Inspection on 06/12/07 for Hartfield House

This inspection was carried out on 6th December 2007.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Hartfield House 20/11/06

Hartfield House 21/02/06

Hartfield House 16/08/05

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 Rebecca Shewan Unannounced Inspection 19th November 2007 09:50 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 Hartfield House DS0000021127.V350423.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Hartfield House DS0000021127.V350423.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hartfield House Address 5 Hartfield Road Eastbourne East Sussex BN21 2AP 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 731322 Mrs Cindy Nahoor Mrs Cindy Nahoor Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Hartfield House DS0000021127.V350423.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users must be aged sixty - five (65) years or over on admission. The maximum number of service users to be accommodated is twenty (20). 20th November 2006 Date of last inspection 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 along with additional outings to places of interest. There are eighteen single rooms of which ten have en-suite facilities. There is one double room, which is utilised as single occupancy that also has en-suite facilities. There are six communal toilets and four bathrooms all of which are assisted. The range of fees charged as from 1 April 2007 is from £340 to £415 per week. Additional charges are made for hairdressing, toiletries, chiropody, aromatherapy and newspapers/magazines. Potential new service users can obtain information relating to the home via the internet, CSCI Inspection Reports, Care Managers, Placing Authorities, by word of mouth, by contacting the home direct and by obtaining the homes vacancy list via the Registered Care Home Association website. Hartfield House DS0000021127.V350423.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place during the morning and afternoon of the 6th December 2007. Incident reports, previous inspection reports and the home’s Annual Quality Assurance Assessment (AQAA), held by the Commission for Social Care Inspection, were read before the inspection. The inspection of the home took five hours. Records such as care plans, staff files and medication records were also viewed. Eighteen residents were accommodated at the home at the time of the inspection. A tour of the whole home was undertaken and the Registered Manager, Deputy Manager, three staff, four service users (known as residents) and three relatives were spoken with. The CSCI also conducted Service User, Relatives and staff surveys. Of which fourteen surveys from service users and three from staff surveys were returned. Comments received included: ‘I cannot imagine a nicer, happier residential care home’. ‘Hartfield house is a lovely home and we are all, very happy and contented here’. ‘I receive all the care and understanding from everyone here and I am very happy her and well looked after’. ‘I love living here and I am very happy’. ‘Since coming to the home I have had more support and care than I have had previously’ ‘This is an excellent home and I would recommend it to anyone look for a residential care home’. What the service does well: The home ensures that pre- admission assessments are carried out on all new and potential residents with only those who needs can be met, being admitted to the home. The health needs of residents are well met with evidence of good multi disciplinary working taking place. Staff provide personal support to residents in such a way that promotes and protects resident’s privacy and dignity. Hartfield House DS0000021127.V350423.R01.S.doc Version 5.2 Page 6 Activities are arranged according to resident choice. Mealtimes are unhurried and all meals are home cooked with an alternative option being available for each mealtime. There is an efficient complaints procedure in place and the homes processes and staff training should protect residents in the event of an allegation of abuse. The location and layout of the home are suitable for its stated purpose. All areas of the home are accessible to residents. The home has a staff team that have the necessary skills and experience to the meet the needs of current residents. Staff training is on going and is appropriate to the level of needs of current residents. The management and administration of the home is good, with evidence of consideration being given to resident’s and/or relatives opinion. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Hartfield House DS0000021127.V350423.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hartfield House DS0000021127.V350423.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home has processes in place for assessing potential new resident’s with services being offered to only those resident’s whose needs can be met. EVIDENCE: The home’s Registered Manager and/or Deputy Manager carry out preadmission assessments. The home obtains a copy of a care management assessment from a placing authority where this exists. Any issues, which are highlighted within this assessment, are addressed by the home and documented records are maintained of all correspondence with the placing authority. Records inspected showed that pre- admission assessments are carried out on all new and potential residents. Residents confirmed that they had been involved in the assessment process and had felt included in their admission to the home. Intermediate care is not offered by this home. Hartfield House DS0000021127.V350423.