Inspection on 26/06/07 for Hawthorne Court Nursing Home

This inspection was carried out on 26th June 2007.

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

Hawthorne Court Nursing Home 17/10/06

Hawthorne Court Nursing Home 01/11/05

Hawthorne Court Nursing Home 07/06/05

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Hawthorne Court Nursing Home Hawthorn Court Nursing Home Coldeast Way Sarisbury Green Southampton Hampshire SO31 7LX Lead Inspector Jan Everitt Unannounced Inspection 26th June 2007 09:00 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 Court Nursing Home DS0000062645.V338712.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. Hawthorne Court Nursing Home DS0000062645.V338712.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hawthorne Court Nursing Home Address Hawthorn Court Nursing Home Coldeast Way Sarisbury Green Southampton Hampshire SO31 7LX 01489 556720 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) Hampshire County Council Mrs Victoria Ann Biggs Care Home 80 Category(ies) of Dementia - over 65 years of age (50), Old age, registration, with number not falling within any other category (30) of places Hawthorne Court Nursing Home DS0000062645.V338712.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th October 2006 Brief Description of the Service: Hawthorn Court is a purpose built nursing home accommodating up to 80 older persons, 50 of the beds are registered to accommodate older people with dementia. The registered provider is Hampshire County Council. The home was first registered on 24 February 2005. The home is located within the former grounds of Coldeast Hospital, Fareham and is surrounded by open countryside. There are good parking facilities and a large enclosed garden. Accommodation is provided on two floors serviced by two passenger lifts. There are 8 units each comprising of a lounge/dining room, kitchenette and ten single bedrooms with en-suite toilet facilities. Other facilities include a visitor’s lounge, activities lounge, hairdressing salon, smoking lounge and medical rooms. Fees for accommodation and care at the home are inline with Hampshire County Councils fees of £446 per week. Residents are expected to pay extra for chiropody, hairdressing, newspapers, magazines and any other personal items. Hawthorne Court Nursing Home DS0000062645.V338712.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The site inspection visit to Hawthorn Court Nursing Home, which was unannounced, took place over a one-day period on the 26th June 2007 and was attended by one inspector. The registered manager, Mrs. Vicky Biggs assisted the inspector throughout the visit and was available to provide assistance and information when required The visit to the home formed part of the process of the inspection of the service to measure the service against the key national minimum standards. The provider had returned the Annual Quality Assurance Assessment (AQAA) to the CSCI and the focus of this visit to the home was to support the information stated in this document and other information received by the CSCI since the last fieldwork visit made to the home in October/November 2006. Documents and records were examined and staff working practice was observed where this was possible without being intrusive. The inspector toured the home and spoke to residents, visitors and staff in order to obtain their perceptions of the service that the home provided. Those spoken to were very satisfied with the care and services that were being provided. Surveys were distributed to service users, relatives, care managers, GP and other visiting professionals. Nine service user surveys, eight relative/carer surveys and one care manager’s survey were returned to the CSCI. The visiting community psychiatric nurse who visits the home weekly was spoken to over the telephone. The outcome of the surveys indicated that there was a high level of satisfaction with the services and that generally residents and relatives were pleased with the home. At the time of the inspection the home was accommodating 79 residents and a large number of these were unable to communicate effectively with the inspector to gain their views of the service. No resident was from a minority ethnic group. What the service does well: The care manager and the home’s registered manager prior to going into the home comprehensively assess service users. Information about the home is distributed to the service users/relatives at this time to enable them to make informed choices about the suitability of the home to meet their needs. Hawthorne Court Nursing Home DS0000062645.V338712.R01.S.doc Version 5.2 Page 6 Service users’ health care needs are well met by the home, which is supported by the primary health care team and other visiting professionals. Service users and staff say that staff are friendly and helpful. Meals are nutritious and healthy, and are served in pleasant surroundings; the catering service responds to service users dietary needs and wishes. A small number of service uses made negative comments about the food when speaking to the inspector, but the majority reported satisfaction with the food. The comments from the surveys returned, indicated, generally there was satisfaction with the meals, with comments such as: ‘The food is very good we