Inspection on 23/08/05 for Hawkhurst Care Centre

This inspection was carried out on 23rd August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Hawkhurst Care Centre 14/02/06

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 Lancashire BB1 8AZ Lead Inspector Jane Craig Unannounced 23 August 2005 09:00 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. Hawkhurst Care Centre F57 F07 S5823 Hawkhurst V240541 230805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Hawkhurst Care Centre Address 16-18 Shear Bank Road Blackburn Lancashire BB1 8AZ 01254 698338 0116 2702318 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) Prime Life Limited Mrs Sandra Hazel Scarr Care Home Only Personal Care (PC) 24 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia - over 65 years of age (MD)(E) 24 of places Dementia - over 65 years of age (DE)(E) 24 Hawkhurst Care Centre F57 F07 S5823 Hawkhurst V240541 230805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 A maximum of 24 service users requiring personal care who fall into the category of MD(E) or DE(E) 2 The registered provider shall, at all times, employ a suitably qualified and experienced manager who is registered with the NCSC. Date of last inspection 03 March 2005 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 are 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 F57 F07 S5823 Hawkhurst V240541 230805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day. At the time there were 24 residents living in the home. The inspector met with most of the residents and observed their interactions with staff. Due to memory and communication difficulties, the majority of the residents were unable to discuss their views or make comment about their experience of living in the home. Discussions were held with the registered manager, three members of staff and a visiting professional. The inspector also met with a resident’s relative. A partial tour of the premises took place and a number of documents and records were viewed. Detailed notes were taken, which have been retained as evidence of the inspection findings. What the service does well: What has improved since the last inspection? The way that staff were recruited to work at the home was better. The manager made sure that only staff who had been through the proper checks were able to start working with the residents. Hawkhurst Care Centre F57 F07 S5823 Hawkhurst V240541 230805 Stage 4.doc Version 1.40 Page 6 The manager had reviewed the numbers of staff on duty at the home. An extra carer was on duty early in the morning to make sure that residents who got up early were supervised properly. 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 F57 F07 S5823 Hawkhurst V240541 230805 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 Hawkhurst Care Centre F57 F07 S5823 Hawkhurst V240541 230805 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) 1 and 3 Prospective residents received sufficient information to enable them to make a decision as to whether the services provided at the home were suitable. The admission procedure was thorough and ensured that staff had a clear understanding of the resident’s needs and how they were to be met. EVIDENCE: The statement of purpose included a plan of the home giving information about bedrooms and communal space. All the required information was available in a range of documents that were sent out to prospective residents. One relative confirmed that they had received some detailed information about the home. Care management and/or hospital discharge assessments were on the four residents’ files seen. Senior staff also visited and assessed residents prior to their admission to the home. The assessments identified residents’ needs and were used to draw up initial care plans. Staff confirmed that they read assessments and care plans before the resident came into the home. Residents and/or their relatives received written confirmation that their needs could be met. Hawkhurst Care Centre F57 F07 S5823 Hawkhurst V240541 230805 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 Care plans were detailed and provided staff with the information they needed to understand and meet residents’ needs. Staff met residents’ healthcare needs with support from outside agencies. Medication policies and practices were generally thorough. However, the practice of removing labels from topical medicines may place residents at risk. Care was provided in such a way as to promote residents’ privacy, dignity and independence. EVIDENCE: The care records of four residents were inspected. The plans were clearly written and explained in detail how the resident’s needs were to be met. Plans contained risk assessments for moving and handling, nutrition, pressure sore risk and potential risks to the individual, for example falls or wandering. Meaningful strategies were recorded where risk was identified. Care plans were reviewed every month and showed evidence of updates when the resident’s needs changed. Staff confirmed that they held monthly care planning meetings and the plans were used as working documents. Relatives were encouraged to read care plans and their comments were recorded. One relative confirmed that they had been fully involved in drawing up the care plans. Hawkhurst Care Centre F57 F07 S5823 Hawkhurst V240541 230805 Stage 4.doc Version 1.40 Page 10 Plans contained evidence of physical and psychological healthcare monitoring. From observation of interactions between staff and residents it was evident that staff had a clear understanding of dementia care and the individual needs of residents. Residents were referred to GPs, community mental health nurses, opticians, dentists, chiropody and other agencies as appropriate. A visiting district nurse said that residents received good care in the home and referrals to the district nursing service were timely