CARE HOMES FOR OLDER PEOPLE
Hampton House 94 Leckhampton Road Cheltenham Glos GL53 0BN Lead Inspector
Mrs Kate Silvey Unannounced Inspection 10:15 8th May 2007 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 DS0000016455.V331131.R01.S.doc Version 5.2 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 DS0000016455.V331131.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Hampton House Address 94 Leckhampton Road Cheltenham Glos GL53 0BN 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) 01242 520527 F/P 01242 520527 www.hamptonhousecare.co.uk Curtis Homes Limited To be arranged Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21) of places Hampton House DS0000016455.V331131.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 27th March 2006 Brief Description of the Service: Hampton House is a large attractive detached house, which has been adapted and extended to provide residential accommodation for twenty-one elderly service users. It is situated in the quiet residential area of Leckhampton, on the outskirts of Cheltenham, within walking distance of the local shops. There are bus services within walking distance to the local area and Cheltenham town. The Care Home provides single accommodation on two floors with en-suite facilities in sixteen of the rooms. There is a staircase and shaft lift for access to the upper floor; the lift is provided for the benefit of those unable to manage the stairs. In addition, a variety of aids and adaptations have been provided throughout the property to assist the service users. An emergency call system is provided in all rooms and ensuite toilets. There are communal toilets and assisted bathrooms on both floors of the building. The comfortably furnished communal facilities consist of two lounges and a dining room plus a conservatory overlooking the attractive enclosed garden. A large selection of garden furniture is provided so that the service users may enjoy this area in good weather. Car parking is provided at the front of the property for visitors to the home. Hampton House DS0000016455.V331131.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. This unannounced inspection was completed over 2 days with one inspector. Eighteen people were accommodated in the home and all were seen and spoken to during the inspection, one person was in hospital. The provider had completed the pre-inspection questionnaire and additional information was provided to update this with regard to training, and reasons for staff leaving the home. Ten staff, ten relative/ friends and eight people who live in the home surveys were returned to the Commission. There was direct contact with the providers, the care staff, and the cook. A number of records were viewed including care plans and medication records. The care and records of four people who live in the home were looked at in detail. The environment was inspected during the day, and staff were observed at meal times interacting with the people who live there. The current weekly charges range from £480.00 to £540.00. There are additional charges for chiropody, hairdressing, newspapers and magazines. What the service does well:
The home has very good care plans, which are individual and help promote the health and wellbeing of the people who live in the home. Health care professionals support the home and people who live there feel safe and well cared for. Some comments from the people who live in the home and their relatives were; I always receive the right care and medical support, and staff are available when needed; medical attention is prompt and professionals are engaged when necessary; one can be utterly confident with the care here; excellent care home will ring and update me on doctors visits or any concerns of my fathers wellbeing; the home treats the residents with respect and allows them to keep their dignity. The people living in the home take part in activities they enjoy, there is a monthly plan of Forthcoming Events which includes; musical entertainment;
Hampton House DS0000016455.V331131.R01.S.doc Version 5.2 Page 6 games e.g. scrabble; quizzes; drinks parties to celebrate national days e.g. St David’s day; craft sessions and pub lunches. Holy Communion is held in the home monthly. Most of the peoples surveys indicated that there was always or usually activities arranged by the home that they can take part in. People have choice and control over their lives and are treated with respect by the staff. Their families and friends are made welcome in the home and opportunities are available for people living in the home to meet with the wider community. People living here like the good quality food provided, and there is always choice and variety. Some comments from people living in the home were; the food is ‘very good’; ‘good choice here for food’; ‘I enjoy what I eat’ and ‘good meat sometimes needs more flavouring’. Relatives made the following comments in the surveys returned; all staff show care and concern; no restriction for visiting any time between 