always get what we want’. ‘There are always choices at meal times’. During this visit it was noted that the general atmosphere in the home was relaxed and good interaction was observed between the service user and staff, with care being given unhurried and at the resident’s own pace. The care manager survey returned also commented that ‘the atmosphere is friendly when entering the home and most residents are pleased with the care’. Service users and relatives commented on surveys that were returned: ‘Its not bad here’. ‘I enjoy the staff’s company’. ‘The staff do their best’. ‘No complaints’. ‘My mother could not be in a better home - all staff know her and care for her’. ‘Hawthorn Court is well run, clean and bright’. ‘Excellent and talented staff and management. ‘I am content and happy with the care I receive’. ‘All staff are helpful and happy and are a credit to the manager’. Residents spoken to confirmed that they were able to make decisions about how they spent their day. They complimented all the staff on their kind and supportive approach towards them and many stated, “that nothing was ever too much trouble, I only have to ask and I get all the help I need”.’ The environment is pleasant and decorated to a good standard. Service user’s rooms are individual and pleasantly furnished with most having a pleasant outlook. The residents report a high level of satisfaction with their living accommodation. ‘Fantastic environment, very clean and no bad smells’. ‘I would not want my father to be anywhere else’. Hawthorne Court Nursing Home DS0000062645.V338712.R01.S.doc Version 5.2 Page 7 Residents spoken with said that the manager was approachable and offered support. Staff also spoke of the support they were receiving from the management. The inspector observed that the manager interacted well with the service users and was obviously aware of their individual needs. 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. Hawthorne Court Nursing Home DS0000062645.V338712.R01.S.doc Version 5.2 Page 8 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Hawthorne Court Nursing Home DS0000062645.V338712.R01.S.doc Version 5.2 Page 9 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 Court Nursing Home DS0000062645.V338712.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Standard 6 is not applicable to this service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users care needs are comprehensively assessed prior to moving into the home to ensure their needs can be met. EVIDENCE: A sample of four service user care plan documents was viewed, two of which related to a more recent admissions. There was evidence of care managers’ assessments in the care plans. The manager told the inspector that she insists on receiving a copy of the care needs assessment from the care manager at the time of the referral and from this she will then visit the person to undertake her own assessment. This was confirmed by a care manager who commented on the survey form that ‘the manager always insists on as much information as possible prior to admission’. Hawthorne Court Nursing Home DS0000062645.V338712.R01.S.doc Version 5.2 Page 11 The pre-admission assessment tool is comprehensive and covers all aspects of physical and emotional care and would enable the assessing nurse to gain detailed information as a basis for developing care plans. Hawthorne Court Nursing Home DS0000062645.V338712.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans are in place to inform practice. However, the system is fragmented and unwieldy and does not consistently give specific details of how the care is to be delivered and therefore has the potential of not ensuring the wellbeing and care needs of all persons living in the home are met. Service users health care needs are met fully. The home does not have an operational medication policy and procedure in place currently, however medication administration, recording and storage is appropriate. The aims and objectives of the home reinforce the importance of treating residents with respect and dignity. Hawthorne Court Nursing Home DS0000062645.V338712.R01.S.doc Version 5.2 Page 13 EVIDENCE: A sample of four service user’s care plans was viewed. The care plans are detailed in terms of describing the medical, personal and social care needs of the service users. The activities of daily living for each resident are assessed and an action documented on how to support the resident in that activity. Risk assessments are undertaken for moving and handling, tissue viability and nutrition. The inspector observed that in some cases although risk assessments were undertaken, the care plan to manage that risk was not specific or personalised enough. In some cases there was not a care plan detailing how to manage the identified risks. The results of a complaints investigation last year identified that there was a lack of detail in a care plan of how to move and handle a resident who was identified as being at risk. All service users must have a care plan that gives clear direction to how their needs are to be met. This care planning system was discussed with the manager and she told the inspector that she appreciates that the present system is not user friendly and easy to follow, but this system has been adopted by the Hampshire County Council