Inspection on 27/04/06 for Hatton Court

This inspection was carried out on 27th April 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Hatton Court 26/02/08

Hatton Court 17/09/07

Hatton Court 27/09/05

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Hatton Court Whitchurch Road Cold Hatton Telford Shropshire TF6 6QB Lead Inspector Keith Salmon Key Inspection 27th April 2006 10:00 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 Hatton Court DS0000064716.V290323.R01.S.doc Version 5.1 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. Hatton Court DS0000064716.V290323.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Hatton Court Address Whitchurch Road Cold Hatton Telford Shropshire TF6 6QB 01952 541881 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) Springcare (Hatton) Limited Care Home 64 Category(ies) of Dementia - over 65 years of age (14), Old age, registration, with number not falling within any other category (44), of places Physical disability (6) Hatton Court DS0000064716.V290323.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home may accommodate a maximum of 44 Older Persons requiring nursing care, 6 can be Younger Persons with a Physical Disability, and 14 persons with Dementia. The minimum staffing levels required throughout the 24 hour day, including weekends, for service users who have low to medium dependency nursing needs is as follows:08:00-14:00 3 Qualified Nurses 9 Care Assistants 14:00-22:00 3 Qualified Nurses 7 Care Assistants 22:00-08:00 2 Qualified Nurse 6 Care Assistants 2. Additional staff must be on duty when service users requiring high direct care provision are accommodated. This is exclusive of the manager (when he/she is carrying out managerial duties). Date of last inspection 27th September 2005 Brief Description of the Service: Hatton Court is one of eleven care homes owned by Springcare (Hatton) Limited. Registered to accommodate a maximum of 64 Residents who may require personal care or nursing and may specifically comprise up-to a maximum of 44 ‘Older Persons’ requiring nursing care, up to 6 ‘Younger’ Persons with a Physical Disability’, and up-to 14 persons with Dementia – fees charged range from a minimum of £360 per week up-to a maximum of £620 per week. The single storey property was initially purpose built and provides spacious communal rooms, single or shared bedrooms, some of which have en-suite facilities, plus an additional six bedrooms and a large lounge housed in the extension. The Home benefits from well-maintained gardens laid to lawn, with flowerbeds, patio and car parking to the front of the property. Hatton Court DS0000064716.V290323.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Unannounced Inspection was undertaken by one Inspector, commenced at 09.30 and took 5.5 hours. Present were Mrs. Helen Whitehouse (Area Manager, Springcare Hatton Limited), and Mrs. Chris Simcock, Manager. Being the first Inspection of 2006/07 it centred on ‘Requirements’ cited at the previous Inspection, held in September 2005, plus all ‘Key’ National Minimum Standards. This Report is based on observations made during a tour of the Home, a review of care related documentation, staff duty rotas and staff employment and training files, plus a range of other documents/records reflecting the general operation of the Home. The Inspectors also held 1:1 discussions with Mrs. Whitehouse, Mrs. Simcock, 5 Residents and several members of Staff. What the service does well: What has improved since the last inspection? The Home had previously slipped to poor levels of management and, as a result of this, was providing less than adequate standards of care provision. At this Inspection, in the relatively early days of new ownership and new management there are definite signs of recovery. This is evident in general ambience, décor, documentation and many operational practices. Hatton Court DS0000064716.V290323.R01.S.doc Version 5.1 Page 6 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. Hatton Court DS0000064716.V290323.R01.S.doc Version 5.1 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 Hatton Court DS0000064716.V290323.R01.S.doc Version 5.1 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): 1,2,3,4. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prior to taking up residency prospective Residents have been enabled to reach an informed choice and to fully understand the service they may expect to receive. Processes to ensure appropriate and thorough care needs assessment, prior to admission, are effectively applied. EVIDENCE: Following the change of ownership the Home has fully revised the Statement of Purpose and User Guide, both of which are concise and easy to read, with content, which meets the requirements of the Standard. The fact that all Residents do not have the benefit of a Statement of Terms and Conditions/Contract detailing the accommodation to be provided is a ‘hangover’ from the previous administration. Evidence seen demonstrated that Residents recently admitted have received such a contract and that the Manager is working systematically to ensure all Residents receive their Contract – completion of this is expected by end May 2006. Hatton Court DS0000064716.V290323.R01.S.doc Version 5.1 Page 9 At the previous Inspection it was ‘Required’ all Residents must have care needs fully assessed prior to admission and have a comprehensive Care Plan based on this assessment. Evidence from 5 randomly selected Care Plans showed these ‘Requirements’ to be fully met. Residents/Relatives confirmed that prospective Residents have the opportunity to visit the Home, or enter the Home on a trial basis, prior to admission. The Home currently uses the “Standex” format for assessment and care records, which provides a structure for all elements of the Standards to be met. Although this appears to be satisfactory in use