Inspection on 01/11/05 for Hartford Hey

This inspection was carried out on 1st November 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Hartford Hey 07/08/07

Hartford Hey 28/11/06

Hartford Hey 27/06/06

Hartford Hey 01/07/05

Hartford Hey 09/11/04

Hartford Hey 02/06/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Hartford Hey Manorial Road South Parkgate South Wirral Cheshire CH64 6US Lead Inspector Maureen Brown Unannounced Inspection 11:00 1 November 2005 st 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 Hartford Hey DS0000006593.V262317.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Hartford Hey DS0000006593.V262317.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Hartford Hey Address Manorial Road South Parkgate South Wirral Cheshire CH64 6US 0151 336 4671 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) Hartford Hey Limited Mrs Jeanette Faland Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places Hartford Hey DS0000006593.V262317.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st July 2005 Brief Description of the Service: Hartford Hey is a residential care home providing personal care and accommodation for up to 28 older people. It is a family run private business. The home is located in a residential area of Parkgate on the Wirral, near to the river Dee estuary. The home is within walking distance of shops, public houses and other community facilities. There are adequate car parking facilities available. Hartford Hey is two large older style semi-detached houses converted into one. Service user accommodation is on three floors, with access to all floors by a passenger lift or the stairs. There is a newer single storey extension to the rear of the property. There are 22 single and 3 double bedrooms, twelve of which have en-suite facilities. The remaining bedrooms have wash hand basins fitted. The home has extensive patio and garden areas. Some of the bedrooms of the ground floor extension have direct access to the gardens via patio doors. Hartford Hey DS0000006593.V262317.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out during 1st November 2005. The total time at the home was five hours. An hour was spent planning the inspection by reviewing previous inspection reports and the service history. The inspection included a tour of the home, inspection of records and discussions with eighteen residents, the owners, the registered manager, deputy manager, care assistants and relatives and friends. Twenty out of thirty-eight standards were assessed and most were met. Two residents comment cards and three relatives/visitors comment cards were received. Feedback from this inspection was given to the registered manager at the end of the inspection. What the service does well: What has improved since the last inspection? Development of the care plans had taken place, but further work needs to be completed. A pre assessment document has been produced to show the home can meet residents’ needs. Also risk assessments have been carried out and documented with regard to falls, moving and handling and other risks identified. Records are now kept of all visits made by and to other professionals. A full copy of the latest inspection report is now made available to residents, relatives and other interested people. Controlled drugs are stored in line with current regulations and are signed and witnessed by two members of staff. Hartford Hey DS0000006593.V262317.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Hartford Hey DS0000006593.V262317.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hartford Hey DS0000006593.V262317.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 & 6 Sufficient information is provided for residents to make a decision about moving into the home. A pre-assessment document is available to ensure that the home can meet the residents’ needs. EVIDENCE: The statement of purpose and service users guide were produced in individual folders. They included all the information needed to make an informed choice about where to live. Information about the facilities, services provided, fees, terms and conditions of residence was included and the service user guide had a summary of a previous inspection report. Both these documents were well presented and easy to read. Residents and relatives confirmed that they had seen these documents. A full copy of the latest inspection report was available and reflected the previous recommendation made. Hartford Hey DS0000006593.V262317.R01.S.doc Version 5.0 Page 9 A pre-assessment document had been developed since the last inspection, which included personal information such as next of kin, medical information, and details of the assessor. Also included was all information required to make an informed decision as to whether the individuals’ needs could be met. Residents and relatives confirmed that they had visited the home prior to admission and staff said that admissions were planned. The manager stated that intermediate care was not provided at Hartford Hey. Hartford Hey DS0000006593.V262317.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 The residents’ health, personal and social care needs are met by the staff team who enable them to maintain their privacy and dignity. EVIDENCE: A sample of three residents’ care records was seen during this inspection. These were presented in individual folders. Since the previous inspection when requirements were made regarding the care plans, a form identifying main needs and problems and how this would be achieved had been developed. Also a 24-hour summary document had been produced. However, these had not been completed for all residents. Risk assessments had been developed for falls, moving and handling, risk of burns from radiators and bathing. Each resident had a visiting professionals sheet that showed visits from GP’s, District Nurses, chiropodist and visits to out patient appointments. The residents did not sign their care plans to show that they agreed with the contents. Daily record sheets seen showed day-to-day activities of each resident. They were written clearly, easy to follow and were signed by carers. Hartford Hey DS0000006593.V262317.R01.S.doc Version 5.0 Page 11 Details of residents’ wishes with regard to dying and death were not recorded. Information regarding residents’ weights was recorded, however this was not kept in line with the Data Protection