Inspection on 05/07/06 for Hawthorn Lodge Nursing Home

This inspection was carried out on 5th July 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 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

Hawthorn Lodge Nursing Home 23/08/09

Hawthorn Lodge Nursing Home 01/07/08

Hawthorn Lodge Nursing Home 26/01/06

Hawthorn Lodge Nursing Home 22/08/05

Hawthorn Lodge Nursing Home 02/02/05

Hawthorn Lodge Nursing Home 18/06/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Hawthorn Lodge Nursing Home 2 Canberra Grove Hartburn Stockton-on-Tees TS18 5EL Lead Inspector Neil McKenzie Key Unannounced Inspection 09:30 5 and 13th July 2006 th 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 Hawthorn Lodge Nursing Home DS0000000172.V301838.R01.S.doc Version 5.2 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. Hawthorn Lodge Nursing Home DS0000000172.V301838.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hawthorn Lodge Nursing Home Address 2 Canberra Grove Hartburn Stockton-on-Tees TS18 5EL 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) 01642 570100 Mr M Ramdhan Mrs K Ramdhan Ms Jacqueline Jane Pallister Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30), Physical disability over 65 years of age (0) of places Hawthorn Lodge Nursing Home DS0000000172.V301838.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. To allow the admission of up to 5 service users Physical Disability 55 years . Total occupancy of the care home not to exceed maximum number of 30. To admit one named service user who is below the age category that the home is registered for. 26th January 2006 Date of last inspection Brief Description of the Service: Hawthorn Lodge is a care home providing both nursing and personal care for older people. It is a converted Victorian building with an extension. The 26 single bedrooms are a minimum of 10 sq.m. The 2 double bedrooms are a minimum of 16 sq.m. There are 3 lounges and a large dining room. There is a passenger lift giving access to both floors. The home is opposite a parade of local shops. There is a small car park at the back of the home. Hawthorn Lodge Nursing Home DS0000000172.V301838.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection. The inspection lasted for 7 hours and this included 2 visits to the home. The reason for the inspection was to see how good a job the home does in meeting the National Minimum Standards set by the government for Care Homes. During the visits the inspector spoke to 3 residents, 1 relative and 3 staff to find out what their views were about living and working at Hawthorn Lodge. The inspector also spent time speaking to the Deputy Manager. The inspector spent some more time watching how staff and residents are with each other. A tour of the home took place and records looked at included staff recruitment and training, resident care plans and how the home handles medication. There was also questionnaire’s sent to the home, residents and relatives and these were looked at to help decide how good a job the home does in meeting the National Minimum Standards. At the time of the inspection the minimum cost for a bed was £327.00 per week and the maximum cost for a bed is £462.00 per week What the service does well: Residents and relatives spoken to and survey questionnaires returned were all satisfied with the level of support and care provided by the home. For example, one relative stated in the survey ‘ A good homely atmosphere, with caring staff’. One resident commented, ‘Great, staff are caring, friendly and professional, excellent level of care’. The residents also benefit from courteous staff respecting privacy. The inspector on numerous occasions observed staff knocking and seeking permission before entering a resident’s room. As a relative stated,’ You are treated with courtesy as a visitor and any questions you may have are always answered’ The residents are also supported by staff who were clear about their roles and responsibilities and could talk about the training to help them deliver safe and competent care. The home is also very good at responding to suggested areas for improvement by the inspection. Hawthorn Lodge Nursing Home DS0000000172.V301838.R01.S.doc Version 5.2 Page 6 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 Nursing Home DS0000000172.V301838.R01.S.doc Version 5.2 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 Hawthorn Lodge Nursing Home DS0000000172.V301838.R01.S.doc Version 5.2 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): 3 The quality in this outcome area is good as residents’ benefit from comprehensive assessment of needs and care plans. This judgement has been made using available evidence from resident plans of care and care records and interviews with staff and residents. EVIDENCE: Care plans and care records examined contained detailed assessments of the residents’ original needs by qualified professionals and these original assessments contained evidence of updating as the residents’ needs change. The care staff who spoke to the inspector were clear about resident assessment needs and both staff and residents were able to confirm that they had access to these plans and referred to them. As one staff member stated, ‘ About bed sores I always look at the assessments and care plan’ Hawthorn Lodge Nursing Home DS0000000172.V301838.R01.S.doc Version 5.2 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): 7,8,9 and 10 The quality in this outcome area is good. This judgement has been made using available evidence from resident files, the pre-inspection questionnaire, relative survey and interview with resident, staff and observation of a meeting between the deputy manager and pharmacist. Each resident has a plan that considers their health, personal and social care needs. The home ensures that these plans are reviewed on a regular basis and where agreed