Inspection on 26/07/05 for Hatt House

This inspection was carried out on 26th July 2005.

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

Hatt House 24/01/07

Hatt House 27/01/06

Hatt House 26/01/05

Hatt House 21/09/04

Hatt House 04/02/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Hatt House 14 Park Road Torquay Devon TQ1 4QR Lead Inspector Graham Thomas Announced 26 & 27 July 2005 th th 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 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. Hatt House D54-D07 S18367 Hatt House V224110 260705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Hatt House Address 14 Park Road, Torquay, Devon, TQ1 4QR Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01803 326316 01803 326316 hatt.house@virgin.net Mr Michael John Oaten Mrs Patricia Anne Oaten Care Home 24 Category(ies) of Dementia (3), Dementia - over 65 years of age registration, with number (24), Mental Disorder, excluding learning of places disability or dementia - over 65 years of age (24), Old age, not falling within any other category (24) Hatt House D54-D07 S18367 Hatt House V224110 260705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Service Users with the category (DE) aged between 50-65 Date of last inspection 26 January 2005 Brief Description of the Service: Hatt House is a detached property in large grounds in a quiet residential area of Torquay. The home has easy access to the local facilities of St. Marychurch and nearby park. There are three double and eighteen single rooms with a lift available to the upper floor. The garden area is level and has good access for those with poor mobility. There is an enclosed courtyard for anyone who is unable to use the main garden area. The home provides care predominantly for older people with dementia. The home has aids including a mobile hoist and bath aids. The communal areas of the home consist of a sitting and dining room. There is a “coach house” attached by a covered corridor which provides accommodation for more able service users which also contains a small sitting room. This is used as a quiet area and a private room for meeting visitors. The home has its own minibus which is used to take service users to local activities. There is a daily programme of activities in the home. Hatt House D54-D07 S18367 Hatt House V224110 260705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. During this inspection the Inspector reviewed a pre-inspection questionnaire completed by the Registered Provider. A tour of the premises was conducted. Four relatives were spoken with and written feedback was received from another. Staff were observed at work with service users individually and in groups. Five service users were spoken with individually and ten care plans were reviewed as well as other documents. Six staff members were interviewed and various issues were discussed with the Registered Providers. A meal was sampled and the home’s system concerning medicines was inspected. What the service does well: What has improved since the last inspection? What they could do better: Some outstanding maintenance issues need to be addressed such the maintenance and provision of door locks. Service users’ choices concerning floor coverings should be clearly recorded. Orientation for service users with dementia could be further improved. Hatt House D54-D07 S18367 Hatt House V224110 260705 Stage 4.doc Version 1.40 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. Hatt House D54-D07 S18367 Hatt House V224110 260705 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Hatt House D54-D07 S18367 Hatt House V224110 260705 Stage 4.doc Version 1.40 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 standard(s) 3 and 6 Service users can be confident that the Registered Providers have established that their needs can be met by the home before they are admitted. EVIDENCE: Each service user has an individual file which contains a detailed plan of care. Improvements were noted in the organisation of the care plans and information, the quality of the information recorded (e.g. concerning falls). Key workers in the home are now recording useful daily information in the files which is used as part of the care planning and review process. One staff member who had previously worked in the home and returned after a five year break commented that “Things are much better organised now”. Those files inspected contained pre-admission assessments from referring authorities and other professional sources. These supplemented the home’s own assessments which include a visit to the potential service users in their current home and visits to Hatt House where possible. Hatt House does not admit service users solely for intermediate care. Hatt House D54-D07 S18367 Hatt House V224110 260705 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10 Service users are well supported by staff to maintain their health and meet their personal needs. EVIDENCE: The ten care plans reviewed each contained details concerning the physical, psychological and social needs of service users. Health care needs are particularly well detailed and include dietary and hydration monitoring as well as an improved falls monitoring system. The care plans and discussion with individual service users and relatives confirmed that both general and specialist health care needs are well catered for. Records were seen of routine appointments and checks as well as specialist interventions. No service users were in control of their own medication at the time of inspection. Records concerning the administration of medicines in the home were found to be in order. No controlled drugs were in use and a list of approved homely remedies had been obtained. One skin cream prescribed for a service user was found in the room of another. This was removed immediately. Patient Information Leaflets were not available for all medicines used in the home though a standard reference