Inspection on 28/09/07 for Hatfield Lodge Residential Home

This inspection was carried out on 28th September 2007.

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

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Hatfield Lodge Residential Home 1-3 Trinity Gardens Folkstone Kent CT20 2RP Lead Inspector Julie Sumner Key Unannounced Inspection 28th September 2007 1:00 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 Hatfield Lodge Residential Home DS0000069773.V346816.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. Hatfield Lodge Residential Home DS0000069773.V346816.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hatfield Lodge Residential Home Address 1-3 Trinity Gardens Folkstone Kent CT20 2RP 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) 01303 253253 hatfieldlodge@fsmail.net Mr Kanagaratnam Rajamenon Mr Kanagaratnam Rajaseelan Mrs Yvonne Copleston Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (0) of places Hatfield Lodge Residential Home DS0000069773.V346816.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies 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. Old age, not falling within any other category (OP). The maximum number of service users to be accommodated is 28. Date of last inspection Brief Description of the Service: Hatfield Lodge is registered to provide residential and personal care for up to 28 older people over the age of 65. The home is located in the busy seaside town of Folkestone and is within walking distance to the town centre and all the local facilities. It is also close to the Leas promenade and the other seaside amenities including the Leas Cliff Hall. It is on the main bus route and is close to Folkestone Central train station. It is approximately 5 minutes drive from the M20. The property is an older style detached premises providing accommodation over four floors. There is a passenger lift in situ for easy access to all floors. Two of the bedrooms are in the basement of the building. A chair lift is provided on the first floor where steps would otherwise make access difficult for those with mobility problems. All rooms are registered for single occupancy and have wash-hand basins and call bells. Eleven rooms have en-suite facilities. Several bedrooms are in the style of small apartments and are very spacious. A garden is provided to the side and a shaded patio to the rear of the property. Communal rooms include a large lounge, dining room and foyer area. A payphone in a cubicle is available for private use. Many residents have had private telephone lines installed into their rooms. Staffing levels are generally 3 people on care support, but this number is dependent on individual support needs. The staff team have over 71 of staff Hatfield Lodge Residential Home DS0000069773.V346816.R01.S.doc Version 5.2 Page 5 who hold NVQ level 2 or better certificates. Currently, the weekly fee for accommodation and services starts at £350.00 rising to £415.00 and is revised annually. This fee can be increased to the assessed needs of residents. There are additional charges for chiropidy, hairdressing, newspapers and toiletries. Information on the homes services and the CSCI reports for prospective residents/relatives will be referred to in the statement of purpose and service user guide. Hatfield Lodge Residential Home DS0000069773.V346816.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This report is based on information received about Hatfield Lodge including an annual quality assurance assessment completed by the manager and an unannounced site visit to the home lasting 5 hours and a further visit also lasting 5 hours. Information was gathered for this inspection in a variety of ways both prior to and during the visits to the home. Surveys have been sent out to residents, relatives, staff and visiting professionals. Those returned have been taken into account in this report. The visit included talking with residents, the manager, and staff. General observations were made during the afternoon of how people are supported. There was a tour of the building and various records were inspected. The people living in Hatfield Lodge were able to participate in the inspection by having conversations about their lifestyle and completing the surveys prior to the visit. It was not necessary to make any requirements or recommendations at this time as the new providers and manager know what the issues are and have plans in place to address them. What the service does well: The manager involves the residents in the planning and development of the home. Residents can see that their suggestions are put into action. There are some semi-self contained apartment style bedrooms. Residents are able to furnish the rooms with chairs, dining furniture, and items of hobbies and interests. Every resident spoken to during this visit complemented the staff and said they would feel OK to complain and feel confident to speak to staff about any issues. The staff are caring and skilled in supporting older people. There were lots of positive comments received in surveys and by residents spoken to during the visit. Some examples were: “They take good care of me” Hatfield Lodge Residential Home DS0000069773.V346816.R01.S.doc Version 5.2 Page 7 “Staff look after mum as I would expect and respect her privacy and treat her as an individual” “I can only praise the home as they do look after my aunt very well. They are very friendly and it is like home from home” “My father is very