Inspection on 14/02/06 for Hawkhurst Care Centre

This inspection was carried out on 14th February 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

Hawkhurst Care Centre 23/08/05

Hawkhurst Care Centre 03/03/05

Hawkhurst Care Centre 03/06/04

Hawkhurst Care Centre 17/02/04

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Hawkhurst Care Centre 16-18 Shear Bank Road Blackburn Lancs BB1 8AZ Lead Inspector Jane Craig Unannounced Inspection 14th February 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 Hawkhurst Care Centre DS0000005823.V280467.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. Hawkhurst Care Centre DS0000005823.V280467.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Hawkhurst Care Centre Address 16-18 Shear Bank Road Blackburn Lancs BB1 8AZ 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) 01254 698338 0116 2702318 Prime Life Limited Mrs Sandra Hazel Scarr Care Home 24 Category(ies) of Dementia - over 65 years of age (24), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (24) Hawkhurst Care Centre DS0000005823.V280467.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. A maximum of 24 service users requiring personal care who fall into the category of MD(E) or DE(E) The registered Provider shall, at all times, employ a suitably qualified and experienced Manager who is registered with the National Care Standards Commission. 23rd August 2005 Date of last inspection Brief Description of the Service: Hawkhurst Care Centre is owned by Prime Life Limited. The home provides 24 hour personal care and accommodation for up to 24 older people who have mental health care needs or dementia. Hawkhurst is located in a residential area and overlooks Corporation Park. Blackburn town centre is easily accessible. The home stands in large, well maintained grounds. There is a small car at the front entrance and a secure garden area at the rear. Hawkhurst is a two storey, detached house. The top floor is accessed by a passenger lift. Bedroom accommodation is on both floors. There is a mix of single and shared rooms with wash basins. There are accessible toilets and bathrooms on both floors. The home has three lounge areas, a conservatory and two dining areas. All communal areas are furnished in a comfortable and homely way. There is a range of seating to meet the needs of the service users. Various adaptations to promote independence and assist mobility are located around the home. Hawkhurst Care Centre DS0000005823.V280467.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 1 day. The previous statutory inspection was done on 23rd August 2005 and information on the findings of this can be obtained from the home or from www.csci.org.uk There had been no additional visits to the home. At the time of the inspection there were 24 residents living at the home. The inspector met with several residents and spent time observing interactions between staff and residents. Due to memory and communication difficulties, a number of residents were unable to discuss their views or make comment about their experience of living in the home. The inspector spoke with two visitors to the home. Discussions were held with the registered manager and three members of staff. A partial tour of the premises took place and a number of records and documents were viewed. Detailed notes were taken, which have been retained as evidence of the inspection findings. What the service does well: Most of the care plans were well written. They gave staff clear directions about what help residents needed and the way they preferred to be helped. Although residents were not able to be involved in their care plans, relatives said that they were consulted. Staff made sure that residents’ health care needs were met. They monitored ongoing problems and made sure that residents saw doctors and other health professionals whenever they needed to. There was a good programme of activities. Staff understood the importance of providing stimulation for residents and worked hard to make sure they had meaningful occupation. One resident who was doing art and crafts during the inspection said, “it’s lovely, I love living here.” Residents were able to have visitors at any time. Visitors said they were always made welcome by staff and they felt involved in their relative’s care. There was a clear complaints procedure for residents and relatives to follow. Staff knew what to do to make sure that complaints were dealt with properly and one resident said she would talk to staff if anything was wrong. All staff received regular training in the protection of vulnerable adults. They also had written information to refer to. This meant that they had a greater understanding of abuse issues, and should ensure that any allegations would be dealt with appropriately. Hawkhurst Care Centre DS0000005823.V280467.R01.S.doc Version 5.1 Page 6 The registered manager was very experienced and well qualified. The staff said the manager was helpful and approachable and knew her job inside out. What has improved since the last inspection? 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. Hawkhurst Care Centre DS0000005823.V280467.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 Hawkhurst Care Centre DS0000005823.V280467.