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Inspection on 29/09/05 for Haslington Residential Home

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

This inspection was carried out on 29th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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

Service users spoken with said they were happy and all their needs were being met. They also said the staff in this home were caring and respectful to them. Visitors are always welcomed. Service users enjoy the activities that are provided. There are good care plans in place and detailed records kept to ensure the well being of the people living at the home. The manager is open and approachable to service users and staff, she offers clear guidance and support to staff and runs the home in the best interests of service users. Service users benefit from having a dedicated activities coordinator 3 days a week.

What has improved since the last inspection?

National Vocational Training is continuing with a number of staff now undertaking level 3 training.

What the care home could do better:

Service users must be provided with, in adequate quantities, suitable, wholesome and nutritious food which is prepared in such a way as to eliminate risk of infection. Service users must be protected through sound recruitment procedures, thorough checks of applicants and adequate identity checks and documentation. Their quality of life must be sustained by ensuring parts of the home used by service user are maintained to an adequate standard whilst building work continues. The registered person must ensure that the needs of service users with dementia are met through accessing specialist training in order to meet their conditions of registration. Service users must be protected from risk of harm through adequate staff training, safe laundry procedures and safe food preparation.

CARE HOMES FOR OLDER PEOPLE Haslington Residential Home Cobham Terrace, Bean Road Greenhithe Kent DA9 9JB Lead Inspector Ruth Burnham Unannounced Inspection 29th September 2005 09:30 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.V253128.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. Haslington Residential Home DS0000031967.V253128.R01.S.doc Version 5.0 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 Mrs Carol Anne Jansz Mr Edward Raphael Jansz Mrs Carol Anne Jansz Care Home 21 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (11) of places Haslington Residential Home DS0000031967.V253128.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. That the owner and all care staff working in the Home receive training in relation to the care needs of Older Service Users with Dementia 5th July 2005 Date of last inspection Brief Description of the Service: Haslington is a large detached Victorian house, situated in a terrace off the main road to Greenhithe. It provides residential accommodation for twentyone older people on two floors. There are thirteen single rooms, one of which has an en-suite facility and four double rooms. There are call points in all rooms and direct phone lines can be installed if requested. The rear garden is currently out of use due to building work. The home has a minibus, which is in regular use for social outings, and shopping trips to Bluewater which is only a few minutes drive away. Major building works are currently in progress to provide a large extension. This is impinging on the existing home in that the availability of some of the rooms has been affected, it is hoped that the new extension will be completed in the next few weeks when service users will be moved into the new part of the building whilst the existing home is refurbished. Whilst this has had an impact on the service users as much as possible has been done to minimise disruption. Haslington Residential Home DS0000031967.V253128.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place on 29th September 2005. It was carried out by 1 inspector who found that many of the national minimum standards had been met or partially met and that the overall quality of care was adequate. A number of staff and service users were spoken with on the visit. The building work is nearing completion, whilst this process has had a negative impact on service users, care has been taken by the provider and staff to minimise this as much as possible. There are currently 17 service users in the home. What the service does well: What has improved since the last inspection? What they could do better: Service users must be provided with, in adequate quantities, suitable, wholesome and nutritious food which is prepared in such a way as to eliminate risk of infection. Service users must be protected through sound recruitment procedures, thorough checks of applicants and adequate identity checks and documentation. Their quality of life must be sustained by ensuring parts of the home used by service user are maintained to an adequate standard whilst building work continues. The registered person must ensure that the needs of service users with dementia are met through accessing specialist training in order to meet their conditions of registration. Service users must be protected from risk of harm through adequate staff training, safe laundry procedures and safe food preparation. Haslington Residential Home DS0000031967.V253128.R01.S.doc Version 5.0 Page 6 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. Haslington Residential Home DS0000031967.V253128.R01.S.doc Version 5.0 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 Haslington Residential Home DS0000031967.V253128.R01.S.doc Version 5.0 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 & 2. 6 is not applicable Service users and prospective service users benefit from having some written information about how their needs will be met however, this lacks sufficient detail to provide the basis for a fully informed choice to be made. EVIDENCE: Service users and prospective service users are informed about how their needs will be met through a detailed statement of purpose, which sets out the aims, objectives, philosophy of care, services and facilities, and terms and conditions of the home. It has been agreed that they will also be provided with a service user guide, before phase 1 of the building work is completed which is expected to be in a few weeks time. Service users are also provided with information within a statement of terms and conditions that includes details of the room that is occupied, the fee and by whom this is payable and additional services which are charged in addition to the fee. Full information is still not being provided in line with the standard, in that the rights and responsibilities of the service user and provider and who is liable if there is a breach of contract is not stated, neither is there details of the overall care and services to be provided. Haslington Residential Home DS0000031967.V253128.R01.S.doc Version 5.0 Page 9 Haslington Residential Home DS0000031967.V253128.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): 11 Service users can be confident that care is being taken wherever possible to respect their wishes in relation to death and dying. EVIDENCE: Information is sought from the families of service users in relation to their wishes around death and dying and the provider makes every effort to provide care until death and avoid unnecessary disruption at these times wherever possible. Service users and their families can be confident that these issues will be dealt with sensitively by staff who have received training in bereavement. Haslington Residential Home DS0000031967.V253128.