CARE HOMES FOR OLDER PEOPLE
Hanningfield Retirement Home 99 London Road Sittingbourne Kent ME10 1NR Lead Inspector
Lucy Ansell Unannounced Inspection 3rd March 2006 10:00 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 Hanningfield Retirement Home DS0000023953.V285400.R01.S.doc Version 5.1 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. Hanningfield Retirement Home DS0000023953.V285400.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Hanningfield Retirement Home Address 99 London Road Sittingbourne Kent ME10 1NR 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) 01795 479587 Hanningfield Retirement Home Ltd Mrs Heather Littlewood Care Home 27 Category(ies) of Old age, not falling within any other category registration, with number (27) of places Hanningfield Retirement Home DS0000023953.V285400.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Variation for an EMI bed for one resident D.O.B 22-02-1917 Date of last inspection 28th September 2005 Brief Description of the Service: Hanningfield Retirement Home is a large detached property providing accommodation over two floors; the Home is registered to provide care for approximately 27 persons within the ‘Older People’ category. There are 27 single rooms; one with en-suite facilities. The Home employs a Manager, a Team Leader, and two ‘Seniors’ in addition to Care staff. The Registered Manager, Mrs Heather Littlewood, has several years experience of managing the Home and holds a City & Guilds Advanced Care Management qualification. The Home is situated on the main A2 London Road into Sittingbourne and is approximately half a mile from the town centre, on a bus route. Hanningfield Retirement Home DS0000023953.V285400.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This Unannounced Inspection took place on the 3rd March 2006 by one inspector Lucy Ansell. The Inspector agreed and explained the inspection process with the Registered manager. Documentation and records were read, including care plans. Time was spent reviewing a sample of written policies and procedures, looking at care plans and records kept within the home. A tour of premises was undertaken. The focus of the inspection was to assess the Home in accordance to the National Minimum Standards for older persons and to seek resident’s and representatives views of the home. In some instances the judgement of compliance was based solely on verbal responses given by those spoken with. Some Standards were not inspected in full and the last report should be read in conjunction to obtain a full picture. What the service does well:
The staff have a good understanding of the support needs of the residents as evidenced in care plans. This is also evident from the positive relationships, which have been formed between staff and residents. All comment received were positive about the service and a district nurse spoken to stated, “how homely it was” “ how happy they all seem to be”. Comments received from the residents included ”shown immense kindness and patience” “like a five star hotel”. The food was also praised as “excellent and very tasty” with lots of choice offered and all home cooked. The home’s primary focus is on developing a tailor made service to enable the clients to maintain their independence and their right to choice. Evidence was seen that the daily routines of the home were entirely focussed on the choice and freedom of the service users. The home has achieved 65 of their staff having gained the NVQ level 2 in care or above. The home provides a comprehensive induction package for all new staff. Hanningfield Retirement Home DS0000023953.V285400.R01.S.doc Version 5.1 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
Hanningfield Retirement Home DS0000023953.V285400.R01.S.doc Version 5.1 Page 7 contacting your local CSCI office. Hanningfield Retirement Home DS0000023953.V285400.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Hanningfield Retirement Home DS0000023953.V285400.R01.S.doc Version 5.1 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 the following standard(s): 1 The home’s statement of purpose and Service User guide contains the required information for residents and families to make an informed decision about moving into the home. EVIDENCE: The home reviews and revises its statement of purpose and service users guide annually. It is clear and concise with all relevant information included. A recent update has just been completed. Hanningfield Retirement Home DS0000023953.V285400.R01.S.doc Version 5.1 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): 7,10, 11 Care plans are well written and detail the care needs of the resident, however they could benefit from better reviews and risk assessments. Residents benefit from being treated with respect and their privacy is upheld. However all residents would benefit from being consulted, regarding their wishes concerning terminal care and arrangements after death. EVIDENCE: The care plans were generally well written, detailing the residents care needs. Most of the care plans seen were written on admission, and had been reviewed by staff several times since then with additions added to the care plans, but these were not always dated. The monthly reviews needed more detail but had always been happening on a regular monthly basis. There was no evidence seen that residents are re-assessed every six months, or yearly a new care plan is written. Evidence seen of care plans indicated that the resident had not been fully involved in the process. Hanningfield Retirement Home DS0000023953.V285400.R01.S.doc Version 5.1 Page 11 The risk assessments were poor and needed to be clear and concise with instructions to minimize risk as well as identifying it, these also not reviewed regularly. The home operates a key worker system where residents have an identified staff member. The home uses key working books, which highlights past achievements of that resident but is not for all staff to see. The daily record sheet, records when events and care delivery occurs throughout the day. These however are not detailed and comprehensive enough and the use of times needs to be improved. The staff also needs to be aware that they are leaving gaps and spaces between each recording. This could mean