Inspection on 16/08/05 for Hartfield House

This inspection was carried out on 16th August 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

Hartfield House 06/12/07

Hartfield House 20/11/06

Hartfield House 21/02/06

Hartfield House 06/12/04

Hartfield House 09/07/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Hartfield House 5 Hartfield Road Eastbourne East Sussex BN21 2AP Lead Inspector Paul Endersby Unannounced 16 August 2005 09:30 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 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. Hartfield House H59-H10 S21127 Hartfield House V237605 160805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Hartfield House Address 5 Hartfield Road Eastbourne East Sussex BN21 2AP 01323 731322 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Cindy Nahoor Mrs Cindy Nahoor Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (OP), 21 of places Hartfield House H59-H10 S21127 Hartfield House V237605 160805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The maximum number of service users to be accommodated is twenty-one (21) 2. Service users must be aged sixty-five (65) years or over on admission Date of last inspection 6 December 2004 Brief Description of the Service: Hartfield House is registered to provide care and accommodation for up to twenty-one older people. The premises are situated opposite the park of Hartfield Square and within walking distance of the town centre of Eastbourne and the mainline railway station. A passenger lift provides access to all floors. The home has well maintained gardens to the rear of the property. Regular social activities are arranged within the home plus outings to places of interest. The home has well maintained gardens to the rear of the property. Hartfield House H59-H10 S21127 Hartfield House V237605 160805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place during the morning and early afternoon. The Inspector met with seven of the residents plus the service provider/manager and other staff members. The inspection included a tour of the building, and reviewing a range of documentation, including records, care plans and policies and procedures. 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. Hartfield House H59-H10 S21127 Hartfield House V237605 160805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Hartfield House H59-H10 S21127 Hartfield House V237605 160805 Stage 4.doc Version 1.40 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 standard(s) 3 & 5 The pre-admission assessment enables the home to assess the care needs of potential residents. Pre-admission visits, assist prospective residents and their families in coming to an informed decision about where to live. EVIDENCE: The registered manager or the deputy manager undertake comprehensive preadmission assessments. The information gathered includes verbal information from relatives to ensure that the staff team are able to meet the needs of prospective residents. Should a local authority place a service user then an assessor from Social Services undertakes an assessment prior to admission. Prospective residents and their families are invited to visit the home prior to admission. All residents are admitted on a one-month trial basis and residents notified, in writing when their stay becomes permanent. Unplanned admissions are avoided. Hartfield House H59-H10 S21127 Hartfield House V237605 160805 Stage 4.doc Version 1.40 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 standard(s) 7, 9 & 11 Care plans ensure that a comprehensive record is maintained of residents needs and that there a consistent response is made by staff. The arrangements for handling medication are well managed. EVIDENCE: Every resident has a detailed plan of care that is reviewed monthly. Care plans outline care needs and how they are to be met. Residents or their representatives are involved in compiling and reviewing care plans. Since the last inspection action has been taken to undertake risk assessments for those residents who have begun to have falls, drink alcohol or present challenging behaviour. Risk assessments have also been undertaken for residents within and outside the home. Risk assessments include the management of any such risks. A monitored dosage system is used for resident’s medications. Both the storage and administration of medication were found to be satisfactory. Detailed policies and procedures on the handling, storing and administration of medication have been prepared. All staff who administer medication have received accredited training provided by one of the local Pharmacists. Wherever possible, and subject to a risk assessment, residents are offered the opportunity to self medicate. Hartfield House H59-H10 S21127 Hartfield House V237605 160805 Stage 4.doc Version 1.40 Page 9 A lockable cupboard is provided for these residents to store their medication. A local pharmacist visits the home regularly to check the medication arrangements and give appropriate advice if this is necessary. The overall policy is to care for residents up to the point of death, subject to the staff being able to provide the required care with the support of health care professionals. In particular Community Nurses and MacMillan Nurses advise on palliative care. A detailed policy and procedure providing advice and guidance to staff, in respect of dealing with residents who are dying, has been prepared. This includes both the practical aspects of the after death process and also the procedure for dealing with residents in the event of a member of staff dying. Hartfield House H59-H10 S21127 Hartfield House V237605 160805 Stage 4.doc Version 1.40 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 standard(s) 13 & 15 Residents are able to maintain contact with family and friends with assistance if required. A varied and wholesome menu, with choices, is provided for residents who are appreciative of the quality of the meals provided. EVIDENCE: Visitors are welcome at all times and this is made clear in the homes Service Users Guide. Residents are encouraged and enabled to maintain links in the community. Residents meetings are held on a regular basis. These meetings are minuted and any issues raised are actioned whenever possible. The home has a pleasant well presented dining room where most people choose to take the main meals of the day, lunch and supper. In the main residents take breakfast in their own room and a few residents elect to eat all meals in their bedroom. A four-week rotating menu is provided and residents are offered alternatives at each meal. Food is varied, wholesome and nutritious. Their food likes and dislikes are recorded in their individual care plans. The Manager seeks advice from relevant professionals, e.g Dieticians in respect of those service users who require a special diet. All residents spoken to were complimentary about meals. Hartfield House H59-H10 S21127 Hartfield House V237605 160805 Stage 4.doc Version 1.40 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 standard(s) 16 & 18 Residents have confidence in the home’s complaints procedure and the service provider or acting manager’s ability to listen to and act on any complaints made. The practices within the home and the relevant staff training in regard to Adult Abuse and Adult Protection contribute to resident’s safety. EVIDENCE: A clear procedure has been prepared for residents and their representatives to make a complaint and how the home will respond. This is included in the Service Users Guide and a copy is publicly displayed. All