book is held giving details of side effects and contra-indications. Hatt House D54-D07 S18367 Hatt House V224110 260705 Stage 4.doc Version 1.40 Page 10 Service users and their relatives all felt that their dignity and privacy was respected by staff . This was confirmed by observations of staff working with service users during the inspection. Medical examinations take place in the service users’ own rooms or a room specifically designated for the purpose. Service users sharing rooms are provided with screening for the purpose of maintaining their privacy. Hatt House D54-D07 S18367 Hatt House V224110 260705 Stage 4.doc Version 1.40 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 standard(s) 12 to 15 Service users lifestyle preferences are actively supported by the staff of Hatt House. EVIDENCE: Service users and relatives who were interviewed felt that the lifestyle of the home matched their preferences as far as these could be ascertained. Visiting arrangements are flexible allowing both for short visits and, in one instance, extended daily visits by a service user’s wife. Some service users spoke of trips out with relatives and friends. Religious interests are recorded and catered for according to individual needs. There are regular activities organised in the home such as armchair aerobics. These are posted on a notice board in the home’s lounge. At the time of inspection the Clinical Manager said that she was reviewing the activities programme. During the inspection service users were observed enjoying table top games with staff and some spoke of enjoying the home’s extensive grounds during recent fair weather. For most service users, the level of individual support required severely limits their autonomy. However, the “Coach House”, a specific area of the home, accommodates those who are able to be more independent. The Registered Providers do not become involved is service users’ finances. These are managed by relatives and/or advocates. Individual rooms contained many personal items which service users were able to bring with them to the home. Hatt House D54-D07 S18367 Hatt House V224110 260705 Stage 4.doc Version 1.40 Page 12 The Inspector discussed menus with the chef, inspected the home’s kitchen and food stores and sampled a meal. The meals provided at Hatt House are tasty, nutritious and adapted to suit individual needs and preferences. Choice is available on a daily basis and fresh fruit and vegetables were seen to be available and in use. Service users spoke well of the food supplied at the home. Dietary monitoring takes place as part of the care planning process and particular attention is paid to hydration. Recent attendance at a course concerning falls has heightened the awareness of the Provider and Clinical Manager to the dietary aspects of prevention and this is being integrated in to the care planning process. Hatt House D54-D07 S18367 Hatt House V224110 260705 Stage 4.doc Version 1.40 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 standard(s) 16 to 18 Service users are adequately protected by an accessible complaints procedure, and robust policies regarding abuse. EVIDENCE: A record of complaints, showing details of the action taken, was available for inspection. There are policies and procedures concerning complaints, whistleblowing and the protection of vulnerable adults from abuse. These contain details of how to contact the Commission directly. At the time of inspection there were no outstanding complaints which had been received either internally or through the Commission. Advocacy services are available to service users and information is made available in the home. Staff receive awareness training regarding adult protection through the use of a locally produced “No Secrets” video. During the inspection a service user was seen with facial bruising. Detailed records showed that this was due to a fall and outlined the incident and the attention received. The Commission had been properly notified and the service users’ risk assessment had been updated. Improvements in recording systems in the home allow for more effective monitoring and early intervention when such problems arise. Hatt House D54-D07 S18367 Hatt House V224110 260705 Stage 4.doc Version 1.40 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 standard(s) 19, 20, 21, 22, 24 and 26 Service users’ needs for safety and comfort are generally well met. However some outstanding maintenance issues detract from service users’ comfort, safety and privacy. EVIDENCE: Whilst some minor decorative and maintenance details were noted which required attention, the premises are generally maintained to a high standard. Furnishings are of a comfortable and homely nature and meet service users’ individual needs. Some service users made favourable comments about the armchairs in the lounge which had recently been replaced. Records were available for inspection which demonstrated the safe maintenance of the premises and equipment (see below). Hygiene standards in the kitchen had been improved by its recent refurbishment. Discussion with Mr. Oaten and a contractor confirmed that the programme of covering radiators in the home would be completed imminently. Various aids and adaptations were seen around the home such as hoists, grab rails and raised toilet seats. Call systems are available in each room. Individual needs for aids and adaptations are assessed by relevant professionals such as Physiotherapists and Occupational Hatt House D54-D07 S18367 Hatt House V224110 260705 Stage 4.doc Version 1.40 Page 15 Therapists. Some signage is provided on the ground floor to assist orientation for service users with dementia. It is recommended that the Registered Providers consider ways in which orientation might be further improved. Individual rooms were found to be comfortably furnished and to contain service users’ possessions and individual aids and adaptations such as grab rails and