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Inspection on 22/07/08 for Haslington Residential Home

Also see our care home review for Haslington Residential Home for more information

This inspection was carried out on 22nd July 2008.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Residents are supported by motivated, skilled and well trained staff. The manager is proactive in ensuring all residents receive an individual service based on their aspirations, wishes and assessed needs. Residents spoke about being happy at the home, and feel valued and cared for. Relatives said they were impressed by the staff, and feel their relatives are safe, cared for, supported and happy.

What has improved since the last inspection?

All medication is appropriately stored. Care staff have received adult protection training.

CARE HOMES FOR OLDER PEOPLE Haslington Residential Home Cobham Terrace, Bean Road Greenhithe Kent DA9 9JB Lead Inspector Sarah Montgomery Unannounced Inspection 14:00p 22 and 23rd July 2008 nd 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 Haslington Residential Home DS0000031967.V367472.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. Haslington Residential Home DS0000031967.V367472.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Haslington Residential Home Address Cobham Terrace, Bean Road Greenhithe Kent DA9 9JB 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) 01322 383229 01322 380556 Haslingtonhome@aol.com Mrs Carol Anne Jansz Mr Edward Raphael Jansz Frances Maynard Care Home 46 Category(ies) of Dementia - over 65 years of age (0), Old age, registration, with number not falling within any other category (0) of places Haslington Residential Home DS0000031967.V367472.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Dementia - over 65 years of age (DE(E) The maximum number of service users to be accommodated is 46. Date of last inspection 24th September 2007 Brief Description of the Service: Haslington Residential Home provides residential accommodation for up to 46 older people with dementia requiring personal care. Following the completion of a major extension and refurbishment of the original building there are now 46 single bedrooms, of which 32 have en-suite facilities. Bedrooms are situated on the ground, first and second floors with access assisted by two passenger lifts. All rooms used by residents are connected to the nurse call alarm system. Each floor has sitting and dining facilities. The home has a range of communal WCs, bath and shower (wet) rooms. The home is staffed 24 hours, including four awake staff at night. The home is located near to the Bluewater shopping complex. Rail and bus services operate nearby. Residents, visitors and staff have access to newly landscaped terraces. On and off site car parking is available. A copy of the latest inspection report is kept in the dining room on the 2nd floor. Current fees range from £410.82 to £546.00 per week. Additional charges are payable for chiropody, hairdressing, toiletries, individual newspapers, dry cleaning, some external activities, escorting to hospital outpatient appointments and special equipment. Current activities include musical bingo, seasonal planting, quizzes, sing-a-longs, bowls and trips to Bluewater for coffee. A monthly religious service also takes place. Haslington Residential Home DS0000031967.V367472.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place on the 22nd and 23rd July 2008. Evidence was gathered by inspection of policies and procedures, care records, talking with management, staff and residents, observation of working practice, and inspection of the environment. All key standards were inspected, and were judged as either meeting or exceeding the required standard. There are no requirements or recommendations. This home has been assessed as excellent, and has a 3 star rating. What the service does well: What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Haslington Residential Home DS0000031967.V367472.R01.S.doc Version 5.2 Page 6 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 Haslington Residential Home DS0000031967.V367472.R01.S.doc Version 5.2 Page 7 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 3, 4 and 5. Standard 6 does not apply. Quality in this outcome area is excellent. Prospective residents can be confident their needs will be assessed prior to moving into the home, and that the home will meet these assessed needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: To assess these standards evidence was gathered from reviewing documentation, discussion with the manager, and discussions with individual residents and a relative. Pre assessment documentation for three residents was inspected. Information contained within the pre assessments demonstrated that the home conducts a thorough assessment of need prior to admission, considering the needs of prospective residents with regard to; personal care, health, mental health, communication, medication, diet, sleep patterns, identified risks, religion, and cultural needs. The home always ensures that they gather as much information Haslington Residential Home DS0000031967.V367472.R01.S.doc Version 5.2 Page 8 as possible from the resident, their family and any relevant professional. Most assessments are conducted jointly with a health or mental health professional. Residents are offered placements in accordance to their assessed needs, and this may be on the ground floor of the home – least dependent, the middle floor – higher dependency, or top floor – medium dependency. Several residents were spoken with. Without exception, all residents expressed positive feelings about the home, the staff, and fellow residents. Two relatives spoken with were very positive about the home, and expressed satisfaction with the admission process, and the care provided to their relative once placed in the home. The home strongly encourages prospective residents and their families and/or representatives visit the home prior to making a decision about moving in. Haslington Residential Home DS0000031967.V367472.