Inspection on 01/11/05 for Hampton House

This inspection was carried out on 1st November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Hampton House 16/06/05

Hampton House 20/09/04

Hampton House 26/05/04

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

CARE HOMES FOR OLDER PEOPLE Hampton House Church Lane Hampton Bishop Hereford Herefordshire HR1 4JZ Lead Inspector Wendy Barrett Unannounced Inspection 1st November 2005 1:15 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 House DS0000024713.V264055.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 House DS0000024713.V264055.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Hampton House Address Church Lane Hampton Bishop Hereford Herefordshire HR1 4JZ 01432 870287 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) Herefordshire Old Peoples Housing Society Limited Mrs Jennifer Mary Bates Care Home 34 Category(ies) of Old age, not falling within any other category registration, with number (34) of places Hampton House DS0000024713.V264055.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th June 2005 Brief Description of the Service: Hampton House is an Edwardian property set in 6 acres of landscaped gardens. It is situated in a village called Hampton Bishop, which is four miles from Hereford. A rural bus service passes approximately a quarter of a mile from the home. The home is owned by the Herefordshire Old Peoples Housing Society Ltd, a company registered with the Registrar of Friendly Societies under The Industrial and Provident Societies Act. The ultimate responsibility for the home lies with a Management Committee. At the point of this inspection the service was registered to provide personal care and accommodation for 34 older persons over the age of 65, who are physically and/or mentally frail, excluding dementia. The Home was opened in 1951. Accommodation is on varying levels up to four floors. Communal rooms are on the ground floor. Some other areas are accessed via small flights of steps between each level. There is a passenger lift and a chair lift to assist access but a few parts can only be reached by negotiating steps. These parts are likely to be unsuitable for residents who have restricted mobility. All the bedrooms are single, and five have en-suite facilities. Hampton House DS0000024713.V264055.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place between 1.15pm and 7pm. Feedback questionnaires had previously been sent to the home so that the views of residents, relatives and visiting professionals could be incorporated into this report. Seven residents, thirteen relatives and a visiting vicar responded to this invitation. During the inspection visit a local G.P. and three relatives were met. Three residents were interviewed and others met around the home. The Provider representative and the Care Manager were present and assisted with the inspection. There was discussion with three other staff at the home. Two National Minimum Standards relating to meals and medication were inspected in full. This means that all core National Minimum Standards have been addressed through the two inspections undertaken this year. The reports of both inspections should be read to obtain overall scores. Arrangements for admitting residents to the home were discussed in detail, and information contained in reports submitted to the Commission between inspections was referenced to offer additional information. What the service does well: This home is managed in a way that creates significant trust in the service’s ability to care well for the residents. Relatives say things like ‘first class’, ‘always informed of any problems’, ‘always helpful’ and ‘always welcomed’. There is thorough attention to the protection of the residents’ rights and the staff understand how to identify and deal with any sign of abuse. The way that new residents are admitted to the home is carefully managed so that there is every opportunity to make it a comfortable and successful move for the individual concerned. Records written by the Provider and the staff contain the information needed to demonstrate that the care, administration and maintenance of the premises are being appropriately managed. Hampton House DS0000024713.V264055.R01.S.doc Version 5.0 Page 6 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. Hampton House DS0000024713.V264055.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 House DS0000024713.V264055.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 There is very thorough attention to make sure admissions to the home are carefully managed so that new residents receive the help they need to settle comfortably into the home. EVIDENCE: Procedures for arranging short stay and emergency admissions have been reviewed in response to a recommendation arising from the last inspection. A copy of the new policy describes how new residents will be supplied with a contract of residence, and also explains how early reviews will be held to make sure the home is suitable. There had been an admission to the home the day prior to the inspection. The way that this was being managed was discussed in depth with the management staff and with two visiting friends of the resident. There was a written record to give staff the information they needed prior to admission, and detailed reports of staff observations etc. since the admission. Staff were Hampton House DS0000024713.V264055.R01.S.doc Version 5.0 Page 9 observed spending one to one time with the new resident to help her gain confidence. A G.P. visited during the inspection following a request for guidance in addressing health care issues already identified by staff. The evidence reflected a very thorough and sensitive introduction to the home that included pre-admission visits, initial assessment of the resident’s needs by the Care Manager and prompt identification of emerging care needs. The resident felt unable to be interviewed while