hoists. Some lavatory frames were found to be corroded and requiring attention. Many rooms have laminate flooring. Mr. Oaten stated that carpets were available and would be fitted if service users’ preferred. Those service users with whom this was discussed were content with their flooring except one who stated that she “wouldn’t mind” a carpet. It is recommended that where a carpet is not provided, this should be recorded with the reason (e.g. service users’ choice or indicated by risk assessment). Locks are being fitted to service users’ doors though this programme has not yet been completed. Some service users’ doors are currently fitted with concealed mortice bolts only and one room was noted to have no lock. The home has 6 rooms with en suite facilities, two communal bathrooms and a shower room. Toilet facilities are throughout the home are accessible to service users. The lock on one communal bathroom did not work. Mrs. Oaten stated that service users were always accompanied by staff when using this bathroom. There were no unpleasant odours in the home and all areas were found to be clean. Hatt House D54-D07 S18367 Hatt House V224110 260705 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30 Service users benefit the support adequate numbers of safely recruited and well-trained staff. EVIDENCE: Observation of work being undertaken and discussion with staff and service users indicated that the home is sufficiently staffed. The Registered Providers are involved on a day-to-day basis in the management of the home, in addition to which there is an unregistered “Clinical Manager”. A former employee is acting as a training consultant. A skills matrix training plan and individual training records were available for inspection. This training activity was confirmed in interviews with staff. NVQ training as well as short courses relevant to the needs of service users are being undertaken. Ten staff are currently undertaking NVQ courses. Mrs. Oaten envisaged that these staff would be qualified in time to meet the nationally set target for numbers of trained care staff. There was evidence that care staff had benefited from this training and that new knowledge and skills were being applied in the home. This applied to key working records and new systems such as those for falls monitoring. Staff records and discussion with staff Demonstrated sound recruitment processes. These include the taking up of two references, CRB and POVA checks and formal interviews. GSCC codes of conduct are made available to staff though not all were aware of these. Hatt House D54-D07 S18367 Hatt House V224110 260705 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 35 and 38 Service users are benefiting from improving systems for the management and administration of the home. EVIDENCE: A notice had been posted in the home to inform service users and relatives concerning the impending inspection. Policies and practices in the home (e.g. concerning recording) had changed in response to review by the Registered Provider and Clinical Manager. The Clinical Manager in particular is commended for her commitment and enthusiasm for the improvement of systems and practice. The Registered Provider had conducted a wide ranging quality audit since the last inspection and systems are now in place for quality monitoring. The Registered Providers are not involved in Service Users’ finances which are managed either by service users, relatives or advocates. Where required, small amounts of personal spending are funded by the home and reclaimed from the relevant party. Records of this spending were available for inspection and Hatt House D54-D07 S18367 Hatt House V224110 260705 Stage 4.doc Version 1.40 Page 18 appeared in good order. Possessions brought to the home are recorded in the care plan files. Health and safety records were seen including checks for electrical wiring and personal appliance testing, gas safety and equipment maintenance. A fire plan was seen as well as evidence of regular fire safety training and the maintenance of fire equipment. Individual and environmental risk assessments had been conducted. After discussion with the Registered Provider it is recommended that risk assessments concerning window restriction should be reviewed. Discussion with staff and a sampling of staff records provided evidence of staff training in health and safety topics such as food hygiene and moving and handling. Accident records were seen which had been properly completed. Hatt House D54-D07 S18367 Hatt House V224110 260705 Stage 4.doc Version 1.40 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 3 15 3 COMPLAINTS AND PROTECTION 2 3 3 2 x 2 x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 x x 3 x 3 x x 3 Hatt House D54-D07 S18367 Hatt House V224110 260705 Stage 4.doc Version 1.40 Page 20 Are there any outstanding requirements from the last inspection? 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 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. 1. 2. 3. 4. 5. Refer to Standard 9 19 24 24 38 Good Practice Recommendations The home should ensure that all skin creams are labelled with the name of the service user for whom they are supplied and are used exclusively for that service user. All service users lavatories and bathrooms should have locks suited to the ability of service users and accessible in an emrgency. The programme of fitting locks to service users rooms should be completed Where service users are not provided with carpeting in their own rooms, this should be recorded in the individual plan with the reason. It is recommended that risk assessments concerning window restriction should be reviewed Hatt House D54-D07 S18367 Hatt House V224110 260705 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Hatt House D54-D07 S18367 Hatt House V224110 260705 Stage 4.doc Version 1.40 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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