and appropriate. A resident said “we are well looked after”. Medication policies had been updated. There was a complete set of policies and procedures in line with current guidance. Appropriate records were kept of medication entering and leaving the home. Medication Administration Record (MAR) charts were completed. Medicines were stored safely. There were a number of containers of cream stored without prescription labels. Labels must not be removed from prescribed medication and any creams no longer in use should be returned to pharmacy. Members of staff were observed attending to residents in a caring and professional manner. Personal care was carried out in the privacy of the resident’s own room or the bathroom. The manager confirmed that medical examinations and treatments were conducted in the residents own room. Staff were taught about basic care values during their induction and two members of staff spoke about the importance of maintaining residents’ privacy, dignity and independence. Directions on care plans made reference to these values. Hawkhurst Care Centre F57 F07 S5823 Hawkhurst V240541 230805 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, 14 and 15 Routines were flexible and residents were able to make choices and decisions about their daily lives. Residents had opportunities to engage in stimulating activities. The meals were varied and of a good standard. EVIDENCE: Residents’ families were asked to complete a “getting to know you” booklet which, when completed, were an excellent source of information about the resident’s past and present life. Staff gave examples of how this information was used to engage residents in one to one activities and discussions. One resident, who was a former cook, regularly baked cakes and another resident helped with the house plants and gardening. Staff were seen to spend time with residents who were not able to participate in activities or discussions. The registered manager was planning to incorporate activities into social care plans to ensure residents’ interests and skills were maintained. There was also a programme of group activities and a weekly trip to local places of interest. Residents’ participation was recorded in their daily notes. This information was then used to audit the success of different activities. The manager and staff advised that, where able, residents made choices about all aspects of their daily lives. They confirmed that where choices were made on behalf of residents it was with a prior knowledge of likes, dislikes and preferences. Staff were also seen to read and understand non-verbal signs of residents unable to communicate. Following a recommendation from a Hawkhurst Care Centre F57 F07 S5823 Hawkhurst V240541 230805 Stage 4.doc Version 1.40 Page 12 previous inspection staff were clear about the policies regarding residents’ choice of times for getting up and going to bed. This was confirmed by one resident who said “we can get up at any time.” During the course of the inspection staff were seen to consult with residents and enable them to make decisions. Lunch served at the time of the inspection looked wholesome and appetising. The records of meals showed that residents received a varied, nutritiously balanced diet. There were fresh vegetables at each meal. Special diets were catered for and residents could have their meals outside of usual mealtimes if they wanted. Residents’ comments about the meals were positive and included; “we always have a lovely dinner,” “very nice,” “I ask for a small meal, that’s just enough” and “lovely, I always clear my plate.” Hawkhurst Care Centre F57 F07 S5823 Hawkhurst V240541 230805 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) 18 Staff had a good understanding of adult protection issues, however, lack of clarity about reporting procedures may result in allegations not being investigated appropriately. EVIDENCE: Adult protection issues were covered during induction training and all staff received annual updates. The company policy on protection of vulnerable adults had been amended to include reporting procedures in line with the local authority policy. Staff spoken with showed a thorough understanding of abuse and how to detect it. Staff were aware of the whistle blowing policy. However, some staff were unclear about how to report an incident without compromising a possible investigation. Hawkhurst Care Centre F57 F07 S5823 Hawkhurst V240541 230805 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, 25 and 26 The home was clean and well maintained. The standard of décor and furnishings providing residents with a safe, comfortable and homely place to live. Inadequate control of hot water temperatures may place residents at risk. EVIDENCE: At the time of the inspection the home was clean, tidy and free from offensive odours. A tour of the premises showed a satisfactory standard of décor throughout the home. Furnishings were comfortable and homely. The company carried out an annual audit and areas for redecoration and refurbishment were identified. The home and grounds were well maintained and systems were in place to ensure repairs were carried out in a timely fashion. Some residents commented that the home was nice and clean and they were happy with their bedrooms. Hot taps were fitted with valves to control water temperatures. These were monitored every month. Records showed temperatures were satisfactory but at the time of the inspection the hot water in two of the bathrooms exceeded Hawkhurst Care Centre F57 F07 S5823 Hawkhurst V240541 230805 Stage 4.doc Version 1.40 Page 15 the recommended temperatures and could pose a risk to residents’ safety. Not all radiators were guarded. Risk assessments were in place to support this practice and the registered manager confirmed that the assessments were updated when new residents were admitted. Water storage