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 and 10. Quality in this outcome area is excellent. Residents can be confident they have individual care plans, which fully set out their support needs, including medication. This judgement has been made using available evidence including a visit to this service. EVIDENCE: To assess these standards, care plans, risk assessments, medication policies and procedures were inspected, and staff and residents were asked about the provision of support and care. All residents have individual care plans and risk assessments based on their individual assessed support needs. All care plans had evidence of review, demonstrating the home’s ability to continually reassess and recognise the changing needs of residents. Support guidelines for staff are clear, and staff spoken with demonstrated knowledge and competence when questioned about the support needs of individual residents. Haslington Residential Home DS0000031967.V367472.R01.S.doc Version 5.2 Page 10 Health care plans are very detailed, and include specific support needs and wishes of residents. All healthcare appointments, including outcomes, are recorded, and if necessary health care plans are amended and updated following consultation with healthcare professionals. During the inspection staff were observed supporting residents in with respect, and were seen to attend to residents needs in a way which upheld their privacy and dignity. Medication protocols are excellent. There are clear pathways of responsibility, which ensures the safety of residents. Medication is stored correctly, and staff are clear of their roles and responsibilities with regard to storage and administration of drugs. Residents spoken with indicated they felt supported and cared for by staff. It was clear that the staff and residents have positive relationships based on trust and respect, and that the residents feel their support needs are being addressed by staff in a sensitive, consistent and caring way. Haslington Residential Home DS0000031967.V367472.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 and 15. Quality in this outcome area is excellent. Residents benefit from being supported and encouraged to make positive decisions about their lifestyle choices. This judgement has been made using available evidence including a visit to this service. EVIDENCE: In assessing this standard, assessment documentation regarding personal wishes and aspirations was looked at, and discussions were held with the manager, staff and residents. It was clear from discussion with the manager, and by observing the working practice of staff that a great deal of thought and research has gone into providing opportunities for residents with regard to lifestyle choices. Staff spoke several times of not being ‘task led’, and sought to maximise their time with residents, supporting them to participate in meaning activities, or sitting talking with them. Haslington Residential Home DS0000031967.V367472.R01.S.doc Version 5.2 Page 12 Staff and management, after consultation with residents and their representatives, have sought to provide lifestyle activities that residents have previously participated in. to this aim, residents are encouraged to participate in household tasks such as folding laundry, hanging out washing, gardening, and using a small kitchen to make and clear away drinks. Residents were observed doing these tasks and it was clear that having a sense of responsibility and purpose was having a positive affect on their wellbeing. Other activities observed during the inspection included listening to music, dancing, reading and talking. Residents spoken with said they enjoyed living at the home, and told the inspector there was ‘always something to do’. The home has an open door policy for family and friends. Two relatives spoken with said they were always made to feel welcome at the home, and that there views on their relatives care were listened to and acted upon. Relatives frequently take meals at the home, and stay all day. Dietary needs for all residents are assessed. Residents spoke highly of the quality and quantity of food. Each floor of the home has a dining area. These areas are spacious and pleasantly decorated. Residents can choose whether to eat in their rooms or in the dining room. Menus viewed demonstrated that residents have at least two choices at each meal, and that all meals are balanced and nutritious. A selection of individual daily notes were read. These notes indicate that residents make choices and decisions on a daily basis, and that staff support residents to lead active and fulfilling lives. Haslington Residential Home DS0000031967.V367472.