that at a later date something could be added to their notes, so to avoid this sign after the recording and draw a line to the end. Arrangements are made for the resident to have visitors, whether it is a family member or a health professional, to be seen in the privacy of their bedroom or in one of the quiet areas within the home. It is left to the residents to choose where they will sit. The pay phone is in the small quiet lounge in the centre of the home. Staff were seen knocking on doors before entering service users bedrooms. The staff on duty were observed indirectly throughout the inspection, they were seen to interact in a positive and respectful manner with residents. Residents gave positive feedback during the inspection about the approach of the staff team, comments included “nothing is too much trouble for the girls” and “they are lovely”. All residents spoken to agree the staff were very “professional and respectful of their dignity and right to privacy”. Residents/relatives are consulted regarding their wishes concerning terminal care and arrangements after death during the pre-assessment stage and if this is known recorded on their care plans. However the home has a duty to follow this up with a letter at a later date if not known or still discussing this issue to ensure it is recorded on their file. Hanningfield Retirement Home DS0000023953.V285400.R01.S.doc Version 5.1 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): Not inspected EVIDENCE: However many comments were made about how good the food was and how it was all homemade. Hanningfield Retirement Home DS0000023953.V285400.R01.S.doc Version 5.1 Page 13 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 17,18 The residents would benefit from all staff knowing how to report appropriately any possible abuse, and what immediate action to be taken to protect them. Residents’ legal rights are protected. EVIDENCE: The residents at the home were all able if they wished to participate in the last elections. Many residents used postal votes and family could take residents up to the polling station, which is very close by. The home has access to an available advocacy service if no family or care manager is available to fulfil this role. The home ensures the residents are safeguarded from any abuse, neglect or harm by using the Local Authority protocols on Adult Protection for the home. The homes nominated trainer gives information for all staff at induction. The staff need to attend courses in the Local Authorities Adult Protection Course. The home has a whistle blowing policy and a policy on gifts and gratuities. Hanningfield Retirement Home DS0000023953.V285400.R01.S.doc Version 5.1 Page 14 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,21,22,24 Residents benefit from living in a safe, well maintained, clean and homely environment in which there are good standards of décor, furnishings and fittings. EVIDENCE: The home’s location and layout is suitable for its stated purpose; it has been visited by the fire officer and environmental health and had met all their requirements. The homes grounds are tidy, accessible to the residents and provide off road parking. The home has three communal lounges spread across the building, one for viewing the television or activities area and then the dinning room. Another of which is a quiet room within the conservatory. The home also has a small lounge for seeing visitors and as a private phone room. The residents can eat in the dinning room or choose to eat in their rooms. Several residents/relatives spoken to commented “On the welcoming feeling of the home”, which was domestic and homely in character. One room has ensuite toilet facilities and all the other rooms are single with a washbasin.
Hanningfield Retirement Home DS0000023953.V285400.R01.S.doc Version 5.1 Page 15 The home has sufficient toilet and bathroom facilities for the number of service users. Residents have the equipment and adaptations required to maximise their independence in all the bathrooms and toilets. Grab rails were seen in all corridors and the home has a lift as well as two stair lifts. The staff also are trained to use a hoist and Sam Haul turner for chair raisers. Call systems were seen in all the rooms and provided in communal areas. Bedrooms seen had all been personalised by the service users. The rooms were all clean and well decorated. All the Bedrooms have sufficient space to accommodate the required furniture. The home has high standards of cleanliness and the cleaning staff has a rotas of which rooms to deep clean daily and no odours were detected in the house. The corridor carpets upstairs and downstairs could be changed due to being worn and are starting to make ridges which could cause a trip hazard. Hanningfield Retirement Home DS0000023953.V285400.R01.S.doc Version 5.1 Page 16 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,30 Residents’ needs are met by sufficient number of staff that are motivated and enthusiastic. Residents’would further benefit from trained staff who are knowledgeable as well as experienced. EVIDENCE: Staff rotas were seen and evidenced that staffing was suitable to provide appropriate shift cover. The staffs working in the home are encouraged to have an NVQ, from domestic to care staff. There are six staff who have NVQ 2 and five more staff taking an NVQ who are due to complete this year; three further staff are waiting to start this year. 4 carers staff the home on the morning shift, then in the afternoons 3 carers and in the evenings 2 waking staff, this also includes the manager .The home also employs a cook, maintenance man and two part time housekeepers for cleaning. Evidence was seen of the homes training matrix and the training programme for the year has concentrated on getting all staff to complete the NVQ 2 and taking intermediate food hygiene. The home would benefit from key staff becoming trainers in Manual Handling, Health and Safety and Adult Protection. It is good practice to ensure all types of training are sought to ensure outside as well as in-house training is being completed to get a balance. The home is aware that training is an area that is poor and needs to looked at. Information has been given to the manager to assist her with this.
