Inspection on 12/12/06 for Hardwick Close (2 and 4)

This inspection was carried out on 12th December 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Hardwick Close (2 and 4) 14/10/08

Hardwick Close (2 and 4) 23/02/06

Hardwick Close (2 and 4) 26/09/05

Hardwick Close (2 and 4) 22/02/05

Hardwick Close (2 and 4) 23/11/04

Similar services:

8 Thorndale Road (Homefield College)

Hunter`s Lodge

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

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

CARE HOME ADULTS 18-65 Hardwick Close (2/4) Holmewood Chesterfield Derbyshire S42 5RL Lead Inspector Judith Beckett Key Unannounced Inspection 4th December &12th December 2006 Hardwick Close (2/4) DS0000020003.V316590.R01.S.doc Version 5.2 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 Hardwick Close (2/4) DS0000020003.V316590.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 Adults 18-65. 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. Hardwick Close (2/4) DS0000020003.V316590.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hardwick Close (2/4) Address Holmewood Chesterfield Derbyshire S42 5RL No2: (01246) 856232 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) Enable Care & Home Support Limited Mrs Susan Amanda Gauntley Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Hardwick Close (2/4) DS0000020003.V316590.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd February 2006 Brief Description of the Service: The care home is purpose built and has been open since 1993. There are two interconnecting four bedded units, which provide ground floor, single room accommodation for residents. Each unit has its own kitchen, adapted bathing facilities and a laundry, in addition to communal areas for the residents. The accommodation is homely, spacious and accessible, and has a secure garden area. Residents who live in the home have high level care and support needs. Care services are provided by the staff group, some of which are seconded from the Health Authority, others being directly employed by DCHS. Some of the staff have known the residents for many years. Fees are £331 per week with hairdressing and toiletries extra. Hardwick Close (2/4) DS0000020003.V316590.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection. Prior to the inspection a pre-inspection questionnaire had been received from the manager. On arrival at the home the manager was not present, one carer and one resident who was unwell were there. The remaining were out in two separate vehicles one group were shopping and both were going out for lunch. A tour of the home took place. A discussion took place with the carer but as she was the only one in the home it was decided that a return visit would be the most appropriate. This would be when the manager was present and access to all files would be possible. On return, the inspection covered all the key standards. Discussions took place with the manager, staff and records were inspected. A number of records were examined, including two residents care plans (as part of the case tracking process, which is used to help determine how the home meets the needs of individual residents). . The residents living at the home have very dependant needs and it was not possible to obtain their views of this service. The inspection took place over two visits. What the service does well: What has improved since the last inspection? A new dishwasher has been the purchased for bungalow number two. Staff who administer medicines have undertaken training in the safe handling of medication. Hardwick Close (2/4) DS0000020003.V316590.R01.S.doc Version 5.2 Page 6 There has been further progress towards meeting the standard relating to National Vocational Qualification (NVQ) training. 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. Hardwick Close (2/4) DS0000020003.V316590.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hardwick Close (2/4) DS0000020003.V316590.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users were provided with information about the home and its services, enabling them to make a decision about the suitability of the home. The support and care needs of individuals were assessed prior to admission, providing reassurances that their needs would be met. EVIDENCE: The statement of purpose and service user guide were well written and easy to read. Both documents included photographs. Simplified copies of the service user guide have been provided for all residents. Two residents were case tracked and had a comprehensive needs assessment in their files. Residents were supported to access local learning disability services. Prior to admission residents receive a full needs assessment. Observations of interaction between staff and service users indicated that the home was able to meet the assessed needs of its service users. Each service user had a contract and statement of terms and conditions, detailing the fees covered. These related to Derbyshire Care and Home Support Ltd.and now requires changing since the change of company name. Hardwick Close (2/4) DS0000020003.V316590.