Inspection on 12/12/06 for Hardwick House

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 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 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 House 07/03/09

Hardwick House 18/10/05

Hardwick House 24/06/05

Hardwick House 25/02/05

Hardwick House 05/08/04

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

CARE HOMES FOR OLDER PEOPLE Hardwick House 6 Hardwick Road Eastbourne East Sussex BN21 4NY Lead Inspector Kathy Flynn Key Unannounced Inspection 12th December 2006 13:30 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 Hardwick House DS0000021125.V320603.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. Hardwick House DS0000021125.V320603.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hardwick House Address 6 Hardwick Road Eastbourne East Sussex BN21 4NY 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) 01323 721230 Mrs Margaret Goddard Fiona Mary Brittain Care Home 19 Category(ies) of Old age, not falling within any other category registration, with number (19) of places Hardwick House DS0000021125.V320603.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of residents to be accommodated is nineteen (19) That service users are sixty-five (65) years or over on admission. Date of last inspection 18th October 2005 Brief Description of the Service: Hardwick House is a care home registered to provide care and accommodation for up to 19 individuals over the age of 65 years. The home is a large four storey property situated in a residential area near the centre of Eastbourne. It is within easy walking distance of the town centre and public transport, with GP and dental surgeries accessible, and reasonably close to the seafront. A large detached property on four floors it provides single accommodation with ensuite facilities, with a passenger lift that enables service users to have access to all floors. On the ground floor there is a large lounge to the left of the entrance with an equally large dining area to the right, the kitchen is to the rear of the building and service users bedrooms are on the three other floors. There is an attractive garden behind the building that service users use when weather permits and a parking area also at the rear of the building. Hardwick House DS0000021125.V320603.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection was carried out over four and a half hours on the 12th December. A pre-inspection questionnaire and residents survey forms were sent to the home prior to the inspection. The pre-inspection questionnaire was returned to the Commission, as were seven completed surveys. The inspection included a tour of the home, an examination of care plans, staff files, medication records, menus and activity records. There were 14 residents at the home during the inspection. 4 residents and 2 visitors were spoken with, those who expressed an opinion were very positive about the support they receive at the home. The manager and care staff were happy to discuss the care they provide for residents. The reader should be aware that the Care Standards Act 2000 and the Care Homes Regulations 2001 uses the terms service user to describe those living in care home settings, for the purpose of this report those living at care homes will be referred to as residents. What the service does well: Residents at Hardwick House are encouraged to regard it as their home and to make choices about how they spend their time. Residents spoken with were very positive about the support they receive, they felt their needs were met ‘staff are very good and look after me’, and were able to decide with staff what care is most appropriate for them. Visitors were equally positive. The staff explained that Hardwick House ‘is the residents’ home’. They felt that they are able to provide appropriate care and are well supported by the manager. The atmosphere in the home was relaxed and comfortable, with communication between staff, residents and visitors open and friendly. Hardwick House DS0000021125.V320603.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Hardwick House DS0000021125.V320603.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 Hardwick House DS0000021125.V320603.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): 3. Standard 6 is not applicable. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are pre-admission procedures in place to ensure that residents care needs can be met at Hardwick House. EVIDENCE: The manager confirmed that detailed assessments are completed for all prospective residents to ensure that the home can meet their needs. New residents to the home said that they knew about Hardwick House because they visited people living there, and one visited a number of homes before deciding ‘this was the best with the manager showing me around’. Hardwick House DS0000021125.V320603.R01.S.doc Version 5.2 Page 9 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): 7,8,9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care planning system is clear and consistent and provides staff with the information they need to satisfactorily meet residents’ needs. The systems for the administration of medicines are good with clear and comprehensive arrangements in place to ensure residents medication needs are met. The staff have a good understanding of the residents support needs. This is clear from the positive relationships, which have been formed between the staff and residents. EVIDENCE: Care plans for recent admissions to the home were viewed. They included detailed information describing the residents needs and appropriate risk Hardwick House DS0000021125.V320603.R01.S.doc Version 5.2 Page 10 assessments. The support and care given by the care staff is recorded in the daily log, which is kept downstairs and available to staff. Medication policies and procedures are in place and are followed by the staff. MAR charts were viewed and were completed appropriately. Risk assessments have been completed for residents who are responsible for their own medication. These are reviewed on a regular basis with the care plans. Residents were positive about the care they receive ‘the staff are always helpful and friendly in every way’, and treat them with respect ‘staff are very supportive and discreet’. Hardwick House DS0000021125.V320603.R01.S.doc Version 5.2 Page 11 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): 12,13,14 and 15. 