involves the family. Residents’ who are not responsible for their own medication are protected by trained and qualified staff who are only allowed to administer the medication. The homes policies and procedures do need updating to state the new procedure for the disposal of medication for residents receiving nursing care. Residents spoken to felt they were treated with respect and dignity. Hawthorn Lodge Nursing Home DS0000000172.V301838.R01.S.doc Version 5.2 Page 10 EVIDENCE: In the files sampled by the inspector each resident had a personal care plan that is reviewed on a regular basis and supported by daily records documented in their file. This care plan is promoted by the home as each resident is allocated a key worker and resident specific training is provided for the key worker. The care plans sampled had all been signed and agreed by the resident. One resident stated in the presence of her daughter, ‘both my daughter and I are aware of the care plan and as a result I feel more secure in myself’ During the inspection the home’s arrangements for receiving, storing, administering, recording and returning resident’s medication were observed, examined and discussed in depth with the deputy manager. At the time of the inspection visit, medication was seen to be correctly stored with accurate records for the medication held. This includes separate records for controlled drugs counter signed when administered by qualified members of staff. The deputy manager was also able to show and describe how medication is disposed of and how this is recorded. The medication for residents receiving nursing care is now disposed in a waste box in the home that is locked in a cabinet until collected by a contracted waste company. Whilst the home is good at looking after resident’s medication this would be better if the policy and procedures were updated to include the new procedures for disposing medication with regard to residents receiving nursing care. At the time of the inspection the deputy manager said no residents received controlled drugs but if this became the case they would consult with their pharmacist with regard to disposal. Disposal at the home must be done with a ‘dupe-kit’ that de-activates controlled drugs. During the inspection the inspector observed the deputy manager meeting with the pharmacist to ensure good practice with regard to the receiving of medication on behalf of residents. The home also introduced a risk assessment tool on behalf of residents’ who administer their own medication. Individual residents’ medication record sheets contain photographs of the person to help ensure that residents receive the correct medication. The residents’ who spoke to the inspector stated that staff treated them with respect and dignity: ‘I like it very much here, you get something when you want it’. ‘Staff are caring, friendly, professional and treat you with courtesy’. Hawthorn Lodge Nursing Home DS0000000172.V301838.R01.S.doc Version 5.2 Page 11 The inspector on numerous occasions observed staff knocking and seeking permission before entering a resident’s room. Hawthorn Lodge Nursing Home DS0000000172.V301838.R01.S.doc Version 5.2 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 and 15 The quality in this outcome area is adequate. This judgement has been made using evidence from a tour of the home, observation, resident care plans and interview with resident, staff and relative. Family members are made to feel welcome when visiting the home. Residents and family are consulted about opportunity to take part in activities inside and outside of the home. Some residents felt there could be more done in this area. Residents are on the whole satisfied with their food but would benefit from an upgraded dining area. EVIDENCE: All relatives spoken to and returned survey questionnaires said they were made to feel welcome in the home at any time. As one relative stated, ‘ You are treated with courtesy as a visitor and any questions you may have are always answered, the staff are very patient and take their time’. A resident said’ Friends regularly come and visit me’. Hawthorn Lodge Nursing Home DS0000000172.V301838.R01.S.doc Version 5.2 Page 13 Residents who spoke to the inspector stated there were things to do and the inspector observed different residents doing different activity such as reading and watching the television or listening to music. As one relative commented in her survey,’ Having three lounges allows staff to accommodate people in different groups to try to satisfy their needs’. A number of residents did comment that there could be more organised activities outside of the home. During the inspection visits this was taken up by the home who displayed a number of arranged activities for the summer that residents could choose to take part in. Residents who spoke to the inspector said they were encouraged to make their own decisions about their daily lives. One resident stated, ‘I could not walk when I came in but now I can and encouraged to do so’. Another resident said, ‘I have a private person that takes me out and I handle my own money’. On the whole residents were observed to receive a wholesome and balanced diet with choice for a more personal menu for example, salad and or alternatives to solid food. The inspector was of the view that residents would benefit from an upgraded dining area with regard to carpet and dining tables. Hawthorn Lodge Nursing Home DS0000000172.V301838.R01.S.doc Version 5.2 Page 14 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 The quality in this outcome area is good. This judgement has been made using evidence from the pre-inspection questionnaire and documentation of complaints and investigations, interview with staff and the relative survey. Residents are protected by a complaints procedure that is available in the home and policy and procedures on