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents are supported in making decisions about how their care is to be carried out and are enabled to make choices according to their care plan. EVIDENCE: The individual written care plans of two residents were examined and their care was discussed with the manager. Care plans were formulated within a framework of risk management and in accordance with their assessed needs. Comprehensive care plans were in place that identified the individual needs and preferences of residents and identified the necessary action to be taken by staff to meet those needs. They were up to date and regularly reviewed .It was noted that care plans address emotional & cultural needs. Staff were aware of the content of the care plans and used them as everyday working documents. Discussions with staff demonstrated that they knew the residents well. Hardwick Close (2/4) DS0000020003.V316590.R01.S.doc Version 5.2 Page 10 Individual risk assessments were in place for service users, these included nutritional and moving and handling risk assessments as well as specific risk assessments for individual circumstances. All service users in the home had very high support needs and communication difficulties. Service users would be unable to participate actively in decisionmaking regarding the running of the home other than instances where staff might understand a reaction as their satisfaction or dissatisfaction. All the residents have lived at Hardwick Close for some time. It is evident that staff know them well. All attend varying services according to their needs and abilities. All are treated as individuals and access different services. They all have access to advocacy services. Hardwick Close (2/4) DS0000020003.V316590.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16,17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ individual rights, independence, wishes and lifestyle preferences were well promoted in accordance with their risk-assessed needs. EVIDENCE: Staff at the home fully support the residents in taking part in activities within and outside of the home. Some of the residents attend a local resource centre where there are activities such as music & movement, foot massage and health & beauty. There is particular emphasis on meeting the sensory needs of the residents. Independence is promoted and staff are attuned to the needs and responses of the residents. The body language of residents is one of the means of communication that staff are skilled in responding to in order to promote choice, for example in respect of the food likes and dislikes of residents. Key workers have an important role to play and know their resident’s likes and dislikes well. One resident had recently been supplied with a new waterbed, which had proved to be very beneficial. Hardwick Close (2/4) DS0000020003.V316590.R01.S.doc Version 5.2 Page 12 All residents have an annual holiday and regular trips are organised. They were all due to go out next week for their Christmas lunch. A four-week menu is operated, with added meal options available to the residents, with the two units offering different choices on a daily basis. All staff have undertaken food hygiene training and prepare the meals for the residents. Hardwick Close (2/4) DS0000020003.V316590.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service There were suitable systems and arrangements in place to ensure that residents are well supported in terms of their personal and health care needs. EVIDENCE: Staff training includes respecting the privacy and dignity of the residents. Preferences in daily routines are acknowledged and this can involve staff picking up on non-verbal clues in order to uphold a resident’s wishes. The services of a local hairdresser are available for the benefit of the residents. Equipment levels are in accordance with the needs of the residents, with hoists, adjustable baths and other dedicated equipment available. Professional support and advice is on hand from a specialist centre, where there are dedicated services including physiotherapy and behavioural support. The residents have a staff keyworker and an external Community Worker, with advocacy services also arranged, as appropriate. Hardwick Close (2/4) DS0000020003.V316590.R01.S.doc Version 5.2 Page 14 The district nurse visits as required; two residents are prone to develop soreness around pressure areas. The medication systems were appraised and it was established that the arrangements operate in the best interests of the residents. Two MAR charts were examined and these were correctly completed. There is an auditable trail of the medications. All staff administering medications receive suitable training and there is competency based assessment for staff on an annual basis. Hardwick Close (2/4) DS0000020003.V316590.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Satisfactory complaints and adult protection procedures are in place in order to safeguard individuals. EVIDENCE: There is an established complaints system with details included in the Statement of Purpose and the Service User Guide. The registered manager described the arrangements in place and it was confirmed that there is an open and transparent system to deal with any concerns. The Commission has received no complaints. One complaint concerning staff attitude had been received by the home, this was in the process of being investigated, and discussions with the manager confirmed that the homes complaints procedure was being implemented. No referrals concerning adult protection had been made. All staff had received up to date appropriate adult protection training. The manager has also undertaken training in the responsibilities of a registered manager with regard to local joint adult protection procedures as outlined in the condition of registration. Hardwick Close (2/4) DS0000020003.V316590.