Inspection on 31/10/05 for Hawthorne Care Home

This inspection was carried out on 31st October 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.

Other inspections for this house

Hawthorne Care Home 07/07/08

Hawthorne Care Home 14/04/08

Hawthorne Care Home 05/11/07

Hawthorne Care Home 11/04/07

Hawthorne Care Home 12/04/06

Hawthorne Care Home 24/01/05

Hawthorne Care Home 10/09/04

Hawthorne Care Home 01/10/03

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 16/02/2010.

CARE HOMES FOR OLDER PEOPLE Hawthorne Care Home School Walk Bestwood Village Nottingham NG6 8UU Lead Inspector Chrisandra Harris Unannounced Inspection 31st October 2005 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 Hawthorne Care Home DS0000026443.V260402.R01.S.doc Version 5.0 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. Hawthorne Care Home DS0000026443.V260402.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Hawthorne Care Home Address School Walk Bestwood Village Nottingham NG6 8UU 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) 0115 9770331 0115 9770332 Mrs Jagruti Patel Doris Agatha Francis Care Home 36 Category(ies) of Old age, not falling within any other category registration, with number (34), Terminally ill (2) of places Hawthorne Care Home DS0000026443.V260402.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Within the total number of beds a maximum of 2 beds maybe used for the category TI The home is registered to provide personal care with nursing for service users of both sexes whose primary needs fall within the following categories: Old Age (OP) (34) Terminally Ill (TI) (2) 3. The maximum number of service users to be accommodated is 34 One Named Service user may be under the age of 65 Date of last inspection 1st June 2005 Brief Description of the Service: Originally built as the village Rectory, Hawthorne Care Home has been extended and developed to provide accommodation and care for up to 34 people over the age of 65 years. A maximum of two places may be used to provide care for people who are terminally ill. The home is situated to the North of Nottingham City centre in Bestwood village behind the village church. It has thirty single bedrooms and three double bedrooms and a range of communal spaces including shared bathrooms and toilets. A passenger lift provides access to the first floor. Outside there is an open garden area. Hawthorne Care Home DS0000026443.V260402.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection was carried out by one inspector and took place over 5 hours. The inspector looked around the communal areas of the home, and several bedrooms, observed the end of breakfast, looked at the storage and dispensing of medication and examined a number of records. In addition the inspector observed the care given to several residents and the use of equipment. The inspector also gained information by speaking with 3 service users, 1 visiting relative and 2 members of staff on duty. The nurse in charge on the day and the homes administrator assisted during the inspection as the registered manager was not on duty. What the service does well: What has improved since the last inspection? What they could do better: There are many outstanding requirements from the last inspection that still need to be actioned. All the care plans and risk assessments need to be brought up to date and be detailed enough to ensure that adequate care is provided. Residents or their representatives must be involved with this so that they feel valued and taken into account. Hawthorne Care Home DS0000026443.V260402.R01.S.doc Version 5.0 Page 6 The social interests of residents’ needs to be recorded and a programme of social activities developed with the residents. One person said ‘there was a list of activities on the wall but she had never seen any taking place’. A record needs to be kept of any complaints and the action taken to resolve them so that residents see that their concerns are listened to and acted upon. Thorough checks and references need to be made when new staff are employed in order to ensure that residents are in safe hands. There are a number of structural matters in the home needing attention in order to ensure a comfortable and safe environment for residents. When residents request simple alterations to their rooms in order to meet their needs these should be acted upon. 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. Hawthorne Care Home DS0000026443.V260402.R01.S.doc Version 5.0 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 Hawthorne Care Home DS0000026443.V260402.R01.S.doc Version 5.0 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 home knows about prospective residents care needs prior to their admission to the home. However prospective residents are still not receiving written confirmation that the home can meet their needs. EVIDENCE: The service user files seen all contained copies of the original assessments of care needs that were undertaken prior to the person entering the home. The initial care plan is devised from this assessment of need. However as on the last inspection the files did not contain a copy of a written confirmation to the prospective resident to confirm that the home can meet their assessed needs. Staff spoken with could not confirm that such documentation was used. Hawthorne Care Home DS0000026443.V260402.R01.S.doc Version 5.0 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, 