Adult protection and prevention of abuse. EVIDENCE: The home has a complaints procedure that is displayed and there was evidence of complaints being dealt with immediately and satisfactorily concluded. As one relative stated in her survey return, ‘ only had one complaint and this was resolved’. The residents are protected by an Adult protection and prevention of abuse policy that was reviewed in October 2004. Staff spoken to confirmed they had training on the protection of vulnerable adults. There has been one incident of adult protection during the last twelve months and this was investigated jointly with the Local Authority and satisfactorily concluded. Hawthorn Lodge Nursing Home DS0000000172.V301838.R01.S.doc Version 5.2 Page 15 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 and 26 The quality in this outcome area is good. This judgement has been made using evidence from a tour of the premises, the pre-inspection questionnaire and interview with staff. The residents on the whole live in a well maintained home. The home presented as free from unpleasant odours. EVIDENCE: A tour of the home showed residents living in a pleasant, comfortable home that is well looked after and kept clean and tidy. Maintenance and associated records were completed and up to date in the pre-inspection questionnaire. Residents also have bedrooms that have lots of their personal belongings as well as plenty of communal space to spend time in. The home has three lounges for residents. Hawthorn Lodge Nursing Home DS0000000172.V301838.R01.S.doc Version 5.2 Page 16 Although the home is on the whole a safe place for residents to live in, it was agreed with the home that the unlocked laundry and sluice rooms must be subject to risk assessment. This is to ensure that the risk of residents walking into the unlocked rooms and scolding themselves on the hot water tap is regularly reviewed. The home completed a risk assessment during the inspection visits. Hawthorn Lodge Nursing Home DS0000000172.V301838.R01.S.doc Version 5.2 Page 17 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 and 30 The quality in this outcome area is adequate. This judgement has been made using evidence from, the pre-inspection questionnaire, rota, staff files and interviews. Evidence indicates that on the whole residents’ needs are met by the number of staff on duty and by a compliment of trained staff. One staff personnel file did not contain the required information. EVIDENCE: An audit of the duty rota was carried out. At the time of the inspection there were 24 residents living at the home. There was 1 trained nurse and four care assistants during the morning shift. This included a chef and domestic. There was 1 trained nurse and 3 care assistants for the afternoon and evening shift and 1 trained nurse and 2 care assistants for the night shift. There are 22 care assistants 11 currently have their National Vocational Qualification Level 2 or 3. One of the personal files did not contain verification of a Criminal checks applied for by the home. Hawthorn Lodge Nursing Home DS0000000172.V301838.R01.S.doc Version 5.2 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 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): The quality in this outcome area is good. This judgement has been made using evidence from, the pre-inspection questionnaire, interview with the deputy manager and the sampling of resident finances. The home is run and managed by a person who is fit to be in charge. Residents and relatives are formally consulted about their views of the home. Resident is safeguarded by policy and procedures that were up to date. EVIDENCE: At the time of the inspection the registered manager was off on leave. The delegated manager was the deputy manager. The deputy manager was clear about her role and responsibilities, qualified and handled the inspection in a knowledgeable and professional manner. Hawthorn Lodge Nursing Home DS0000000172.V301838.R01.S.doc Version 5.2 Page 19 Regulation 26 reports are sent to the Commission for Social Care Inspection every month, which covers areas such as cleanliness and décor; questionnaires are sent to residents’ and their family members for their opinion of the service provided. The 2005 quality assurance report has been written up and made available. Policy and procedures are available with regard to the handling of resident’s money and all transactions are counter signed by 2 people. Details of health and safety were made available through the pre-inspection questionnaire and were presented as up to date. Hawthorn Lodge Nursing Home DS0000000172.V301838.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X 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 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Hawthorn Lodge Nursing Home DS0000000172.V301838.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No 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 OP9 Regulation 13 (2) Requirement The manager must make safe arrangements for the disposal of controlled drugs when received into the home The manager must ensure that staff who are employed have confirmation of Criminal checks applied for. Timescale for action 31/08/06 2 OP29 19 (5) 31/08/06 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. Refer to Standard OP19 OP12 Good Practice Recommendations The Manager should ensure that the dining room carpet and furniture is upgraded. The manager should ensure choice of activity for residents Hawthorn Lodge Nursing Home DS0000000172.V301838.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Tees Valley Area Office Advance St. Marks Court Teesdale Stockton-on-Tees TS17 6QX 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 Nursing Home DS0000000172.V301838.R01.S.doc Version 5.2 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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