Inspection on 23/01/06 for Claridge Nursing Homes (Hampton Grange) Limited

This inspection was carried out on 23rd January 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Claridge Nursing Homes (Hampton... 25/08/09

Claridge Nursing Homes (Hampton... 30/07/07

Claridge Nursing Homes (Hampton... 23/05/06

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

CARE HOMES FOR OLDER PEOPLE Hampton Grange Nursing Home Hampton Grange Nursing Home 48-50 Hampton Park Road Hereford Herefordshire HR1 1TH Lead Inspector C Presley Unannounced Inspection 23rd January 2006 16:00p 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 Hampton Grange Nursing Home DS0000064819.V258392.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. Hampton Grange Nursing Home DS0000064819.V258392.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Hampton Grange Nursing Home Address Hampton Grange Nursing Home 48-50 Hampton Park Road Hereford Herefordshire HR1 1TH 01432 272418 01432 274265 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) ANEW 24 Ltd Sylvia Mary Steed Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35), Physical disability over 65 years of age of places (35), Terminally ill over 65 years of age (35) Hampton Grange Nursing Home DS0000064819.V258392.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The three multiple occupancy bedrooms will be out of operation by 1st April 2006. The Homes registration will remain at 35 registered beds throughout the building of the new extension. 29th & 17th August 2005 Date of last inspection Brief Description of the Service: The Health Authority first registered Hampton Grange as a nursing home in 1992. Since the implementation of the Care Standards Act 2000 the home has been registered to provide care with nursing for up to thirty-five people who must be aged at least sixty-five years. Residents must require personal care and also have general nursing needs which may be a consequence of age related frailty or due to a physical disability or to terminal illness. The property comprises of a large Victorian house, which is set in fairly extensive grounds on the banks of the River Wye. The home is located in a residential area about a mile from the centre of Hereford and is also on a main bus route to the city. The accommodation currently available for residents includes fourteen single, six double and three triple rooms. The extension is due to complete in the next twelve weeks and will address the use of three-bedded rooms, as this does not meet the guidelines in the National Minimum Standards. The home has one large sitting room, a substantial conservatory and large dining room. There are plans to create a further sitting room upstairs. The grounds are accessible and provide a suitable and safe area with seating and tables for outdoor use. The home has recently been re-registered to new owners. Hampton Grange Nursing Home DS0000064819.V258392.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection commenced at 4pm, time was spent with the deputy manager and the directors of the company. This inspection focused on standards not inspected at the last inspection visit, requirements from that report, policies and procedures, and a tour of the premises, which included greeting a number of residents. What the service does well: What has improved since the last inspection? What they could do better: The homes recruitment procedure is not robust enough and does not protect residents who are vulnerable. A quality assurance programme requires further development to ensure residents, visitors and visiting professionals have the opportunity to put their views and experiences forward. Hampton Grange Nursing Home DS0000064819.V258392.R01.S.doc Version 5.0 Page 6 A number of fire doors were wedged with various objects this placed residents at unacceptable risk from fire and an immediate notice was issued requiring the home to fit devices to fire doors which comply with fire regulations. 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. Hampton Grange Nursing Home DS0000064819.V258392.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 Hampton Grange Nursing Home DS0000064819.V258392.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): None of the standards in this section of the inspection report were inspected at this visit. For further information refer to previous inspection report. EVIDENCE: The home is planning to implement a new pre-assessment document which was seen and meets the required standard. Hampton Grange Nursing Home DS0000064819.V258392.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): 9 Medication is handled and administered safely and residents who self medicate do so within a risk framework. EVIDENCE: The medication records were inspected and appeared in order. Medication is administered safely. Residents who self medicate are risk assessed each month and keep their medication in a lockable drawer in their bedrooms. The medication policy and procedure did not reflect the current disposal practice of medication. It was also noted a number of hand written medication charts which included medication alterations had not been signed by the registered nurse Hampton Grange Nursing Home DS0000064819.V258392.R01.S.doc Version 5.0 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14 & 15 Residents are offered a nutritious diet with choice at all mealtimes. Residents may choose where they eat their meals and are offered assistance with food in a dignified manner. EVIDENCE: The current upgrading and refurbishment programme includes the kitchen area. The home is implementing a new diarised system to ensure risk in preparation, storage and food delivery to residents is kept to a minimum. A programme of food hygiene training for all nursing staff is in progress. Records of food given to residents needed to be more precise and the soft diet given to residents needed to be more specific. Liquefied meals are presented in an appealing manner. There are a number of residents who require assistance with food and staff were observed offering assistance in an appropriate and unhurried manner. Residents spoken to during a tour of the premises were clearly happy with the care provided and spoke highly of staff. Hampton Grange Nursing Home DS0000064819.V258392.R01.S.doc Version 5.0 Page 11 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): None of the standards in this section of the inspection report were inspected at this visit. For further information refer to previous inspection report. EVIDENCE: Hampton Grange Nursing Home DS0000064819.V258392.R01.S.doc Version 5.0 Page 12 