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents are offered a good provision of health care and personal support by the home. All care is administered in way that protects residents privacy and dignity. Medication procedures ensure that all necessary precautions are taken to ensure errors do not occur and that medications are stored and administered safely. EVIDENCE: Following the inspection of November 2006 the home has made improvements to ensure that the Statutory Requirement that care plans and risk assessments include direction to staff in meeting service users needs, including manual handling. Care plans need to be updated in line with the monthly reviews has been met in full. Care plans were comprehensive, detailed in content and covered all aspects of resident’s needs and are written to allow the assessor to gain a good overview of individuals medical, social and personal care needs. Residents informed the inspector that care plans are devised with their involvement. Details of any specialist interventions required e.g. for the Hartfield House DS0000021127.V350423.R01.S.doc Version 5.2 Page 10 management of nutrition, diabetes are specified and recorded in residents care plans. Suitable risk assessments are also in place. Daily care records were maintained and these reflect the individual residents needs/care. The health needs of residents are well met with evidence of good multi disciplinary working taking place, on a required basis. Residents are registered with a GP of their own choice or with one from the local surgeries. Resident’s are encouraged to attend the GP surgery were able and home visits are conducted when necessary. Referrals to the Occupational Therapist, Physiotherapist, Dietician and Audiologist are made via the GP or the hospital. Following the inspection of November 2006 the home has made improvements to ensure that the Statutory Requirement that all staff who administer medication must receive satisfactory training and that all medication administered is appropriately recorded. The home has good, clear procedures in place for the monitoring and recording of all drugs administered and those entering and leaving the home. Staff training in medication has been conducted since the previous inspection and all staff that administer medications have been certificated as safe to do so. Staff were observed providing personal support to service users in such a way that promoted and protected residents privacy and dignity. Residents spoken with said that care staff were ‘kind and considerate at all times’. Hartfield House DS0000021127.V350423.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 People who use the service experience Excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents are able to enjoy a full and stimulating lifestyle with a variety of options to choose from. The home provides a wide range of social, cultural and recreational facilities, including specialist diets to residents, with resident’s choice and wishes being respected. EVIDENCE: Residents said that they enjoyed many of the home’s activities and that the home staff were flexible in allowing residents to choose the level of activities attended. A published list of activities is made available to residents, with residents being informed of special events being held in the home. Activities consist of Music for health, motivation, a visiting pianist, bingo, quizzes, poetry club, cooking club, beauty mornings, knitting club and Sunday newspapers and magazines. Trips to the local library, shopping in Eastbourne and outings to places of local interest are also arranged. Special festive activities have also been arranged for December. Service users assisted to attend outdoor activities or are encouraged to do so independently, where able. A pantomime was being held on the day of the inspection and residents were ‘looking Hartfield House DS0000021127.V350423.R01.S.doc Version 5.2 Page 12 forward to it’, ‘excited’ and ‘pleased to have something festive to look forward to’. Residents commented that the activities are ‘plentiful, sometimes I miss them because I’m just too tired to partake in all of them’, ‘We, at Hartfield House have great activities, exercises, quizzes and lots more and we also have lovely outings’ and ‘I love the activities here, we are never short of something to do’. Resident’s religious wishes are observed and arrangements are in place for residents to receive Holy Communion if they wish. The home also has access to PARCHE services, whereby people from the local church attend the home as ‘friends’ and sing hymns and conduct prayer readings, which are non denominational. Discussions with the Deputy Manager highlighted that although the current residents fell into a specific age group and had similar religious beliefs, the home would welcome any potential new resident who has special cultural/religious/spiritual beliefs and would make provision to accommodate their needs. The home believes in promoting an equal and diverse culture among staff and residents. Contact with family and friends is positively encouraged with visitors being able to attend the home at any time and in accordance with the resident’s wishes. One service user stated that ‘this is my home, not a care home and my family are welcomed as if this is their home also’. Residents are treated with respect and there is a good rapport between staff of the home and residents. Residents reported that the home assists them to maintain their independence with their daily living and daily routines. The home’s menus are devised on a four week rolling programme. All meals are home cooked with an alternative option available for each mealtime. Mealtimes can be varied upon request and residents guests are also welcome to have meals at the home. Family meals and dining events are arranged on a special occasions, such as Christmas, Easter, service users birthdays, Halloween, Harvest Festival. Such events are well attended and residents relatives feel very welcomed at such events. Relatives spoken with stated that ‘the food is very nice and fresh and we enjoy coming here’. Medical, therapeutic or religious diets are provided as needed. Drinks and snacks are available at all times. The meal served during the inspection was ample in quantity and attractively presented. Mealtimes were observed to be unhurried. Residents spoken with reported that ‘the food is very good here’, ‘The meals are just lovely, very appetising and nourishing and we have a choice of meals and ‘I like the food here, it is always warm and well presented. Since I have been here I have put on weight, which is a good thing as I had lost too much before I came here.’ Hartfield House DS0000021127.V350423.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from a robust and efficient complaints procedure, whilst the homes procedures, processes and staff training should protect resident’s in the event of an allegation of abuse. EVIDENCE: The home has an established complaints procedure in place. The home has not received any complaints since the previous inspection. Residents were asked whether they knew about the homes complaint procedure and all responded that knew who to complain to. Service user surveys comments also included ‘We know exactly who to speak to if not happy’ and ‘Yes, I know how to make a complaint.’ Both CRB and Protection of Vulnerable Adult (POVA) checks are carried out on all new staff. Following the inspection of November 2006 the home has made improvements to ensure that the Statutory Requirement that all staff be trained in adult protection has been met. The home has a copy of the East Sussex County Council Multi-agency Procedures for the Protection of Vulnerable Adults. There have been no Safeguarding Alerts in the last twelve months. The home has also made improvements to ensure that the Statutory Requirement that systems be devised to notify the CSCI of all adverse events including allegations of abuse has also been met. Hartfield House DS0000021127.V350423.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home provides accommodation for residents that is safe, hygienic and odour free, whilst infection control procedures are adhered to at all times. EVIDENCE: The location and layout of the home are suitable for its stated purpose. The home is well maintained and all areas of the home, including the garden, are accessible to residents. The home has an ongoing plan of refurbishment in place. Residents spoken with said that they liked their bedrooms and that the communal areas of the home were comfortable. The home is currently in the process of redecorating a hall area and that suitable risk assessments were in place to support any building work being conducted. Hartfield House DS0000021127.V350423.R01.S.doc Version 5.2 Page 15 The home has an infection control policy in place and staff are trained in infection control procedures. Staff were observed adhering to infection control procedures. The home was clean and odour free throughout. There is a daily cleaning schedule in place. Residents spoken with stated that the home is ‘lovely and clean’ and that ‘the cleaner does an exceptional job’. A service user survey comment was that ‘Hartfield house is a beautiful clean home and always so sparking and so lovely and fresh.’ Hartfield House DS0000021127.V350423.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home has a staff team that have the necessary skills and experience to the meet the needs of current residents. EVIDENCE: A competent staff team meets the resident’s needs. There is a staff rota in place, which details staff designations and hours of working. The home has a permanent staff team of sixteen care staff, the Registered Manager, the Deputy Manager and three ancillary staff. Eleven carers are trained in National Vocational Qualification (NVQ) level 2 or above, in care. Staff recruitment files were viewed and it was evidenced that these files contain all items required under the Care Homes Regulations 2001. The home has an Equal Opportunities policy in place and is an equal opportunities employer. Staff induction training is now conducted in line with Skills for Care in accordance with the previous inspection Requirement that induction is carried out in accordance with the Care Skills Sector guidance, where appropriate. Over the last twelve months staff have been provided with a range of training, Hartfield House DS0000021127.V350423.R01.S.doc Version 5.2 Page 17 including Fire Training, Moving & Handling, Medication, Protection of Vulnerable Adults and Infection Control. Additional training is also provided as required. Hartfield House DS0000021127.V350423.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 37 & 38 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The management and administration of the home is good, consideration being given to resident’s choice and opinion. The health, safety and welfare of residents and staff is protected at all times. EVIDENCE: The Registered Manager and Deputy Manager of the home both have many years relevant experience in caring for older people and both have relevant qualifications in care. Residents and staff spoken with said that the Manager was friendly, approachable and always takes service user’s concerns or comments about the home seriously. Hartfield House DS0000021127.V350423.R01.S.doc Version 5.2 Page 19 Following the inspection of November 2006 the home has not made improvements to ensure that the Statutory Requirement that quality monitoring and quality assurance systems be expanded. Quality Assurance questionnaires are distributed annually to residents. The results of the Quality Assurance audit are not currently published or made available for all interested parties. The Management team report that they now have a clear focus for the manner in which they wish to conduct their Quality Assurance procedures in the future and are currently developing a new system, to be utilised for the next annual audit. Residents meetings are held, the minutes of which are recorded and displayed for all to see. Appropriate action is taken by the home to address any issues raised by residents during these meetings. Monthly staff meeting are also held. The home does not take any responsibility for any of the resident’s finances and most residents have family, friends or representatives who protect their financial affairs. Following the inspection of November 2006 the home has made improvements to ensure that the Statutory Requirement that all accidents are appropriately recorded as required under Regulation 17 Schedule 3 and 4 and that systems be devised to notify the CSCI of all adverse events including allegations of abuse. Fire drills, fire alarm testing and fire equipment checks, water checks and Portable Appliance Testing (PAT) had been carried out within the last twelve months. The homes annual policy reviews have also been conducted within the last twelve months and in accordance with Guidance/Regulatory changes. Hartfield House DS0000021127.V350423.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X 3 3 Hartfield House DS0000021127.V350423.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? YES 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 OP33 Regulation 24 (1ab) (2)(3) Requirement That quality monitoring and quality assurance systems be expanded. Timescale for action 06/02/08 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 Hartfield House DS0000021127.V350423.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Hartfield House DS0000021127.V350423.R01.S.doc Version 5.2 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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