Inspection on 05/01/07 for Hanningfield Retirement Home

This inspection was carried out on 5th January 2007.

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

Hanningfield Retirement Home 15/11/07

Hanningfield Retirement Home 03/03/06

Hanningfield Retirement Home 28/09/05

Hanningfield Retirement Home 22/03/05

Hanningfield Retirement Home 09/02/05

Hanningfield Retirement Home 09/02/04

Hanningfield Retirement Home 06/11/03

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

CARE HOMES FOR OLDER PEOPLE Hanningfield Retirement Home 99 London Road Sittingbourne Kent ME10 1NR Lead Inspector Jo Griffiths Key Unannounced Inspection 5th January 2007 09:30 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.V326641.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. Hanningfield Retirement Home DS0000023953.V326641.R01.S.doc Version 5.2 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.V326641.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd March 2006 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 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. The fees for this service currently range from £330 - £420 per week depending on individual need. Hanningfield Retirement Home DS0000023953.V326641.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was unannounced. The Manager and the owner were present throughout the inspection. Ten of the people living at the home and one relative were spoken with as part of the inspection. The inspector had a look around the home and also inspected some of the records, including the care plans. What the service does well: What has improved since the last inspection? The Manager has assessed the risk of falls for each person. A record of health needs is now being kept for each person living at the home so that staff can quickly see any changes to a persons well being. Residents have been asked if they have any particular needs around ageing and for the end of life, these have been recorded so that staff can offer the best support in the event of a person’s death. The staff have received training in medication and safeguarding vulnerable adults, which will help to protect residents. All the policies for the running of the home have been reviewed and staff have read them so that they know what procedures they should be following to protect residents. The carpets have been replaced throughout the home, providing a more pleasant and comfortable environment for the residents to live in. Hanningfield Retirement Home DS0000023953.V326641.R01.S.doc Version 5.2 Page 6 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 be made available in other formats on request. Hanningfield Retirement Home DS0000023953.V326641.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hanningfield Retirement Home DS0000023953.V326641.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1 and 2 Standard 6 is not applicable at this home. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are provided with the information they need to make a decision about moving to the home. Residents have their needs assessed before they move to the home so that they know these can be met. EVIDENCE: The Manager said there were no changes to the Statement of Purpose or Service User Guide. Residents spoken with said that they had been given information about the home before they moved in. Each person has an assessment of their needs before they move to the home, which is completed by the Manager. The Manager then offers a place at the Hanningfield Retirement Home DS0000023953.V326641.R01.S.doc Version 5.2 Page 9 home if the person’s needs can be met. A more detailed assessment is completed once they move into the home and this focuses on their needs and skills in everyday living. Intermediate care is not offered at the home, but respite places can be arranged. Hanningfield Retirement Home DS0000023953.V326641.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9, 10 and 11 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents’ care may be compromised, as staff do not have a clear and directive plan to follow. Residents health needs are fully met, but they would benefit if staff kept more accurate records. Residents are protected because staff follow safe procedures for administering their medication. Residents are treated with respect and are assured that staff will treat them with sensitivity and respect their wishes at the time of their death. EVIDENCE: Each resident has a file that includes the full assessment of their needs and risk assessments. The Manager was advised that the care plan needs to be Hanningfield Retirement Home DS0000023953.V326641.R01.S.doc Version 5.2 Page 11 clearly identified as separate from the assessment. The assessment must detail what the persons needs are and the care plan must detail how the needs will be met. This will ensure that staff are given accurate information about how they should be supporting each person. Individuals needs relating to mobility and falls have now been assessed. The assessments would benefit from more detail about that actions staff must take to reduce the risks. Residents’ health needs are well met by the GP and district nurse. Records of health appointments have been introduced to make it easier for staff to keep up to date with any relevant health issues. The staff need to make sure that where a health need is identified the records show the action that is taken, for example, calling the GP, reporting to a Manager or seeing the district nurse. All staff have now completed a 12 week training course in administering medication. This has given them more in depth knowledge in this area and will help to ensure that residents’ medication is handled safely. Residents said they were happy with the way their medication was managed. Residents spoken with said that the staff are sensitive and respectful when they are caring for them. Positive relationships were seen between staff and residents. Those asked said their privacy was always respected. The Manager has worked with residents and their families to establish any wishes they have in the event of their death. These have been recorded on the care plan to ensure that staff can respect these wishes and support people sensitively at the end of their life. Where people do not want to share this information at this stage this has been respected. Hanningfield Retirement Home DS0000023953.V326641.