Inspection on 07/06/06 for Hartlands Rest Home

This inspection was carried out on 7th 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 Rest Home 02/10/08

Hartlands Rest Home 09/01/06

Hartlands Rest Home 19/04/05

Hartlands Rest Home 13/12/04

Hartlands Rest Home 05/05/04

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

CARE HOMES FOR OLDER PEOPLE Hartlands Rest Home 57 Salop Road Oswestry Shropshire SY11 2RJ Lead Inspector Pat Scott Unannounced Inspection 7th June 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 Rest Home DS0000020680.V296965.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 Rest Home DS0000020680.V296965.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hartlands Rest Home Address 57 Salop Road Oswestry Shropshire SY11 2RJ 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) 01691 658088 NONE declan.roche@btinternet.com None Mr Declan Joseph Roche Mrs Rita Marion Clarke Care Home 17 Category(ies) of Dementia (17) registration, with number of places Hartlands Rest Home DS0000020680.V296965.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th January 2006 Brief Description of the Service: Hartlands is a privately owned care home registered to provide care for a maximum of 17 older people with mental health problems. The original house has been extended and offers accommodation on ground and first floor levels to provide 9 single and 4 double bedrooms. The first level of the home can be accessed by a shaft lift. The home has a large lounge and separate dining room. There is an outside seating area at the rear of the home. The home is situated in the town of Oswestry and is within walking distance of the town centre, providing access to the local church, shops and other amenities. There is a railway station three miles away at Gobowen, which links to all main lines. D Roche Ltd make their services known to prospective service users in: The Statement of Purpose and Service Users Guide. Large print copies are available on request. The inspection report is mentioned in the service users guide 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 extra hairdressing, some activities, chiropody 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 Rest Home DS0000020680.V296965.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 and a relative, discussions with the staff team, discussion with the manager and a visiting professional, 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. A visiting professional and a relative were spoken to following the review of a service user’s placement. What the service does well: What has improved since the last inspection? Thermostatic valves are in place on all hot water outlets. Some decoration and renewal of carpets has taken place. Plans are in place to improve the garden area to the side of the home. Hartlands Rest Home DS0000020680.V296965.R01.S.doc Version 5.2 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. Hartlands Rest Home DS0000020680.V296965.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 Rest Home DS0000020680.V296965.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: The statement of purpose and service users guide were reviewed October 2005. This is clear, jargon free and easy to understand. Receipt is signed for to demonstrate that relatives have a clear understanding of what they can expect from the home. 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. Hartlands Rest Home DS0000020680.V296965.R01.S.doc Version 5.2 Page 9 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. A visiting relative commented that the pre-admission process had been conducted very professionally and tactfully. Hartlands Rest Home DS0000020680.V296965.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 a good attitude to their work and the principles of respect, dignity and privacy are put into practice. EVIDENCE: All service users have a robust care plan and four were examined as part of ‘case tracking’. These were very well written and up to date and had been regularly reviewed. A visiting Community Psychiatric Nurse commented that plans are shared with herself and the family and that communication between all parties is very good. Hartlands is a small home and employs regular staff, but the quality of the care plan recording is such that it could be used in an emergency by people who are not familiar with its content. Hartlands Rest Home DS0000020680.V296965.R01.S.doc Version 5.2 Page 11 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. A visitor also spoke of how the “difficult behaviour of her husband had been explained to her” and that she found more comfort in understanding the problems and being included in how the staff managed them. Staff keep up to date with training and the visiting professional confirmed she provides training on any elements of clinical need that staff are unsure of. The systems to receive, store, administer and dispose of medication in the home are robust and followed according to the home’s policies. Staff were seen and heard to respect service users’ privacy and dignity. They were allowed to go about their usual routines and sit where they liked. The staff were seen to constantly interact with service users and it was evident that relationships are close but still professional. Hartlands Rest Home DS0000020680.V296965.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): 12,13,14,1,5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are able to participate in social activity and keep in contact with family and friends. Residents receive a healthy, varied diet according to their assessed requirement. EVIDENCE: A new cook was undergoing an induction as it was her first day. The menu is kept in the kitchen and offers a choice of meal with the exception of 2 days of the week when it is a roast meal. The manager stated that they could have something else if they didn’t fancy the roast option. Staff stated that they are aware of service users likes and dislikes so they do not routinely ask them their preference each day and that they may forget what they had ordered anyway. Social activities take place within the home on a daily basis. Escorted trips into the town are encouraged. The home has a leisure committee which organises day trips out into the community on a frequent basis. Some service users had recently enjoyed a trip on the canal at Llangollen. Photographs are taken of events and shared with service users and visitors. Hartlands Rest Home DS0000020680.V296965.R01.S.doc Version 5.2 Page 13 Staff commented that there is a lively ‘social feel’ to the home. A visitor said that that there is always something going on and that Hartlands was a very friendly, happy place. Hartlands Rest Home DS0000020680.V296965.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 Rest Home DS0000020680.V296965.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. Hartlands is comfortable and homely and service users live in a safe, wellmaintained environment. EVIDENCE: Rooms entered into were personalised according to individual wishes and tastes. The manager stated that service users share by choice. Communal areas were clean and comfortable. Service users have access to a garden area which the manager stated will be improved. The laundry is not equipped to deal with soiled linen. Staff implement procedures to minimise cross infection but improving this facility could reduce the risk further. The manager stated that this aspect of the service had been identified as an area for improvement. Hartlands Rest Home DS0000020680.V296965.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 fulfil the aims of the home and meet the changing needs of residents. EVIDENCE: The file of a recently recruited member of staff was seen which showed that robust recruitment practices had been carried out. This staff member confirmed that induction had been provided. Staff confirmed that training is provided and there are many equal opportunities to improve themselves for the benefit of service user care. The home accesses the facilities at the local college for staff to update their skills. A visitor commented that staff are knowledgeable about the needs of people with different kinds of dementia and they deal with difficult problems in a sensitive way which puts you at ease. Hartlands Rest Home DS0000020680.V296965.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): 31,32,33,35,38 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 manager to achieve good outcomes for service users in all areas of care. EVIDENCE: The registered manager has the required qualification and experience to meet the standards and aims and objectives of the home. Through discussion she demonstrated that she manages the service efficiently, providing quality care to service users. She seeks to develop the service, encouraging staff to improve their skills to create a confident staff team. Other professionals and Hartlands Rest Home DS0000020680.V296965.R01.S.doc Version 5.2 Page 18 staff commented that the manager is a good leader who consistently provides a good quality service. The home actively encourages service users, where able, to manage their own money. 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 recent survey results showed that people thought the service was above average or excellent with some very positive written comments about the staff and the care provided. The home keeps records to show that the health and safety of service users is promoted and protected. The fire records were seen as an example of this. Hartlands Rest Home DS0000020680.V296965.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 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 2 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 X X 3 Hartlands Rest Home DS0000020680.V296965.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. 1 Standard OP26 Regulation 13(3) Requirement The registered provider must install a washing machine with a sluice wash to minimise cross infection. Timescale for action 07/09/06 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 Refer to Standard OP15 Good Practice Recommendations To explore ways of demonstrating service user choice with regard to meal preferences. Hartlands Rest Home DS0000020680.V296965.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. Extracts may not be used or reproduced without the express permission of CSCI Hartlands Rest Home DS0000020680.V296965.R01.S.doc Version 5.2 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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