Inspection on 23/09/05 for Hartlands Residential Home

This inspection was carried out on 23rd September 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

Hartlands Residential Home 06/06/06

Hartlands Residential Home 02/03/06

Hartlands Residential Home 08/02/05

Hartlands Residential Home 08/06/04

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

CARE HOMES FOR OLDER PEOPLE Hartlands Residential Home Whitehall Street Abbey Foregate Shrewsbury Shropshire SY2 5AD Lead Inspector Gurinder Cheema Announced Inspection 23rd September 2005 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Hartlands Residential Home DS0000020676.V254042.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. Hartlands Residential Home DS0000020676.V254042.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Hartlands Residential Home Address Whitehall Street Abbey Foregate Shrewsbury Shropshire SY2 5AD 01743 356100 01743 341268 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) D Roche Limited Mrs Ann Sargeant Care Home 31 Category(ies) of Dementia (31) registration, with number of places Hartlands Residential Home DS0000020676.V254042.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th February 2005 Brief Description of the Service: Hartlands care home is registered to provide care for the elderly, male and female, over 65 years of age who have some form of dementia. The home is an old Victorian building with a spacious and private garden at the rear and ample parking facilities at the front. The house is set close to Shrewsbury town centre, is easily accessible by public transport and only a short walk away from the Abbey and river. Hartlands Residential Home DS0000020676.V254042.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the homes first annual inspection of the year. Care homes are inspected at least twice a year. The inspection was announced and took place on September 23rd 2005 between 10:00am and 1:15pm. The registered provider, manager and staff on duty were all very welcoming and helpful throughout the inspection. Only one of the National Minimum Standards inspected was not met and the overall quality of care provided was found to be very good. Written comments and feedback via questionnaires were sought prior to the inspection from a number of individuals. These included: Service users, staff, General Practitioners, Health and Social care professionals and service users’ carers. Mainly questionnaires from relatives and 4 from Service users were received back and these were all found to be positive. The care home has a history of meeting National Minimum Standards and providing a good service for people; consequently on this occasion mainly those standards identified as “key” by CSCI have been inspected. What the service does well: Information available for service users is good. Personal care needs are assessed and met, with each service user having their own care plan. These are detailed and appropriately documented giving clear instructions to staff on service users individual care needs. These are also accessible to all service users or their representatives. A number of service users were met, both in private and in groups, and where possible they expressed satisfaction with the care they are receiving. Three family members were also met in private. The comments received were very positive and included: “My mum couldn’t have better care” “The care at Hartlands is exceptional” “More than satisfied, very impressed – excellent caring staff” Risk assessments are comprehensive and information regarding individuals is provided to staff before they begin caring for the individual. The home have not had a formal complaint made for some time however they did have an anonymous letter of complaint left at the door. This was found to have been properly investigated, recorded and documented in a central complaints file. Hartlands Residential Home DS0000020676.V254042.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Generally this inspection was positive and found the overall service delivery to be very good with clear and concise records being kept. There is some improvement required however in the reviewing of service user care plans. It is recommended that the home conduct formal assessment reviews, at least once a year, where all relevant parties are invited to attend and that the monthly reviews are more detailed to accurately reflect changes. One of the toilets on the ground floor opens outwards to the corridor and there are limited handrails around the building generally. Both of these points need to be risk assessed and actioned accordingly. A comment received back from a relative of a service user highlighted that the carpets in certain areas needed replacing. This was picked up discussed at the inspection where the provider gave reassurance that it was due to be actioned by May 2006. Please contact the provider for advice of actions taken in response to this Hartlands Residential Home DS0000020676.V254042.R01.S.doc Version 5.0 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Hartlands Residential Home DS0000020676.V254042.R01.S.doc Version 5.0 Page 8 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 Hartlands Residential Home DS0000020676.V254042.R01.S.doc Version 5.0 Page 9 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): 3 The home has a satisfactory and functional admissions procedure proving an effective needs assessment and evaluation of suitability for both privately funded residents and those placed by the local authority. EVIDENCE: The Registered Manager, or her deputy, undertakes a pre-admission assessment of potential Service users prior to them moving in. The process of pre-admission assessment is outlined for the service user in the Guide. Four residents’ files were inspected, of which one was a recent admission. These were found to contain detailed assessments and showed that they were completed before admittance. This was confirmed further from discussions held with residents’ relatives. Relatives spoken to also confirmed that trial visits had taken place before moving into the home. Hartlands Residential Home DS0000020676.V254042.