nursing homes in the area and she is duty bound to work with this system, but she will have further talks with her operational manager and other home managers to seek their opinions. The care plans viewed by the inspector were observed to be recorded as being reviewed monthly. Detailed daily records of the care delivered to each resident are maintained. A number of visitors were spoken with. They told the inspector that they provide information about their relative’s social and personal life to assist with the development of care plans, and that they consider they are included in the planning of care and the reviews that are held. They reported that they consider the care their relative receives is appropriate and that the home is ‘very good’. Service user surveys that were returned to CSCI, generally indicated that the residents and relatives are happy with the care in the home. Conversation with service users did not indicate there were any concerns with their care needs being met. A number of care plans were observed to be signed by service users or relatives as evidence of their participation and agreement with the care plan. All service users are registered with a local GP service through which referrals are made to access the multidisciplinary health care team. The GP visits three times a week to review any service users whose conditions have changed. Hawthorne Court Nursing Home DS0000062645.V338712.R01.S.doc Version 5.2 Page 14 The inspector observed in a care plan that the speech and language therapist had visited the home to assess a resident’s swallowing capacity and she had written a care plan of how this was to be managed when giving food and drink. The home is also visited every week by the community psychiatric nurse (CPN) to review service users that have been referred to her. The inspector spoke with the CPN who reported that she spends about 16-20 hours a week at the home. She said that, generally the nurses, and in particular the carers, are good at identifying any changes in the service user and sharing this information with her. She reports that she has a good professional working relationship with the carers and nurses and she considers the home offers a good service. The CPN described the procedure followed for any changes in treatment and medication. She reported that she informs the GP and faxes through a report and any suggested changes in medication and they then will issue a new prescription or action any change in treatment. The inspector observed that the care plans contained detailed records of all contacts the resident has with any of the health care professionals. Medication administration record (MAR) sheets were viewed by the inspector and were generally recorded appropriately with codes to identify if medication had not been given. Trained nurses administer all medications at the home. The inspector viewed the cupboards and trolley and observed that all medications are stored in secure cabinets in a clean and orderly fashion. The ordering and receiving of medications is documented and the home checks the prescriptions before they are sent to the pharmacist for dispensing, this is seen as good practice, and avoids receiving unwanted medication. There inspector observed signed statements in the prescription folder, that were signed by the GP in consultation with the pharmacist, that medication for identified service users could be crushed or administered covertly. There is not a policy for the management and administration of medications currently. The home has a Care Practice Manual for guidance and nurses work within their Nursing and Midwifery Council code of practice, as identified in the inspection report of November 06. The progress of the development of the medication policy was discussed with the manager. She told the inspector that the policy and procedures are at the present time with Hampshire County Council legal department for legal verification and that they are about to go operational once they are released from the department and staff have had guidance on their content. The inspector observed throughout her tour of the home that staff members were observed giving support to residents in a sensitive and friendly manner. Residents spoken with said that the staff are friendly, nice and caring and will Hawthorne Court Nursing Home DS0000062645.V338712.R01.S.doc Version 5.2 Page 15 generally go out of their way to help you. This was also illustrated in conversations held with visitors. A comment on a survey returned quoted ‘I often visit at meal times and am very impressed by the attitude of staff towards the residents’. Staff were observed to be interacting well with service users and knocking on residents doors before entering their rooms. This was confirmed during conversations with service users that they felt that staff treat them with respect and that they ‘enjoy the staff’s company’. Hawthorne Court Nursing Home DS0000062645.V338712.