Inspection on 27/06/06 for Hartford Hey

This inspection was carried out on 27th June 2006.

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 01/11/05

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 Key Unannounced Inspection 09:30 27th June 2006 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.V290877.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. Hartford Hey DS0000006593.V290877.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Hartford Hey Address Manorial Road South Parkgate South Wirral Cheshire CH64 6US 0151 336 4671 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 Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places Hartford Hey DS0000006593.V290877.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st November 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. The fees at Hartford Hey are £440.00 per week. Optional extras include hairdressing, chiropody and newspapers. Hartford Hey DS0000006593.V290877.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The site visit took place over one day as part of the key inspection, which takes into account all evidence gathered from the last inspection of the service. Feedback was given to the acting manager at the end of this visit. The day was spent looking at care plans, policies and procedures and other documentation and discussions with service users, staff and the acting manager. The inspector spent three hours examining the information provided by the home before the site visit. Five relatives and two GP comment cards were received. What the service does well: What has improved since the last inspection? The management of the home has improved since the Deputy Manager took over in February 2006. She has worked hard in learning and developing into her new role. The main areas of improvement had been with the improvement of the care plans and mandatory training had also taken place for most staff members. The residents or their representative now sign the plan of care, to show their agreement with the care plan. Details are now kept of residents’ wishes with regard to dying and death. Information regarding residents’ weights are now kept on individual records. To ensure that residents are cared for, by staff that are trained and competent to do their jobs some mandatory training had been undertaken, however further training is required to ensure all staff are adequately trained. The induction programme had been reviewed in line with the specification from Skills for Care, which was formally the TOPPS organisation. Hartford Hey DS0000006593.V290877.R01.S.doc Version 5.1 Page 6 To ensure safe working practices a full fire risk assessment had been produced and six monthly training in fire awareness for staff is now completed in line with the Statement of Purpose and Function. Copies of certificates for fire, environmental heath, gas and electric are now kept within the home. 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.V290877.R01.S.doc Version 5.1 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.V290877.R01.S.doc Version 5.1 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. Standard 6 does not apply Quality in this area outcome is good. This judgement was made using available evidence including a visit to this service. Sufficient information is provided for residents to make a decision about moving into the home. A preassessment 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 confirmed that they had seen these documents. A full copy of the latest inspection report was available. A pre-assessment document was available for each service user, 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. Hartford Hey DS0000006593.V290877.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this area outcome is good. This judgement was made using available evidence including a visit to this service. 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 four residents’ care records were seen during this site visit. These were in individual folders, which were well presented and easy to read. Significant progress had been made since the previous visit to develop the care plans. 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. Two GP comment cards were received and they stated “they were satisfied overall with the care provide to their patients” and “it is always a pleasure to visit this home. The calls are always for genuine medical problems and I always receive prompt attention. They are well organised”. 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.V290877.R01.S.doc Version 5.1 Page 10 Medication records examined showed that this was recorded and administered appropriately. Medication was kept secure. A copy of the British National Formulary dated March 2004 and the Royal Pharmaceutical Society book entitled “ The Administration and Control of Medicines in Care Homes and Children’s Services” were available for reference. Staff confirmed that they received in house training on medication awareness prior to administering medication to service users. 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”. From surveys received relatives stated, “I couldn’t wish for a more caring and friendly place” and “the staff approach was excellent” and also “I am satisfied with the overall care provided and I am kept informed of important matters”. 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 issues are covered during induction and also independence and quality of life. Hartford Hey DS0000006593.V290877.