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Inspection on 24/06/05 for Hawthorn Lodge Care Home

Also see our care home review for Hawthorn Lodge Care Home for more information

This inspection was carried out on 24th June 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Residents were happy that their environment was improving and there were enough staff seen to spend time with residents.

What has improved since the last inspection?

Regal Care Ltd are investing in the environment of the home and residents were looking forward to living in a brighter, cleaner and better equipped home.

What the care home could do better:

The registered manager should ensure better liaison with all residents and relatives to keep them up to date of progress during the refurbishment. The registered manager must also ensure that complaints are recorded and where projects of this size take place appropriate pre planning and risk assessments take place and are recorded.

CARE HOMES FOR OLDER PEOPLE Hawthorn Lodge Care Home Beckhampton Road Bestwood Park Nottingham NG5 5LF Lead Inspector Susan Lewis Unannounced 24 June 2005 at 1.00 pm 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. Hawthorn Lodge Care Home C53 C03 S61999 Hawthorn Lodge V235526 240605 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Hawthorn Lodge Care Home Address Beckhampton Road Bestwood Park Nottingham NG5 5LF 0115 9676735 0115 9676735 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) Regal Care Homes Limited Gemma Else Care Home 60 Category(ies) of Old age - 60 registration, with number of places Hawthorn Lodge Care Home C53 C03 S61999 Hawthorn Lodge V235526 240605 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. To admit one named Service User with Dementia 2. The named Service Users needs are to be reviewed 6-monthly with the Social Worker. 3. When the Service Users contract is terminated for any reason the registration returns to its pre-existing state. Date of last inspection 4/05/05 Brief Description of the Service: Hawthorn Lodge is a large home that was previously owned by the Local Authority. The home is registered to provide personal care for up to 60 older people. It has several large lounges and one large dining room. Some of the bedrooms are ensuite. There is a passenger lift to the first floor. The home is set in its own grounds in a residential area with easy access to shops and bus routes. Regal Care Ltd bought the company in August 2004 and have begun a major refurbishment programme that will see all the communal areas redecorated, along with the residents bedrooms. This work started on 9th May 2005 and most of the work should be completed by the beginning of July 2005. Hawthorn Lodge Care Home C53 C03 S61999 Hawthorn Lodge V235526 240605 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over two hours and was a result of an anonymous complaint received by the Commission for Social Care Inspection regarding the refurbishment taking place in the home. It alleged that residents were distressed by the refurbishment and they were all in one lounge. Only standards pertinent to the complaint were inspected, for a more detailed inspection of the service and the requirements made please refer to the inspection of 4th May 2005. A tour of the premises took place and four staff and nine residents were spoken with. Staff files were not inspected this time but risk assessments for safe working practices were looked at. What the service does well: 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. Hawthorn Lodge Care Home C53 C03 S61999 Hawthorn Lodge V235526 240605 Stage 4.doc Version 1.40 Page 6 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 Hawthorn Lodge Care Home C53 C03 S61999 Hawthorn Lodge V235526 240605 Stage 4.doc Version 1.40 Page 7 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) EVIDENCE: Standards not assessed see inspection 4/05/05. Hawthorn Lodge Care Home C53 C03 S61999 Hawthorn Lodge V235526 240605 Stage 4.doc Version 1.40 Page 8 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) EVIDENCE: Standards not assessed see inspection 4/05/05. Hawthorn Lodge Care Home C53 C03 S61999 Hawthorn Lodge V235526 240605 Stage 4.doc Version 1.40 Page 9 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) EVIDENCE: Standards not assessed see inspection 4/05/05. Hawthorn Lodge Care Home C53 C03 S61999 Hawthorn Lodge V235526 240605 Stage 4.doc Version 1.40 Page 10 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 Complainants do not always believe that their complaints are taken seriously. EVIDENCE: The complaint received by the Commission was anonymous, however the complainant did say that they had raised the complaint with the registered manager but she had not been effective. The manager is reminded she must record all complaints including action taken. Hawthorn Lodge Care Home C53 C03 S61999 Hawthorn Lodge V235526 240605 Stage 4.doc Version 1.40 Page 11 