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service acknowledges the present and past interests and the social background of service users and is striving to make appropriate provision of activities for all residents living at the home. The practices and attitudes of the staff team give residents the opportunity to remain as independent as they can be and make their own choices about daily life. The home management enables service users to retain contact with family and friends. Service users benefit from a balanced menu that is continually being reviewed. EVIDENCE: There was a recommendation from the previous report that an activities organiser be delegated to that specific role. The AQAA documented that an Hawthorne Court Nursing Home DS0000062645.V338712.R01.S.doc Version 5.2 Page 17 activities organiser was about to be employed for 24 hours per week as a result of listening to the service users and relatives at meetings. This has now taken place. The person employed is also a carer for the remaining full-time hours per week. This was discussed with the manager that the role for such a large home may warrant a full-time activities person. She agreed with this and is campaigning to obtain more hours for this role, but that it had only just been agreed for 24 hours a week. She told the inspector that other carers are allocated 2 hours per week to support the activities in the home. The inspector observed that information is obtained during the assessment process about the person’s social history and their past life. The activities organiser reported that, as yet, this does not influence the programme provided but once she is more familiar with the home and residents she will work with individuals to develop activities around past interests. One relative spoken to said that her daughter had made up a photograph album for her father of his life and when looked at was always a stimulus for conversation and talking about old times. The activities programme was displayed on a notice board, these include musical movements, outside entertainers, skittles and bingo. The activities organiser was spoken with. She has had training and experience in previous activity jobs. She is intending to create a file for each person with personal histories and is at present documenting the level of individual’s involvement when activities take place. She is currently undertaking a Pool Activity Level (PAL) assessment on the service users who have dementia. The assessment tool identifies the type of activity the person would get involved in and the likely level of involvement and this would allow the organiser to plan activities around these assessments. The home has the support of a good voluntary group that has been established with volunteers and ex-relatives and who fund raise for the home. The AQQA reported the one of the changes to be made in the coming months is the building of a sensory room for residents with dementia and this has been funded by a donation from the voluntary group. The service users spoken to and the surveys returned to the CSCI indicated a mixed response about the activities in the home. Some saying that they wish there were more social events like bingo and music, other says they could join in but choose not to do so. Surveys also said that more activities would be welcome and ‘day trips out for the more able’. Taking into account that the activities organiser has not been in post for very long and is in the process of organising the activities and undertaking research as to what is available and what is most suitable for the client group, the inspector concluded that further development is needed on activities and that the next inspection would identify a more organised programme around the needs and preferences of the service users. Hawthorne Court Nursing Home DS0000062645.V338712.R01.S.doc Version 5.2 Page 18 The home has open visiting although the manager says that is within reason. The visitor’s book demonstrated a large number of visitors to the home each day. The manager told the inspector that visitors are very welcome and it is good to see so many in the home. Families visit to take their relative out if they are able. The relatives the inspector spoke to said that they are always welcome into the home at any time and that staff keep them informed of their relatives condition and care needs The inspector observed practices throughout the visit and spoke to a number of service users which confirmed that service user were able to choose how they spend their days, where they wish to sit and eat their meals and that they have autonomy over their daily lives. The Hampshire County Council’s catering department, HC3S, provides for catering at the home. There is a large kitchen at the home where the meals are prepared and cooked by HC3S. The menu plan is developed by the head office of HC3S and is a 4-week rotating menu. The manager said that comments about the menu plan are acted upon by head office. Speaking to catering staff indicated that they can always provide alternative choices at meal times and that they have the resources to cater for persons with special catering needs such as health or religious dietary needs. At the time of this visit there were no special diet needed on religious grounds. Service users spoken with said that they enjoyed the meals provided at the home. Surveys returned to CSCI by service users and relatives identified mixed opinions with comments such as: ‘The food could be more interesting and better cooked the vegetables are sometimes hard’. ‘Rotten’ ‘The cooking could be better’. ‘The food is always of a good standard’. ‘Usually good’ ‘Very good