Inspection on 16/06/05 for Hampton House

This inspection was carried out on 16th June 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

Hampton House 01/11/05

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 HR1 4JZ Lead Inspector Wendy Barrett Announced 16 June 2005 9:30 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 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 E52 E02 S24713 Hampton House V233086 160605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Hampton House Address Church Lane, Hampton Bishop, Hereford HR1 4JZ Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01432 870287 Herefordshire Old Peoples Housing Society Ltd Care Home 34 34 places Category(ies) of Old People registration, with number of places Hampton House E52 E02 S24713 Hampton House V233086 160605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 20 September 2004 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 E52 E02 S24713 Hampton House V233086 160605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Information reflected in this report has been gathered from the Commission’s records of previous contact with the service and during the inspection visit on June 16th between the hours of 9.30am and 5pm. The main focus of this inspection was on reviewing action taken to comply with previous inspection requirements and recommendations. Additional information was obtained at a previous afternoon meeting and general tour of the premises undertaken on 1st June. The primary purpose of this contact was to discuss the current registration conditions and the Care Manager designee’s application for registration with the Commission. Several residents were met during the two visits and were invited to discuss their experience since coming to live at the home. Some time was spent observing activity in the communal areas and chatting informally to residents and two visitors. The Provider’s representative and Care Manager designate were present during both visits. The Assistant Manager and a recently recruited care assistant were interviewed. Other staff were met as they went about their duties in the home. A number of records and other documentation kept at the home were inspected. As a result of discussions throughout the above work with this service the Provider has formally requested amendment to the registered categories of need. The reduction in the scope of care needs that the home will accept at the point of admission should ensure that the service has the capacity to provide a good quality of care for all residents. The Care Manager designee’s application for registration with the Commission has been approved prior to the writing of this report. What the service does well: There is a responsive and open approach seen in the management of the service. The Provider shows a commitment to complying with relevant legislation and the Commission is kept appropriately informed of events occurring at the home between inspection visits. This attitude allows other authorities to support the Provider and staff in their protection and care of the residents. The staff are carefully selected and they are well supervised and supported. Potential risks to residents are quickly identified and action is promptly taken to make sure they are not put at unacceptable risk. This work is done with Hampton House E52 E02 S24713 Hampton House V233086 160605 Stage 4.doc Version 1.30 Page 6 recognition of the residents’ rights to make choices about their lifestyles. Relatives and other professionals are consulted, when appropriate, as part of this assessment. What has improved since the last inspection? What they could do better: The positive developments undertaken since the last inspection were the main focus of this inspection. It is appropriate that all the work achieved has priority attention in this report. It is recommended that further consideration be given to the present policy of accepting referrals for emergency admissions. Although this service is obviously needed by the wider community, it can create additional demands on staff and affect the quality of life for permanent residents when emergency placements prove to be unsuccessful. This is why there must be robust agreements prior to the acceptance of any referral that will ensure the home is well supported by other agencies in the early stages following an emergency admission. Please contact the provider for advice of actions taken in response to this Hampton House E52 E02 S24713 Hampton House V233086 160605 Stage 4.doc Version 1.30 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Hampton House E52 E02 S24713 Hampton House V233086 160605 Stage 4.doc Version 1.30 Page 8 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 Standards Statutory Requirements Identified During the Inspection Hampton House E52 E02 S24713 Hampton House V233086 160605 Stage 4.doc Version 1.30 Page 9 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 standard(s) 1, 2, 3, 4, 5 There is thorough attention to ensuring that potential residents have the information they need to decide whether the home will suit them. The procedures for staff in assessing the homes capacity to meet potential residents needs are also thorough so that inappropriate admissions can be avoided as far as possible. This procedure may be difficult to apply in emergency situations because limited information may be available. This is why a recommendation is made to have additional safeguards in place when admitting a previously unknown individual at very short notice. EVIDENCE: The Provider has supplied the Commission with a revised Statement of Purpose that reflects the proposed change of conditions of registration relating to categories of need. A resident confirmed she had received written information about the service at the point of her admission. A resident showed awareness of specific details of her conditions of residence when interviewed during the inspection. The Statement of Purpose contains details of general terms and conditions. Care records include copies of signed Hampton House E52 E02 S24713 Hampton House V233086 160605 Stage 4.doc Version 1.30 Page 10 agreements and contracts of residence. There is a comprehensive and recorded pre-admission assessment process. An Admission’s policy is included in the Statement of Purpose. This refers to the opportunity for pre-admission visits and an initial trial period of residence. The Statement also indicates that short-term care and emergency admissions will be considered when there are vacancies. It would be advisable to review the situation regarding emergency admissions, as decisions regarding suitability often have to be made on the strength of limited information. Where this service is offered it is recommended that particularly robust emergency admission agreements are obtained, prior to any agreement to admit, with any placing authority or individual to confirm an early discharge strategy should the placement prove to be