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 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. Residents generally find the lifestyle meet their expectations and needs, but would benefit from further consultation about activities. Residents can receive visitors when they wish to and are helped to exercise choice in most areas of their lives. Residents enjoy a balanced menu, but would benefit from a choice of main meal. EVIDENCE: There is a programme of activities that residents can choose to take part in each week within the home. A record is kept of the activities that take place and who was involved to allow the Manager to monitor that people’s social needs are being met. The activities available include music and singing, exercise sessions, bingo, arts, reading and external entertainers. A comedian has been booked to provide entertainment in the next month. Most residents said they were happy with the amount of activities provided. Some people said Hanningfield Retirement Home DS0000023953.V326641.R01.S.doc Version 5.2 Page 13 they were sometimes bored, but did not have anything particular they wanted to do. It is recommended that the Manager explore activities in detail in the next quality survey sent to residents. Residents can receive visitor when they want to and can see them in private in the visitor’s lounge or their own rooms. Residents said they are given a choice of whether they would like to join in the activities and that they are given a choice of teatime meals. They said that there is one choice on the lunchtime menu, but that they could ask for something else if they did not like what was on offer. It is recommended that 2 choices of hot meal be offered each day. One resident and their relative raised some concerns about the choices available to them for meals. The Manager agreed to address any concerns immediately. The inspector was contacted by the relative following the inspection and informed that the matters had been resolved and that they were very happy with the outcome. Residents said their choices were generally respected by staff but that they would sometimes like to be able to have a lie in. It is suggested that this could be explored again through the next quality survey. Information about activities and meals are displayed in the home. It is recommended that there be one notice board for residents with all the information that is relevant to them in large print to make it easier for them to see. Hanningfield Retirement Home DS0000023953.V326641.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be confident that they can make a complaint if they need to and that their concerns will be properly addressed. Because staff have recently received relevant training, residents are better protected from being abused. EVIDENCE: The home has a complaints procedure that is provided to residents within the Service User Guide when they move to the home. It is suggested that a copy also be placed on a residents notice board so that they, or their visitors, can refer to it at anytime. There have been no complaints received by the home or by CSCI. Residents spoken with said they would speak with the Manager if they had a complaint. All staff have now received training in safeguarding vulnerable adults. There is a clear policy for protecting adults and there have been no concerns raised. Hanningfield Retirement Home DS0000023953.V326641.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19, 20, 21, 24 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a safe and well-maintained environment and have access to plenty of communal and private space. Their bedrooms meet their needs and are comfortable and private. Residents benefit from living in a clean and hygienic home in which there are sufficient toilets and bathrooms to meet their varying needs. EVIDENCE: The home is welcoming, warm and homely. All areas of the home are very clean and nicely decorated. The carpets throughout the home have been recently replaced. There is a maintenance man who has been employed in the home for many years who ensures that the home is very well maintained. The communal areas are fully furnished and comfortable for residents, there is a Hanningfield Retirement Home DS0000023953.V326641.R01.S.doc Version 5.2 Page 16 choice of lounges they can use and a large dining room. There is a rear garden that can be enjoyed in the summer. Each resident has a single bedroom and are able to furnish their room to their own tastes. The bedrooms have been personalised with their own belongings and residents said that their private space is respected. There are plenty of bathrooms and toilets around the home. These are clean and equipped for a variety of mobility needs. The Manager was advised that the lino around one of the baths needed resealing and she said this would be done. Residents said they were very happy with the home and their own rooms. There are facilities for residents to store their own foods and make their own drinks if they wish to. Some residents have their own private telephones. Since the last inspection the home has won the 1st place ‘In Bloom’ award for the local area for the gardens to the front of the house. Hanningfield Retirement Home DS0000023953.V326641.