food’. Service users spoken to at the time of this visit were complimentary about the food and said they had enjoyed their lunch. The inspector observed that the service users were given the choices of what they would like for their lunch, the same morning. A mealtime was observed in one of the wings. It was observed to be a relaxed social event with assistance being given to those needed it with sensitivity. Service users confirmed that they have the choice to take meals in the dining areas or in their bedrooms. Facilities are available in each lounge/dining area of each wing for care staff to make simple snacks for the service users. The inspector observed that biscuits and cakes are made on the premises and are distributed with the morning coffee and afternoon tea and service users reported that they were ‘very good’ and thoroughly enjoyed them’. Hawthorne Court Nursing Home DS0000062645.V338712.R01.S.doc Version 5.2 Page 19 The inspector visited the kitchen and spoke to kitchen staff. The kitchen was clean and well organised. There was evidence that all the food is cooked fresh with one kitchen assistant making soup from mixed vegetables and fortifying this with cream. Hawthorne Court Nursing Home DS0000062645.V338712.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users and their representatives are able to express concerns and are confident that their concerns will be addressed promptly. The policies, procedures of the home and staff training ensure that service users are protected from abuse. EVIDENCE: The home has a complaints procedure in place that includes time scales that complaints will be responded to. On the day the AQQA was completed by the manager it recorded nine (9) complaints had been received in the past twelve months. Seven (7) had been resolved and two (2) remained under investigation at that time. The inspector viewed the complaints log. This demonstrated that clear investigation and action outcomes records were being maintained. The log recorded that, at the time of this visit there remained one unresolved issue with a relative. This was currently under investigation. A comment survey returned from a care manager stated that if any concerns about care are highlighted, a review meeting would be booked at the home with staff, family and the care manager and at which any concerns about care can be raised and discussed. Hawthorne Court Nursing Home DS0000062645.V338712.R01.S.doc Version 5.2 Page 21 The surveys returned to the CSCI, speaking with relatives and service user who were able to understand, indicated that they would have no concerns to voice complaints or worries to staff at the home and that these concerns/complaints will be dealt with effectively and promptly. The previous inspection report required that the staff have a clearer understanding of the procedures that protect vulnerable service users from the effects of abuse. The manager showed the inspector the training matrix, which demonstrated 24 staff having attended training in adult protection in March 07. Staff spoken with clearly understood what to do should they suspect or witness any forms of abuse. The inspector also observed that this was part of the induction programme undertaken by the home following corporate induction with Hampshire County Council. Discussion with the manager evidenced that she has a clear understanding of the protection of vulnerable adults. There have been no reported incidences of abuse. Hawthorne Court Nursing Home DS0000062645.V338712.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a home that is a well-maintained, homely environment, which provides aids and equipment to meet their needs. The well being of those living at the home is protected by good hygiene and infection control practices. EVIDENCE: The inspector toured the home. Hawthorn Court is a purpose built care home that was opened in February 2005. Living areas are divided into eight separate units each accommodating ten residents. Each unit has a lounge/ dining room with facilities for staff to make snacks and drinks for the service users. In addition there are three quiet lounges, a smoking lounge and activity rooms, Hawthorne Court Nursing Home DS0000062645.V338712.R01.S.doc Version 5.2 Page 23 and further seating areas around the home with windows that over look farmland. Furniture and soft furnishings are in good order and of a good standard. Each bedroom has en-suite toilet and hand washing facilities appropriate to meet resident’s needs. There are also sufficient communal bathing and toilet facilities to meet resident’s needs. The enclosed garden area is landscaped with level walking areas and appropriate seating. A patio door has been fitted, which now gives access into these garden areas. A survey comment returned stated that the gardens are pleasant to take relatives out into for walks and talks. At the time of this visit the gardens were looking splendid with many perfumed plants in bloom. Bedrooms are individually and naturally ventilated with windows conforming to recognised standards. Central heating is under floor with residents having the ability to control the temperature. At the time of the visit the premises were clean, hygienic and free from offensive odours throughout. A team of cleaners have responsibility for maintaining the cleanliness