unsuccessful. Hampton House E52 E02 S24713 Hampton House V233086 160605 Stage 4.doc Version 1.30 Page 11 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 standard(s) 7, 8, 9, 10 There has been considerable work done since the last inspection to develop a structured approach to care planning so that residents changing needs are quickly identified and addressed. The evidence in written records indicates that this is done with appropriate consultation with other health care professionals and the resident or relative representative so that the best possible outcome can be achieved. The process of risk assessment has also been developed to ensure that residents are safe although their right to make informed choices is not unnecessarily restricted. EVIDENCE: Care records reflected considerable attention to improve care planning and review procedures. This indicates a positive response to related requirements arising from previous inspections. There was evidence of risk management, consent issues e.g. medication, restrictions applied to ensure safety, and consultation with residents and/or relatives. Care plans are originated from the initial assessment work. This covers all aspects of need e.g. dietary needs and preferences. A key worker system Hampton House E52 E02 S24713 Hampton House V233086 160605 Stage 4.doc Version 1.30 Page 12 ensures that each resident receives particular attention from a named staff member. This system is designed to protect each resident’s sense of individuality. The Commission is receiving notifications of events as required under Regulation 37. These include reference to prompt attention to health care needs. There is also reference to consultation with other health care professionals e.g. Parkinson’s Nurse, G.P., and Mental Health specialists. Regular monitoring and review of care plans is reflected in the detail of notification reports received by the Commission and within care records seen at the home. Consultation with residents and/or relatives is also evidenced. New, purpose designed storage facilities for medications had been purchased since the last inspection. A fan and thermometer enabled staff to maintain an acceptable temperature for storing medications. A care assistant mentioned lockable storage for topical applications that are kept in residents’ bedrooms. There is an acceptable procedure for covert administration. Records are kept to confirm appropriate consultation with the G.P. and relative representatives when this practice has to be used. A self-administration risk assessment record was seen in a case file. The Care Manager and key worker had signed this. Records relating to medication management identified an audit trail, and a controlled drugs register was being properly maintained. Residents were observed being approached with respect and sensitivity, and comments from them indicated that they were very satisfied with this aspect of the service. Hampton House E52 E02 S24713 Hampton House V233086 160605 Stage 4.doc Version 1.30 Page 13 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 standard(s) 12, 13, 14. The management approach encourages staff and visitors to support residents in their enjoyment of social opportunities. Group activities are offered but there is also recognition that some residents prefer a little private time to chat informally about their lives. The Provider demonstrates a commitment to complying with the Commissions requirements to ensure that the service is managed in compliance with the relevant legislation. EVIDENCE: A Care assistant described encouragement from the Care Manager to spend social time with residents whenever possible. Care records include information about residents’ social backgrounds, interests, life experiences. A number of activities had recently been provided or were planned for the near future e.g. quiz night, garden fete, seaside holiday in July. A musician was at the home entertaining residents during the day of the inspection. Residents expressed satisfaction with the provision of social opportunities at the home and there are examples of staff support in helping residents get out into the local community when they wish. Visitors were seen at the home and the visitors’ book indicated that this is a regular occurrence. The Provider has responded to a previous requirement regarding the setting up of individual bank accounts for all service users. It has not been possible to Hampton House E52 E02 S24713 Hampton House V233086 160605 Stage 4.doc Version 1.30 Page 14 negotiate a suitable arrangement with the bank. In order to reach a satisfactory situation the Provider has closed a corporate account and no longer holds personal monies for residents. Relatives are now asked to undertake this responsibility where residents are unable to manage their own affairs. Hampton House E52 E02 S24713 Hampton House V233086 160605 Stage 4.doc Version 1.30 Page 15 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 standard(s) 16 There is an acceptable written complaints procedure that is available at the home which enables residents rights to be protected. EVIDENCE: The Provider has revised a Complaints procedure since the last inspection so that it now contains all the required information. A copy of this document has been sent to the Commission. Hampton House E52 E02 S24713 Hampton House V233086 160605 Stage 4.doc Version 1.30 Page 16 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 standard(s) 19, 20, 21, 23, 24, 25 and 26 The safety and comfort of residents and staff is well addressed through a programme of regular risk assessment audits and planned maintenance work in respect of the building. Funds are made available to ensure that the condition of the building and facilities can be regularly upgraded to maintain their attractiveness and suitability for everyone using them. EVIDENCE: All communal and utility areas of the home were visited during this inspection. Several bedrooms were also seen. All areas were being maintained well and felt very homely. Bedrooms reflected the individuality of the occupants. The Care Manager designate had identified the need to offer a gentleman resident a double bed, as the usual single size was not comfortable for him. Following his approval, a larger bed had been supplied. It fitted easily into his bedroom. Hampton House E52 E02 S24713 Hampton House V233086 160605 Stage 4.doc Version 1.30 Page 17 There was evidence of attention to previous inspection requirements. This includes the provision of approved safety locks on bedroom doors, additional call alarm points in communal lounges, new non-slip flooring in laundry room, new flooring in top floor toilet, covering of hot surfaces that may present a risk of scalding to residents. New, non-glare fluorescent light fittings had been fitted throughout the home and corridors were being decorated at the time of the inspection. There is a programme of future decorating priorities. An unoccupied bedroom on the