Inspection on 19/12/05 for Hare Lodge

This inspection was carried out on 19th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Hare Lodge 30/04/09

Hare Lodge 09/02/09

Hare Lodge 26/02/07

Hare Lodge 13/03/06

Hare Lodge 14/09/04

Hare Lodge 11/05/04

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

CARE HOMES FOR OLDER PEOPLE Hare Lodge 57 Harebeating Drive Hailsham East Sussex BN27 1JE Lead Inspector Andy Denness Unannounced Inspection 19th December 2005 11:00 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 Hare Lodge DS0000021126.V270243.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Hare Lodge DS0000021126.V270243.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Hare Lodge Address 57 Harebeating Drive Hailsham East Sussex BN27 1JE 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 849913 01323 849913 The Harebeating Care Company Vacant Care Home 32 Category(ies) of Dementia (32) registration, with number of places Hare Lodge DS0000021126.V270243.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of service users to be accommodated is thirtytwo (32) Service users must be older people aged sixty-five (65) years or over on admission Service users with a senile dementia type illness only to be accommodated 14th September 2004 Date of last inspection Brief Description of the Service: Hare Lodge is a large, detached, purpose built care home situated in a residential area of Hailsham, approximately one mile from the town centre. Accommodation is provided on two floors and a shaft lift is fitted to assist those service users who may have mobility problems. The home is registered to accommodate up to 32 older people with a dementia type illness. The registered owners are the Harebeating Care Company. Hare Lodge DS0000021126.V270243.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced Inspection took place over a morning and afternoon in December. To help gather evidence on how the home is performing the Inspector sat and ate a meal with service users, met with staff and the home’s acting manager, examined a range of records and written information and undertook an inspection of the premises. Discussions took place with eight service users. What the service does well: 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. Hare Lodge DS0000021126.V270243.R01.S.doc Version 5.1 Page 6 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 Hare Lodge DS0000021126.V270243.R01.S.doc Version 5.1 Page 7 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, 2 & 3 Preadmission procedures are good and ensure that service users move into a home that is suitable to meet their assessed needs. EVIDENCE: Written information in the form of a statement of purpose and a service user’s guide are in place; these documents provide information for prospective service users about Hare Lodge and the service provided. Improvements have been made to the statement of purpose since the last inspection; both documents were examined, they were of a good quality. Assessments of service users’ needs are undertaken by the acting manager prior to them moving in; the assessments of the last two service users admitted were examined, they were of a satisfactory quality. The information pack given to prospective new service users was shown to the inspector, this included the last inspection report for the home and a contract which details the terms and conditions of service users stay at Hare Lodge, the contract covered all necessary areas. Hare Lodge DS0000021126.V270243.R01.S.doc Version 5.1 Page 8 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, 8 & 9 Arrangements regarding meeting service users needs in relation to health and personal care needs were generally good, however some work is required to ensure that their mental health needs are appropriately documented. Current medication arrangements are not satisfactory. EVIDENCE: Individual plans of care are in place for all service users, these describe their needs and what help they need from staff; several plans were examined, these were generally satisfactory, however they did not contain sufficient information regarding service users’ mental health needs and one plan made no reference to the support the service user needed with their personal care. Also guidance was not included for staff on how they should manage difficult situations with service users linked to their dementia. Care plans were stored in an unlocked cupboard in the dining room; this was not satisfactory as the documents contain personal details. Action has been required to address these concerns. Records examined confirmed that a range of health professionals are accessed to help met service users physical and mental health needs. Because of the poor memory issues linked with dementia, staff manage medication for all service users. An easily monitored dispensing system is used, records and storage were examined and several concerns were noted. In several instances Hare Lodge DS0000021126.V270243.R01.S.doc Version 5.1 Page 9 medication had not been dispensed from the packs although staff had signed as having given them to service users and some service users who regularly go out during the day, have missed their medication; immediate action has been required to address these concerns. Medication is currently stored in what is a sluice room; there is insufficient storage space in the room and medication and dressings were being stored on the floor. The sluice is still in the room and pipe work has been uncovered and the panels that box them in have not been refitted. Action has been required to ensure more appropriate and hygienic storage arrangements. Hare Lodge DS0000021126.V270243.R01.S.doc Version 5.1 Page 10 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 & 15 Current arrangements in the home mean that service users have a choice of activities and entertainment. A varied and wholesome menu is provided. EVIDENCE: The Inspector was told that an activities coordinator is employed for five days a week; activities provided include arts and craft, exercises, sing songs etc, this was confirmed in discussions with some service users and from records examined. Service users have been provided with a range of seasonal Christmas entertainment; a party for service users and their relatives was taking place during the afternoon of the inspection, and records confirmed that service users had been to a party held locally by the Alzheimer’s Society. The Inspector was told that a Carol concert and Christmas meal are also planned. Records examined confirmed that a varied and wholesome menu is provided. The Inspector sat and ate lunch with service users; they enjoyed the meal and staff provided discrete assistance to those service users who needed help to eat. Hare Lodge DS0000021126.V270243.R01.S.doc Version 5.1 Page 11 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 & 17 Arrangements in the home for managing complaints and adult protection matters were