9am and 9pm; the home treat the residents with respect and allow them to keep their dignity; the regime is very flexible and allows residents to make choices; the home is sensitive to residents individual needs, unfailing cheerfulness, communicates well and excellent catering; The home deals with any concerns by the people who live there quickly and has not had any formal complaints to indicate that they are dissatisfied with the service. The homes adult protection procedures and the staff training ensure that the staff have the knowledge to prevent and identify any abuse to safeguard everyone. A person living at the home said that the provider was brilliant if there was a problem as it was sorted quickly. The home is maintained to a high standard with good furniture and decoration. The bedrooms were clean, decorated well, personalised and adapted where wanted or required. People spoken to liked their rooms and most enjoy the use of ensuite facilities. The home has well trained staff in sufficient numbers to care for all the people who live in the home as most are independent and have low dependency needs. The homes recruitment practices and staff having had a good induction when starting, and supervision during their employment helps protect people from abuse. The people who live in the home were pleased with the recent change of the providers managing the home since the registered manager left. One relative’s survey commented on the staff changes, but said there had been no falling of standards and all the staff seemed capable and friendly. The home is managed well and people who live in the home and their friends and relatives take part in the quality assurance system to continually monitor and improve standards. The regular health and safety checks and servicing and maintenance of equipment protect people who live and work in the home. One of the registered providers has a health and safety qualification and reviews the homes policy every six months. The inspector saw the policy, which included fire risk assessments completed for six ‘areas’ of the home, which covered all aspects within the home.
Hampton House DS0000016455.V331131.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can
Hampton House DS0000016455.V331131.R01.S.doc Version 5.2 Page 8 be made available in other formats on request. Hampton House DS0000016455.V331131.R01.S.doc Version 5.2 Page 9 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 DS0000016455.V331131.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. All people are assessed prior to admission to ensure the home can meet their needs and they are able to stay for a trial period to make up their minds before moving in. EVIDENCE: The registered provider explained the admission procedure, which may include a visit to the prospective persons home or a hospital. People are also asked to visit the home, if possible, and sample a meal and meet the staff and other people accommodated there. One person commented in the surveys that ‘I was impressed by the invitation to spend a week here before deciding to move in’. Hampton House DS0000016455.V331131.R01.S.doc Version 5.2 Page 11 A written detailed assessment is taken about the person to be admitted by the provider with the help or a member of staff with NVQ level 3 qualifications. The assessment of a recently admitted person was seen. The assessment was good with detailed records, which included most of the recommended details in Standard 3 of the National Minimum Standards. However, there was no specific record where the history of falls or mental health could be recorded. It is recommended these should be included in the assessment to ensure that any healthcare professional advice or equipment needed is provided before admission. The registered provider is training senior care staff to complete a comprehensive pre-admission assessment. Hampton House DS0000016455.V331131.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 & 9 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. The care plans were detailed and contained well written individual actions that also addressed equality and diversity issues for staff to use, which included all heath care issues and the involvement of healthcare professionals. The good practice seen will promote the health and wellbeing of the people who live in the home. Medication is well managed and staff have good training promoting safe practice to protect the vulnerable people accommodated. EVIDENCE: Four care plans were looked at in detail and the people receiving the care were spoken to about the quality of care provided. The plans were detailed and individual and had good planned actions for all care issues identified, which included addressing any diversity issues. An example of this was a partially sighted person had a picture of a plate in the care plan to ensure staff always put the types of food where they could be identified, this is excellent practice which promotes equality and addresses the diversity of physical disabilities.