happy here and he has come to think of the staff as family, they take good care of father” “I feel the staff are always busy but have time when there is a query” What has improved since the last inspection? What they could do better: The risk assessments need to be clearer with specific risks in a situation written down and what steps staff need to take to support each person and prevent unnecessary accidents or discomfort. There was one example where sometimes a person needs the support of two carers and it was not clear how carers were to decide when the extra support was needed. Hatfield Lodge Residential Home DS0000069773.V346816.R01.S.doc Version 5.2 Page 8 The physical environment really needs to improve. There are plans for improvement in most areas of the home, which have been considered and are being implemented in priority order. There was concern about the number of staff on duty not being enough because of what they have to do. Comments saying more staff were needed came from the people living in the home and relatives. When asked in the survey how the home could improve a response was: “putting on more staff, I feel they are understaffed”. The manager needs to review the staffing level to make sure there are sufficient staff to support individuals to have a good quality of life. 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. Hatfield Lodge Residential Home DS0000069773.V346816.R01.S.doc Version 5.2 Page 9 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 Hatfield Lodge Residential Home DS0000069773.V346816.R01.S.doc Version 5.2 Page 10 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): People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Admissions are not made to the home until a full needs assessment has been carried out. Prospective individuals are given the opportunity to spend time in the home. EVIDENCE: The home has a statement of purpose but the deputy manager said it was under review to reflect new changes and to have a more user friendly design. There is a new service user guide format with large print colour and pictures. This was viewed. At the time of the visit the assessment process had continued as before and forms the basis of the individual plan of support. Two people have come into the home for respite but no new residents have moved into the home since Hatfield Lodge Residential Home DS0000069773.V346816.R01.S.doc Version 5.2 Page 11 new owners have taken over. A person on respite spoke positively about her experience in the home. Hatfield Lodge Residential Home DS0000069773.V346816.R01.S.doc Version 5.2 Page 12 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): People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The staff team meets the health and personal care needs of the service users and their privacy and dignity are respected. People living in the home are given the support they need to manage their medication. EVIDENCE: A sample of service user plans were viewed and discussed with the deputy manager. There was current information that gives guidelines for staff on how to support individuals. They have been reviewed but some of the outdated information has been left in the folder. Information including assessments and records from other professionals was contained in other folders and was also viewed. From the sample of individual risk assessments viewed it was noted that some of the information that was passed on verbally was not incorporated in the written guidelines. All individual risk assessments need to be reviewed to make sure they contain the practical information that is necessary to support people safely and in the way they wish. Hatfield Lodge Residential Home DS0000069773.V346816.R01.S.doc Version 5.2 Page 13 There is a new care plan format that is planned to be implemented and replace the current care plan design. The deputy manager explained that the new care plan will include all the records, plans and risk assessments in one place for an individual. Each person has a key worker. Residents spoken to confirmed that they have a care plan and they know what is in it. A sample of district nurse notes were viewed and discussed. There are records of health appointments both in the home and outside with opticians, chiropodist and dentist. Residents keep their own GP if they wish. Medication storage and records were viewed and administration was discussed. Individuals have the opportunity to continue to manage their own medication when they move into the home. Some of the people who participated in the visit spoke about their medication and several people had their own tablets and took them independently. The level of support needed for medication administration is included on the individual assessment and is monitored as part of the service user plan review. Comments received from people living in the home and relatives said that staff respected individual privacy and dignity. There are individual telephone lines in the bedrooms. Hatfield Lodge Residential Home DS0000069773.V346816.R01.S.doc Version 5.2 Page 14 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): People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Some residents are supported to maintain an independent lifestyle and opportunities for meaningful occupation need to be increased for less able residents. The home has sought the views of residents with regard to mealtimes and this needs to be ongoing. EVIDENCE: Residents spoke about their lifestyle in the home. Some people