good. EVIDENCE: The home has a written complaints procedure in place, this was of a satisfactory quality; the procedure is included in the home’s statement of purpose, this has recently been amended to give correct contact details of the Commission for Social Care Inspection. Records examined confirmed that most staff are now trained in adult protection matters. A recent adult protection alert was forwarded to the Local Authority and the Commission for Social Care Inspection; the action taken by the acting manager and the owners of the home was appropriate and ensured the immediate protection of the service user involved. Hare Lodge DS0000021126.V270243.R01.S.doc Version 5.1 Page 12 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): 19,20,21,22,23,24,25 & 26. Physical standards in the home are good ensuring that service users live in a well maintained, hygienic and generally safe environment. EVIDENCE: Hare Lodge is a large, detached, purpose built care home situated in a residential area of Hailsham, approximately one mile from the town centre. Accommodation is provided on two floors and a shaft lift is fitted to assist those service users who may have mobility problems. All communal areas and some bedrooms were inspected. All bedrooms comply with the size requirements of national minimum standards and most are ensuite; service users said that they are able to bring their own furniture with them; some have done this, which has resulted in pleasant personalised rooms. It was noted that some window restrictors, fitted to ensure service users safety are broken, action has been required to address this problem. There is a choice of a lounge, two dining rooms and a conservatory for service users to use; these rooms are furnished and decorated in a comfortable homely style. Heating is provided by an oil fired central heating system, which has recently been replaced; radiators are fitted in all rooms, these are of a low surface Hare Lodge DS0000021126.V270243.R01.S.doc Version 5.1 Page 13 temperature type, which present no risk to service users of burning. Tests confirmed that hot water is delivered to wash hand basins and baths at a safe temperature. The home is fitted with a shaft lift to assist service users access first floor accommodation. Some bathrooms are fitted with hoists to assist access to baths and handrails and other adaptations are sited throughout the home to aid mobility. A satisfactory standard of cleanliness was found in all areas of the home. The laundry was seen to be suitably equipped. Records examined indicated that a considerable number of staff are not yet trained in infection control matters. Hare Lodge DS0000021126.V270243.R01.S.doc Version 5.1 Page 14 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, 28, 29 & 30. Staffing arrangements ensure that service users are supported by a welltrained, motivated and caring staff group EVIDENCE: Staffing numbers on the day of the inspection were sufficient to meet service users needs; an examination of records confirmed that this is the case at all other times. Observations made during the inspection confirmed that staff are caring and respectful in their interactions and that they manage sometimesdifficult situations linked to service users mental health needs with calmness and professionalism. Service users spoke well of staff, their comments included “staff are very nice” and “there are always enough staff to help me”. Training records examined confirmed that staff have received training in a number of subjects including, first aid, fire prevention, moving and handling, dementia, medication and adult protection. Currently 50 of staff have not completed the required national level training course. An examination of records confirmed that correct recruitment procedures are followed when new staff are employed, this includes the use of application forms, following up of references, CRB checks, POVA checks and identity checks. Hare Lodge DS0000021126.V270243.R01.S.doc Version 5.1 Page 15 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, 34, 35, 37 & 38. In the absence of a registered manager current arrangements are good and ensure that staff receive the required level of managerial and administrative back up. EVIDENCE: The home does not currently have a registered manager, the deputy manager is currently acting manager and a new permanent manager is starting in January 2006. The Insurance certificate was seen and cover is set at the required level. The Inspector has been told that current system for managing service users personal spending monies involves purchases being made on their behalf and then service users or their representatives being billed or having money deducted from a special central account where service users or their representatives can deposit personal spending money; records regarding this were in order. A range of records required by regulation was examined, these were in order. Health and safety records were examined, these were in Hare Lodge DS0000021126.V270243.R01.S.doc Version 5.1 Page 16 order and up to date. Training records confirmed that staff are trained in most health and safety subjects. It was noted that the registered owners of the home are not currently producing reports of their required monthly monitoring visits to the service; action has been required to address this. Hare Lodge DS0000021126.V270243.R01.S.doc Version 5.1 Page 17 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 3 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 1 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 X 3 3 3 3 3 3 2 2 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X 3 3 X 2 3 Hare Lodge DS0000021126.V270243.R01.S.doc Version 5.1 Page 18 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 Standard OP7 Regulation 15 Requirement That care plans are expanded to include full guidance regarding service users dementia, personal care needs and contain guidance for staff on how to manage challenging situations. To ensure confidentiality the plans should be stored securely. That all medication is dispensed to service users at the prescribed time. Storage arrangements for medicines and dressings should be improved to ensure orderly and hygienic storage. That the broken window restrictors are repaired. That staff are trained in infection control matters. That 50 of staff are trained to NVQ level 2. That the required Regulation 26 visits by a representative of the owners are reintroduced with reports being forwarded to the Commission for Social Care Inspection. Timescale for action 19/01/06 2 OP9 13(2) 19/12/05 3 4 5 6 OP25 OP26 OP28 OP37 12(1)(a) 18(1)(a) 18(1)(a) 26 19/01/06 19/05/06 30/12/05 19/01/06 Hare Lodge DS0000021126.V270243.R01.S.doc Version 5.1 Page 19 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 Hare Lodge DS0000021126.V270243.R01.S.doc Version 5.1 Page 20 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. 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