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,29,30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of the environment within the home is good providing service users with an attractive and homely place to live. EVIDENCE: A tour around both bungalows took place. The homes were clean, well ventilated and well lit. Both bungalows have a fitted kitchen with a range of up-to-date appliances. Each bungalow has its own spacious dining area and lounge. Both lounges have a television and music centre. Resident’s rooms were personalised and well decorated. The residents and key workers had all chosen their own colour schemes and bedding, each room is very individual. There was adequate storage space and enough space for their personal possessions e.g. televisions, music systems, sensory equipment. Each room had a window at a level providing a view when seated, good lighting and ventilation and individually controlled heating. Hardwick Close (2/4) DS0000020003.V316590.R01.S.doc Version 5.2 Page 17 All residents have single rooms with adequate space for wheelchairs and to enable these to be turned and residents to be transferred. There is also enough space to be able to access their belongings. Specialist beds are provided for those requiring them. Some rooms have a hoist in place; where it is indicated in the care plan. Each bungalow has a large bathroom; one has a hoist and the other a specialist bath. The bathrooms have been identified as requiring adapting to meet the residents changing mobility needs. A walk in shower and a tracking device for the hoist have been requested by the home. These requests are being addressed. The home it is very well maintained and attractive, clean and free from any odours. Fixtures and fittings are of a high quality, well maintained and adapted to meet the needs of the residents. Hardwick Close (2/4) DS0000020003.V316590.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users are well supported by a stable staff team and the manager constantly seeks to facilitate staff development in accordance with the needs of the service user group accommodated. EVIDENCE: There were two staff vacancies within the home. Staff are able to ‘pick-up’ the hours up as many are part time. Duty rotas were looked at and staffing levels were satisfactory. Staff are attuned to the needs of the residents. Some of the staff have known many of the residents for a considerable period of time. A number of staff either have the required competencies from their past experience or have undertaken National Vocational Qualification (NVQ) training (or are in the process of undertaking this training). There has been further progress with NVQ training since the last inspection, with four staff members achieving NVQ Level 2, two working towards NVQ Level 2 and two staff having applied to study for NVQ Level 2. However, there is still some progress to be made in order to meet the 50 target of care staff Hardwick Close (2/4) DS0000020003.V316590.R01.S.doc Version 5.2 Page 19 with NVQ 2 (or demonstrable equivalent skills and expertise from past experience). Notwithstanding this there is no evidence that the needs of the residents are being compromised. The files of two staff members were examined. These were seen to have all the relevant details as listed in schedule 2 of the National Minimum Standards. Supervision by the manager is carried out on a two monthly basis. As the home employs 26 staff (many are part-time) it was felt that the manager requires extra supernumerary hours in order to carry out supervision alone. Hardwick Close (2/4) DS0000020003.V316590.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42. Quality in this outcome area good. This judgement has been made using available evidence including a visit to this service The home is well managed and service users rights and interests are promoted within the framework of effective communication and management systems. EVIDENCE: The registered manager has successfully completed the Registered Managers Award and National Vocational Qualification Level 4 in Health Social Care. The manager demonstrates competence in her role and the indications are that the service is managed effectively. The quality assurance measures have been further developed, with a survey questionnaire now being used since the last inspection. This is for use with other professional services that are involved with the care of the residents at the home. Discussions with staff concerning these took place. Hardwick Close (2/4) DS0000020003.V316590.R01.S.doc Version 5.2 Page 21 In general, there was documentary evidence that services had been regularly maintained/inspected (dates of these were supplied on the pre-inspection questionnaire). Procedures had been put in place for the recording of water temperatures as a control measure for the prevention of Legionella. However, recording of these were not consistent and appeared in various places. A recognised log is recommended. Evidence to confirm that there was a valid certificate held for the electrical installation (hard wiring) had been obtained. Staff receive on-going training and training updates in safe working practices, including fire safety and moving & handling. Reports of regular visits to the home by the registered provider were made. Hardwick Close (2/4) DS0000020003.V316590.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 4 26 3 27 2 28 3 29 3 30 4 STAFFING Standard No Score 31 X 32 2 33 X 34 4 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 X 3 X 3 X X 3 X Hardwick Close (2/4) DS0000020003.V316590.R01.S.doc Version 5.2 Page 23 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 2 3 4 5 Refer to Standard YA5 YA27 YA32 YA33 YA42 Good Practice Recommendations Contracts and terms & conditions should indicate the change of company name. Bathrooms are updated to accommodate the residents changing mobility needs. At least 50 of care staff should be working towards NVQ Level 2 in care. The providers should ensure that the manager has sufficient supernumerary time to fulfil managerial duties and responsibilities. Water temperatures must be recorded in the appropriate place. Hardwick Close (2/4) DS0000020003.V316590.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Hardwick Close (2/4) DS0000020003.V316590.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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