Inspection on 26/09/05 for Hardwick Close (2 and 4)

This inspection was carried out on 26th September 2005.

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 no outstanding requirements from the previous inspection report, but made 2 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) 23/02/06

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 Ray Coonan Unannounced Inspection 26th September 2005 1:20 Hardwick Close (2/4) DS0000020003.V250912.R01.S.doc Version 5.0 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.V250912.R01.S.doc Version 5.0 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.V250912.R01.S.doc Version 5.0 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.V250912.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. That Mrs Gauntley undertakes training in the responsiblities of a registered manager with regard to local joint adult protection procedures. 23/02/05 Date of last inspection Brief Description of the Service: The Home, which is purpose built, has been open since 1993. There are two interconnecting four bedded units, which provide ground floor single room accommodation for service users. Each unit has its own kitchen, adapted bathing facilities and a laundry in addition to communal areas for residents. The accommodation is homely, spacious and accessible, and has a secure garden area. The first floor offices are accessed by flights of stairs. Service users do not have access to this area. Service users 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 service users for many years. Hardwick Close (2/4) DS0000020003.V250912.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Inspection took place over a period of approximately three and a half hours on the 26th September. The manager, Susan Gauntley, was present throughout the visit. There was also the opportunity to meet with several of the residents and also speak with some of the care staff from both units. A tour of the premises was undertaken and a variety of documentation was examined such as care plans, staff files and training records. What the service does well: What has improved since the last inspection? What they could do better: The amount of staff receiving NVQ training could be improved. Hardwick Close (2/4) DS0000020003.V250912.R01.S.doc Version 5.0 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.V250912.R01.S.doc Version 5.0 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.V250912.R01.S.doc Version 5.0 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): Standards in this section were not assessed on this occasion. EVIDENCE: Hardwick Close (2/4) DS0000020003.V250912.R01.S.doc Version 5.0 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): 6, 7 and 9. The care of residents is underpinned by a detailed assessment process and is planned in a thorough manner, taking into account the individuality of each resident and their developmental needs. EVIDENCE: Each resident had an individual care plan and a sample of these was examined in detail. These were generally well - organised and informative with detailed assessments around daily living activities and included social and emotional care needs. Individual medical histories were recorded and any specific health needs were clearly detailed. Care plans themselves were comprehensive and contained clear instructions/guidelines for staff. There were relevant risk assessments on files in such areas as mobility, issues for consideration whilst on outings, and health matters such as skin integrity. Each file had notes on the residents’ capacity for consent and agreements on the management of finances and specific medical interventions. There was evidence on files of input from family, advocacy and other professional agencies as appropriate. There was also evidence that care plans were reviewed and evaluated on a regular basis. Hardwick Close (2/4) DS0000020003.V250912.R01.S.doc Version 5.0 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): 11,13, 14 and 15. Service users benefited from a suitable range of leisure and developmental opportunities related to their individual interests and competencies. EVIDENCE: All service users in the home had high support needs. Levels of achievable independence were low. Several service users attended a range of day services with one attending three times a week. There was evidence of referral to speech and language therapists and clear guidance is provided to assist the development of communication with service users. The Home is located close to local facilities and it was stated that service users access shops, the local pub and two residents attend the local church with the assistance of staff. Activity programmes are maintained and day trips are arranged on a regular basis. The Home has its own minibus and estate car, which are used for outings. Staff stated that some service users participate in weekly supermarket shopping trips. Hardwick Close (2/4) DS0000020003.V250912.R01.S.doc Version 5.0 Page 11 The majority of service users had little or no contact with friends or family and some had no relatives. Any such contact was recorded on care plans. Hardwick Close (2/4) DS0000020003.V250912.R01.S.doc Version 5.0 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): 19. The physical and emotional needs of service users are appropriately assessed, monitored and promoted at the Home. EVIDENCE: There was clear evidence on care plans and assessment information that individual health needs were fully recognised at the Home. Full records of medical appointments were maintained, including contacts with community health resources as well as the more specialist services provided by Ash Green community hospital for people with learning disabilities. There was also evidence of regular links with optician and dental services as well as physiotherapy as necessary. Any particular health needs, for instance epilepsy, would have a specific care plan. Skin integrity was also closely monitored and records kept on care plans. Specialist equipment such as hoists was in place. Hardwick Close (2/4) DS0000020003.V250912.R01.S.doc Version 5.0 Page 13 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): 23. The Home had satisfactory policies, procedures and training programmes in