of the home. Service users told the inspector that they were ‘very happy with their rooms’ and another saying ‘they clean everyday’. This was supported in the comments received from service users and relatives that ‘cleanliness if always 100 when I have visited’. ‘The room is cleaned every day’. ‘They do not always dust behind the furniture’. ‘The bathrooms are cleaned everyday’. Systems are in place to control the spread of infection. The inspector visited the laundry, it is sited away from any food areas and so that soiled articles are taken through a dirty area and the clean washing is exited out of another door. The inspector observed that the home has appropriate coloured codes trolleys for the transportation of all laundry. The inspector observed that the laundry area was clean and well organised, although the laundry person reported that the she does continue to receive personal clothes unmarked and this causes problems if relatives report lost clothing. Suitable hand washing facilities are provided for staff and the residents, protective equipment such as gloves and aprons are readily available for staff members. Staff members have attended courses about the control of infection thus ensuring staff have a good understanding of the policies and procedures in the prevention of cross infection. The home has dealt with an outbreak of infectious disease recently and this was dealt with efficiently with the support of the Health Protection Agency from Portsmouth. Hawthorne Court Nursing Home DS0000062645.V338712.R01.S.doc Version 5.2 Page 24 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are confident that their care needs are met by sufficient numbers of staff with a mix of skills. Service users are supported and protected by the organisations recruitment policies and procedures and are in safe hands at all times. EVIDENCE: The home employs a multi-cultural group who are able to speak many languages and are of mixed gender. The manager told the inspector that she does occasionally have comments from service users that there is a lack of understanding of the language but that generally the service users are happy with whichever staff that are allocated to them and that the gender factor is never a problem. Service users spoken to reported ‘staff are helpful and always do their best’. ‘Staff are very busy but respond to the call bell as quickly as they can’. ‘Excellent staff’. The home is split into four wings each accommodating twenty residents. A staff group is allocated to each wing and this is usually one trained nurse, five care staff and one housekeeper. A member of the kitchen staff serves meals Hawthorne Court Nursing Home DS0000062645.V338712.R01.S.doc Version 5.2 Page 25 and drinks throughout the day. The atmosphere in the home was certainly not rushed and staff were observed to be taking time to talk with service users and generally interact with them. One service user commenting that she has a particular carer who is ‘always happy and smiling and very caring’. The inspector and manager discussed the staffing levels. The home has staff vacancies that they are recruiting into. Whilst this is in process agency staff are called on to complement the staffing levels. The manager said that they are contracted to use one agency and usually get the same agency staff that offers some continuity of care to residents. Service users spoken to said they thought there was enough staff on duty. Surveys returned from the relatives comment about staffing levels were ‘On a weekend there does not seem to have enough staff on duty’. ‘The staff need more time to cope with the patients’. ‘More staff on duty especially between 1.30-3.30 at change over time’. ‘There is a lot of agency staff’. At the time of this visit the home could demonstrate that sufficient staff were on duty to meet the needs of the service users in residence. Hampshire County Council delivers a corporate three-day induction course to all new staff. This together with a departmental induction, commencing on the first day of employment, constitutes the induction programme. The manager reported that she books staff on the relevant courses during induction that are in line with the Skills for Care Council induction programme. The inspector could only identify a checklist for the induction but there was no evidence of formal induction or a workbook. The inspector did evidence the training matrix for a new member of staff and this documents that the have attended a moving and handling course as part of their induction. The manager told the inspector that most of the new care staff have commenced their NVQ level 2 course and this would include all the relevant courses on the Skills for Care Programme. The inspector evidenced training certificates in personnel files and the electronic training records matrix demonstrated that staff are attending their mandatory training as well as attending specialist training that appertain to the client group. i.e. dementia foundation certificate, rights, risks and limitations to freedom, medication related falls. Staff spoken with report that there is ‘Plenty of training’ and that they are well supported to fulfil their role. They told the inspector that they receive regular supervision and have an annual appraisal. The records of the supervision