Inspection on 06/06/06 for Hartlands Residential Home

This inspection was carried out on 6th June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 02/03/06

Hartlands Residential Home 23/09/05

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 Pat Scott Unannounced Inspection 6th July 2006 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.V296963.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. Hartlands Residential Home DS0000020676.V296963.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hartlands Residential Home Address Whitehall Street Abbey Foregate Shrewsbury Shropshire SY2 5AD 01743 356100 01743 341268 declan.roche@btinternet.com None D Roche Limited 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) Mrs Ann Sargeant Care Home 31 Category(ies) of Dementia (31) registration, with number of places Hartlands Residential Home DS0000020676.V296963.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd March 2006 Brief Description of the Service: Hartlands Care Home is owned by D. Roche Limited and registered to provide residential care for 31 Residents, with dementia, who are aged 65 years and over. Built in the Victorian period, the Home is set close to Shrewsbury Town Centre, is easily accessible by public transport, and just a short walk from Shrewsbury Abbey and the River Severn. Accommodation is provided on two floors, with access via a passenger lift, and comprises mainly single bedrooms many with en-suite toilet facilities. The Home benefits from a spacious and private garden at the rear, with ample parking facilities to the front of the property. D Roche Ltd make their services known to prospective service users in: The Statement of Purpose and Service Users Guide contained in an information pack. The inspection report is mentioned in the statement of purpose and how a copy can be obtained. The care home rates are reviewed annually on 1st April each year and service users are notified one month in advance. The only additional charges to service users are for hairdressing, newspapers, activities and escorting to hospital for routine appointments. This is clearly laid out in the terms and conditions. Fees for Hartlands as of 1st April 2006 are: £380. All service users pay monthly. Hartlands Residential Home DS0000020676.V296963.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A range of evidence was used to make judgements about this service. This includes: information from the provider, staff records kept in the home, medication records, discussion, where possible, with people who use the service, discussions with the staff team, discussion with the manager, tour of the premises, previous inspection reports, quality assurance process, Fire Authority reports, Environmental Health Office reports, observation of care experienced by people using the service. As the service users accommodated have varying types of dementia outcome judgements are based more on observation and written evidence. Service user views are recorded where appropriate. What the service does well: What has improved since the last inspection? Care planning has always met the national minimum standards. The staff have changed the format to make it more clear, readable and so service users (if able) and their families can understand the information better. The provider has employed an activities co-ordinator to complement the staff team. This has allowed for more time for activities and stimulation enabling service users to be included in decisions about how they spend their day. Hartlands Residential Home DS0000020676.V296963.R01.S.doc Version 5.2 Page 6 A quality assurance process has been implemented which seeks the views of service users and their relatives, the results of which are fed back to staff. It is intended that this will also be communicated to relatives and prospective service users via a newsletter. 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. Hartlands Residential Home DS0000020676.V296963.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 Hartlands Residential Home DS0000020676.V296963.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents and their representatives have the information needed to choose a home which will meet their needs They have their needs assessed and a contract which clearly tells them about the service they will receive. EVIDENCE: Discussion with the care manager demonstrated that the service Hartlands provides is carefully explained to them when they enquire about a vacancy. An individual member of staff is allocated to give them information, special attention and enable them to ask questions about life in the home. The information pack provides written information to reinforce this. The manager is planning to introduce a newsletter. This will provide an account of the quality of life and experience for service users living at the home. Hartlands Residential Home DS0000020676.V296963.R01.S.doc Version 5.2 Page 9 Hartlands admits people with dementia and provides staff with training and guidance to enable them to be responsive to individual needs. Staff have access to training materials. Care plans contained full needs assessments that were conducted prior to service users being admitted. These documents confirmed that the assessment had been conducted professionally and sensitively and had involved the family or representative of the prospective service user. Hartlands Residential Home DS0000020676.V296963.R01.S.doc Version 5.2 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 Quality in this outcome area is excellent . This judgement has been made using available evidence including a visit to this service. The health and personal care, which a service user receives, is based on their individual needs thus promoting good health. Staff have an excellent attitude to their work and the principles of respect, dignity and privacy are put into practice. EVIDENCE: Discussions with staff showed that the home has a strong ethos of involving service users in all aspects of their life. The care plans that were read had improved further and were very clearly written. Information from the improved initial assessments had been written into the plan of care. Care plans are reviewed monthly by staff. Placement reviews take place 6 monthly and were quite clear about the agreed care with signatures of the service user, family and staff. Feed back and involvement is a continuous process at Hartlands. All service users have some form of dementia and staff were observed to spend time with individual services users to ensure they understood decisions and Hartlands Residential Home DS0000020676.V296963.R01.S.doc Version 5.2 Page 11 actions. The manager intends to promote the keyworker system more robustly so that relationships between key staff and individuals is enhanced. Care plans demonstrated that staff actively promote the service users’ right of access to the health service both within the home and the community. Appointments are planned or arrangements are made for professionals to visit frail service users. The home operates an efficient medication system and staff spoken with understood their roles and responsibilities. Regular audits confirm that policy is put into practice. Induction training covers privacy and dignity. Staff were seen to respect service