Hampton House DS0000016455.V331131.R01.S.doc Version 5.2 Page 13 Care plan issues are collectively reviewed monthly with the people who live in the home and are signed by them. Risk assessments include preventative actions and are reviewed monthly. To help promote continuity of care there is a formal team meeting each morning at 9.15 for the care staff on duty and various topics are discussed relating to the care for people who live in the home. Some care plans have a personal profile completed to help identify personal interests and hobbies. The daily records seen were meaningful and staff should be encouraged to continue to write positive remarks as well as any problems identified. The keyworker for each person living in the home has a duties list to follow and must ensure these areas are completed for each person weekly. Visits by health care professional are recorded and it was evident that all care issues were well planned and followed up. It was recommended that the district nurse provide the care staff with a written protocol for staff to manage a person’s supra-pubic catheter site. Surveys from people in the home and their relatives stated that; • • • I always receive the right care and medical support, and staff are available when needed medical attention is prompt and professionals are engaged when necessary, one can be utterly confident with the care here excellent care home will ring and update me on doctors visits or any concerns of my fathers wellbeing. The home treats the residents with respect and allows them to keep their dignity. The medication system used is monitored dosage. One random audit completed by the inspector identified a minor error in recording for a service user who had recently returned from hospital. There was no record of the total amount of medication available as additional stock acquired had not been added. Audits of other people’s medication were correct. The records were good there were no gaps seen in the administration charts. There is also a medication care plan for each person accommodated where the reason for medication is stated and any instructions for ‘as required’ medication is identified, this is good practice. When as required creams and eye drops have been administered they are also recorded in the persons daily record. People who live in the home who self-medicate are monitored regularly to ensure they can safely continue. Currently two people self-medicate and have lockable storage. Information sheets on all the current medication are kept. The registered provider also ordered the latest British National Formulary on the day of the inspection, which will provide an up to date reference of all medication. The senior carer helping the inspector was knowledgeable about most of the medication administered, and was able to refer to individual care plans for further information.
Hampton House DS0000016455.V331131.R01.S.doc Version 5.2 Page 14 The storage of the medication was well organised, and secure as staff kept the keys with them at all times. Medicines needing refrigerated storage are not kept securely in the utility fridge (near an external door). A fixed locked container must be used in this fridge or a separate locked medicine fridge provided, this is a breach of Regulation 13(2). The last medication review was in December 2006. The supplying pharmacist completes a quarterly audit of the medication. It was recommended that the registered persons record a regular monthly audit to check compliance and safe administration. The medication policy required some expansion, and the provider was able to show the inspector a recent example of the new procedure format which will be adapted for Hampton House staff to use. It was recommended that the latest Royal Pharmaceutical Society’s guidance be downloaded for reference. The staff medication training records were seen which includes induction training, training from the supplying pharmacist and from an accredited outside agency. Care staff are supervised many times while achieving competence before they are able to administer medication alone. Observation sheets were seen to support this good practice. Hampton House DS0000016455.V331131.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 & 15 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The people living in the home take part in activities they enjoy, have choice and control over their lives and are treated with respect by the staff. Their families and friends are made welcome in the home and opportunities are available for people living at the home to meet with the wider community. People living here like the good quality food provided, and there is always choice and variety. EVIDENCE: The provider sent to the Commission three monthly programmes for Forthcoming Events prior to the inspection, which included musical entertainment, games e.g. scrabble, quizzes, drinks parties to celebrate national days e.g St David’s day, craft sessions and pub lunches. Holy Communion is held in the home monthly. The home has a loudspeaker system to all rooms and activities and meal times are announced to enable everyone to know when to attend should they wish to. Hampton House DS0000016455.V331131.R01.S.doc Version 5.2 Page 16 Several of the people who live at the home were spoken to at length and commented that they were content with the range of activities provided. During the two days of the inspection groups were seen enjoying games of domino and bingo. One partially sighted person spoken to enjoys knitting squares, which the staff arranged to be sewn together, and listens to talking books from the library. With the help of the staff she can also join in with Scrabble, skittles and some quizzes and with the help of another person who lives there goes for a walk locally. Her visitors take her to church and a monthly luncheon club, however she said ‘I would like to go out more’. Many people spoken to were independent and said they could ‘do what they liked’ and enjoyed their own activities and going out alone. Many people had their own telephone and kept in close contact with their