Act 1998 as all the residents’ information was recorded on a single sheet. Medication records examined showed that this was recorded and administered appropriately. Medication was kept secure and controlled drugs were stored in line with current regulations. Controlled drugs are signed and witnessed by two members of staff. A copy of the British National Formulary dated March 2004 had been obtained in line with previous recommendations. A copy of the Royal Pharmaceutical Society book entitled “ The Administration and Control of Medicines in Care Homes and Children’s Services” had been obtained. The manager said staff that administer medication had started a booklet with the pharmacist that would lead to certificated training, however this training had lapsed. The manager said that this was due to be restarted in mid November 2005. Staff confirmed that they were due to restart this training. During discussions with the residents it was said “the care was very good”, “were well looked after” and “the home had a lovely atmosphere” and “the food is good”. Relatives said “the home has a good name locally” and “the staff approach was excellent” and also “they were kept informed of changes in health needs”. During the inspection privacy and dignity was shown by the staff knocking on residents’ doors, bathroom doors and using the screens in twin bedrooms. Privacy and dignity is covered during induction and also independence and quality of life. See requirement No. 1 and recommendation Nos. 1 & 2. Hartford Hey DS0000006593.V262317.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14 Residents’ were able to take part in a range of activities of their choosing. Personal and family relationships were encouraged by the home and the staff team supported people with this. EVIDENCE: A range of activities were undertaken which included reading, bingo, hairdressing, manicures, arts and crafts and watching television. Residents said they particularly enjoyed reading the paper or chatting to other residents in the mornings and participating in activities or watching television during the afternoons. One of the lounges was used as a quiet lounge for people wanting this facility. Visits from family and friends were noted throughout the day and these were recorded in the case notes. Residents shared with the inspector the contact they had with family members and said they could choose to see visitors within their own room or in the lounges or dining area. Relatives said that they were always made very welcome by the staff and were offered refreshments. They said that they could visit their family in the privacy of their own bedroom, in one of the lounges or the dining room. Hartford Hey DS0000006593.V262317.R01.S.doc Version 5.0 Page 13 The manager said that she was aware of advocate services and leaflets were available for residents for the “Care Aware” advocacy service. During a tour of the home some bedrooms were seen and these were personalised by the residents with small items of furniture and personal photographs and mementoes. Hartford Hey DS0000006593.V262317.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Residents and relatives were satisfied with the support they received from the manager and staff. Clear policies and procedure were in place to ensure that residents were protected from abuse, neglect and self-harm. EVIDENCE: The policy on complaints was seen and included timescales for any complaint made and information about who else could be contacted, for example the Commission for Social Care Inspection. All relevant paperwork was available if a complaint is received. The Commission received a complaint about the home on 3rd March 2005 and this remains unresolved. This was discussed with the manager who said that a letter of apology would be sent to the complainant, with a copy forwarded to the Commission. Residents and relatives confirmed that they were aware of the complaints procedure and who to direct their complaint to. Residents and relatives were confident that any complaint would be dealt with. One relative also said “has never made a complaint as this is a very good home”. The home had signed up to the Cheshire County Councils’ policy and procedure in line with the “No Secrets” guidance from the Department of Health. A copy of Cheshire’s Social Services policy on Adult Protection was available within the Hartford Hey DS0000006593.V262317.R01.S.doc Version 5.0 Page 15 home and was accessible to staff. Staff confirmed that they were aware of the procedures and who to contact with any concerns. Training on Adult Protection was given during the induction process the manager stated, which was also seen on staff files. Hartford Hey DS0000006593.V262317.R01.S.doc Version 5.0 Page 16 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, 25 & 26 The home provides a clean and comfortable environment for the people to live in. EVIDENCE: The home was furnished in a domestic style with additional equipment such as grab rails, raised toilet seats and hoists provided as necessary to meet the residents’ needs. An acceptable standard of décor was evident throughout. The bedrooms were all light and airy and had personal possessions and mementos belonging to the residents. The radiators that residents might come into contact with did not have low surface temperatures, however since the previous inspection risk assessments had been produced to minimise the risk of burns. The heating and lighting was sufficient throughout the home. The grounds were well maintained and extensive. They were secure and plants in hanging baskets were placed around the seating areas. Residents said that it was nice to sit out in the good weather and staff confirmed that the seating area was used in the better weather. Hartford Hey DS0000006593.V262317.R01.S.doc Version 5.0 Page 17 The home was clean, tidy and free from any unpleasant smells. The home had a separate laundry room, which was clean and tidy. Cleaning materials were stored appropriately and basic information on hazardous materials was kept and accessible to the staff. Staff stated they were aware of this file and that chemicals must not be mixed with other chemicals. Following the previous requirement regarding hot water temperatures risk assessments have been carried out and the risks of scalding have been minimised. “Hot water” notices had also been provided by every hot water tap