were able to go out and socialise with their friends independently and one person said one of the things she likes about living here is the fact that she is not restricted. Sometimes trips to town are organised and some residents have attended local shows in the Leas Cliff Hall and the pantomime. Wine and cheese evenings have been organised. The staff said they have Bingo and other games but some of the residents are not able to concentrate on these. They said that they have some training in supporting people with confusion but at the present time they do not have the time to spend on activities which is frustrating. Less able residents were unoccupied in between mealtimes. Other residents said they were happy Hatfield Lodge Residential Home DS0000069773.V346816.R01.S.doc Version 5.2 Page 15 occupying themselves reading, watching TV, doing puzzles and said they usually chose not to participate in organised activities. It was stated in the AQAA that the new owners plan to employ and activities coordinator. The deputy manager said they have just got a CD with ideas for activities for people with dementia and also has fund raising ideas. Generally residents are in control of their finances, and family or appointees help people who need additional support. The home only holds small amounts of cash on residents’ behalf, if this is requested. Records are kept of any transactions. At the time of the visit the dining room was being refurbished and was out of use. Residents had been given the choice of whether to have their meals in other communal areas or in their bedrooms. Residents said they were happy with the arrangements. There were mixed comments about the meals provided. Some people said that the food was really nice and others said that because they had a special dietary need their food was a bit boring and repetitive. Residents said they were happy to talk to the manager and staff about the food. There was evidence that efforts had been made by the manager and staff to accommodate the preferences and dietary needs of individuals. It is necessary to continue to listen to residents’ views and review the menus and types of food provided. Hatfield Lodge Residential Home DS0000069773.V346816.R01.S.doc Version 5.2 Page 16 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): People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents’ complaints are taken seriously and acted upon and they are protected from abuse by the procedures in the home. EVIDENCE: The home has a complaints procedure on the notice board in the entrance lobby. It is also included in the service user guide. Residents spoken to said they were happy to talk to the manager or staff if they have a problem. Staff talked about supporting less able residents. One person discussed some issues which she had already discussed with the staff but did not wish to make any complaint and was happy to discuss again to find ways to resolve them. Adult protection training is included in the matrix. The deputy has updated the training matrix and more courses are being planned including adult protection. Nearly all the staff team have achieved NVQ level 2 or above and others are studying it. Hatfield Lodge Residential Home DS0000069773.V346816.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. JUDGEMENT – we looked at outcomes for the following standard(s): People who use the service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is clean and comfortable and has a programme to improve the decoration, fixtures and fittings. EVIDENCE: A tour was undertaken with the deputy manager. During the tour there was discussion about the planned improvements, which were extensive. There are changes planned to upgrade toilets, provide a sluice room, move the medication room, provide better washing and shower facilities and systematically decorate the whole home. The smoking area has moved completely and there is a covered area and an area outside or residents smoke in their own room. Hatfield Lodge Residential Home DS0000069773.V346816.R01.S.doc Version 5.2 Page 18 The refurbishment has started with the dining room. A Reg 37 was received to explain what is happening and how residents are being supported. Discussed the risk assessments with the deputy manager, as they need to be more detailed unless the providers or manager already have copies in another place in which case they need to be accessible. The kitchen is in reasonable condition and was clean. The home employs 2 domestics and kitchen assistants as well as 3 cooks. The home looked clean on the day of the visit. Some of the carpet had a mild odour despite repeated cleaning and the deputy said that it was going to be replaced. Hatfield Lodge Residential Home DS0000069773.V346816.