relatives and friends. Those without a phone have access to the homes portable telephone. The people who live in the home choose what name they want to be called by and this is recorded. Staff were seen being respectful and friendly towards people in the home. The people living in the home told the inspector that; • the staff were very kind • the staff take me out in the car • the staff are kind and helpful Most of the surveys from people who live in the home indicated that activities are always or usually arranged by the home that they can take part in. Comments from relatives/friends surveys were; • all staff show care and concern, no restriction for visiting any time between 9am and 9pm • the home treat the residents with respect and allow them to keep their dignity. The regime is very flexible and allows residents to make choices • the home does well the personal attention given to residents and visitors • the home is sensitive to residents individual needs, unfailing cheerfulness, communicates well and excellent catering • I cannot fault the home I think they all do a good job my mum is happy with the home • the home provides a friendly, homely atmospheres and keeps residents entertained. Could listen more to eating preferences, as my mother prefers small portions, which she does not always get. The menus seen were varied and a choice is provided. The quality of the food seen during the two days of inspection was high and was well presented, staff ensured that hot meals remained hot while serving. The cook was spoken to
Hampton House DS0000016455.V331131.R01.S.doc Version 5.2 Page 17 and assured the inspector that she had everything she needed in the kitchen, was experienced and had the required qualification to handle food. Fresh produce is used daily and special diets are catered for. The kitchen was clean and organised. The atmosphere in the dining room was one of cheerful activity with staff helping where required and people talking. Where food needs to be cut up for some people it is done away from the table to preserve dignity. Each table has name places with personal napkins and people are encouraged to mix so staff arrange places differently every fourth week. People can eat in their own rooms if they wish. Two people commented to the inspector they would prefer to choose where they sit. This was discussed with the provider who subsequently reviewed the arrangement with service users and the overwhelming response was not to change the system. However, the provider agreed to regularly review this to ensure that everyone can comment. The people commented to the inspector that the food was ‘very good’, ‘good choice here for food’, ‘I enjoy what I eat’ and ‘good meat sometimes needs more flavouring’. The Environmental Health Officers last report dated 09/01/07 was seen by the inspector, the home was rated good and the provider stated that the requirements had been completed. All staff have food hygiene training as they help prepare breakfasts and suppers. The provider informed the inspector about, and staff also mentioned, the staff hospitality training last year. The provider stated that the training helped to raise the profile with regard to providing quality and consistency when communicating with everyone in the home. Hampton House DS0000016455.V331131.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home deals with any concerns by the people who live there quickly and has not had any formal complaints to indicate that they are dissatisfied with the service. The homes adult protection procedures and the staff training ensure that the staff have the knowledge to prevent and identify any abuse to safeguard everyone. EVIDENCE: The home provides new people admitted to the home with a complaints procedure, seen by the inspector. It is recommended that the procedure contains the following: all complainants will receive a response within 28 days as any actions taken must be recorded. All people living in the home should have a copy of the entire Service Users Guide, which contains the complaints procedure. A relatives survey commented that ‘‘full details of the complaints procedure was included with the contract’. A person living at the home said that the provider was brilliant if there was a problem as it was sorted quickly. The home has not had any recorded complaints since the last inspection, and people living in the home confirmed that the staff deals with any concerns quickly. There appeared to be some confusion from the people who live in the home about who they would complain to when required, as the registered manager
Hampton House DS0000016455.V331131.R01.S.doc Version 5.2 Page 19 had left. The registered providers were now completing the manager’s duties and continue to be involved in the day to day running of the home. The staff surveys also indicated there was some need for clarification about who to report a complaint to as the new management structure meant that senior carers were sometimes in charge. However, since the inspection one of the providers has made the decision to become the registered manager and will be on the rota at the home at least four days each week and on call at most other times. The homes adult protection and prevention policy was last reviewed on 24 February 2007 and contains the contact details for the Adult Protection Team in Gloucester. Staff interviewed by the inspector had read the procedure and had received training during their induction for adult protection, they have also had one day training in Protection of Vulnerable Adults from an outside agency. Staff spoken to knew what ‘whistleblowing’ meant and who to contact and were aware of the types of abuse to look out for. People living in the home said they felt safe and were treated in a dignified manner by the staff. Hampton House DS0000016455.V331131.