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): EVIDENCE: None of the above standards were assessed during this inspection. Standards 1 and 3 were assessed and met during the inspection of 23/08/05. Hawkhurst Care Centre DS0000005823.V280467.R01.S.doc Version 5.1 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 the following standard(s): 7, 8 and 9 The new care plan format ensured that residents’ needs were continually assessed and staff were provided with direction. Staff met residents’ healthcare needs with support from outside agencies. Medication policies and practices provided safeguards for residents. EVIDENCE: A new care plan format had been introduced. Each resident had a range of assessments covering personal; health and social care needs. The assessments highlighted the areas where care plans should be drawn up. The concept was very good and some of the summaries written by staff were excellent. The standard of care plans varied. Some were pre-printed and gave little information about the individual’s care needs and how they were to be met. A member of staff said that they liked the new format but the preprinted care plans would not be thorough enough to instruct staff who did not know the residents very well. Other care plans, which had been written by staff, provided clear directions and included information about residents’ individual routines and preferences. The assessments and plans were reviewed at least once a month or whenever the resident’s needs changed. Regular care plan review meetings were held. These ensured that all staff had Hawkhurst Care Centre DS0000005823.V280467.R01.S.doc Version 5.1 Page 10 input into the care plans. There was evidence that resident’s relatives were consulted. One visitor said that he had read and agreed to the plans of care. Risk assessments and management strategies were on file for moving and handling, nutrition and pressure sores. Records showed that ongoing health care needs were monitored. Residents were referred to GPs, district nurses, community mental health nurses, opticians, dentists, chiropody and other agencies as necessary. It was usual practice to ask relatives to accompany residents to hospital appointments. One relative commented that the last time he had escorted his wife he did not have enough information to be able to answer the doctor’s questions, which meant that the consultation was not as beneficial as it should be. Discussions took place with the registered manager as to how this type of situation could be avoided. As an interim measure a staff escort was arranged for the next appointment. The previous requirement and recommendation to improve the management of medicines had been implemented. There was a complete set of medication policies. The records of medicines entering and leaving the home were complete. Medication Administration Record (MAR) charts were up to date and reasons for any omissions were recorded. Handwritten amendments to MAR charts were not always signed or witnessed. Records of changes to medication in the middle of the month were not always clear and safe. A number of residents took when required medication. A chart was displayed in the treatment room of the medication and effects. Discussions took place as to how this could be further developed to include criteria to assist staff to know when the medication should be given and minimise the risk of under or over medication. Medicines were stored safely and temperatures of storage areas were monitored. Hawkhurst Care Centre DS0000005823.V280467.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 and 13 Residents had opportunities to engage in appropriate and meaningful activities. Open visiting arrangements meant that residents were able to maintain contact with their relatives and friends. EVIDENCE: Following a company wide campaign, a new programme of activities had been introduced. A range of equipment had been purchased to assist. The staff team talked about the importance of engaging residents in meaningful activities and were keen to implement the new programme. Throughout the course of the inspection most residents were occupied for part of the day and records showed that this was a usual occurrence. Residents’ participation and enjoyment were recorded and the manager said the aim was to use the information to plan specific activities around residents’ individual needs. One resident who was doing an art and craft group said, “It’s lovely, I love living here.” There was an open visiting policy. One resident said it was nice to see people around. Two visitors to the home said that they were always made welcome. One said that the staff were always polite and another said that they were made to feel comfortable and involved. Relative meetings were held annually. Staff were available to discuss care issues but the event was also a social occasion. Several residents had church visitors and there were some links with the local schools who gave concerts at Christmas. Hawkhurst Care Centre DS0000005823.V280467.R01.S.doc Version 5.1 Page 12 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 and 18 Staff understood how to deal with complaints, which meant that any complaints would be dealt with appropriately. The manager and staff were clear about their roles in protecting vulnerable adults which meant that any allegations of abuse would be dealt with appropriately. EVIDENCE: The complaints procedure was prominently displayed. The procedure was clear and included all the necessary information. One resident said she had no complaints but she would be able to tell staff if she was unhappy about anything. Staff were aware of how to deal with any complaints in accordance with the complaints policy. Records showed there had been no complaints over the past year. Staff, residents and visitors had access to information about the protection of vulnerable adults. The home’s policy dovetailed with the local authority policy, which was available for reference. Staff received training in adult protection issues and those spoken with were very clear about their role in reporting any allegations. Staff were aware of the whistle blowing policy and when anything should be reported outside the home. The manager was clear about her role in reporting abuse. Hawkhurst Care Centre DS0000005823.V280467.R01.S.doc Version 5.1 Page 13 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): 