temperatures controlled risk of Legionella. The laundry was separate from resident areas. It was adequately equipped and on the day of the inspection clean and tidy. The clothing worn by the residents looked clean, tidy and well cared for. Hygiene and infection control procedures were covered in the induction training and updated annually. There were sufficient hand washing facilities and protective clothing was seen to be used. Hawkhurst Care Centre F57 F07 S5823 Hawkhurst V240541 230805 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, 28, 29 and 30 There were sufficient staff on duty to meet the needs of the residents. Recruitment practices had improved. Pre-employment checks were carried out, providing safeguards for residents. Staff had access to training which increased their knowledge and understanding of the needs of the residents and assisted them to fulfil the responsibilities of their roles. EVIDENCE: A previous requirement to review staffing levels had been actioned and there was an extra member of staff on duty early morning to ensure adequate supervision of residents who got up early. The registered manager and other members of staff confirmed that there were sufficient staff on duty at all times to meet the needs of the residents. A visitor to the home said that there was always someone with the residents no matter what time of the day they came. They also said the staff were “spot on, they know how to look after residents, some very difficult.” One resident said “I get on with them all.” A visiting professional talked about the good atmosphere in the home. Recruitment procedures had improved since the previous inspection. The files of two new members of staff were viewed. Pre-employment checks had been conducted before staff started work at the home. The files contained all of the required information and documents. Staff were employed on a probationary period and received appropriate supervision and mentorship. Hawkhurst Care Centre F57 F07 S5823 Hawkhurst V240541 230805 Stage 4.doc Version 1.40 Page 17 There were good opportunities for staff training. The induction training programme met the national training organisation specifications and took place over the first 6 weeks of employment. Training comprised discussions, inhouse training and self-study. There was an assessment of competency. The foundation training followed the same format. Other training included; dementia care, mental health, care practices and supervision. Training needs were identified during supervision and all staff had a training and development plan and file. All staff had opportunities to undertake NVQ training and 90 of care staff had attained at least a level 2. Hawkhurst Care Centre F57 F07 S5823 Hawkhurst V240541 230805 Stage 4.doc Version 1.40 Page 18 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) 37 and 38 Record keeping practices safeguarded residents. Staff were appropriately trained in health and safety measures. Failure to ensure timely servicing of gas appliances may place residents and staff at risk. EVIDENCE: A previous requirement, to keep reports of unannounced visits to the home by the responsible individual, had been actioned. All other records were in place and were stored appropriately. Residents or their representatives had access to personal records. Despite a previous recommendation, the documentation used for recording accidents did not comply with data protection legislation. Staff training in safe working practice topics was up to date. The company maintenance team tested the electrical installations and portable appliances. The registered person has confirmed that the maintenance team have the appropriate qualifications, equipment and testing schedule as recommended by the health and safety executive. The most recent gas safety inspection Hawkhurst Care Centre F57 F07 S5823 Hawkhurst V240541 230805 Stage 4.doc Version 1.40 Page 19 certificate was forwarded to the CSCI after the inspection. The certificate shows that the inspection was conducted in December 2004. The inspection should have been carried out in May 2004 and was, therefore, 7 months overdue. Testing of fire systems and equipment was up to date. Fire drills were conducted regularly. Environmental risk assessments were in place. Hawkhurst Care Centre F57 F07 S5823 Hawkhurst V240541 230805 Stage 4.doc Version 1.40 Page 20 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 3 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x x x 2 3 STAFFING Standard No Score 27 3 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 2 x x x x x x 2 2 Hawkhurst Care Centre F57 F07 S5823 Hawkhurst V240541 230805 Stage 4.doc Version 1.40 Page 21 No 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. 2. Standard 9 25 Regulation 13(2) 13(4) Requirement Labels must not be removed from prescribed medication. Hot water temperatures in bathrooms must be maintained at an acceptable level to ensure the safety of residents. Timescale for action 24/08/05 31/08/05 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. Refer to Standard 9 18 37 38 Good Practice Recommendations Unused medication should be returned to pharmacy. Staff should be clear about their roles in reporting any allegations of abuse. Documentation used to record accidents in the home should comply with data protection legislation. Systems should be in place to ensure that safety inspections for gas appliances are completed by the due date. Hawkhurst Care Centre F57 F07 S5823 Hawkhurst V240541 230805 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection 1st Floor, Unit 4 Petre Road, Clayton-Le-Moors Accrington Lancashire. 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 F57 F07 S5823 Hawkhurst V240541 230805 Stage 4.doc Version 1.40 Page 23 - 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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