Inspection on 06/06/06 for Hassingham House Care Centre

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 Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Hassingham House Care Centre 14/08/08

Hassingham House Care Centre 23/08/07

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Hassingham House Nursing Home Hardingham Street Hingham Norfolk NR9 4JB Lead Inspector Mrs Marilyn Fellingham Unannounced Inspection 6th June 2006 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 DS0000066011.V299191.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. DS0000066011.V299191.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hassingham House Nursing Home Address Hardingham Street Hingham Norfolk NR9 4JB 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) 01953 851890 01953 852458 hassinghamhouse@btconnect.com Hassingham Limited Jacquelyn Foran Care Home 46 Category(ies) of Old age, not falling within any other category registration, with number (46), Physical disability over 65 years of age of places (46) DS0000066011.V299191.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users should be aged 30 years and over. Date of last inspection 08/11/05 Brief Description of the Service: Hassingham House is a purpose built home circa 1997, situated in the small Norfolk town of Hingham. It is approximately 15 miles west of Norwich. The local amenities consist of a post office, a public house, a convenience store, hairdresser and facilities for bed and breakfast. Hassingham House is registered to provide nursing care to 46 elderly service users or those with a physical disability under the age of 65 years. All the accommodation is on the ground floor and it comprises of a large reception area, two spacious day rooms, two dining rooms and a quiet room. The grounds have undergone extensive alteration this year and there are now beautiful laid out gardens that can be accessed by the Service Users. All rooms have a door to access the grounds and some Service Users had personalised these areas with bird tables and garden chairs. Each room has a hospital designed bed to ensure safe handling of the Service Users. Chiropody and hairdressing services visit the Home on a regular basis. The fees are currently between £550 and £1,200 per week. DS0000066011.V299191.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place over nine hours and twenty minutes. Opportunity was taken to examine care and staff records, tour the Home, speak with service users and relatives who were visiting the Home at the time of inspection. The inspector also spoke with senior staff and all other staff members who were on duty during the duration of the inspection. The Home has undergone a number of changes over the last six months. has new provider and manager from December 2005. It Eleven comment cards were received from relatives and service users, these reflected that in general they felt that they were well cared for; a few comments were made in relation to the quality of the food and this is mentioned in the content within this report. What the service does well: The home has a very good assessment process with service users and relatives being involved in the whole process. The service users spoke well of the staff, saying they were very kind and caring. Visitors said that they were always made very welcome. The Home is well maintained and is clean and tidy. DS0000066011.V299191.R01.S.doc Version 5.2 Page 6 The home is good at ensuring the service users live in a safe and comfortable environment inside and out. The Home is good at ensuring all aspects of compliance are attended to. This team took over a Home that was not compliant with many of the National Minimum Standards; there were many issues that needed to be addressed. The home has achieved a lot in the six months and needs commending for meeting the requirements inherited from the last provider. What has improved since the last inspection? Many improvements have taken place since the new providers and Manager have taken over. Clinical waste is now disposed of in the correct and safe manner. The electoral warranty for the Home is now in place and PAT testing has been carried out. Recruitment is more robust. A kitchen audit trail is now in place with all meat temperatures being monitored before delivery into the Home. Care plans have greatly improved with service users health care needs being assessed and care prescribed accordingly. The Home now has regular fire alarm testing and fire risk assessments are in place. A new call bell system has been set up. The shift patterns have been changed giving better continuity of care thus enabling the staff to spend more quality time with the service users. The Management has made progress in providing better activities for the service users. The Management needs to be commended for its record keeping, which has vastly improved at the Home since it was taken over. All records are now available for inspection purposes. DS0000066011.V299191.R01.S.doc Version 5.2 Page 7 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. DS0000066011.V299191.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000066011.V299191.