users privacy when dealing with personal care. They had patience with those who were confused or agitated and staff allowed them to go at their own pace in all aspects of care. One service user commented about her personal care: “I look lovely today, done up a treat.” Hartlands Residential Home DS0000020676.V296963.R01.S.doc Version 5.2 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): 12,13,14,15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users are able to choose their life style, social activity and keep in contact with family and friends. Social and recreational activities meet service users’ expectations. Residents receive a healthy, varied diet according to their assessed requirement and choice. EVIDENCE: Service users, who were able to give an opinion, were very complimentary about the food provided. They were not all able to state what they had chosen for lunch but some said that staff come round and ask them their preference from the menu each day. The menu records show that this is consistently happening with information kept about what food had been chosen and any special diets catered for on a daily basis. The home has a main kitchen and a small, well equipped, kitchenette. The catering staff are to attend a day on nutritional training in June 2006. The activities co-ordinator is fairly new in post and has improved this aspect of care. Service users are enabled to enjoy a full and stimulating life style with a variety of options to choose from. The co-ordinator seeks the views of service users and considers their varied interests and abilities and concentration span Hartlands Residential Home DS0000020676.V296963.R01.S.doc Version 5.2 Page 13 when planning and arranging activities. She keeps a detailed record of all that takes place for each individual. This records show that she takes into account the diversity of each person into consideration in her activity planning and that her input makes a difference to people’s lives. The hairdresser was in the home and service users were asked individually what style they preferred. Hartlands Residential Home DS0000020676.V296963.R01.S.doc Version 5.2 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users have access to a robust, effective complaints procedure that enables them or their supporters views to be listened to and acted upon. Staff are provided with induction and on-going training regarding adult protection. This provides staff with the relevant knowledge to safeguard service users from many types of abuse. EVIDENCE: The CSCI has not received any complaints about the home. Nor have their been any adult protection issues. Service users were seen to speak easily to staff and were comfortable in their company. Staff are skilled in communicating with people with dementia to ascertain their well being. The reviews that take place give a forum for concerns to be aired. Hartlands Residential Home DS0000020676.V296963.R01.S.doc Version 5.2 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 outcome area is good. This judgement has been made using available evidence including a visit to this service. The physical design and layout of the home enables residents to live in a safe, well-maintained and comfortable environment, which encourages independence. EVIDENCE: Rooms entered into were personalised according to individual wishes and tastes. Staff stated that service users share by choice and agreement which the care manager agreed could be recorded in the care plan. Communal areas were clean and comfortable. Service users have access to a large well maintained garden. The laundry is equipped to deal with ordinary and soiled linen. Hartlands Residential Home DS0000020676.V296963.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 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 outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to fulfill the aims of the home and meet the changing needs of residents. EVIDENCE: The file of a new recruit on induction in the home was seen which showed that robust recruitment practices are carried out. The manager was providing induction to two new members of staff. This is seen as an extension to the recruitment process. Staff records were seen regarding induction and training. The induction standards having been amended to meet those for ‘Skills for Care’. Staff confirmed that training is provided and there are many equal opportunities to improve themselves for the benefit of service user care. Senior staff have undertaken qualifications beyond the basis requirements, e.g. both care managers have achieved NVQ level 4 and are to go on to develop their interest and skill in palliative care. The manager stated it is her intention to have had all staff trained in dementia care by the end of 2006. Other training completed or planned includes; first aid, manual handling, nutrition in the elderly. Hartlands Residential Home DS0000020676.V296963.R01.S.doc Version 5.2 Page 17 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,,35,36,37,38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The ethos of the home is based on openness and respect with effective quality assurance systems developed by qualified, competent management to achieve good outcomes for service users in all areas of care. EVIDENCE: The manager and her senior staff (care managers) have attended many training events and updates to complement their roles within the home. Through discussions with the care manager on duty, she demonstrated that she is confident in her ability to lead a staff team whilst being fully aware of the individual needs of the service users living at Hartlands. Hartlands Residential Home DS0000020676.V296963.R01.S.doc Version 5.2 Page 18 The registered manager seeks to continually improve her performance through research into best practice in elderly and dementia care. The home actively encourages service users, where able, to manage their own money. One service user likes to go out daily to the local shop. Staff were seen to deal with his request for his money in a polite and safe manner. Accurate records are kept. Equality and diversity for service users were seen to be promoted throughout the home within the assessments, care plans and activities. Equality for staff is promoted through the opportunities for training at all levels. Quality assurance takes place throughout the service in both a formal and informal manner. Meetings, surveys, audits, day to day contact all provide records to show that service user satisfaction is at the heart of the service. The home keeps records to show that the health and safety of service users is promoted and protected. Hartlands Residential Home DS0000020676.V296963.R01.S.doc Version 5.2 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 3 X 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 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 4 4 3 X 3 3 3 3 Hartlands Residential Home DS0000020676.V296963.R01.S.doc Version 5.2 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. Standard Regulation Requirement Timescale for action 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 Hartlands Residential Home DS0000020676.V296963.R01.S.doc Version 5.2 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. 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