10. There is great variation in the standard of care plans. All staff responsible for care planning need to adopt the same approach. Some care plans are not updated as needs change. Some care plans do not evidence that residents are being involved in the planning of their care or consulted about risks. These requirements remain unmet from previous inspections and could lead to individual needs not being met. Medication is not being handled or stored correctly. This could put residents at risk of infection. Residents at the home are treated with respect and their privacy upheld. EVIDENCE: The qualified nursing staff complete the care plans. Each has responsibility for a number of plans, although the format is the same in each plan. The inspector found a great variation in the plans that were looked at. One plan was up to date with clear and detailed information. It was easy to read, had up to date risk assessments, had been regularly reviewed and was signed by the resident. Hawthorne Care Home DS0000026443.V260402.R01.S.doc Version 5.0 Page 10 However other plans looked at contained risk assessments that had not been updated since 2002, charts recording temperature, pulse and weight monitoring information that appeared to have been discontinued without explanation, had information that was difficult to read and had not been signed by the resident. Several plans had risk assessments for bed rails that were inadequate and out of date. The dispensing of medication was observed. The member of staff was seen handling tablets and picked up a tablet that a resident had dropped on the floor and returned it to her. Some cream prescribed for individual residents was seen to be stored unsecured at the bottom of the medication trolley. The residents and staff members spoken with during the inspection gave information that indicated that residents are treated thoughtfully and with respect, and their privacy is respected for example when personal care is provided. Residents said that staff always knock before entering their rooms and that staff are ‘friendly and willing to help’. Hawthorne Care Home DS0000026443.V260402.R01.S.doc Version 5.0 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, 13,14, 15. The home is not consulting with residents about their interests and does not organise a programme of activities. This is leaving residents under occupied and without mental stimulation. Residents are able to remain in contact with their friends and relatives and are able to make some choices. Comments about the food were varied and there is no choice of meals. EVIDENCE: Some care plans did not contain information on residents’ social interests, and where this was recorded on some files the information had not been reviewed for several years. Although there was a list of activities on the wall neither residents nor staff could provide any evidence of activities being provided at the home. A regular visitor to the home said that they had never seen any activities taking place. Residents and relatives said that that visitors can come to the home at any time. Residents can see their visitors in private or in the communal areas. Hawthorne Care Home DS0000026443.V260402.R01.S.doc Version 5.0 Page 12 Some residents were able to give examples of how they could continue to have choice and control over their lives, for example by handling their own financial affairs and by bringing personal possessions into the home. Breakfast was observed to be unhurried. Residents said that they could get up when they wanted and were woken with a cup of tea in bed. Comments about the quality of food were varied with the meat being described as ‘could be better’ and ‘ a bit hard as if it had been cooked too much’. Positive comments were made about the evening soup, sandwiches and cake. The lack of choice of meals was also commented on. Hawthorne Care Home DS0000026443.V260402.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 A record is not being kept of complaints made or of the action taken to investigate them. Therefore residents and relatives cannot be confident that their concerns are taken seriously and acted upon. Staff training and awareness helps to protect residents from any abuse. EVIDENCE: The home has a complaints book with no complaints recorded in it. However from discussions with residents, relatives and staff it was clear that complaints had been made recently and action has been taken in response. Staff spoken with had completed training in protecting residents from abuse. They were clear about the homes policies and procedures in this area and how to protect residents from abuse. Hawthorne Care Home DS0000026443.V260402.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 22, 23, 24, 25. The accommodation is generally of a good standard however there are a number of areas where repairs or attention is needed in order to safeguard residents. EVIDENCE: The layout of the home is suitable for its purpose and rooms were well furnished and comfortable. There is a programme of maintenance and bedrooms are decorated as they become vacant. The residents’ rooms seen were personalised and residents said they had been able to bring their personal belongings when they moved into the home. At the last inspection one resident had asked for accessible lighting that he could control from his bed. This still needs to be arranged. The quiet room is cool and does not have adequate heating. This requirement remains unmet from the previous three inspections. Hawthorne Care Home DS0000026443.V260402.R01.S.doc Version 5.0 Page 15 The lighting in the entrance area is not working making it difficult to see clearly. A requirement was made regarding this at the last inspection and has not been met. The storage space is limited and an under stairs area is used to keep wheelchairs and other equipment. This equipment spills out on to the passageways and makes it difficult for residents to move past safely. Hawthorne Care Home DS0000026443.V260402.