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home provides an excellent well maintained environment where people feel at home and have adapted facilities to meet their individual needs. EVIDENCE: The home is maintained to a high standard this includes furniture and decoration. The communal areas have had new carpets fitted and new light fittings. Room six has recently been refurbished. The continual programme of refurbishment ensures that all areas are a good standard. The office area on the ground floor has had a new ceiling window fitted to give more natural light and the staff say this is a definite improvement. Hampton House DS0000016455.V331131.R01.S.doc Version 5.2 Page 21 The bedrooms were clean, decorated well, personalised and adapted where wanted or required, people spoken to like their rooms and most enjoyed the use of ensuite facilities. Comments from the people that live there and their relatives were: • sometimes my room is cold during the day when the heating goes off • the room is warm enough • environment excellent and the owners philosophy of what they would want for their own parents is working • the home provides the closest I have ever seen to a real family atmosphere. The provider explained to the inspector that the home had three different heating systems and that some people may need help with the thermostats provided. The person concerned about the cold was helped immediately and was reassured that a close check would be made to ensure a comfortable heat. The laundry was seen and although small was well organised to ensure infection control standards were maintained. It was recommended that an infection control policy seen was updated and a copy of how to handle the laundry was posted on the wall to remind staff of their duties for health protection. Subsequently the provider sent the Commission an updated version of the homes infection control policy. All three assisted bathrooms were seen and were well maintained and attractive, however, one had limited room to manoeuvre, and the staff surveys had identified a need to provide a more suitable bathroom for older people. This was discussed with the provider who will consider ways to improve the space in this bathroom. Hampton House DS0000016455.V331131.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has well trained staff in sufficient numbers to care for all the people who live in the home as most are independent and have low dependency needs. The home does not have staff awake after 23.00 hours, this is continually monitored to ensure the home can meet the needs of all people. People are protected by the homes recruitment practices and staff having good induction and supervision when starting their employment. EVIDENCE: The dependency of the seventeen people accommodated, one was in hospital, was discussed with a senior carer and all were said to be low dependency. The rota was seen and the current level of staffing was judged by the provider to be sufficient to meet the needs of the people living at the home. Many people told the inspector that they were independent and required very little care from the staff. Two care staff and a manager are on duty every weekday until 17.00 hours, then two day care staff are on duty until 20.00 hours. Night staff duty is from 20.00 – 8.00, the two night staff sleep-in from 23.00-07.00 hours. Both carers remaining awake until 23.00 hours to ensure everyone are settled for the night and can be contacted by the call bell system. During the weekend there is two
Hampton House DS0000016455.V331131.R01.S.doc Version 5.2 Page 23 care staff on duty all day, one of which is always a senior carer and the manager is on call at the weekends. The provider keeps a record of when staff are called at night and any incidents of falls etc. to risk assess the need for waking night staff regularly. There were no people who were confused and would wander and be at risk. The inspector saw evidence that there was little activity at night, however one person spoken to recalled how she had fallen and was unable to reach the bell or her bed and slept on the floor all night. The providers have decided that staff awake in the home at night are not required, there are risk assessments to support this. In view of the number of people accommodated and the location of the staff, who sleep in, it is recommended that further consideration is given to the introduction of waking night staff to ensure vulnerable people are protected at all times. Another person spoken to was concerned that if care was required during the night that a move to another home may be required and had discussed this with the providers, but still felt vulnerable. The providers should think carefully about how they assess the provision of waking night staff. There are ancillary staff five days each week who complete the main cleaning duties in the home and there is also a handyman. There are two cooks who cover the seven days each week preparing lunch every day and some supper dishes in advance. The provider gave the inspector details of all staff training completed and there was evidence that the percentage of staff who had completed NVQ level 2 or above was thirtysix, two of the fourteen staff had recently started NVQ studies. Eleven staff have left the home in the last year including the registered manager and assistant manager and the reasons for leaving were given to the Commission. Some had sought promotion elsewhere or moved away and two did not pass their probationary period, none had been dismissed. The homes training schedule provided to the Commission was evidence that staff are adequately trained to meet the needs of the people who live in the home. Staff commented in the surveys that the training was adequate and was well done. A sample of the staff training records were seen and included a good induction record and copies of all certificates. The inspector provided information to the home regarding the new induction standards required in the regulations. The provider keeps supervision records separate and secure to maintain confidentiality. The Criminal Reference Bureau records of all six new staff that remain employed at the home were seen by the inspector and another six who had been employed and have left the home since the last inspection. A Sample of the recruitment records for two staff were seen as complete.