as a reminder to residents. Hartford Hey DS0000006593.V262317.R01.S.doc Version 5.0 Page 18 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 & 30 The manager provided clear leadership. Care plans were not well maintained. Other records were maintained in a satisfactory manner. Staff received support to enable them to meet residents’ needs. EVIDENCE: At the time of this inspection the agreed staffing levels were met. A recorded staff rota confirmed this. The owner, registered manager, deputy manager, cook, domestic staff, laundry staff and maintenance people support the care staff in the care of the residents. The staff team was well established and the team had a range of life experiences and training. Four of twenty care staff had obtained NVQ level II in care and eight were due to start NVQ level II in care in December the manager stated. Some staff confirmed they had completed NVQ training in care. Relatives said the staff worked in a caring manner. Residents and relatives confirmed that the care given was very good. Hartford Hey DS0000006593.V262317.R01.S.doc Version 5.0 Page 19 It has been detailed previously in this report that some of the care plans were not well maintained. Daily records about residents were well written and accurate. Policies and procedures seen were appropriate to the home. An induction programme was used at the home. Staff confirmed that they had undertaken an induction process. The induction process was a basic format and should be reviewed in line with the specification from Skills for Care, which was formally the TOPPS organisation. Some staff had completed training in moving and handling, first aid, food hygiene and health and safety. However, mandatory training needs to be completed by all staff and specialist training in line with the specific needs of the residents undertaken. See requirement No. 2 and recommendation Nos. 3 & 4. Hartford Hey DS0000006593.V262317.R01.S.doc Version 5.0 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 The manager is competent, experienced and able to meet the homes stated purpose aims and objectives. Staff received support to enable them to meet residents’ needs. EVIDENCE: The manager had the In-service Course in Social Care (ICSC) and NVQ level III D32 Assessors Award. The manager said that she was considering undertaking NVQ level IV in Care and Management, the standard set by the Department of Health for managers of care homes to achieve. All policies and procedures seen were up to date and accurate. These were kept secure within the home. Hartford Hey DS0000006593.V262317.R01.S.doc Version 5.0 Page 21 Residents and relatives said that they felt the home was well run and that the manager and staff were very welcoming and friendly. This was confirmed during the inspection. Relatives said that the staff worked in a very friendly manner. Fire alarm tests were being undertaken on a weekly basis and records kept. Emergency lighting tests were also being carried out on a monthly basis with records kept. However, the fire risk assessment was only partially completed and staff had not received training in fire awareness. In the Statement of Purpose and Function for the home states “fire awareness training for staff will be undertaken every six months”. The manager stated that a quality assurance process was not in place at this time. This needs to be developed and produced on an annual basis with a summary published for residents and other interested parties. The manager said that residents meetings were held in the past and that she intended to reinstate these each month. The manager said that service users were encouraged to keep only a small amount of money on the premises. All residents have a lockable drawer in their bedrooms. The management holds no money for the residents. Visits from the fire safety officer and the environmental health officer had occurred recently the manager stated. Although the manager said that gas safety, electrical safety certificates were in place, copies of these were not available during this inspection. See requirement Nos. 3, 4 & 5 and recommendation No. 5. Hartford Hey DS0000006593.V262317.R01.S.doc Version 5.0 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 X X X X X 3 3 STAFFING Standard No Score 27 3 28 2 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X X 2 Hartford Hey DS0000006593.V262317.R01.S.doc Version 5.0 Page 23 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 OP7 Regulation 15 Requirement The registered person must ensure that the service user or their representative sign the care plans. (Outstanding requirement of 31.1.05 & 30.08.05 were not met) The registered person must ensure that all staff undertakes mandatory training and specialist training in line with residents needs. The registered person must undertake a full fire risk assessment and provide six monthly training in fire awareness for staff in line with the Statement of Purpose and Function. (Outstanding requirement of 30.08.05 was not met). The registered person must ensure that a quality assurance process is undertaken on an annual basis and a summary published. The registered person must ensure that information regarding safe working practices are held within the home. DS0000006593.V262317.R01.S.doc Timescale for action 30/12/05 2 OP30 18 30/01/06 3 OP37 23 30/12/05 4 OP33 24 30/01/06 5 OP38 13 30/12/05 Hartford Hey Version 5.0 Page 24 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 2 3 4 Refer to Standard OP7 OP7 OP28 OP30 Good Practice Recommendations The registered person should ensure that details are kept of residents’ wishes with regard to dying and death. The registered person should keep details of residents’ weights of each resident on individual records. The registered person should ensure that 50 of care staff obtains NVQ level II in Care. The registered person should ensure that the induction programme is reviewed in line with the specification from Skills for Care, which was formally the TOPPS organisation. The registered person should ensure that a plan is produced to show how the manager will obtain NVQ level IV in Care and Management. 5 OP31 Hartford Hey DS0000006593.V262317.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Hartford Hey DS0000006593.V262317.R01.S.doc Version 5.0 Page 26 - 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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