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this area outcome is good. This judgement was made using available evidence including a visit to this service. 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. One of the service user files contained an activities record, describing what that person liked to do, what they didn’t like and what they used to like doing. It is recommended that this be completed for all service users. Visits from family and friends were noted in the daily records. 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. Relative’s surveys confirmed they were always made welcome by the staff and were offered refreshments. Hartford Hey DS0000006593.V290877.R01.S.doc Version 5.1 Page 12 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. See recommendation No. 1. Hartford Hey DS0000006593.V290877.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this area outcome is poor. This judgement was made using available evidence including a visit to this service. Policies are in place to ensure that residents are protected from abuse, neglect and self-harm. However none of the staff were trained in the Protection of Vulnerable Adults. EVIDENCE: The policy on complaints 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. Neither the Commission nor the home had received any complaints since the last visit to Hartford Hey. Through discussions with residents and from relative’s surveys, individuals were aware of the complaints procedure and who to direct their complaint to. Residents were confident that any complaint would be dealt with. 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 home and was accessible to staff. The acting manager had attended training on POVA but not the staff. Staff must receive POVA training so that vulnerable service users are protected from abuse. During discussions with the staff team they were able to describe what the term abuse meant and if they had any suspicions they would contact the acting manager. However they were not Hartford Hey DS0000006593.V290877.R01.S.doc Version 5.1 Page 14 fully able to describe the indicators of abuse or had any knowledge of the POVA policy or “No Secrets” guidance. See requirement No. 1. Hartford Hey DS0000006593.V290877.R01.S.doc Version 5.1 Page 15 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 & 26 Quality in this area outcome is good. This judgement was made using available evidence including a visit to this service. 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 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.V290877.R01.S.doc Version 5.1 Page 16 The home was clean, tidy and free from any unpleasant smells. A separate laundry room was seen, 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. Risk assessments have been carried out and the risks of scalding have been minimised. As a reminder to residents “Hot water” notices have been provided by every hot water tap. Hartford Hey DS0000006593.V290877.R01.S.doc Version 5.1 Page 17 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 Quality in this area outcome is poor. This judgement was made using available evidence including a visit to this service. The deputy manager provided clear leadership. Most records were maintained in a satisfactory manner. Staff must receive regular supervision and fully complete mandatory and specialist training as required. Service users are protected by the homes recruitment policy and practices. EVIDENCE: At the time of this site visit the agreed staffing levels were met and confirmed by the staff rota. The owner, 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. Five of twenty care staff had obtained NVQ level II in care. Four staff are currently undertaking NVQ II and two were due to start NVQ level II in care. Three staff have recently started NVQ level IV. Some staff confirmed they had completed NVQ training in care. Residents said, “the staff are very good” and “we are well looked after by the staff”. An induction programme was used at the home. During discussions staff confirmed that they had undertaken an induction process. The induction process was a basic format but since the last visit it had been reviewed in line Hartford Hey DS0000006593.V290877.R01.S.doc Version 5.1 Page 18 with the specification from Skills for Care, which was formally the TOPPS organisation. During this site visit three staff files were examined. These contained all preemployment checks, including references and Criminal Record Bureau checks. The home had an equal opportunities policy that stated it was committed to equal opportunities for all staff. It stated that equal opportunities would be used in recruitment of staff, recruitment publicity and staff development. Since the previous visit further development of mandatory training had taken place. Most staff had completed training in moving and handling, first aid, food hygiene and health and safety. However, all staff must undertake completion of mandatory training. Specialist training in line with the specific needs of the residents must also be undertaken. See requirement Nos. 2 & 3 and recommendation No. 2. Hartford Hey DS0000006593.V290877.R01.S.doc Version 5.1 Page 19 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, 32, 33, 35, 36 & 38 Quality in this area outcome is poor. This judgement was made using available evidence including a visit to this service. The health, safety and welfare of the service users are protected. The views of service users are not obtained to influence the running of the home. Staff are not fully supervised. EVIDENCE: The registered manager has resigned following a long period of sickness