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): There were a number of environmental issues, which placed residents at unacceptable risk. EVIDENCE: During a tour of the premises it was noted a number of fire doors had been wedged open with commodes, zimmer frames and in one instance a slipper. This is a breach of fire regulations and places residents at unacceptable risk if a fire occurred. Some fire doors did not close on rebates. Bedroom windows had been left open during the day and not closed, a number of bedrooms were cold and one radiator did not appear to be working well. One bedroom had a freestanding heater, which had not been risk assessed and posed a health and safety risk. A number of hot pipes at floor level were seen and these were hot to the touch, and were unguarded. Hampton Grange Nursing Home DS0000064819.V258392.R01.S.doc Version 5.0 Page 13 Areas in the home required refurbishment, which included replacement of vanity units and sinks in some bedrooms. Residents were not provided with lockable space in their bedrooms to keep safe money and valuables. Bath temperatures had not been recorded when residents were bathed. A number of toiletries belonging to residents had been left in bathrooms. Time was spent feeding back information and shortfalls to the new owners who said they had ordered some doorgards which when the fire bells rang closed the fire door automatically. There is a planned four-year refurbishment in place, which includes new furnishing, and redecoration of all areas of the home. The main focus at this time is the new build, which will create new bedrooms for those residents currently occupying triple bedrooms. Hampton Grange Nursing Home DS0000064819.V258392.R01.S.doc Version 5.0 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 29 & 30 The recruitment procedure is not robust and places vulnerable residents at unacceptable risk by employing staff who do not have the relevant criminal record checks in place. EVIDENCE: Staff files of two new employees were inspected, these files did not contain a photograph of the employee, adequate references in one case and no criminal record check or POVA first check at enhanced level for either. Both members of staff were currently working in the home. An immediate notice requirement was left with the home and the owners were informed neither of these staff members could remain working in the home until these checks had been carried out. The owners said they would apply for a POVA first check the following morning and inform the Commission once these had been received. The seriousness of employing staff without checks was explained to the deputy manager and the owners. It was noted at the last inspection that another member of staff was working without a criminal record check at enhanced level. **The owner telephoned and informed the Commission as of 24/01/06 both staff have been suspended until relevant criminal record checks are in place. The inspector acknowledges this appropriate and swift action** Staff follow an induction and foundation programme which has been developed by the PCT and work supernumerary for at least a week. Staff are encouraged Hampton Grange Nursing Home DS0000064819.V258392.R01.S.doc Version 5.0 Page 15 to begin NVQ training in direct care once they are competent. The home is currently recruiting a training officer. Hampton Grange Nursing Home DS0000064819.V258392.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, 33, 35 & 38 The home is well managed by a competent and experienced registered manager. Health and safety is well managed on the whole. The quality assurance programme did not cover all aspects of home life for residents. EVIDENCE: The registered manager has the necessary qualifications and experience to manage the home and is supported by her deputy and a committed staff team. Management of health and safety issues on the whole are addressed, there are some shortfalls in this area and these have been raised in sections of this report as requirements, some of them immediate. A quality assurance programme could be further developed to include visiting professionals to the home. Hampton Grange Nursing Home DS0000064819.V258392.R01.S.doc Version 5.0 Page 17 There are facilities for the safe keeping of monies for resident if the need arose. Hampton Grange Nursing Home DS0000064819.V258392.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 x 8 x 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x 2 x x x x 2 x 3 STAFFING Standard No Score 27 x 28 x 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x 3 2 x 3 x x 3 Hampton Grange Nursing Home DS0000064819.V258392.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? yes OP19 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 OP9 Regulation 13(2) Requirement Hand written medication charts which includes alterations to the prescription must be signed by the registered nurse The medication policy and procedure must reflect the current practice of disposal of medication Fire doors must not be wedged at any time with items that do not comply with fire regulations Immediate requirement notice Fire doors must close on rebates The free standing heater in use must be risk assessed Hot water pipes must be risk assessed and guarded Radiators must be repaired and risk assessed Bedrooms must be kept warm Bath temperatures must be recorded when residents are bathed Residents must be offered lockable storage space in their bedrooms to keep valuables unless a reason for not doing so is explained in the care plans DS0000064819.V258392.R01.S.doc Timescale for action 23/01/06 2 OP9 13(2) 30/01/06 3 OP19 23 23/01/06 4 5 6 7 8 9 10 OP19 OP19 OP19 OP19 OP24 OP25 OP24 23 13 13 13 23 13 12,13 23/01/06 23/01/06 15/02/06 15/02/06 23/01/06 23/01/06 18/02/06 Hampton Grange Nursing Home Version 5.0 Page 20 11 OP29 19 12 OP29 19 Recruitment procedures must be 23/01/06 developed in accordance with the requirements of Regulation 19, Schedule 2 and Standard 29 Staff must not be employed 23/01/06 unless a POVA first and Criminal Record check at enhanced level has been received IMMEDIATE NOTICE LEFT WITH HOME AND OUTSTANDING FROM LAST INSPECTION VISIT 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 OP15 Good Practice Recommendations It is recommended a record of food given to residents is more concise Hampton Grange Nursing Home DS0000064819.V258392.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW 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 Hampton Grange Nursing Home DS0000064819.V258392.R01.S.doc Version 5.0 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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