residents identified the manager or deputy manager as the person they would take complaints to, and were confident that they would be listened to and action taken. All incidents and complaints are recorded and include outcomes and actions taken. The Inspector recommended that the records indicate clearly which are complaints and which are incidents. Notwithstanding this, it is evident that most complaints tend to be of a day-to-day nature and the Manager takes steps to resolve them immediately. Detailed policies and procedures on adult protection have been provided that are based on East Sussex, Brighton & Hove Policies and Procedures for the Protection of Vulnerable Adults Protocols. These include information for staff on recognizing all types of abuse. Additionally there is a Whistle-Blowing policy and procedure to enable staff to raise concerns. The home has a rolling programme to train all staff in adult protection overseen by the deputy manager. A policy on staff receiving gifts is also available. Hartfield House H59-H10 S21127 Hartfield House V237605 160805 Stage 4.doc Version 1.40 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 standard(s) 19, 20, 21 & 22 The overall standard of the environment and maintenance of the home is good, providing residents with an attractive and safe place to live. Action has been taken to ensure that relevant aids and adaptations are provded. EVIDENCE: The premises provide a homely and comfortable home for older people. There is an ongoing maintenance programme, with the result that home is in good decorative order. Provision of a lift facilitates access to all floors. The gardens are attractive, well maintained and accessible to residents. There are regular checks to ensure that the home meets the required fire safety standards. The Environmental Health Department also inspect from time to time. Lighting and furnishings in the home are domestic in character. The home meets the communal space requirements for existing homes. The lounge is suitable for a range of social and leisure activities. The home has toilets close to resident’s bedrooms and all communal areas. The Inspector requested that action be taken to repair the broken lock on one of the communal toilets. Hartfield House H59-H10 S21127 Hartfield House V237605 160805 Stage 4.doc Version 1.40 Page 13 All baths in the home have electrically or manually operated seats. Grab rails and toilet riser seats are in evidence throughout the home. All service users bedrooms have a call bell. Currently aids and adaptations in the home have been provided for individual residents. Where necessary individual residents are assessed and provided with specialist equipment and/or adaptations as required. Since the last inspection the home, including the garden, have been assessed by an Occupational Therapist in regard to aids and adaptations. Recommendations included in the subsequent report have either been implemented or are in hand. Hartfield House H59-H10 S21127 Hartfield House V237605 160805 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 & 29 The staffing levels are sufficient to meet the needs of the current residents. The recruitment procedures need some improvement to ensure that they provide adequate safeguards for protection of residents. EVIDENCE: Normal care staffing provision is for a minimum of three carers each morning and two or three plus the deputy manager during the afternoon/early evening period. Night staffing comprises one person awake. In addition the service provider/manager employs cooks, domestic assistants and a gardener. The manager or deputy manager are on duty everyday except Sundays. However one of them is always on call. These staffing levels, plus the comprehensive staff training programme, contribute to the process of meeting the assessed needs of residents. The Inspector reviewed a sample batch of staff personnel files. These revealed that the recruitment procedures are not entirely satisfactory. In particular gaps in employment are not always fully explored. Checks with the Criminal Records Bureau (CRB) are carried out on new staff prior to their commencing work and two written references are received. Hartfield House H59-H10 S21127 Hartfield House V237605 160805 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 37 & 38 The quality assurance systems assist in ensuring that the home is run in the best interests of residents. The record keeping systems and policies and procedures contribute to the welfare of the residents. Appropriate arrangements have been made for providing a safe environment for residents. EVIDENCE: The manager has recently completed a resident’s survey. The results were available for inspection. These are comprehensive and provide useful feedback on the service provided. It is intended that the system be extended to resident’s families and visiting professionals and the results included in the Service Users Guide. A wide range of polices and procedures have been provided for the guidance and instruction of staff. A number of records were reviewed and they were found to be accurate and up-to-date and held in accordance with the requirements of the Data Protection Act 1998. Residents may view their personal records on request. Hartfield House H59-H10 S21127 Hartfield House V237605 160805 Stage 4.doc Version 1.40 Page 16 Appropriate action has been taken to provide a safe environment for residents and staff. This includes a range of policies and procedures on Health and Safety, including control of substances hazardous to health and Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR). Health and Safety is included in staff induction training and as an on-going process during supervision. All staff have received training in moving and handling, handling medication, fire safety and infection control. A further training session on first aid was due to take place on the day of the inspection. This will ensure that there is a trained first aider on each shift. All safety procedures are posted in appropriate sites throughout the premises. Water storage and distribution temperatures meet the required standard to control the risk of Legionella. Evidence was provided to demonstrate that electrical systems and appliances plus gas appliances are serviced annually. Fire alarms, call bell systems and emergency lighting are tested regularly. All accidents are recorded. Hartfield House H59-H10 S21127 Hartfield House V237605 160805 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 3 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 x x x x STAFFING Standard No Score 27 3 28 x 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x x x 3 3 Hartfield House H59-H10 S21127 Hartfield House V237605 160805 Stage 4.doc Version 1.40 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 29 Regulation 19(1)(a)(i )& Schedule 2(1-6) Timescale for action Recruitment of staff must comply 16.08.2005 with the Care Homes Regulations 2001 Requirement 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 16 Good Practice Recommendations The complaints record should indicate clearly what is a complaint as opposed to an incident. Hartfield House H59-H10 S21127 Hartfield House V237605 160805 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection Ivy House 3 Ivy Terrace Eastbourne East Susssex 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 Hartfield House H59-H10 S21127 Hartfield House V237605 160805 Stage 4.doc Version 1.40 Page 20 - 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. 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