first floor annexe will require attention to potential risk areas before being allocated i.e. covering of hot surfaces (or temperature controls), security of wooden window restrictor. Records were seen of routine water dechlorination and temperature checks of all water outlets. This work addressed legionella controls and the records indicated a satisfactory situation in all aspects. A detailed record of premises risk assessment had been reviewed in May 2005. This record included details of action taken to address any work identified as a result of the reviews. A fire log showed entries to confirm routine servicing and internal checks of fire safety equipment. A care assistant who was interviewed during the inspection described procedures for dealing with soiled laundry and disposables to maintain a hygienic environment. Hampton House E52 E02 S24713 Hampton House V233086 160605 Stage 4.doc Version 1.30 Page 18 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 and 30 Staffing arrangements at the home are well managed so that residents receive a good standard of care and prompt,individual attention to their needs. New staff are only appointed after their suitability is carefully vetted to ensure residents will be treated respectfully and kindly. Staff receive training and support to help them deal competently with the tasks they are expected to undertake. EVIDENCE: A Care Manager designate has been recruited at the home since the last inspection. The Commission has approved her registration as the Care Manager since the date of the current inspection. Staff felt that staffing levels were adequate. There had been an increase in numbers of care assistants on duty. Residents were satisfied with staff availability. A training matrix provides a visual picture of individual staff training. It illustrated that health and safety training was being kept up to date with the exception of a few staff who are due to receive manual handling refresher instruction. A senior member of staff had recently completed her NVQ level 3 award and was due to do a manual handling assessor training course in the near future. She had completed medication training from Boots pharmacy and was aware Hampton House E52 E02 S24713 Hampton House V233086 160605 Stage 4.doc Version 1.30 Page 19 that more detailed training was currently being sought for those staff who handle medication. A recently recruited care assistant described a thorough recruitment process that included appropriate checks to ensure the suitability of the applicant to work with vulnerable people e.g. CRB check. Within this account was a description of the Provider’s refusal to accept open references offered by the applicant. The insistence on obtaining specific references following a direct approach by the Provider strengthens the effect of any vetting procedure. The care assistant described her introduction to the home as ‘one of the best inductions I’ve had’. She was not expected to undertake any hands on work for the first few days. During this initial phase she was familiarised with essential safety procedures e.g. fire procedure, hygiene procedures. There then followed a period when the new employee shadowed a more experienced member of staff. A formal programme of induction was now being undertaken. A record of this was seen to comply with national specifications. Staff are being supported in pursuing NVQ qualifications. Some more senior staff have achieved the level 3 award, approximately 9 care assistants are due to start work on NVQ level 2 awards this year. It is particularly impressive that all domestic staff have been supported with, and successfully obtained an NVQ level 1 award. There is evidence of opportunities for staff to receive relevant specialist training e.g. ‘falls and bones’ teaching session in May 2005, abuse awareness training. Hampton House E52 E02 S24713 Hampton House V233086 160605 Stage 4.doc Version 1.30 Page 20 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 35, 36 and 38 The overall management approach is effective. The Provider works closely with the Care Manager to ensure that essential resources and oversight are made available to allow the staff to offer a high standard of personal care. This means that residents can live in comfortable accommodation where they feel respected as individuals but also safe and well cared for by competent staff. EVIDENCE: The Care Manager has successfully applied for registration with the Commission since the last inspection. There is a constructive relationship between the Provider’s representative and the Care Manager. The positive impact of this is reflected in the various work undertaken at the home since the Care Manager’s appointment in December 2004. This has resulted in previous inspection requirements now complied with and in other good Hampton House E52 E02 S24713 Hampton House V233086 160605 Stage 4.doc Version 1.30 Page 21 practices being introduced or developed e.g. staff supervision programmes, care planning processes. Both staff who were interviewed this time were being offered one to one supervision by senior managers. They considered their managers to be approachable and supportive. This report includes examples of management practices relevant to the standards in this section that address health and safety aspects of the service. These reflect the improved situation now that there is an on site Care Manager who can closely monitor and improve day-to-day management. Some of this work has involved development of record keeping. There are also examples of the Provider’s willingness to make financial investment into the home in order to support the Care Manager with this work e.g. new medication storage facilities, additional staffing. Hampton House E52 E02 S24713 Hampton House V233086 160605 Stage 4.doc Version 1.30 Page 22 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 2 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 4 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 3 x x 3 3 x 3 Hampton House E52 E02 S24713 Hampton House V233086 160605 Stage 4.doc Version 1.30 Page 23 no 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. 1. Standard Regulation None 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. Refer to Standard 3 Good Practice Recommendations It would be advisable to introduce a specific procedure for emergency admissions that ensures the agreement of an early discharge strategy with the placing authority or individual should the placement be unsuccessful. This agreement should be confirmed prior to any decision to admit. Hampton House E52 E02 S24713 Hampton House V233086 160605 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Hereford CSCI Area Office 178 Widemarsh Street Hereford 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 E52 E02 S24713 Hampton House V233086 160605 Stage 4.doc Version 1.30 Page 25 - 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. 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