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5. The overall quality outcome for these standards is good. The admission process is good and allows for prospective service users and their relatives to make an informed choice before admission to the Home. Service user’s needs are assessed prior to admission and the Home is able to demonstrate its capacity for meeting their needs. Prospective service users are given the opportunity to visit the Home prior to admission. This Home does not provide intermediate care. EVIDENCE: The Inspector examined the Home’s Statement of Purpose and service users guide; these were found to be very informative and easy to read; they also complied with the requirements and standards. DS0000066011.V299191.R01.S.doc Version 5.2 Page 10 Each service user is given a contract that lays out the agreement fees, room to be occupied and any additional services that might be required that are not included in the general fees. The assessment documentation for three recent admissions to the Home were examined and were found to contain detailed information so that a plan of care could be formulated from this and the care needs of the service user met. Those three service users felt when questioned that they had been given enough information about the Home before they were admitted; one of the comment sheets supported this by the remark that the information given to them prior to admission “was excellent” and other remarks confirmed that they were given the opportunity to visit the Home before making a decision. DS0000066011.V299191.R01.S.doc Version 5.2 Page 11 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. The overall quality outcome for these standards good. The care plans contain detailed guidance to staff so that the service users needs can be met. The care plans show evidence of continual review. The service users health care needs are being met. The procedure for handling and administering medication appears to be safe. EVIDENCE: The Inspector looked at six care plans. These contain assessments with regard to those who are at risk of falling, risk of pressure sores, moving and handling along with assessments for nutritional status. Accidents and falls are now audited and the Inspector noted that the data for these incidents were reflected in the care plans and the accident records, risk DS0000066011.V299191.R01.S.doc Version 5.2 Page 12 assessments are also generated from this information if they have not previously been in place. The care plans showed evidence of being updated and reflect the actual needs of the service user. It is good to see that the new management has addressed these areas and requirements made with the last provider have been met. Daily records are most informative and can be seen to influence the formulation of new plans of care where a need has been identified. The Inspector looked at the medication system that is in use. A random check was made of the medication in use, this was found to tally with the MAR charts and a good indication of what medication had been given, refused or destroyed. After examination of policies and procedures for the handling and administration of medication and MAR charts that the Registered Nurses adhere to the policies and procedures for the handling and administration of medication. DS0000066011.V299191.R01.S.doc Version 5.2 Page 13 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. Overall the quality outcome for these standards is good. Activities are being managed well and service users feel that the lifestyle experienced in the Home matches their expectations. Visitors are made welcome. The management of meals could be better. EVIDENCE: In the past the Home has not managed activities well and many service users have indicated that they were not offered sufficient activities to satisfy their social and recreational needs. The new management has made a concerted effort to provide an activity programme for the service users. Unfortunately having appointed an activity coordinator she has now left, however it was very evident that the Home was making every effort to counter balance this and they are hoping to appoint a new activity coordinator. An activity programme was seen by the Inspector, and those service users spoken with stated that they were given the DS0000066011.V299191.R01.S.doc Version 5.2 Page 14 opportunity to participate in the programme. One service user said that they chose not to join in any of the activities and that the staff respected her wish not to do this, this service users went on to confirm that they made choices every day about their daily activities was glad to be to still make these decisions. Another service user indicated that they enjoyed the musical afternoons and also the Sunday cinema. The change of the shift pattern has also allowed the staff to spend quality time with the service users. Those visitors spoken with at the time of inspection confirmed that they were always made welcome, the Inspector observed this to be so. The Inspector also observed some service users arranging with the staff to be taken out into the town to do shopping, a number of them were sitting outside enjoying the summer sun. It was also noted that some of the service users were entertaining their visitors outside. After discussion with a number of service users the Inspector came to the conclusion that generally meals could be better managed and many service users spoken to made unfavourable comments about the standard or the food. The comment cards also gave indication that the meals could be better. Others indicated that there should be more choices and that the food could be more flavoursome. Discussion with the management and kitchen staff revealed that the home was attempting to rectify this situation and a new chef had been appointed and had only been in post two weeks at the time of inspection. The menus have been revised and appropriate checks made on all food entering the Home. It will be interesting to ascertain what impression the changes have made at the next inspection. DS0000066011.V299191.R01.S.doc Version 5.2 Page 15 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. The overall quality outcome for these standards is good. Arrangements for dealing with complaints, are satisfactory. Service users are protected from abuse. EVIDENCE: Service users indicated to the Inspector that they knew whom to