she was still busy settling in but the visiting friends were reassured by their initial contact with staff and optimistic that the admission would be successful. Hampton House DS0000024713.V264055.R01.S.doc Version 5.0 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): 8 and 9 There is an informed and prompt response to residents’ health care needs and competent staff manage medication safely. EVIDENCE: The Commission has received reports from the home in between this and the last inspection. These reports provide details of resident accidents and health care crises. They also provide details of the action taken by staff to deal with these. The evidence confirms good attention to emerging health care needs with referral to other health care professionals and risk assessment work when necessary. The Care Manager and staff had promptly identified health care issues requiring referral to a G.P. in their initial care of the new resident e.g. possible infection. The home uses a monitored dosage system of medication administration and is supported by Boots pharmacy. There had been a recent inspection by the Boots pharmacist and the Care Manager had already responded to advice that the home should have an up to date book that provides information about drugs e.g. uses, side effects. Hampton House DS0000024713.V264055.R01.S.doc Version 5.0 Page 11 There is purpose designed equipment for safe storage of medication e.g. trolley, portable carriers, medication fridge, controlled drugs cabinet. Current stocks of controlled drugs were accurately recorded in a controlled drugs register. Staff receive training in medication administration. Four senior staff were booked on a training session to be provided by Boots pharmacy at the end of November 2005. The staff had quickly identified difficulties experienced by the newly admitted resident in swallowing her tablets. Advice from the G.P. had immediately been requested and the G.P. gave this at a visit during the inspection. Staff were observed sitting with the resident to offer encouragement in taking her tablets and so that they could monitor whether the medication was, in fact, successfully swallowed. This example illustrates a responsible approach to medication management at the home. Hampton House DS0000024713.V264055.R01.S.doc Version 5.0 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): 15 Residents enjoy varied and well-balanced meals and they are encouraged to help staff plan the way this service is organised. EVIDENCE: Minutes of a residents meeting held on October 17th 2005 referred to a request for two residents to have serving dishes at their table. This had been done. Winter menus had recently been prepared. Residents were consulted as part of this work e.g. spinach was included following a resident’s request. The menu of the day was displayed in the dining room. The kitchen contained written dietary guidance for the cooks e.g. diabetic recipes obtained from a web site. Two pantry assistants are under 18years of age. They described how their safety in the kitchen had been addressed through risk assessment e.g. not allowed to handle hot liquids. Their parents had signed authorisation forms confirming their satisfaction with the working conditions. Jugs of squash and drinking glasses were distributed around the residents’ lounges as an encouragement for them to drink plenty of fluids. The kitchen and dining room were clean and tidily presented. Stock included fresh and dry produce. The tidy storage and adequate but not over supplied amount of stock suggested careful stock rotation. Fridge/freezer temperatures Hampton House DS0000024713.V264055.R01.S.doc Version 5.0 Page 13 were being regularly checked and recorded and there was written health and safety guidance in the kitchen for staff to follow. A thank you card from a relative referred to the supply of a birthday celebration and cake. The majority of feedback responses indicated complete satisfaction with the meals (three indicated the resident ‘sometimes’ liked the food). A relative was appreciative of ‘special meals, extra treats’. When the newly admitted resident left the dining room after tea she said ‘ I’ve had a lovely tea – all the meals have been nice’. This is particularly encouraging as pre-admission information suggested she had difficulty swallowing her meals. Staff were monitoring her ability to cope with the food she was being offered during this early stage of her care at Hampton House. Hampton House DS0000024713.V264055.R01.S.doc Version 5.0 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): 17 and 18 Relatives have considerable confidence in the staff to protect the residents’ rights and protect them from abuse. Examples of practice at the home support these views. EVIDENCE: Feedback responses from relatives contained many comments reflecting confidence in the attitude and competence of all staff e.g. ‘ the Manager is the most understanding and compassionate lady I’ve met’, ‘my father is very well cared for – the Care Manager and staff provide all necessary support and advice’. A resident wrote ‘I feel happy, safe and well cared for’. The local authority vulnerable adults co-ordinator had visited the home in October 2004 to provide a training session on abuse awareness. She had recently been invited back to repeat this exercise. A resident was observed correcting a second resident by confirming that everyone has a lockable facility to keep valuables. Discussions regarding the recent admission offered a number of examples of staff attention to the resident’s safety and protection of her rights e.g. reports of unexplained bruising noticed immediately after her admission, clarification of ‘Power of Attorney’ arrangements and authorised representatives. Hampton House DS0000024713.V264055.