Staff have expressed difficulties in using the documentation and as a result of this Management and Staff are in the process of modifying the documentation to suit their needs. A ‘Requirement’ cited at the previous Inspection was “Staff must have the skills and experience to deliver care and services which the Home offers.” Review of staff training and supervision records, observation during the Inspection and discussion with Residents provided evidence to support the view the Staff group have been suitably trained. Hatton Court DS0000064716.V290323.R01.S.doc Version 5.1 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): 7,8,9,10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care provided by the Home is effective in meeting the Residents’ assessed care needs, and is delivered considerately and effectively. The approach of Staff in providing such care is good, with relationships between Residents and Staff being friendly and respectful. The storage, administration, and disposal of medicines are in accordance with accepted good practice. EVIDENCE: At the previous Inspection a number of ‘Requirements’ were cited under Standards covering Health and Personal Care. These being: − The Home must ensure Care Plans are comprehensive. − Home must ensure that Care Plans, Training, Assessment and Skills are in place so that Service Users’ needs are met. Also, since the previous Inspection an ‘incident’ relating to a Resident having severe pressure sores was brought to the attention of CSCI. Hatton Court DS0000064716.V290323.R01.S.doc Version 5.1 Page 11 Five Residents’ Care Plans/Files were reviewed (i.e. those of the two most recently admitted Residents, plus 3 randomly selected) as a component of ‘Case Tracking’. This process provided clear evidence of these ‘Requirements’ having being fully met and the Home’s practices in relation to ‘risk assessment, prevention and management of pressure sores to be satisfactory. In addition, the Home was ‘Required’ to ensure medicine administration protocols are followed at all times. An inspection of the medicine storage provision and medicine administration records showed this ‘Requirement’ to be fully met. The Home’s practices now meet the guidelines of the Royal Pharmaceutical Society. Through observation, and individual discussions with Residents, it is clear they are treated in a considerate and respectful manner. Hatton Court DS0000064716.V290323.R01.S.doc Version 5.1 Page 12 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A range of leisure opportunities, consistent with Residents’ capabilities, is provided and the Home facilitates achievement of desired lifestyle through Residents conducting the pattern of their day as they wish. This includes contact with family and friends and continuation of religious practices. The Home provides a daily choice of attractive, nutritionally balanced meals. EVIDENCE: The Home has a very full programme of activities, which is planned and organised by an Activities Co-ordinator. The programme is up-dated on a monthly basis and displayed on notice boards around the Home. Activities include bingo, films/videos, sing-a-longs, seasonal celebrations (e.g. Easter), birthdays. Residents informed the Inspector they received visitors whenever they wished. The Home displays menus, which are planned on a weekly basis, but contain flexibility to cater for individual preferences. Residents were complementary about the quality of meals and the choices they are afforded. Hatton Court DS0000064716.V290323.R01.S.doc Version 5.1 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): 16,18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The interests of Residents are protected through ready access to information relating to advocacy services and the Home’s Complaints Procedure. Staff are aware of their role in protecting Residents from abuse. EVIDENCE: Complaints Procedure details are included in the Service User Guide and are displayed prominently for the benefit of visitors. There are policies and procedures in place intended to provide protection for vulnerable people. These fully meet the requirements of this Standard and staff training files confirm the topic is covered both at induction and through on-going staff training. Hatton Court DS0000064716.V290323.R01.S.doc Version 5.1 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): 19,20,21,26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Generally the Home provides a safe, well-maintained environment with the exception being safe access for all Residents to the gardens. Specialist equipment, consistent with meeting the assessed care needs of Service Users, and the demands of tasks carried out by Care Staff, are provided and appropriately serviced and maintained. The cleanliness and general state of repair in all areas of the Home is of a good standard. EVIDENCE: At the previous Inspection four ‘Requirements’ were cited under Standards covering ‘Environment’ i.e.: − The Home must provide a nurse call system which minimises disruption to other Service Users when Staff are being alerted. (Previous timescale of 19th October 2004 not met). Hatton Court DS0000064716.V290323.R01.S.doc Version 5.1 Page 15 − A safe pathway must be laid from the new extension to the car park. − The handrail in Bathroom 1 must be secure and safe for use at all times. − The handrail in the toilet of the new extension must be secure and safe for use at all times. The Inspector observed the previous ‘nurse-call’ system (which was very loud) has been replaced with a new system, which alerts Staff to calls from Residents without being intrusive. A check of handrails found them all to be secure. At the time of this Inspection the Home has not yet laid a safe pathway from the extension patio to the car park. In addition, the Home has yet to provide a ‘safe-garden’ for the use of Residents