Inspection on 07/03/09 for Hardwick House

This inspection was carried out on 7th March 2009.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hardwick House 12/12/06

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 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Hardwick House 6 Hardwick Road Eastbourne East Sussex BN21 4NY     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Gwyneth Bryant     Date: 0 7 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 23 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 23 Information about the care home Name of care home: Address: Hardwick House 6 Hardwick Road Eastbourne East Sussex BN21 4NY 01323721230 Telephone number: Fax number: Email address: Provider web address: margaretgoddard968@btinternet.com Name of registered provider(s): Type of registration: Number of places registered: Mrs Margaret Goddard care home 19 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 19 The registered person may provide the following category/ies of service only: Care home only - PC to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - OP Date of last inspection Brief description of the care home 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 en-suite facilities, with a passenger lift Care Homes for Older People Page 4 of 23 Over 65 19 0 Brief description of the care home 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. Current fees range from £371 to £525 per week with additional charges for hairdressing, chiropody, toiletries and some outings. Care Homes for Older People Page 5 of 23 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced inspection and took place in just over five hours. The purpose of the inspection was to check compliance with key standards. A number of documents and records were viewed; including personnel files, medication charts, care plans and a tour of the premises was also carried out. There were twelve people in residence on the day and they were spoken with both individually and as a group. Discussion with the Registered Manager took place in respect of all aspects of the service. As part of the inspection process we ask the Registered Providers to complete an Annual Quality Assurance Assessment (AQAA). The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. This was provided within the last twelve months and the information is included in this report as necessary. Comments from residents spoken with included: Care Homes for Older People Page 6 of 23 - The staff are charming and so kind. - Food is excellent and any problems just ring and its done. - Sometimes all you have to do is hint and its there. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 23 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 23 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Satisfactory pre-admission assessments are carried out prior to people moving into the home but improvements need to be made to the Statement of Purpose and service users guide to ensure current and prospective service users have accurate information on the services offered. Evidence: Pre-admission sheets for the last two people to be admitted to the home were viewed and found to be satisfactory. Discussion with the manager found that as part of the admission process all people who wish to move into Hardwick House are offered a visit to enable them to meet staff and others who live in the home. Statement of Purpose and service users guide need to be reviewed to accurately reflect the services currently provided. Care Homes for Older People Page 10 of 23 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. All aspects of the health, social and care of those living in the home are identified and planned for enabling staff to deliver care in a structured and consistent manner. Evidence: Five care plans were viewed and it was evident that pre-admission assessments are used to inform the care planning process. Care planning documents included information on meeting healthcare needs such as dental, hearing and eyesight checks and also provided clear direction to staff. Each person has a daily care action sheet which outlines their preferred daily routine, including care needs. One resident did not have a full care plan and the Registered Manager explained that she intended to create a full plan when the person had undergone a surgical procedure to ensure their current needs would be met. Not all care plans included a photograph of the resident and this needs to be rectified to facilitate identification for visiting social and healthcare professionals. One persons needs had changed and this was recorded in the daily notes rather than the care plan. Care plans need to be updated to reflect current care needs. While care plans are brief the daily notes and daily routines sheets are comprehensive and care needs to be taken to ensure they are not used instead of Care Homes for Older People Page 11 of 23 Evidence: the care plans as a point of reference for staff. Risk assessments had been carried out and they clearly identified the hazards and included sufficient detail for the management of risks. Some residents arrange and access healthcare appointments independently while others are assisted in doing so. There is an arrangement for those who are more independent to inform the Registered Manager to ensure she is aware of changing needs and can update the care plan accordingly. Observation of staff showed they worked as a team and were clearly comfortable approaching the manager for support and advice. Where work is on-going to create a care plan for an individual templates are in place even if it is not fully completed. Residents are supported to manage their own medication and satisfactory risk assessments are in place which are regularly reviewed. Some residents manage some of their medication such as eye drops but the home administers other prescribed drugs. This demonstrates a commitment to equal opportunities by treating each resident as an individual. The Medication Administration Records were viewed and found to be accurate, clear and up to date. Some residents take homely remedies such as simple cough linctus and the home has policies and procedures on this and the GP is always consulted as required. Although no residents were taking controlled drugs on the day the home has a controlled drugs cupboard which meets the current guidelines and all records are satisfactory. Comments included -I feel very lucky to be here and am glad to be home. We are well looked after and its quite nice here. One comment was of its kind its the best place to be in. Care Homes for Older People Page 12 of 23 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People in the home have the opportunity to experience a lifestyle that matches their expectations, choice and preferences in respect of leisure activities and meals. Evidence: The home provides a range of in-house activities in addition to outings to the town. The Registered Manager said she is in the process of devising a food and drink quiz which will include giving residents the opportunity to taste different foods and drinks. There are records of all activities which include who participated and which activities were preferred to ensure all residents have the opportunity to be involved in the group activities. One person is registered blind but has talking books and other equipment to enable them to maintain their independence. The activity organiser produces a newsletter for all activities and each resident is given a copy with an additional copy pinned to the noticeboard. Activities are provided both for groups and as one to one. They include bingo, quizzes, baking, music clubs and shopping trips into the town. Residents spoken with said how much they enjoyed the activities in particular the quizzes and baking sessions. Throughout the site visit staff were seen to treat people with care and respect and were seen to knock on doors before entering. People spoken with confirmed that staff were considerate