and the deputy manager has been acting as manager since February 2006. The acting manager is currently applying to become registered with the Commission and has applied for the post of manager. She has recently started NVQ IV. She currently holds NVQ II in care. During discussions with residents and information received by relatives it was felt the home was well run and that the acting manager and staff were very welcoming and friendly. This was confirmed during the site visit. From relatives surveys they confirmed that staff worked in a very friendly manner. Hartford Hey DS0000006593.V290877.R01.S.doc Version 5.1 Page 20 Policies and procedures seen were appropriate to the home. However, there were several files with many policies and procedures. It was difficult to know which policies were currently in use. It is recommended that current policies and procedures be arranged in one filing system and all other documents kept separately. The home had an equal opportunities policy that stated it was committed to equal opportunities for all staff and service users. During discussions with the acting manager regarding the service users of different faiths she said that she discusses this with them prior to admission to check if she can meet their needs. She stated that often people were now not practicing their faith and therefore did not require or desire any specific religious or cultural needs to be taken into account. The acting manager stated that a quality assurance process was not in place at this time. This must be developed and produced on an annual basis with a summary published for residents and other interested parties. A residents meeting had been held on 17th May and activities and food were discussed. This was the first meeting that had been held for some months. The acting manager said that she plans to hold these each month. Meetings must be held on a monthly basis, with records kept. The acting 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 acting manager holds some money for the residents. This is kept secure in the office. It is in individual wallets with records and receipts kept. The acting manager said that formal supervision is not undertaken. This must be completed at least six times a year with records kept. Day to day supervision was seen during the site visit and this was good. It is recommended that annual appraisals be undertaken. It is also recommended that regular staff meetings are held, with records kept. The acting manager stated that during the hand over session of each shift any changes in service users or other issues that arise are discussed. 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. A fire risk assessment of the home had been completed and all staff had received training in fire awareness. A visit from the environmental health officer had occurred recently. Gas safety, electrical safety certificates were current and copies of these were available during this site visit. Also seen were up to date records of fire alarm system tests and annual inspections of the hoist and passenger lift. See requirement Nos. 4, 5, 6 & 7 and recommendation Nos. 3, 4, 5 & 6. Hartford Hey DS0000006593.V290877.R01.S.doc Version 5.1 Page 21 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 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 2 2 X 3 2 X 3 Hartford Hey DS0000006593.V290877.R01.S.doc Version 5.1 Page 22 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. 2. Standard OP18 OP30 Regulation 13 18 Requirement The registered person must ensure that all staff receives POVA training. The registered person must ensure that all staff undertakes mandatory training. Requirements were made on 1st November 2005 and 3rd February 2006. The registered person must ensure that staff undertake specialist training in line with residents needs. Requirements were made on 1st November 2005 and 3rd February 2006. The registered person must ensure that residents meetings are held each month. The registered person must ensure that a quality assurance process is undertaken on an annual basis and a summary published. Requirements were made on 1st November 2005 and 3rd February 2006. DS0000006593.V290877.R01.S.doc Timescale for action 30/09/06 30/09/06 3. OP30 18 30/09/06 4. 5. OP32 OP33 24 24 30/09/06 30/09/06 Hartford Hey Version 5.1 Page 23 6. OP33 12 7. OP36 18 The registered person must ensure that policies and procedures are in line with current guidelines and reviewed annually. The registered person must ensure that each staff member receives regular formal supervision. 30/09/06 30/09/06 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. 5. 6. Refer to Standard OP12 OP28 OP31 OP32 OP33 OP36 Good Practice Recommendations The registered person should produce an activities record sheet for all service users. The registered person should ensure that 50 of care staff obtains NVQ level II in Care. The registered person should ensure that a plan is produced to show how the manager will obtain NVQ level IV in Care and Management. The registered person should ensure that regular staff meetings are held with records kept. The registered person should ensure that the policies and procedures are amalgamated into one file for ease of use. The registered person should ensure that annual appraisals are undertaken. Hartford Hey DS0000006593.V290877.R01.S.doc Version 5.1 Page 24 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.V290877.R01.S.doc Version 5.1 Page 25 - 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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