approach if they wished to raise concerns or make a formal complaint; those service users spoken with stated that they would go to the manager or the head of care. A comprehensive complaints procedure is in place and all new admissions to the home are made aware of this. There have been no formal complaints since the last inspection. Small domestic issues are managed on a ‘day-to-day’ basis. A complaints record is now kept by the new management. It is recommended that a record is kept of all concerns made by the service users and what action taken. Staff have now received training in the protection of vulnerable adults and when questioned were familiar with all aspects of abuse and stated that they DS0000066011.V299191.R01.S.doc Version 5.2 Page 16 would not hesitate in ‘blowing the whistle’ if they suspected anyone of being abusive. DS0000066011.V299191.R01.S.doc Version 5.2 Page 17 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): 19,20,23,26. The overall quality outcome for these standards is good Service users live in a well-maintained and safe environment. The Home is clean and tidy, except for one room. EVIDENCE: The Inspector was shown round the Home by the manager and it appears safe and well maintained and suitable to meet the needs of the service users. The Inspector established that appropriate fire, health and safety practices were being observed, and records for these were seen. Service users have access to a range of outdoor facilities and many service users were enjoying the sun and sitting outside under awnings that were protecting them from the ultra violet rays. DS0000066011.V299191.R01.S.doc Version 5.2 Page 18 On the whole the Home was found to be very clean and tidy, except for one room that smelt strongly of urine. The manager assured the Inspector that they were aware of this and that the providers are happy to change the carpet if and when necessary as they did not want to lay special flooring that is not very homely. All those service users spoken with said that they were happy with their rooms and that they were always kept clean and tidy; they also said that they felt that they had everything that they required. DS0000066011.V299191.R01.S.doc Version 5.2 Page 19 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. The overall quality outcome for these standards is adequate. Staff are employed in sufficient numbers to adequately meet service users needs. There is a robust system in place for recruitment. Training needs to be addressed. EVIDENCE: Examination of duty rotas revealed that the Home is adequately staffed in order to meet the service user’s needs. In the past the Home has had a very poor training record and the new management have yet to address this; however it is their next project having achieved so much already. A training matrix is in place and some training has begun. A requirement is being made to ensure that a training programme is up and running and that all staff receive induction and mandatory training. Service users felt that they were well looked after and the Inspector observed that the staff appeared to have a good understanding of service user’s support needs and seemed to maintain positive working relationships with them. DS0000066011.V299191.R01.S.doc Version 5.2 Page 20 Some staff have left but more staff have been recruited; the Inspector examined records of all new recruits and found them to be in good order and reflected a robust system in place with all necessary checks and references to ensure the safety and protection of the service users. DS0000066011.V299191.R01.S.doc Version 5.2 Page 21 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): 31,35,38. The overall quality outcome for these standards is good. The Home is managed well. The financial interests of the service users are safeguarded by the home’s policies and procedures. There is clear leadership and it is evident that this promotes and safeguards the welfare and safety of the people living and working in the Home. EVIDENCE: Detailed discussion with staff and service users led the Inspector to believe that the Home is now managed well and that there is clear leadership and direction. DS0000066011.V299191.R01.S.doc Version 5.2 Page 22 Very good records are now in place and readily available for inspection purposes and the office manager needs to be commended for this. Members of staff that were spoken to made comments such as, “things have changed for the better”, “we are given more direction now”, “manager is very approachable and always here”. Other comments made were “we pull together more”, “more staff members so we spend more time with the residents” and the kitchen staff said that they were “doing things by the book now”. Having not been managed well in the past it would seem that the Home has made vast improvements and needs to be commended for the work that it has done. DS0000066011.V299191.R01.S.doc Version 5.2 Page 23 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 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X 3 X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X 3 X 3 3 DS0000066011.V299191.R01.S.doc Version 5.2 Page 24 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 OP30 Regulation 18 (1) (i) Requirement It is required that all staff receive training appropriate to the work they are to perform. Timescale for action 06/09/06 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 OP16 Good Practice Recommendations It is recommended that a record be kept of all concerns expressed by the service users and action taken. DS0000066011.V299191.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 DS0000066011.V299191.R01.S.doc Version 5.2 Page 26 - 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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