25 Inadequate control of hot water temperatures may place residents at risk. EVIDENCE: The manager had taken steps to meet a previous requirement to ensure that hot water in the bathrooms was maintained at an acceptable temperature. Maintenance staff checked temperatures every month and records showed they were maintained between 410c and 430c. However, the inspector found the water in one bathroom to be 520c and in another to be 230c. The maintenance person checked the temperatures at the time of the inspection and found them to be satisfactory, which suggests the fault may be intermittent. Hawkhurst Care Centre DS0000005823.V280467.R01.S.doc Version 5.1 Page 14 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 There were sufficient staff on duty to meet the needs of the residents. EVIDENCE: At the time of the inspection there were enough staff on duty. Visitors said that in their opinion there were enough staff on duty. One said, “there is always someone on hand.” Another said, “there are enough staff to sit and talk to them.” Staff said there were enough staff unless there were residents who were poorly or needed extra care. They said if this was the case they would be able to ask for extra staff. The manager confirmed this and said she had some flexibility to increase staffing levels if it was necessary. Extra staff had been rostered early in the morning to ensure the supervision of residents who got up early. Hawkhurst Care Centre DS0000005823.V280467.R01.S.doc Version 5.1 Page 15 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, 33, 35, 37 and 38 An experienced and competent manager was in charge of the home. Systems were in place to ensure that the service was run in the best interests of the residents. Residents’ finances were managed in a way that safeguarded their interests. Record keeping practices safeguarded residents. EVIDENCE: The registered manager was qualified to NVQ level 4 in care and management. She had many years experience of managing the home. The manager kept up to date through attending short courses and personal study. Throughout the course of the inspection the manager showed a commitment to developing and improving the service. Any previous requirements or recommendations within the control of the registered manager had been actioned and it was apparent that she attained high standards of care for residents at Hawkhurst Care Centre. Staff were aware of the lines of accountability within the home and respect for the manager was evident. Staff commented that the manager was helpful, approachable and knew her job inside out. Another member of staff Hawkhurst Care Centre DS0000005823.V280467.R01.S.doc Version 5.1 Page 16 commented that the manager was responsible for the good atmosphere in the home. Following a recent assessment the home had retained the Blackburn with Darwen Quality Assurance Award. The only recommendation made was to provide the registered manager with supernumerary hours. The manager carried out various internal audits to monitor the quality of systems such as care planning, activities and staff training. The inspector was told that the company are planning to introduce a new system for seeking the views of residents and relatives. A senior manager is due to visit the home in March to talk with residents and relatives. Those who are not able to discuss their views at the time will be invited to complete comment cards. The manager was not clear about how the meeting would inform the annual development plan for the service. Staff handled finances for one resident. Monies for fees and personal allowance were handled separately. Families managed all other residents’ finances. None of the residents had a personal bank account. Personal money held on behalf of residents was deposited in a non-interest resident account. There were individual records showing all transactions and current balances. Receipts were kept of any money paid out on behalf of a resident. A previous recommendation to ensure accident records complied with data protection legislation had been met. Accidents were recorded on individual forms and stored in the residents’ personal file. This meant that residents or relatives did not have access to information about other residents. The previous recommendation to ensure that servicing of gas appliances was carried out on the due date had been met. The safety inspection due in December 2005 was carried out. Hawkhurst Care Centre DS0000005823.V280467.R01.S.doc Version 5.1 Page 17 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 X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 X X X X X X 2 X STAFFING Standard No Score 27 3 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X 3 3 Hawkhurst Care Centre DS0000005823.V280467.R01.S.doc Version 5.1 Page 18 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. 2. Standard OP25 Regulation 13(4) Requirement Hot water temperatures in bathrooms must be maintained at an acceptable level to ensure the safety of residents. Timescale for action 28/02/06 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. 2. 3. Refer to Standard OP8 OP9 OP9 Good Practice Recommendations The registered manager should provide written information or a staff escort for any resident attending a hospital appointment. Any handwritten amendments to MAR charts should be signed and witnessed. Any changes to residents’ medication in the middle of the month should be clearly and safely recorded on the MAR chart. Hawkhurst Care Centre DS0000005823.V280467.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB 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 Hawkhurst Care Centre DS0000005823.V280467.R01.S.doc Version 5.1 Page 20 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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