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 29, 30. The home does not have robust recruitment procedures and therefore could be recruiting unsuitable staff and putting residents at risk. It appears that staff at the home are having some training but because of inadequate records it is not possible to be clear that adequate and appropriate training is being provided. Therefore residents may not be receiving care from appropriately qualified and competent staff. EVIDENCE: The recruitment records for the two most recent members of staff were examined. Only one reference could be found for each member of staff. There was no evidence to show that either member of staff had had CRB or POVA checks taken up by the home, only evidence relating to checks at their previous employment was available. Some records of staff training existed, for example there was evidence of twelve members of staff having completed training in first aid this year. Individual members of staff spoken with were able to describe recent training courses that they had undertaken. However as a result of the lack of records, it was not possible to obtain a clear picture as to the training that had been completed by each member of staff, or to identify any gaps in training. Hawthorne Care Home DS0000026443.V260402.R01.S.doc Version 5.0 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35 Appropriate measures are in place to ensure that residents’ financial interests are safeguarded. EVIDENCE: The home does not act as an agent for any resident. A small amount of petty cash is available for residents to access. Appropriate records of service users finances were seen. Secure facilities were seen for the safe keeping of monies and valuables. Hawthorne Care Home DS0000026443.V260402.R01.S.doc Version 5.0 Page 18 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 2 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 1 17 X 18 3 3 X X 2 3 3 2 X STAFFING Standard No Score 27 X 28 X 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X X X Hawthorne Care Home DS0000026443.V260402.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP3 Regulation 14 Requirement Prospective residents must receive confirmation in writing that the home can meet their assessed needs. Outstanding requirement - Original timescale of 31/7/05 not met. Care plans must be reviewed and amended when care needs change. Outstanding requirement, unmet from the last three inpsections, last timescale of 31/7/05 not met. Resident’s (or their representatives) must be consulted with about their care plan unless impractible. Outstanding requirement original timescale of 31/7/05 not met. Up to date and detailed risk assessments need to be completed for those residents using bedrails. Outstanding requirement - original timescale of 31/07/05 not met. Ensure that medication is DS0000026443.V260402.R01.S.doc Timescale for action 31/10/05 2 OP7 15 31/10/05 3 OP7 15 31/10/05 4 OP8 13 31/10/05 5 OP9 13(2) 31/10/05 Page 20 Hawthorne Care Home Version 5.0 6 7 OP9 OP12 8 9 OP16 OP22 10 OP25 11 OP25 12 OP25 13 14 OP29 OP30 handled appropriately. Ensure that all medication is stored appropriately. 16(2) The residents social interests must be recorded in the care plan and a programme of activities established in consultation with residents. Outstanding requirement – original timescale of 31/07/05 not met. 17(2) Sc Keep a record of all complaints 4 and the action taken in response to the complaint. 23(l) Provide appropriate and safe storage of equipment such as hoists and wheelchairs. Outstanding requirement – original timescale of 30/09/05 not met. 23 2(p) Ensure that residents can access lighting controls from their beds. Outstanding requirement – original timescale of 31/07/05 not met. 23 2 (p) Adequate heating must be provided in the quiet room at all times. Outstanding requirement from previous two inspections – timescale of 31/07/05 not met. 23 2 (p) The light in the reception area must be repaired or replaced. Outstanding requirement original timescale of 14/07/05 not met. 19 (4) Obtain two written references Sch 2 and a current POVA/CRB check before employing staff. 18 (1) ( c) Ensure that staff receive appropriate training and keep records to evidence this. 13(2) 31/10/05 31/10/05 30/11/05 31/10/05 31/10/05 31/10/05 31/10/05 31/10/05 31/12/05 Hawthorne Care Home DS0000026443.V260402.R01.S.doc Version 5.0 Page 21 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 OP14 Good Practice Recommendations Provide residents with a choice at meal times. Hawthorne Care Home DS0000026443.V260402.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Nottingham Area Office 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 Hawthorne Care Home DS0000026443.V260402.R01.S.doc Version 5.0 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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