place in order to protect the interests of service users and enhance their safety. EVIDENCE: The manager has now attended interagency training, provided by the local authority, concerning the protection of vulnerable adults. The Providers also have in-house training programmes in this area for staff and relevant policies and procedures were in place. Staff spoken to demonstrated an appropriate awareness of protection issues and stated they would feel comfortable in raising any concerns. The Home’s arrangements for the handling of service users’ personal monies were viewed and were satisfactory. Residents had individual accounts and any cash on the premises was kept secure. Appropriate records were maintained of any transactions. Hardwick Close (2/4) DS0000020003.V250912.R01.S.doc Version 5.0 Page 14 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): 24,25,26,27,28,29 and 30. Service users had a comfortable, safe and clean living environment, which was appropriately adapted to their individual preferences and needs. EVIDENCE: Most parts of the Home were viewed during this visit, including several service users’ bedrooms. Overall the Home was satisfactorily maintained, clean and hygienic. There is a programme for ongoing decoration and general décor was of a good standard. However, the dining area in one unit (No. 4) needed the walls repainting. It was also noted that the fridge door in the kitchen for the other unit (No.2) required attention and that there were some marks on the work surface in this area. Generally the Home was spacious with satisfactory light, heating and ventilation. Service users’ bedrooms were suitably furnished, of an appropriate size and individualised with personal items and differing colour schemes. Lounge areas were satisfactorily furbished and comfortable. There were suitable toilet and bathing facilities on each unit. Both bathrooms were pleasantly decorated and had Parker baths installed to assist service users. The Home had satisfactory aids and adaptations in place throughout the Home. Hardwick Close (2/4) DS0000020003.V250912.R01.S.doc Version 5.0 Page 15 Each unit had a laundry area, which was well - maintained, organised and equipped. To the rear of the building there were well looked after garden and sitting areas that were accessible for service users. Hardwick Close (2/4) DS0000020003.V250912.R01.S.doc Version 5.0 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): 32,33,34,35 and 36. Care is provided by a staff group whose overall developmental needs are generally well met, though formal qualification training was below expectations. Staffing levels were appropriate and in line with the expressed needs of service users. EVIDENCE: Staffing rotas were seen and demonstrated that the Home maintained suitable staff numbers commensurate with the needs of service users. There were 2 staff on long-term sickness absence and these were being covered internally. Staff spoken to indicated they felt somewhat stretched in these circumstances though it is understood that adverts have been placed to cover these posts on a temporary basis. A sample of staff files was examined and these were generally in good order containing appropriate interview and contractual information. Criminal record checks were obtained as well as written references, though one file only contained one written reference. Examples of induction training systems were viewed and a relevant checklist is used for this process. Individual training records are maintained and regular programmes are provided covering mandatory care courses such as Moving and Handling and Food Hygiene. Staff also confirmed that they received Fire Safety training as well as supervision and personal development reviews on a six monthly basis. Whilst courses in specialist care practice was arranged though links with Ash Hardwick Close (2/4) DS0000020003.V250912.R01.S.doc Version 5.0 Page 17 Green and Walton Hospital some staff did mention that they would welcome more input on epilepsy. It was stated that two staff are currently undertaking NVQ training and that overall 20 of the staff group had NVQ qualifications. Hardwick Close (2/4) DS0000020003.V250912.R01.S.doc Version 5.0 Page 18 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 and 39 The interests of residents are enhanced by clear systems for measuring the quality of services. EVIDENCE: The manager has considerable practice experience with the service user group, has completed NVQ4 in Management and is continuing to study for NVQ4 in Care. The Home had ongoing systems in place to assess the quality of services they provide. Including quality of service questionnaires with families and carers, though it was more difficult to develop a structured exercise with the service users. It was stated that verbal checks were made with District Nurses. The Provider organisation undertake a range of annual audits on the Home in such areas as housekeeping and finances and make regular visits with detailed reports. Hardwick Close (2/4) DS0000020003.V250912.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 X 13 3 14 3 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X 2 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Hardwick Close (2/4) Score X 3 X X Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X X X DS0000020003.V250912.R01.S.doc Version 5.0 Page 20 NO Are there any outstanding requirements from the last inspection? 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. 2. Standard YA24 YA32 Regulation 23 18 Requirement Improvements to the premises must be undertaken as detailed in the main body of the report. NVQ training must be further promoted at the Home. Timescale for action 30/11/05 31/12/05 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 YA34 YA39 Good Practice Recommendations All written references should be kept on staff files. The manager should consider developing quality of service questionnaires for use with other professionals involved with the care of service users. Hardwick Close (2/4) DS0000020003.V250912.R01.S.doc Version 5.0 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.V250912.R01.S.doc Version 5.0 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. 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!