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. JUDGEMENT – we looked at outcomes for the following standard(s): People who use the service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. People using services are generally satisfied with the care they receive to meet their needs but there are times when they may need to wait a short time for staff support and attention. The manager is aware that there are some gaps in the training programme and plans to deal with this. EVIDENCE: Whilst the home was changing ownership some staff left the team and at the time of the visit they had not been replaced. There were several comments received from residents and relatives about the shortage of staff. One person living in the home also commented that staff are so busy you do not see them to talk to at all. The staffing tool designed using the residential formula for homes for older people was used to calculate the staffing level during the visit. This also indicates there is a shortfall of staff at the present time. The manager commented in the AQAA that “extra staff have been advertised to enable the home to meet the needs of higher dependency service users…” The manager does need to make this a priority to make sure individual needs are being met and people have a good quality of life in the home. The home has a well established NVQ training programme with over 70 of the staff having achieved NVQ level 2. Hatfield Lodge Residential Home DS0000069773.V346816.R01.S.doc Version 5.2 Page 20 Staff spoken to and surveyed said that the home had made sure all the checks such as CRB/POVA and references had been carried out before they had started work. A sample of staff files were viewed and records checked. This confirmed checks that had been undertaken. The training matrix has been updated and was on office wall. This was viewed and discussed with the deputy manager who said that the gaps in mandatory training have been identified and training is being arranged. Training certificates were also viewed in the sample of staff files seen. Staff commented that they receive: “regular training covering all areas”, some staff said that they had only received the basic mandatory training recently and that there was difficulty being able to attend training because they were needed to work in the home. Training needs to be developed with more courses and discussions on communication, dementia, promoting activities and person centred planning to develop skills from the NVQ training basis. The deputy manager said that the provision of training has slowed down since some of the staff left and during the sale process of the home. The deputy estimated that training would be up to date in the next 3 months. There was also reference in the AQAA to developing the range of training provided. Hatfield Lodge Residential Home DS0000069773.V346816.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. JUDGEMENT – we looked at outcomes for the following standard(s): People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The manager has a clear understanding of the key principles and person centred focus of the service. The manager has highlighted areas where they need to make improvements and has a development plan for undertaking the work. EVIDENCE: The registered manager was not in the home at the time of the visit. The manager has been in post for several years and has a good record of effectively managing the home. Positive comments were received about the way the home is managed and staff spoke highly of the manager also. Hatfield Lodge Residential Home DS0000069773.V346816.R01.S.doc Version 5.2 Page 22 The deputy manager, who is recently in post, assisted with the visit to the home. The deputy manager explained the homes quality assurance system. Regular feedback is requested from residents and relatives. At the current time feedback is not requested from visiting professionals and this could be developed. The deputy manager also said that there is a development plan for the improvements to the home that needs to be modified with the new owners’ priorities. It was not available to view at the visit. However the deputy manager was able to describe some of the improvements planned for the environment and some of the formats for new care plans etc were viewed. Call and answer time of call bells is recorded so the manager can monitor the responsiveness of staff. Monitoring this has been used to indicate whether there are sufficient staff on duty but only measures initial responsiveness. The comments received from residents and staff have been about the amount of time that has been able to be spent with the person responding to the call and this needs to be part of the manager’s review of staffing levels. Environmental risk assessments (not available in the home) need to include the disruption of the building work and refurbishment. There needs to be a work plan with timescales in the home. Servicing of the lift, hoists and chair lift were discussed and all have been serviced regularly. There was some discussion about moving and handling risk assessments with the deputy manager and some of the staff. The information contained in them does not give the practical guidance that staff need. This seems to be passed verbally but it is then difficult to maintain consistency. One risk assessment in particular for a person who sometimes needs two staff to support her with mobility but not always, needs to be re-written. Hatfield Lodge Residential Home DS0000069773.V346816.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 x 3 x x x 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 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 x x x x x x 3 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Hatfield Lodge Residential Home DS0000069773.V346816.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. 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 Hatfield Lodge Residential Home DS0000069773.V346816.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Local 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 Hatfield Lodge Residential Home DS0000069773.V346816.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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!