Inspection on 18/10/05 for Hardwick House

This inspection was carried out on 18th October 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 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 12/12/06

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 Judy Gossedge Announced Inspection 18th October 2005 10:15 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.V249528.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 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.V249528.R01.S.doc Version 5.0 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.V249528.R01.S.doc Version 5.0 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 24th June 2005 Brief Description of the Service: Hardwick House is a care home registered to provide care and accomodation 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 accomodation with en-suite 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 bulding 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.V249528.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over six and a half hours on 18 October 2005. This is the second statutory inspection of this year. A tour of the home took place including communal areas and a selection of service users bedrooms. Rotas and care records were also inspected. Nine of the fifteen service users resident were spoken with in their bedrooms and four of these service users were case tracked as part of the inspection process. The Manager, deputy manager, two care workers and the cook were spoken with. One relative a regular visitor was spoken to in the home. Three relatives and another service user also filled in a comment card each. What the service does well: What has improved since the last inspection? There were no requirements made following the last inspection. The one recommendation made relating to the recording of medication has been addressed Hardwick House DS0000021125.V249528.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Hardwick House DS0000021125.V249528.R01.S.doc Version 5.0 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.V249528.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 5 and 6. Detailed information about Hardwick House is available to be viewed. Service users and their representatives are also encouraged to visit the home prior to any admission. There are pre-admission procedures in place to ensure that service users care needs can be met at Hardwick House. EVIDENCE: A Statement of Purpose and Service Users Guide are in place. It should be ensured these documents are kept up-to-date. There are forums for service users and their representatives to give their views on the service received, but as yet this feedback has not been collated for prospective service users and their representatives to view for further information. Relatives commented they are aware of how to access the inspection reports about the home. Hardwick House DS0000021125.V249528.R01.S.doc Version 5.0 Page 9 The Manager visits prospective new service users and a detailed assessment is completed. Two new service users spoken with and documentation in place confirmed this. Both service users and one relative also stated they or their relatives had been able to visit the home prior to any agreement to move in. Two service users also confirmed that their initial period in the home had been considered a ‘trial period.’ One relative commented ‘ My mother and I visited Hardwick House and knew straight away my relative would be happy there.’ Another stated ‘Everyone is kind, caring and so tuned into the residents needs.’ Observations, service user documentation viewed and discussions with staff highlighted that one service user’s care needs have increased during their stay in the home and now also has a degree of short-term memory loss. The care needs of this service user must be kept under regular review to ensure that these continue to be met in the home. Intermediate or rehabilitative care is not provided. Hardwick House DS0000021125.V249528.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,9 and 10. Care plans and supporting risk assessments are in place to ensure that service users’ health, personal care needs are met whilst resident in the home. The care service users receive ensures that their privacy and dignity is upheld whilst resident in the home. Policies and procedures in place to manage medicine are followed to ensure the protection of service users. EVIDENCE: Four of the individual care plans were viewed. These were detailed describing service users’ care needs with supporting risk assessments. Recording evidenced these are reviewed monthly. Medication policies and procedures are in place and were viewed at the last inspection. Procedures have been changed to enable the signing of administration of medication to be completed at the time of administration. Where service users are self-administering detailed risk assessments were in place to support this activity and are updated monthly. Staff confirmed they had attended medication training and that they are due to receive further Hardwick House DS0000021125.V249528.R01.S.doc Version 5.0 Page 11 training before Christmas. The storage and a sample of the recording of any administration of medication viewed were adequate. It was recommended that a bound controlled drugs register is also put in place to record administration where required. A pharmacist regularly visits the home. Staff observed and feedback from service users and their relatives was that the overall care provided is very good and privacy and dignity is respected at all times. One relative commented ‘ Excellent care, very friendly and professional staff and Manager.’ Hardwick House DS0000021125.V249528.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 and 15. There are limited opportunities for service users to participate in activities during their stay, so that their social care needs are not always fulfilled. There is flexible visiting in the home and visitors are welcomed. The catering arrangements are good, providing an appropriate variety and choice of meals to meet individual service users needs. EVIDENCE: There are some opportunities for service users to participate in activities in the home. The Manager and service users spoke of slide shows, musical entertainers coming in to the home, card games, bingo and a monthly church service which all occur during the year. Several of service users also go out and access the community independently. On the day there were no activities planned in the home, some service users had gone out for a walk or to visit local facilities with the remainder in their bedroom’s reading, resting or watching television. The Manager and some service users spoke of activities arranged in the home which had had limited attendance on the day. Three service users stated they would welcome more opportunities to participate in activities and one relative commented that activities were only sometimes provided. Hardwick House DS0000021125.V249528.R01.S.doc Version 5.0 Page 13 Service users and relatives confirmed that there is flexible visiting, that staff were always very welcoming and they are able to meet with their relative in private. There is rotating menu in place with a good variety and choice of dishes from which service users can select. Lunch on the day was soup or fruit juice, roast lamb with vegetables and gooseberry crumble and cream. There was a relaxed and social atmosphere in the dining room during the meal. All service users commented that the food was very good and one stated, ‘The food is fantastic.’ One relative commented ‘ Super food.’ Special diets and likes and dislikes are catered for. Hardwick House DS0000021125.V249528.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16. There is a complaints procedure in place and service users and their representatives are enabled to raise any concerns that they might have. EVIDENCE: A satisfactory complaints policy and procedure is in place. No complaints have been received since the last inspection and the CSCI have not received any complaints in relation to the service provided at Hardwick House. Service users and relatives confirmed that if they had any concerns they would feel comfortable raising these with the staff or the Manager. Although Standard 18 was not assessed on this occasion the Manager confirmed that she is due to attend further adult protection training later in the month and the information will then be cascaded down to staff. Hardwick House DS0000021125.V249528.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 23, 24, 25 and 26. The standard of the environment within the home is good and provides service users with a safe, attractive, clean and homely place to live. EVIDENCE: The standard of décor, furnishings and carpeting in the home is good. All bedrooms meet the minimum space requirements and are used for single occupancy including the four double bedrooms. These are available to be occupied by a couple if required. Service users are able to control the temperature in their own bedrooms and have an emergency call bell system. The selection of the bedrooms viewed reflected a range of individual styles and interests. Service users had personalised their bedroom and brought with them small pieces of furniture, pictures and ornaments. All service users bedrooms have en-suite facilities and most are fitted with either a bath or shower. A bath seat has been purchased to facilitate bathing Hardwick House DS0000021125.V249528.R01.S.doc Version 5.0 Page 16 for those service users who are less mobile. Records were viewed of the regular testing of the hot water in the home. Nine hot water outlets accessed by service users were tested and temperatures were recorded between 35.5 °C and 51.7 °C. An Immediate Requirement form was left. There is a separate lounge and dining room on the ground floor. There is a passenger lift in the home to provide access to all floors. The home was clean and free from offensive odours. Infection control was discussed with staff and it was recommended that the staff usage of the sink for washing their hands in the kitchen be revisited to ensure health and safety requirements continue to be met. The recording of routine fire checks were seen and were adequate. Hardwick House DS0000021125.V249528.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 and 28. Adequate staffing levels are maintained to ensure that all the care needs, the health safety and welfare of the service users resident are met. EVIDENCE: The staff rota was viewed and staffing was adequate on the day to meet the care needs of the service users resident. There is a dedicated team of staff working in the home, they have a range of skills, which enable them. Service users and relatives spoke very well of the staff team. One relative commented, ‘Mrs Britain employs the highest quality staff and nothing is too much trouble.’ The Manager has stated that forty-five percent of the staff had completed an NVQ Level 2 in care or its equivalent. Hardwick House DS0000021125.V249528.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Staff are supported with clear leadership in the home and all staff demonstrating an awareness of their roles and responsibilities. Service users and their representatives are enabled to give their views on the home and the care provided. Systems are in place to ensure the health, safety and welfare of service users and staff. EVIDENCE: The Manager has worked in the home for a number of years and has completed the Registered Managers Award and the NVQ Level 4 in Care. All staff spoke very well of working in the home and of the support provided to them by the Manager. A quality assurance system has been implemented in the home. There are opportunities for service users and their representatives to put forward their Hardwick House DS0000021125.V249528.R01.S.doc Version 5.0 Page 19 views about the home and the care received through forums and questionnaires completed. This informs the Manager and staff of the quality of the service being provided, but the feedback needs to be collated and available to view. Feedback from other stakeholders needs to be regularly sought and recorded. The Manager only holds a small ‘float’ for a couple of service users and the records to support this activity were adequate. The Manager undertakes regular risk assessments for safe working practices in the home and these are recorded. Any accidents in the home are adequately recorded. Staff confirmed they had received training in Moving and Handling, First Aid, Fire Safety and Food Hygiene. Records to be viewed to evidence staff training and updates completed need to be more accessible. Certificates for the servicing of gas and electrical appliances and systems and equipment in the home were available in place. Hardwick House DS0000021125.V249528.R01.S.doc Version 5.0 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 3 X 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 3 3 X 3 3 2 3 STAFFING Standard No Score 27 3 28 2 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 Hardwick House DS0000021125.V249528.R01.S.doc Version 5.0 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. 1 2 Standard OP12 OP25 Regulation 16 (1) (m) 13 (4) (ac) 24 (1) (2) (3) Requirement That leisure activities continue to be developed to meet individual service users social care needs. That hot water is delivered to outlets accessed by service users near to the recommended safe temperature of 43° C. That the quality assurance systems in place are further developed, to enable the outcome of service user surveys are made available to view, and feedback sought from other stakeholders which is recorded. Timescale for action 31/01/06 12/10/05 3 OP33 31/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP9 Good Practice Recommendations That a bound controlled drugs register is in place. Hardwick House DS0000021125.V249528.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 House DS0000021125.V249528.R01.S.doc Version 5.0 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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