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported by sufficient numbers of trained and qualified staff to meet their needs. Residents are protected by the home’s robust procedures for recruiting new staff. EVIDENCE: Staff training has improved since the last inspection. Training in medication, 1st aid and infection control has taken place and updates in manual handling are planned for next month. Most staff have achieved their NVQ award and some staff have attended training in dementia care. Some updates in fire safety are needed for some staff as the last course was in 2000. A letter had been received from the trainer who carried out the medication training. It stated, “ Rarely does one home have so many staff showing commitment, enthusiasm and such hard work”. This demonstrates the hard work staff have put into their training courses in the last year. Hanningfield Retirement Home DS0000023953.V326641.R01.S.doc Version 5.2 Page 18 Recruitment files were sampled and it was found that robust procedures had been followed for employing new staff. This ensures that residents are protected. The rots showed that sufficient staff are on duty each day to meet the needs of the residents. Residents spoken with said that staff respond very quickly to call bells and are always available when they are needed. Hanningfield Retirement Home DS0000023953.V326641.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 32, 33, 35, 37 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a well managed home that is run in their best interests by a qualified and competent manager. Residents benefit from the clear leadership of the home which has up to date polices which in practice are implemented by staff. Residents financial interests are safeguarded and their health and welfare are protected. EVIDENCE: Hanningfield Retirement Home DS0000023953.V326641.R01.S.doc Version 5.2 Page 20 The Manager holds the advanced management of care award and has many years experience in running the home to a high standard. Residents spoken with said they felt the Manager was approachable and ran the home well. The Manager demonstrates clear leadership of the home and provides support to staff through team meetings and supervisions. The Manager is in the home 5 days per week and the owners visit several times per week. The owners carry out a monthly quality audit of the home and every year surveys are sent to residents to ask their views of the home. Meetings are held bi-monthly for residents to give their views, raise concerns or share ideas. A weekly health and Safety check is made of the environment. Risk assessments have been completed for the general environment but also for any risks facing each individual. Equipment in the home has been serviced as needed. The home does not manage money on any residents’ behalf, but will hold money for safe keeping if required. Where this is the case a record is kept. All policies for the running of the home were reviewed in June/July 2006. Hanningfield Retirement Home DS0000023953.V326641.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 3 3 X X 3 X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 3 3 X 3 X X 2 Hanningfield Retirement Home DS0000023953.V326641.R01.S.doc Version 5.2 Page 22 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 15(1) Timescale for action Unless it is impracticable to carry 28/02/07 out such consultation, the registered person shall, after consultation with the service user, or a representative of his, prepare a written plan (“the service user’s plan”) as to how the service user’s needs in respect of his health and welfare are to be met. In that, the Service Users plan must be in addition to the assessment of need and must detail how the persons assessed needs will be met. The risk assessments included in the care plan must inform staff of all the actions they need to take to reduce the identified risks for that person. The registered person shall ensure that the care home is conducted so as to promote and make proper provision for the health and welfare of service users. In that, it must be clear within Hanningfield Retirement Home DS0000023953.V326641.R01.S.doc Version 5.2 Page 23 Requirement 2 OP8 12(1)(a) 28/02/07 3 OP30 OP38 13(5) the daily records what action has been taken in response to a health complaint by a resident. The registered person shall make 31/03/07 suitable arrangements to provide a safe system for moving and handling service users. In that updates for staff in safe moving and handling of residents must be provided. Subject to paragraph (4A) the 31/03/07 registered person shall after consultation with the fire and rescue authority make arrangements for persons working at the care home to receive suitable training in fire prevention. In that training updates for staff in fire safety must be arranged. 4 OP30 OP38 23(4)(d) 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 OP12 Good Practice Recommendations It is recommended that residents be consulted on the range and frequency of activities available to them as part of the next quality survey. Residents should also be consulted on the times they would like to get up. It is recommended that 2 choices of hot main meal be available each day. It is recommended that one notice board be dedicated to residents’ information so that they can easily see the activities, menus and any news in one place. It is recommended that a copy of the complaints procedure be placed on this board. It is recommended that all documents displayed for residents be in large print. 2 3 OP15 OP16 OP12 Hanningfield Retirement Home DS0000023953.V326641.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Hanningfield Retirement Home DS0000023953.V326641.R01.S.doc Version 5.2 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. 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