with dementia. However, it is accepted these areas of work are included in further plans to improve the functionality of the premises. As indicated in the ‘Summary’ above, the Home has made considerable progress in meeting shortfalls identified at earlier Inspections. There remain areas to address and these would be facilitated if the Home had an on-going maintenance/redecoration plan, which includes target dates and a written record reflecting targets achieved. The ‘Responsible Person’ must produce and implement (with records kept) a programme of routine maintenance and renewal of the fabric and decoration of the premises. Hatton Court DS0000064716.V290323.R01.S.doc Version 5.1 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): 27,28,29,30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff numbers on duty and skill-mix were sufficient to meet the assessed care needs of current Residents. Recruitment and employment practices are consistent with the safeguarding of Residents. The commitment of the Home in providing training for Care Staff is satisfactory, and in accordance with individual Staff Member’s learning needs. EVIDENCE: The current staffing rota, and those from the immediately preceding weeks, were examined demonstrated staffing numbers and skill-mix enable a service provision, which meets the care needs of the Service Users. At the previous Inspection it was ‘Required’ under Standard 30 the Manager and Nurses must complete training in Supervision (first issued in October 2004). Staff training records, and discussion with the Manager, demonstrated the ‘Requirement’ has been met. Staff are subject to a thorough and relevant orientation/induction programme, a comprehensive ‘foundation’ training, e.g. ‘manual handling and lifting’, ‘fire safety’, ‘simple infection control’ followed by access to NVQ Training. A review of employment files for 5 members of Staff, (i.e. those relating to the 2 most recently employed, plus 3 selected at random), provided evidence of full compliance with the Standard, and Schedule 2, of the Regulations. Hatton Court DS0000064716.V290323.R01.S.doc Version 5.1 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): 31,32,33,35,36,38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Home is well managed by the Registered Manager, Mrs. Chris Simcock, and provides an ambience, which is warm, friendly and inclusive with the central purpose being ‘the best interests of Residents’. Operationally, it is well organised with lines of accountability being clearly defined and observed. The views of Residents and other interested parties are sought by the Home and acted upon. The interests of Service Users may be at risk by the financial procedures employed to safeguard Residents’ ‘small cash’ amounts. All Staff are subject to effective support with regular supervision, and appeared involved and happy in their work. Health and Safety Policies/Procedures/Practices were satisfactory. Hatton Court DS0000064716.V290323.R01.S.doc Version 5.1 Page 18 EVIDENCE: Observation by the Inspector, together with comments from Residents and Staff, suggest the Home is currently being well managed. Written reports from regular attendance at the Home by the Area Manager demonstrate evidence of good support for the Manager. The Home conducts financial management of personal monies for a few Residents. These amounts of cash (usually quite small) are deposited for safekeeping by Relatives/Visitors and locked in the Home’s safe. As required by the Standard the storage of these amounts is kept as separate amounts and receipts recording evidence of expenditure are retained and transactions checked by two signatories. However, the use of paper envelopes for this storage is not satisfactory. In addition, the use of an indexed accounting ledger would be preferable to the book currently in use. It is a ‘Requirement’ of this Inspection that practices relating to the management of Residents’ cash amounts are reviewed to ensure implementation of ‘best practice’. All other records were seen to be secure and well maintained. The Home’s practices in the context of health, safety and welfare of Residents, Visitors, and Staff were seen to be in accordance with the Regulations, i.e. COSHH requirements were satisfactory, with maintenance and servicing of equipment regularly undertaken, and appropriately documented. Records are maintained for hot water supply to baths, and water tested during the Inspection was satisfactory. Hatton Court DS0000064716.V290323.R01.S.doc Version 5.1 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 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 X N/A 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 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 2 3 X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 2 3 X 3 Hatton Court DS0000064716.V290323.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? YES 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 OP19 Regulation 23. -(2) (b)(c)(d) Requirement The ‘Responsible Person’ must produce and implement (with records kept) a programme of routine maintenance and renewal of the fabric and decoration of the premises. A safe pathway must be laid from the new extension to the car park. Practices relating to the management of Resident’s cash amounts must be reviewed to ensure implementation of ‘best practice’. Timescale for action 30/06/06 2. 3. OP20 OP35 23. (2)(o) 12. – (1)(a) 31/08/06 30/05/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Hatton Court DS0000064716.V290323.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE 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 Hatton Court DS0000064716.V290323.R01.S.doc Version 5.1 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. 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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