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 varied programme of activities. The routines at the home are flexible this enables the residents to have control over their lives and encourages them to make choices about all aspects of their day to day living. Dietary needs of residents are well catered for with a balanced and varied selection of food available that meets residents’ tastes and choices. EVIDENCE: The manager advised that a programme of activities has been developed by the activity co-ordinator, with the involvement of residents. Activities are arranged for four days a week, including evenings, and feedback from residents has been very positive. Some said how much they enjoyed making mince pies, which they would be eating later in the week with mulled wine, when they are putting the Christmas decorations up. Hardwick House DS0000021125.V320603.R01.S.doc Version 5.2 Page 12 Residents said that they are able to make choices about all aspects of their lives, with staff helping them, although they ‘let you do what you want’. Residents also confirmed that there is flexible visiting at Hardwick House, they are made very welcome, and the relatives spoken with said they were able to talk in private. The meals are good, offering choice and a variety at each meal. All the residents spoken with said the ‘food is very good’, and staff said that ‘this is their home’ they can have what they want. Special diets and residents likes and dislikes are catered for. Some residents use the dining room for each meal, with other preferring to remain in their rooms, all residents choose to have their lunch in the dining room. Hardwick House DS0000021125.V320603.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints system with some evidence that residents feel their views are listened to and acted upon. Staff have good knowledge and understanding of Adult Protection issues which protects residents from abuse. EVIDENCE: A satisfactory complaints policy and procedure is in place. No complaints have been received since the last inspection and the CSCI received an anonymous complaint that was discussed with the manager during the inspection. Residents confirmed that if they had any concerns they would talk to the staff or the manager, although they also said they had nothing to complain about. The manager has completed a train the trainer course for adult protection, which she confirmed has been cascaded down for the staff. Staff spoken with demonstrated an understanding of the protection of vulnerable adults, and were able to explain what they would do if they had any concerns. Hardwick House DS0000021125.V320603.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. 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 this home is good providing residents with an attractive and homely place to live. All parts of the home are safe and accessible with satisfactory infection control systems in place to protect residents and staff. EVIDENCE: Hardwick House offers residents a comfortable and homely environment. Following the flood earlier this year the basement has been completely refurbished, residents spoken with said they are very pleased with the rooms on this floor and are looking forward to the summer when they can enjoy the garden. As part of the improvements flood defences have been installed. Hardwick House DS0000021125.V320603.R01.S.doc Version 5.2 Page 15 The manager confirmed that the hot water temperatures in residents rooms are tested regularly and recorded, they are approximately 43°c. Unless the resident has requested it to be higher, risk assessments are carried out and the temperature is discussed and agreed with the residents, with the information included in the care plan. Staff spoken with have received training in infection control, and are aware of appropriate practices in the kitchen when preparing food. Hardwick House DS0000021125.V320603.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 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. Staff morale is high resulting in an enthusiastic workforce that work positively with residents to improve their whole quality of life. Robust recruitment procedures are in place to ensure the protection of service users. The arrangements for the induction of staff are satisfactory, enabling staff to provide appropriate levels of support and care for residents. EVIDENCE: The manager confirmed that there is a dedicated team of staff working at the home. They have a range of skills, which enable them to meet the needs of residents. While over 50 of staff have completed NVQ Level 2 in care or its equivalent. The home follows robust recruitment procedures. Staff files for new care staff were viewed and relevant information was available. The manager explained that one member of staff is working under supervision until her CRB check has been completed. Hardwick House DS0000021125.V320603.R01.S.doc Version 5.2 Page 17 Induction training in line with Skills for Care is provided for staff, and one of the care staff on duty is working through this with senior staff. Hardwick House DS0000021125.V320603.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management approach at the home is open and inclusive. Staff, residents and relatives are encouraged to be involved in any decisions about changes to the support and care provided. Systems are in place to ensure the health, safety and welfare or residents and staff. EVIDENCE: The manager encourages staff, residents and relatives to put forward their views about the home and the care provided, through day to day discussions, meetings and questionnaires. Hardwick House DS0000021125.V320603.R01.S.doc Version 5.2 Page 19 This quality assurance and monitoring system enables the manager to review the quality of the services provided at the home, and will be extended to include GP’s and other health professionals who are linked to the home. The information collected has been collated and included in the Service Users Guide. The manager holds a small amount of money for some residents for additional payments, appropriate records are kept. Training in line with legislative requirements is provided for staff and records are kept to evidence this. Hardwick House DS0000021125.V320603.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X 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 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Hardwick House DS0000021125.V320603.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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. Refer to Standard Good Practice Recommendations Hardwick House DS0000021125.V320603.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 House DS0000021125.V320603.R01.S.doc Version 5.2 Page 23 - 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!