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 and 10 Staff are sensitive to the individual needs of each service user and meet these in a professional manner. There is a clear and consistent care planning system in place. This can be further improved upon by regular reviews that will provide staff with the information they require to meet residents’ needs. EVIDENCE: Four samples of Individual plans of care completed for all residents were inspected. They identify individual needs and show how these are addressed by the home. The inspection of these care plans showed that they are reviewed initially at four weeks and then about annually. It is recommended that the home conduct formal assessment reviews, at least once a year, where all relevant parties are invited to attend and that the monthly reviews are more detailed to accurately reflect changes. All care plans inspected were consistent and very detailed in that they contained regular and accurate recording and were individually geared depending on the needs of that particular resident. Hartlands Residential Home DS0000020676.V254042.R01.S.doc Version 5.0 Page 11 All resident files inspected contained comprehensive medical detail including GP and visiting Community Nurse notes which showed that residents access a range of medical practices / resources in the Shrewsbury area. The home has a comprehensive policy and complementary procedures relating to the administration and storage of medication. Medication is administered through a ‘blister pack’ system. Only staff appropriately trained administer medication to residents. Records kept were observed to be satisfactory, and include a system of recording all medicines as they are received and returned or disposed of. Comments received from Service user and relatives confirmed that staff are very caring and always treat them with respect. Residents’ files include details about personal likes and dislikes and preferred form of address. No unreasonable limitations are placed upon residents receiving guests or family visitors. Residents usually receive GP visits in the privacy of their own room. The homes Service User Guide includes detail about its promotion of privacy, choice, fulfilment, rights and independence for residents Hartlands Residential Home DS0000020676.V254042.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): 12,13,14 and 15 Staff work in close liaison with service users and their relatives to understand their individual lifestyles and preferences in order to promote choice and control over their lives. EVIDENCE: The home incorporates a range of gentle activities into the daily routine to suit the needs and preferences of the residents. This is usually done through an activities co-ordinator who is currently on maternity leave. However, other staff members have taken on these responsibilities whilst management try and resolve the situation. Residents can choose either to become involved in the entertainment or retire to another lounge or the privacy of their own rooms. Residents have no restrictions put on their access to relatives. Relatives are encouraged to visit the home or take residents out. Residents spoke of family members visits and of the support they continue to receive. Hartlands Residential Home DS0000020676.V254042.R01.S.doc Version 5.0 Page 13 Families usually handle the financial affairs of their relatives. Where this is not possible the home provides a system in order to safeguard this aspect of their care. Service users able to comment said that they are able to choose where they go and how they spend their day. But many are mentally frail and need direction from staff to structure their lives. A number of the residents at Hartlands have personalised their own rooms, many bringing their own furniture with them to the home. All residents/representatives are given information about and have access to their personal files. The residents/relatives spoken to were complimentary about the quality and quantity of food presented to them. Some residents were observed receiving help with eating when necessary and being treated with respect and dignity. The home provides a range of freshly prepared nutritious meals for the residents. These include special diets catering for individual needs. Hartlands Residential Home DS0000020676.V254042.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 and 18 Service users are protected from abuse by the home’s policies and procedures. EVIDENCE: The home has not had a direct formal complaint made for some time. However, they did have an anonymous letter of complaint left at the door. This was found to have been properly investigated, recorded and documented in a central complaints file. The home has policies and procedures relating to the protection of vulnerable adults. These mitigate against the potential for any abuse of residents. Hartlands Residential Home DS0000020676.V254042.R01.S.doc Version 5.0 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 and 26 The standard of the environment is generally good however some risk assessments are needed in order to provide service users with a safe wellmaintained environment to live in. EVIDENCE: Hartlands Residential Home DS0000020676.V254042.R01.S.doc Version 5.0 Page 16 The home is located in a residential area of Shrewsbury, with pleasant grounds and good access. All bedrooms have en-suite facilities and are located on the ground or first floor. Communal areas include three lounges, a dining area and a spacious conservatory. The home opens to the rear to a well-presented garden. One of the toilet doors on the ground floor opens outwards into the corridor and is therefore a potential for a hazard. There are also limited handrails around the building generally. Both of these points need to be risk assessed and actioned accordingly. The carpets in certain areas are in need of attention however the provider has plans to replace these by May 2006. Hartlands Residential Home DS0000020676.V254042.R01.S.doc Version 5.0 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): There appeared to be satisfactory numbers of competent staff on duty to meet the identified care needs of the residents. EVIDENCE: These standards were not inspected fully on this occasion. However, there appeared to be an adequate number of staff on duty and those spoken to showed knowledge and understanding of the needs and wishes of the residents. Residents and relatives spoken to all commented positively about the staff and stated that they are very caring and responsive to their needs. Hartlands Residential Home DS0000020676.V254042.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 38 Health, safety and welfare of service users and staff are promoted by safe working systems in place. EVIDENCE: There is evidence of regular checks and maintenance of the equipment used in the home including electrical wiring and Gas Safety. Hartlands Residential Home DS0000020676.V254042.R01.S.doc Version 5.0 Page 19 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 4 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 x x x x x x 3 STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x x x x x 3 Hartlands Residential Home DS0000020676.V254042.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? NO 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 19 Regulation 23(1)(2) Requirement The Registered Manager must conduct risk assessments on the toilet door that opens outwards and for the need to have handrails in corridors. These must then be actioned accordingly. Timescale for action 31/10/05 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 7 Good Practice Recommendations That the home conduct formal assessment reviews, at least once a year, where all relevant parties are invited to attend and that the monthly reviews are more detailed to accurately reflect changes. That worn or faded carpets are replaced. 2 19 Hartlands Residential Home DS0000020676.V254042.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE 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 Hartlands Residential Home DS0000020676.V254042.R01.S.doc Version 5.0 Page 22 - 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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