE: The home has a suitable complaints procedure in the home and a book is displayed in the reception area of the home with an invitation to write in any concerns. The statement of purpose indicates the complaints procedure for residents and families. The Registered Provider confirmed that there had been no complaints raised since the previous inspection. Although Standard 18 was not inspected at this visit, the Inspector has previously seen evidence of staff training in adult abuse awareness and the Registered Manager has written a very good, clear and suitable policy for the staff regarding ‘whistle blowing’. Hamiltons Residential Home DS0000061038.V250521.R01.S.doc Version 5.0 Page 14 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): 26 Residents know the environment is kept clean, pleasant and hygienic. EVIDENCE: The home was clean and tidy at the time of the unannounced inspection. The domestic assistant was on duty at that time and told the Inspector that she worked to a rota unless necessity required she had to change. The home is large and rambling and the Inspector queried the time required to maintain the cleanliness. The domestic assistant said that carers undertake the cleaning of bathrooms and toilets and night staff have cleaning duties also, the senior carer confirmed this. The Registered Provider said that if the home became larger they would employ further domestic help. The laundry has equipment suitable for maintaining high washing temperatures for soiled linen and alginate sacks are used for this purpose and to enhance infection control. COSHHE items are stored in a locked cupboard. Hamiltons Residential Home DS0000061038.V250521.R01.S.doc Version 5.0 Page 15 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 30 Residents know that staff training is promoted. Residents know that numbers and skills of staff are maintained EVIDENCE: The Registered Provider confirmed that the staff rota was fully covered at the time of the inspection. Staff induction is TOPSS accredited and evidence of induction was seen. The Registered Provider confirmed that since the previous inspection they had now identified and obtained funding and a suitable provider of NVQ training for the staff. They were unsure of the numbers of staff who had completed their NVQ or who was currently undertaking NVQ as the Registered Manager had the up to date figures. A training matrix was seen and although this included a variety of training courses including those required by the National Minimum Standards; was not up to date with the latest training recently undertaken by some staff. The Registered Provider agreed to ask the Registered Manager to complete this and forward it to the Inspector. Staff told the Inspector that the Registered Manager was positive about promoting training and would encourage further training identified as meeting needs of residents. Hamiltons Residential Home DS0000061038.V250521.R01.S.doc Version 5.0 Page 16 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 32 36 The Registered Provider has a clear development plan for the home that is supported by the Registered Manager. Residents know that the Registered Manager has demonstrated management of staff responsibilities including supervision. The Registered Manager is reviewing policies and procedures therefore ensuring residents best interests. EVIDENCE: The Registered Manager has been in post for approximately a year and has previously stated her intention of reviewing all the homes’ policies and procedures. Although the Registered Manager was not on duty at the time of the unannounced inspection, there was evidence of some of the procedures having been reviewed. There is a clear line of accountability in the home between the Registered Provider and the Registered Manager. The home has an up to date insurance certificate. Hamiltons Residential Home DS0000061038.V250521.R01.S.doc Version 5.0 Page 17 The Registered Provider discussed the future business plans for the home and this includes the possibility of redeveloping the home and increasing numbers of registered places. Staff confirmed they receive regular supervision and written evidence was seen of this. Annual appraisals are also undertaken. The Registered Provider said that a supervision-training course had been arranged for some of the staff to improve their understanding of and increase the contents of supervision sessions. Hamiltons Residential Home DS0000061038.V250521.R01.S.doc Version 5.0 Page 18 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 3 11 3 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 X X X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X X 3 X X Hamiltons Residential Home DS0000061038.V250521.R01.S.doc Version 5.0 Page 19 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Hamiltons Residential Home DS0000061038.V250521.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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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