and appraisal meetings were evidenced in personnel files that the inspector viewed. The AQAA stated that there are now 57 of care staff hold or are in the process of completing their NVQ level 2 in care qualification. A further twelve will commence this in October 07. Hawthorne Court Nursing Home DS0000062645.V338712.R01.S.doc Version 5.2 Page 26 The inspector viewed the personnel files for six staff member, two of which are recent recruits. The Human Resources Department of Hampshire County Council maintain the personnel files but the home has copies of the all necessary information required to be kept and stated on Schedule 2 of the Care Home Regulations. This information was evidenced in all personnel files viewed by the inspector. The files demonstrated that robust recruitment procedures are in place. The manager told the inspector that she interviews all new staff. Staff spoken to were satisfied wit their jobs and with the terms and conditions of their employment. Hawthorne Court Nursing Home DS0000062645.V338712.R01.S.doc Version 5.2 Page 27 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A competent person manages the service. The service responds to suggestions made by service users and their representatives. Quality auditing assists the home to put systems in place to improve the service. Clear procedures protect resident’s finances. The home has a good record of meeting relevant health and safety requirements and legislation. . Hawthorne Court Nursing Home DS0000062645.V338712.R01.S.doc Version 5.2 Page 28 EVIDENCE: The registered manager is an experienced qualified manager and has been the manager since the home opened in March 05. There is a clear organisational management structure that promotes good communications between staff. The manager has a group of senior nurses and one senior nurse who is the deputy. Staff spoken with, hold the manager in high regard and consider her very supportive and approachable and available to talk at any time she is on duty. The home has a quality audit system in place. Quality audit documents based on the national minimum standards are completed annually. The operational manager visited the home during the inspection visit to undertake the regulation 26 visit. The inspector viewed the previous months reports that identified sampling of all areas of the home and service user care. The home holds relative support group meetings and these are minuted and chaired by a care manager. The inspector viewed the May minutes. The manager told the inspector that the student nurses and medical students, who had been on placement at the home, had undertaken their own research and had asked forty residents, eight questions. The outcomes were written into a report with charts to indicate the level of satisfaction. The inspector viewed this and observed that generally there was a high level of satisfaction throughout the home for all the various services delivered to Hawthorn Court. Relatives’ surveys were distributed in February 07. The response was quite poor but the over riding theme from the results was that relatives wanted more information made available to them. Their relatives manage the majority of service user’s monies. The County Treasurer’s department is a representative for one service user and all records are electronically recorded. The department send money to the home when requested. The home has health and safety policies in place that are reviewed regularly. The staff records demonstrate that staff have regular health and safety training; the inspector observed two carers transferring a resident onto a hoist, this was undertaken in a dignified and safe manner with the carers explaining to the lady what they were doing. The home has a fire risk assessment and the sprinklers and fire alarms are checked weekly. The operational manager of the home is responsible for all maintenance and servicing of the equipment and systems. Hampshire County Hawthorne Court Nursing Home DS0000062645.V338712.R01.S.doc Version 5.2 Page 29 council are responsible for contracting out all repairs and maintenance to the home. The issue of the ventilation around one of the nurse’s offices is in the process of being resolved and contractors attended the home during the inspection visit to assess the job. Hawthorne Court Nursing Home DS0000062645.V338712.R01.S.doc Version 5.2 Page 30 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 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 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Hawthorne Court Nursing Home DS0000062645.V338712.R01.S.doc Version 5.2 Page 31 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 OP7 Regulation 15. Requirement The registered person must continue to develop the care planning system to ensure that service users have care plans that set out in detail the action to be taken by staff in respect of identified risks and how these will be managed. Timescale for action 31/08/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Hawthorne Court Nursing Home DS0000062645.V338712.R01.S.doc Version 5.2 Page 32 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Court Nursing Home DS0000062645.V338712.R01.S.doc Version 5.2 Page 33 - 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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