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 and 26 The environment is being transformed into a pleasant, clean and bright living area. EVIDENCE: Regal Care Ltd have begun a major refurbishment of the home. All areas of the home are affected. The open brickwork along the corridors and in the lounge areas has now been covered over and in most areas painting has been completed. The upstairs lounge was completed first and residents and staff spoken with said that they had been able to use that lounge as well as a temporary lounge created in the dining room. Although the latter was not ideal it was seen as a temporary solution. The manager said that entrance lobby had also been used as a temporary lounge area, however this was not in general use on the day of the inspection. On the day of the inspection the decorating in the smoke room had been completed and residents were also sat there. The decoration had more or less been completed on the upper floor with all the dark paint being replaced with light colours and doors frames painted in different colours to enable residents to find which corridor they live Hawthorn Lodge Care Home C53 C03 S61999 Hawthorn Lodge V235526 240605 Stage 4.doc Version 1.40 Page 12 on. Evidence was seen that new furniture and curtains and carpets would be provided for all bedrooms and lounges and corridors. Although there was plaster dust in some parts of the building, staff were seen to be working hard to minimise the disruption to residents. All the residents spoken with were positive about what was happening, saying ‘it will be lovely when it is finished’. All residents acknowledged that it was very disruptive but as one resident said ‘you can’t make an omelette without cracking eggs’. Staff were mixed in their reaction. Some staff were very enthusiastic and very proud of what had been achieved showing the inspector all that had been done. Others did comment on the fact that it was very disruptive and that some residents had become disorientated when their rooms had been decorated. As the residents were coping very well with refurbishment on the day of the inspection and were not seen to be distressed or confined to one room the complaint is not upheld. Hawthorn Lodge Care Home C53 C03 S61999 Hawthorn Lodge V235526 240605 Stage 4.doc Version 1.40 Page 13 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) EVIDENCE: Standards not assessed see inspection 4/05/05. Hawthorn Lodge Care Home C53 C03 S61999 Hawthorn Lodge V235526 240605 Stage 4.doc Version 1.40 Page 14 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 and 38 Residents are placed at potential risk by lack of risk assessments and pre planning. EVIDENCE: Some of the residents spoken with had been aware of the refurbishment plan but did not know how long it would take. Staff spoken with said that a ‘wipe board’ had been put up prior to the refurbishment advising relatives and residents of the possible disruption to the home. However since the start of the refurbishment no other information has been provided and notice boards had been removed due to the refurbishment. Although there were some generic risk assessments to cover when work is undertaken in the home, there were no risk assessments specifically to look at the risks associated with this type of major refurbishment. There was also no project plan to show critical pathways detailing how the project would develop and who, what and where the disruption would be. Hawthorn Lodge Care Home C53 C03 S61999 Hawthorn Lodge V235526 240605 Stage 4.doc Version 1.40 Page 15 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 x x x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x x x x 2 x x x x 2 Hawthorn Lodge Care Home C53 C03 S61999 Hawthorn Lodge V235526 240605 Stage 4.doc Version 1.40 Page 16 Yes 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 16 Regulation 22 Requirement The registered person shall ensure that any complaint made under the complaints procedure is fully investigated. The registered person shall ensure that all parts of the home to which the service users have access are so far as reasonably practicable free from hazards to their safety. For all outstanding requirements please see inspection report 4/05/05. Timescale for action Immediate 2. 38 13 Immediate 3. 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. Refer to Standard 33 Good Practice Recommendations It is also recommended that the registered manager liaise closely with residents and relatives to keep them up to date with the refurbishment. Hawthorn Lodge Care Home C53 C03 S61999 Hawthorn Lodge V235526 240605 Stage 4.doc Version 1.40 Page 17 Commission for Social Care Inspection Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Hawthorn Lodge Care Home C53 C03 S61999 Hawthorn Lodge V235526 240605 Stage 4.doc Version 1.40 Page 18 - 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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