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18. Quality in this outcome area is good. Residents can be confident their complaints will be listened to and acted upon, and that they will be protected from harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a complaints procedure, which is displayed, in the entrance hall. Additionally, all residents and their representatives are given a copy of the home’s statement of purpose and service user guide, which also includes a copy of the complaints procedure. Relatives spoken with during the inspection are aware of the policy, and of their right to complain. Both relatives said they would take up any concerns with the manager, and added that she was approachable and felt confident that any concern would be dealt with appropriately. Residents indicated that they would talk to staff or their families if they had a concern, but all stated that they had no complaints and were happy at the home. Training records indicate that the majority of staff have received training in safeguarding vulnerable adults. Staff questioned about safeguarding concerns demonstrated competence in practice and procedures in this area. Haslington Residential Home DS0000031967.V367472.R01.S.doc Version 5.2 Page 14 Haslington Residential Home DS0000031967.V367472.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19, 20, 24 and 26. Quality in this outcome area is good. Residents benefit from living in a homely, safe, clean and wellmaintained environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All communal areas and some bedrooms were inspected. The entrance area is comfortable and welcoming. There is a seating area for residents, and this appears to be a popular area providing a place where people can meet and interact with fellow residents and visitors to the home. All lounges are pleasantly decorated and have comfortable homely furniture. There are sufficient coffee tables for residents to place drinks on, and areas are Haslington Residential Home DS0000031967.V367472.R01.S.doc Version 5.2 Page 16 hazard free, enabling residents to walk around safely. The top and middle lounges both have doors leading out to a safe and well maintain garden. Bathrooms and toilets were clean and had appropriate equipment to assist with any residents support needs. The carpeting on the middle floor has been damaged and has an unpleasant odour, which cannot be eradicated. The manager is arranging for this floor to be disposed of, and replaced with more suitable flooring. All areas of the home were found to be clean, safe and hygienic. Four bedrooms were inspected. Residents are encouraged to bring in items from home, and it was clear from inspection of these bedrooms that they had been personalised with individual’s possessions in accordance with the resident’s wishes. Haslington Residential Home DS0000031967.V367472.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 and 30. Quality in this outcome area is excellent. Residents can be confident they are supported by competent and well trained staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: These standards were assessed by observing working practice, speaking with staff, and inspection of staff files, the staff rota and staff training matrix. The home has seven care staff on duty on each shift. Four staff are on duty on the middle floor, two staff on duty on the top floor, and one member of staff is on duty on the ground floor. In addition, the home also employs two activity staff, 4 kitchen staff, 5 cleaners, and 4 waking night staff. Evidence gathered throughout the inspection demonstrated that at present, the needs of residents are being met by the staff on duty, and indicate that staffing levels are satisfactory. The staff training matrix demonstrated the home’s commitment to ensuring all staff receive appropriate training enabling them to carry out their roles professionally and effectively. Training is accessed by a variety of means, Haslington Residential Home DS0000031967.V367472.R01.S.doc Version 5.2 Page 18 including in house training provided by the manager, distance learning training, and attending colleges and training courses. The management emphasis that support staff duties are to engage and interact with residents. Staff were observed doing this throughout the inspection, and residents spoken with said they felt valued and cared for. It was clear that staff at the home are skilled, trained, competent and motivated, and residents benefit from having a staff team which is dedicated to meeting their support and care needs. Staff files inspected evidenced the home operates a robust recruitment procedure. All staff are CRB and POVA checked prior to starting, and references are obtained and vetted. All staff files contain information as required in Schedule 2. Haslington Residential Home DS0000031967.V367472.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 32, 33, 37 and 38. Quality in this outcome area is excellent. Residents benefit from living in a well run home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager demonstrated innovative and proactive practice, and is highly knowledgeable about practice and research in the field of dementia. Observation of working practice, inspection of policies, practices, assessments and care planning, and discussions with residents, relatives and staff, all evidenced that the home is well run, that pathways of responsibility, leadership and management are clear, and that the home is run in the best interests of the people who live there. Haslington Residential Home DS0000031967.V367472.R01.S.doc Version 5.2 Page 20 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 4 4 X HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 4 X X X 4 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 4 X X X 4 4 Haslington Residential Home DS0000031967.V367472.R01.S.doc Version 5.2 Page 21 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 Haslington Residential Home DS0000031967.V367472.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Haslington Residential Home DS0000031967.V367472.R01.S.doc Version 5.2 Page 23 - 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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