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 The standard of the accommodation is good and provides residents with an attractive and homely place to live. EVIDENCE: Even though it is a large building the home has a very homely feel. This is particularly noticeable in the communal lounges where armchairs are surrounded by small personal items such as newspapers, knitting, radios, and handbags. Residents’ bedrooms are attractively presented with many personal items reflecting the individuality of the occupant. All areas visited during this inspection were warm, clean, tidy and well maintained. A relative commented that a central heating radiator in a bedroom did not work and that an electric heater had been supplied instead. Although the electric heater provided sufficient heat the relative felt that this might be an expensive option and it would be preferable if the radiator could be fixed. It is unclear whether the relative had raised this issue with staff at the home and a Hampton House DS0000024713.V264055.R01.S.doc Version 5.0 Page 16 recommendation is made to investigate the situation. This would need to consider potential safety risks associated with the use of an electric heater if this has not, in fact, already been addressed. There is an established programme of regular checks of health and safety aspects of the premises. Hampton House DS0000024713.V264055.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 and 30 There are enough staff to make sure the residents’ needs are met. The staff are given training to ensure they are competent to do their jobs. EVIDENCE: A notice board displayed in the communal lounges listed the names of seven staff at work in the home on the morning of the inspection. Ten staff names were listed for the afternoon/evening period and two staff on active duty throughout the night. In addition, the Care Manager and Assistant Manager were at work and the Provider representative was at the home. This reflects a satisfactory number of staff to care for the resident group. Three relatives felt that there are not enough staff. Perhaps these people visit during the busier times of day e.g. when staff are helping residents to bed and are, therefore, less visible in communal areas. It is a sensible idea to display the names of the staff at work each day and this current practice should reassure visitors of the actual levels. Perhaps it would be beneficial if staff were encouraged to spend a few minutes with any visitors who arrive during busy periods of day. If it appears the visitor needs more time than is immediately available they could be offered a future appointment for a more planned interview. Staff are receiving ongoing health and safety training opportunities e.g. 12 staff have received manual handling refresher training since May 2005. Eight staff are due to start work on an National Vocational Qualification (NVQ) level 2 before the end of the year. One member of staff will be doing the NVQ Hampton House DS0000024713.V264055.R01.S.doc Version 5.0 Page 18 level 3. There had been a delay in getting this off the ground due to the scheme provider being unable to allocate an assessor. There are other schemes that may be more responsive if this difficulty cannot be sorted out. Hampton House DS0000024713.V264055.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): 32 and 37 Relatives feel that the residents receive a high quality service through the leadership and management approach of the home. Staff keep good written records to safeguard the rights and best interests of the residents. EVIDENCE: The report of the last inspection referred to the constructive relationship between the Provider’s representative and the Care Manager. This had resulted in positive developments to strengthen the overall management of the service. Comments received from relatives since this time support this view – ‘Many thanks to the staff and Committee’, ‘nothing but praise - look after my mother with full care and attention’. A resident states that ‘the staff do far more than they are paid to do’. The Commission is receiving reports of regular visits to the home by the Provider’s representative. These reports contain details of close monitoring of Hampton House DS0000024713.V264055.R01.S.doc Version 5.0 Page 20 the service – ‘met with all domestic staff’, ‘discussed work load and responsibilities with manager’. There are regular references to contact with residents – ‘Mrs X recovering from a fall, said her arm was fine’, ‘looking forward to MacMillan morning –going to sort their possessions to see what they had for bring and buy table’. Relevant policies and procedures are implemented and are reviewed when necessary e.g. admissions procedure referred to in this report. Records required under regulation are being maintained and are safely stored. These are being continually developed to ensure they are effective e.g. staff have worked hard to maintain and improve systems for recording the everyday care of each resident. Hampton House DS0000024713.V264055.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 4 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 3 18 4 3 x x x x x x x STAFFING Standard No Score 27 3 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x 4 x x x x 3 x Hampton House DS0000024713.V264055.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? 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. 1 2 Refer to Standard OP19 OP27 Good Practice Recommendations The relative’s comment about the use of an electric fire in a bedroom where the central heating radiator doesn’t work should be further explored. Some relatives may visit at busy times when staff are not readily available. It may be helpful if staff make a point of welcoming any visitors who come into the home at these times. Hampton House DS0000024713.V264055.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Hereford Office 178 Widemarsh St Hereford Herefordshire HR4 9HN 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 House DS0000024713.V264055.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!