and consulted them as necessary. Comments Care Homes for Older People Page 13 of 23 Evidence: included - nothing is too much trouble; I just cant fault them. Cups of tea and coffee just appear. The menus are seasonal and based on residents preferences. The lunchtime alternatives are generally omelette or salad but people spoken with said they were happy with these choices. The supper menu is more varied with residents being able to choose from a wide range of options. As a result of consulting with residents pots of spreads are now made available on the table at supper time. Residents frequently leave notes with the Registered Manager with suggestions for meals and these are acted upon whenever possible. One person spoken with said the food is excellent, you couldnt get better. Care Homes for Older People Page 14 of 23 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a satisfactory complaints procedure with evidence that those living in the home feel that their views are listened to and acted upon. People living in the home are further protected by satisfactory adult protection systems. Evidence: Information provided prior to the site visit confirmed that the service has policies and procedures on both complaints and Safeguarding Adults. There is a complaints log and all complaints are handled in line with the homes policies and procedures. The home has received one query but as it was in respect of contractual arrangements it does not come within the regulatory remit. However, discussion with the Registered Manager found that she is attempting to deal with the matter fairly and appropriately. All staff have been trained in Safeguarding Adults and the Registered Manager has undertaken the training for trainers therefore she is able to ensure all new staff receive this training and updates are provided for existing staff. Care Homes for Older People Page 15 of 23 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The standard of decor within the home is good, providing people living in the home a safe, homely and comfortable environment. Evidence: A tour of the premises was carried out and a random selection of rooms inspected. Generally the home continues to provide a well maintained, safe and attractive place in which to live. Individual bedrooms were attractively decorated and it was evident that many of the people living in the home had taken the opportunity to personalise their rooms with pictures and ornaments. All parts of the home were clean, tidy and free from offensive odours. About half the residents prefer their water deliver temperatures to be above the recommended level but there are detailed risk assessments in place which ensure they are not at risk. This practice demonstrates that individual preferences are respected without putting residents at risk. Discussion with the Registered Manager found she is in the process of researching the possibility of having equipment installed to enable residents to access extra-terrestrial television to further enhance their lives. This would be on a individual basis with residents arranging their own accounts. Information provided prior to the site visit indicated that there is an on-going maintenance and refurbishment programme for all parts of the home. All staff have been trained in infection control to ensure the risk of infection is reduced. Care Homes for Older People Page 16 of 23 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are sufficient staff with the skills and competency to meet the needs of people living in the home and recruitment practices are robust ensuring that people using the service are protected. Evidence: Recruitment records for the last three people to be employed were viewed and these showed that all the required information had been provided including a Criminal Records Bureau check, proof of identity and two written references. In order to fully comply with the regulations a full employment history needs to be obtained with a written explanation for any gaps. There are two care staff on duty throughout the day shifts in addition to the activity co-ordinator and the manager. There is one night waking staff with the manager and the deputy manager as on-call. Cooks and domestics are also employed. Of the eleven care staff, seven have at least an National Vocational Qualification in care at level 2, therefore the home exceeds the required level of 50 of care staff with this qualification. All staff have done mandatory training which is regularly updated however, records for staff training could be greatly improved to ensure any additional training needs are quickly identified and planned for. In addition to mandatory training staff also do first aid, food hygiene and infection control. It would be good practice to consider additional staff training in dementia care for those residents who have become slightly confused. Residents spoken with praised staff for the high level of Care Homes for Older People Page 17 of 23 Evidence: care and there was total agreement in that staff are kind and nothing was too much trouble. One person said that most importantly they take the time to listen. Care Homes for Older People Page 18 of 23 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is well managed and all aspects of the welfare, safety and health of people living in the home are protected and promoted. Evidence: The Registered Manager has the required qualifications in management and care and is experienced in the care industry and she undertakes additional training to update her skills and knowledge.There are various quality monitoring systems in place such as regular meetings for both residents and staff with the minutes of these meetings available. These demonstrate that people living in the home are listened to and their suggestions acted upon and that they have a say in how the home is run. Minutes of meetings showed they had been consulted in menus, outings and other activities. In addition regular surveys are carried out for both residents and their families. The Registered Provider makes monthly, unannounced, visits to the home as part of the quality monitoring process and the subsequent reports are available for inspection. The Registered Manager holds small amounts of money for residents and all transactions are recorded and receipts provided as required. Annual accounts for one Care Homes for Older People Page 19 of 23 Evidence: resident are prepared for the person who holds their Power of Attorney. The AQAA showed that regular checks are made on all electrical and gas appliances and systems and these records were checked on the day and found to be up to date. In addition checks are carried out on call bells, water delivery temperatures and emergency fire systems. All staff have been trained in fire safety and a fire safety risk assessment has been carried out for all parts of the premises. These systems ensure the safety of people living in the home in the event of fire. Accident records are maintained in line with the latest legislation. Improvements need to be made to all aspects of the record keeping process to both facilitate the quality monitoring system and ensure that they easily accessible and available for inspection. Care Homes for Older People Page 20 of 23 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 21 of 23 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 1 4 That the statement of purpose and service users guide be updated. To ensure service users have accurate information on the services provided. 07/07/2009 2 7 15 That all care plans include a photograph of the service user. To facilitate identification. 07/04/2009 3 7 15 That all service users have a 07/04/2009 complete and up to date plan of care. To ensure care plans reflect current care needs. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 22 of 23 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 23 of 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. 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