Hampton House DS0000016455.V331131.R01.S.doc Version 5.2 Page 24 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35,& 38 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. The and and and home is managed well and people who live in the home and their friends relatives take part in the quality assurance system to continually monitor improve standards. The regular health and safety checks and servicing maintenance of equipment protect people who live and work in the home. EVIDENCE: The registered manager left the home in December 2006 and one of the registered providers is managing the home and has recently decided to apply to the Commission to become the registered manager. Staff surveys sent to the Commission in February/March 2007 indicated that there was some concern about the management structure, as some staff did not feel well supported. This was discussed during the inspection with the
Hampton House DS0000016455.V331131.R01.S.doc Version 5.2 Page 25 registered providers and they felt that the new structure, recently implemented, was working well but needed time to settle for staff to feel confident, as some care staff had been promoted. Three care staff interviewed during the inspection had no adverse comments about the new management structure. The people who live in the home were pleased with the providers managing the home. One relative’s survey commented on the staff changes, but said there had been no falling of standards and all the staff seemed capable and friendly. The providers have their own system of quality control and survey the people who live in the home and their family and friends regularly. This included surveys relating to the cleanliness of the home and the atmosphere, breakfast provision and other food related surveys in 2006. There are occasional staff meetings the minutes from the last meeting in June 2006 were seen and related to the keyworker duties. Some people living in the home told the inspector that they would like to have their own meetings to discuss any changes in the home. The providers were informed about this on the day. The pre-inspection questionnaire completed by the providers stated that all the people that live in the home manage their own personal finances. One of the registered providers has a health and safety qualification and reviews the homes policy every six months. The inspector saw the policy, which included fire risk assessments completed for six areas of the home. Fire safety records including staff fire training were complete. Accident reports were seen and there is a quality audit and analysis recorded. There is a comment for action taken and should there be a wound the district nurse is involved immediately. All staff have had first aid and manual handling training. The recommendation at the last inspection, to randomly check all hot water outlet temperatures, is being completed every four weeks and the record was seen. Information given to the Commission from the providers gave good evidence that the home is well maintained with regard to the health and safety checks and servicing of equipment in the home. Hampton House DS0000016455.V331131.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 x 18 4 4 X 3 X X X X 4 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 4 Hampton House DS0000016455.V331131.R01.S.doc Version 5.2 Page 27 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. 1 Refer to Standard OP3 Good Practice Recommendations The history of falls and any mental health care needs should be included in the pre-admission assessment to promote healthcare professional advice and/or supply any equipment needed admission. A regular monthly audit of the medication should be completed by the staff to check compliance and safe administration. The complaints procedure should contain the following: all complainants will receive a response within 28 days. Any actions taken must be recorded, and all people living in the home should have a copy of the entire Service Users Guide, which contains the complaints procedure. One assisted bathroom has limited space to manoeuvre and could be made more suitable for use by the older
DS0000016455.V331131.R01.S.doc Version 5.2 Page 28 2 OP9 3 OP16 4 OP21 Hampton House person. 5 OP27 In view of the number of older people accommodated and the location of the staff that sleep in the home; it is recommended that further consideration is given to the introduction of waking night staff to ensure vulnerable people are protected at all times. Hampton House DS0000016455.V331131.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 DS0000016455.V331131.R01.S.doc Version 5.2 Page 30 - 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!