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15 Service users are being placed at risk of harm by poor practice around food and nutrition and their quality of life is adversely affected by the impact of building work on the dining room. EVIDENCE: Service users are being placed at risk of harm by unsafe practices around the preparation of food, not all staff who handle food have had basic food hygiene training. On the day of the inspection a small joint of lamb was found in the fridge, which had been cooked the day before, the cook intended to reheat this to serve up to 17 service users. Those service users who have their meals liquidised were to be provided with fish cakes instead, these only contained 40 fish. The cook said that she was just following instructions from the other cook and had no idea why not all service users were being offered lamb or why the meat was pre cooked. The provider did take steps to protect service users once alerted to the risk, by instructing the cook to serve the meat cold, she also said that there were normally 2 joints and had no idea why this was not the case on the day of the inspection other than that the cook was new. Service user’s diet may not be as nutritional as it should be in that only semi skimmed milk is being served to them, they will benefit from the forthcoming training on nutrition for the elderly, which both cooks are soon to attend. Haslington Residential Home DS0000031967.V253128.R01.S.doc Version 5.0 Page 12 The new building has seriously impacted the quality of life of service users in that the dining room has been partially boarded off due to unforeseen building problems, this space is now windowless with temporary boarding and badly damaged décor which does not provide a congenial setting for meals. Haslington Residential Home DS0000031967.V253128.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 17 & 18 Measures taken in the home to protect service users from abuse are generally good, however, they are being placed at risk of harm in one area. EVIDENCE: Service users have their legal rights protected and are enabled to participate in the civic and political process should they wish to do so. Information and training is provided to staff to help them to protect service users from abuse; there is a copy of the Local Authority adult protection procedure at the home. Financial records are maintained wherever the home acts on behalf of service users. However, service users are being placed at risk by the fact that a member of staff has been working at the home without having received a current satisfactory check through the criminal records bureau. Haslington Residential Home DS0000031967.V253128.R01.S.doc Version 5.0 Page 14 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 The quality of life for service users is being adversely affected by major building works however, they will greatly benefit from a much more pleasing environment when the extension and the programme of redecoration and refurbishment to the home has been completed. They are being placed at risk of infection through poor hygiene practices. EVIDENCE: An extension to the home is nearing completion and service users will move into this new part of the building whilst the existing building is completely redecorated and refurbished. The disruption caused by the building work is however, having a detrimental effect on the environment. Service users are being placed at risk due to laundry procedures which increase the risk of infection, in the home in that staff are instructed to soak fouled laundry receptacles and then rinse in a sink where commode pans are washed and where staff, who have not all received infection control training, also have to wash their hands. It was agreed that the provider would liaise Haslington Residential Home DS0000031967.V253128.R01.S.doc Version 5.0 Page 15 with the Environmental Health Officer on how to implement safe systems in the home in the interval before the laundry is refurbished. Haslington Residential Home DS0000031967.V253128.R01.S.doc Version 5.0 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): 29 & 30 Recruitment practices and gaps in staff training do not fully protect service users. Service users with dementia cannot be confident that their needs will be met. EVIDENCE: Recruitment procedures are still not protecting service users in that staff files do not all include 2 written references, proof of identity or photographs. The needs of service users are not being met in that the home remains in breach of it’s conditions of registration in that not all care staff in the home have received specialist training in dementia. Haslington Residential Home DS0000031967.V253128.R01.S.doc Version 5.0 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): 35 & 38 Service users are protected from financial abuse; however, they are being placed at risk through inadequate staff training. EVIDENCE: Service users are protected where the home has involvement in managing their finances, through good recording systems, which include receipts of all transactions carried out on their behalf. Service users are being placed at further risk by failure to train all staff in basic food hygiene, first aid, infection control, moving and handling, fire safety and health and safety. Haslington Residential Home DS0000031967.V253128.R01.S.doc Version 5.0 Page 18 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 2 x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 x 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 1 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 3 18 2 1 x x x x x x 1 STAFFING Standard No Score 27 x 28 x 29 2 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x x 3 x x 2 Haslington Residential Home DS0000031967.V253128.R01.S.doc Version 5.0 Page 19 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 15 Regulation 13(3)(4)c &16(2)i Requirement Timescale for action 15/10/05 2 18 19(1) 3 19 23(2) The registered person shall provide in adequate quantities, suitable, wholesome and nutritious food which is prepared in such a way as to eliminate risk of infection to service users. The registered person shall not 15/10/05 employ person to work at the care home unless he has obtained in respect of that person the information and documents specified in paragraphs 1 to 9 of Schedule 2, in that satisfactory CRB checks must be obtained before staff work alone with service users. Fitness of premises 31/12/06 23. (2) The registered person shall having regard to the number and needs of the service users ensure that (b) the premises to be used as the care home are of sound construction and kept in a good state of repair externally and internally; (d) all parts of the care home are kept clean and reasonably decorated. DS0000031967.V253128.R01.S.doc Version 5.0 Haslington Residential Home Page 20 4 30 18(1)19 (5)b23(2) a All staff should be provided with specialist training in relation to dementia and suitable adaptations to the premises should be made. Laundry procedures should ensure the prevention of infection and be prepared in consultation with the Environmental Health Officer The registered person shall not employ person to work at the care home unless he has obtained in respect of that person the information and documents specified in paragraphs 1 to 9 of Schedule 2. The registered person must comply with the conditions of registration in that all care staff must receive specialist training in dementia All staff should receive core training by a suitably qualified and competent trainer. 31/12/05 5 26 13(3) & 23(5) 31/10/05 6 29 19(1) 31/10/05 7 30 19(5) (b) 31/12/05 8 38 18(1) & 19(5)(b) 31/12/05 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 2 Good Practice Recommendations A statement of terms and conditions must be provided to each service user in line with the standards Haslington Residential Home DS0000031967.V253128.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Haslington Residential Home DS0000031967.V253128.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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