Hanningfield Retirement Home DS0000023953.V285400.R01.S.doc Version 5.1 Page 17 The induction is a very thorough process and each section is signed off before they can move on to the next part. The manager is responsible for carrying out the induction with all new staff. Good practice would recommend that key policies are signed by staff when they have read them. Hanningfield Retirement Home DS0000023953.V285400.R01.S.doc Version 5.1 Page 18 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): 34,35,37 The residents benefit from financial procedures that safeguard their best interests. The residents’ best interests could be better safeguarded by a revision of all the homes policies and procedures. EVIDENCE: The home has suitable accounting and financial procedures in place that evidence financial viability. The home is financially viable and finances are spent on improvements as are needed. A copy of the homes development and financial plan needs to be seen to evidence future plans for redecoration and programme of renewal. Insurance cover for the home was seen. Records are kept of all transactions entered into by the manager or owner. Evidence was seen that the home does have procedures in place for the monitoring and accounting of resident’s money within the home. Accounts of one resident were checked and found to be correct and receipts were seen for
Hanningfield Retirement Home DS0000023953.V285400.R01.S.doc Version 5.1 Page 19 all transactions. Agreed with the manager to sign in places she has carried out random checks and to draw a line under totals before she adds new balance so it is clearer. During the course of the inspection a number of records, policies, procedures and other documents were examined. Records are stored securely and safely in the office, which is kept locked. The homes policies and procedures were woefully out of date and need to all be reviewed and revised with clear review dates seen. Hanningfield Retirement Home DS0000023953.V285400.R01.S.doc Version 5.1 Page 20 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 3 x x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 x 10 4 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 3 x 3 3 x 3 x x STAFFING Standard No Score 27 3 28 x 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x 3 3 x 2 x Hanningfield Retirement Home DS0000023953.V285400.R01.S.doc Version 5.1 Page 21 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. 1 Standard OP7 Regulation 13(c) Requirement Timescale for action 30/08/06 2 OP11 17(1) 3 OP18 18(c1) 4 OP30 18(c1,2) For all residents plans to include updated risk assessments and manual handling assessments with attention to prevention of falls. Care and comfort are given to 30/08/06 service users who are dying, their death is handled with dignity and propriety, and their spiritual needs and rites recorded on their plans of care. The registered person ensures 30/08/06 that service users are safeguarded from physical, financial or material, psychological or sexual abuse, neglect, discriminatory abuse or self harm, inhuman or degrading treatment, through deliberate intent, negligence or ignorance, in accordance with written policies. The registered person ensures 30/08/06 that there is a staff training and development programme which meets the National Training Organisation (NTO) workforce training targets and ensures staff fulfil the aims of the home and
DS0000023953.V285400.R01.S.doc Version 5.1 Hanningfield Retirement Home Page 22 5 OP37 17 meet the changing needs of service users. Records required by regulation for the protection of service users and for the effective and efficient running of the business are maintained, up to date and accurate. 30/08/06 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 OP7 OP7 Good Practice Recommendations The home to ensure daily recordings are detailed, signed and timed with no gaps The home to ensure monthly reviews are happening and well recorded with detail and dates. Hanningfield Retirement Home DS0000023953.V285400.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Hanningfield Retirement Home DS0000023953.V285400.R01.S.doc Version 5.1 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!
