Inspection on 23/02/06 for Hardwick Close (2 and 4)

This inspection was carried out on 23rd February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

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

Hardwick Close (2 and 4) 12/12/06

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 Andrew Bailey Unannounced Inspection 23 February 2006 10:00 Hardwick Close (2/4) DS0000020003.V283764.R01.S.doc Version 5.1 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.V283764.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 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.V283764.R01.S.doc Version 5.1 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) Derbyshire Care & Home Support Limited Miss Susan Amanda Gauntley Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Hardwick Close (2/4) DS0000020003.V283764.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. That Mrs Gauntley undertakes training in the responsibilities of a registered manager with regard to local joint adult protection procedures. 26th September 2005 Date of last inspection 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. Hardwick Close (2/4) DS0000020003.V283764.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection and the duration was approximately three hours. A number of records were examined, including 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 focused on key National Minimum Standards. What the service does well: What has improved since the last inspection? What they could do better: There is still some progress to be made to achieve NVQ training targets. There must be evidence available at inspection to confirm that the electrical services and the Legionella prevention measures are satisfactory. Hardwick Close (2/4) DS0000020003.V283764.R01.S.doc Version 5.1 Page 6 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. Hardwick Close (2/4) DS0000020003.V283764.R01.S.doc Version 5.1 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.V283764.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Assessments are undertaken prior to admission to ensure that the home can provide appropriate provision for residents. EVIDENCE: Two care files were inspected to examine the pre-admission assessment procedures. There was evidence of a thorough assessment process to ensure that the needs of residents could be met by the service. The documentation on file included assessments carried out by other professional agencies. Hardwick Close (2/4) DS0000020003.V283764.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None EVIDENCE: (All key standards were assessed at the last inspection, with no requirements or recommendations made) Hardwick Close (2/4) DS0000020003.V283764.R01.S.doc Version 5.1 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 16 & 17 Supported by staff, residents engage in a suitable range of opportunities, in relation to individual interests and abilities. Choice and independence for residents is promoted as far as possible. Varied and well presented meals are provided for the residents. 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. 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 Hardwick Close (2/4) DS0000020003.V283764.R01.S.doc Version 5.1 Page 11 staff have undertaken food hygiene training and prepare the meals for the residents. Routine nutritional assessments are carried out for residents. The midday meal on the day of the inspection was well presented and looked appetising. Hardwick Close (2/4) DS0000020003.V283764.R01.S.doc Version 5.1 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 & 20 Routines are based around the needs of the residents, with individual preferences, privacy and dignity respected. Residents are protected by systems that promote the safe administration and handling of medicines. 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. The medication systems were appraised and it was established that the arrangements operate in the best interests of the residents. There is an auditable trail of the medications. Hardwick Close (2/4) DS0000020003.V283764.R01.S.doc Version 5.1 Page 13 Appropriate resource information is held on-site (including Royal Pharmaceutical Society guidance). All staff administering medications receive suitable training and there is competency based assessment for staff on an annual basis. Hardwick Close (2/4) DS0000020003.V283764.R01.S.doc Version 5.1 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 There is a complaints procedure and an open culture exists where there is confidence that any concerns will be dealt with appropriately. 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. Hardwick Close (2/4) DS0000020003.V283764.R01.S.doc Version 5.1 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 The home provides a safe and comfortable setting for the residents. EVIDENCE: The facility was inspected during the visit and there were no significant issues to report. Some minor fixture/fitting issues are being addressed and followed up by the registered manager. The building is of a modern design, purpose built and is decorated to a good standard. Appropriate equipment/adaptations are in place to meet the needs of the residents. Hardwick Close (2/4) DS0000020003.V283764.R01.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 Experienced staff meet the needs of the residents. There has been progress towards achieving NVQ training targets, but the relevant National Minimum Standard has not been attained. EVIDENCE: 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 of 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 one staff member achieving NVQ Level 2, one working towards NVQ Level 2 and two staff having applied to study for NVQ Level 2. There is also a list of staff who have expressed interest in undertaking NVQ training, although the arrangements for assessing staff were incomplete. There is still some progress to be made in order to meet the 50 target of care staff 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. Hardwick Close (2/4) DS0000020003.V283764.R01.S.doc Version 5.1 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 There has been progress in developing the quality assurance measures. In general, the safe working practices systems promote the health and safety of the residents, but there are two matters to address in order to provide further assurance of the protection of residents. EVIDENCE: The registered manager has successfully completed the Registered Managers Award and is on the point of submitting a final portfolio in respect of National Vocational Qualification Level 4 in 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 devised since the last inspection. This is for use with other professional services that are involved with the care of the residents at the home. The questionnaire is scheduled for introduction in due course, with the intention of providing feedback on this particular service from the perspective of other agencies and professionals who interact with the service. Hardwick Close (2/4) DS0000020003.V283764.R01.S.doc Version 5.1 Page 18 In general, there was documentary evidence that services had been regularly maintained/inspected (a sample of records was examined at this visit). However, there must be further assurance that control measures for the prevention of Legionella follow a risk assessment and action plan (detailed and specific to this care home), with up-to-date and consistently documented evidence that an action plan has been followed. It is possible that there are appropriate design solutions in place for Legionella prevention, but there was no documentary evidence available to support this at the inspection. In addition, there was no documentary confirmation available to confirm that there was a valid certificate held for the electrical installation (hard wiring). Staff receive on-going training and training updates in safe working practices, including fire safety and moving & handling. Hardwick Close (2/4) DS0000020003.V283764.R01.S.doc Version 5.1 Page 19 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 X ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 2 33 X 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X X X LIFESTYLES Standard No Score 11 X 12 3 13 X 14 X 15 X 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 X 3 X 3 X 3 X X 2 X Hardwick Close (2/4) DS0000020003.V283764.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? Yes 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 YA32 Regulation 18 Requirement NVQ training must be further promoted at the Home (Requirement from last inspection - Progress made and original timescale of 31/12/05 extended) The registered persons must provide evidence that there is a valid certificate for the Electrical Installation (No certification available at inspection). The registered persons must provide evidence of the design solutions to control risk of Legionella (including a risk assessment, action plan and ongoing record of steps taken to control risk). Timescale for action 31/08/06 2. YA42 13(4) 31/05/06 3. YA42 13(4) 31/05/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Hardwick Close (2/4) DS0000020003.V283764.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Hardwick Close (2/4) DS0000020003.V283764.R01.S.doc Version 5.1 Page 22 - 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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