Inspection on 07/06/05 for Hawthorne Court Nursing Home

This inspection was carried out on 7th June 2005.

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 26/06/07

Hawthorne Court Nursing Home 17/10/06

Hawthorne Court Nursing Home 01/11/05

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 Hawthorn Court Nursing Home Coldeast Way Fareham Southampton Hampshire Lead Inspector Roy Bega Unannounced 07 June 2005 10:00am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Hawthorn Court Nursing Home v231458 h54 s62645 hawthorn court v231458 070605.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Hawthorn Court Nursing Home Address Coldeast Way, Fareham, Hampshire Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01489556720 Hampshire County Council Mrs Victoria Ann Biggs CRH 80 Category(ies) of DE- Dementia : 50 registration, with number OP- Old Age: 30 of places Hawthorn Court Nursing Home v231458 h54 s62645 hawthorn court v231458 070605.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection Not applicable. Brief Description of the Service: Hawthawn Court is a purpose built nursing home for 80 older persons managed by Hampshire County Council Social Services Department. It was registered 24 February 2005 and commenced admitting residents on 5 March 2005. This visit was its initial inpection subsequent to registration. The home is located within the former grounds of Coldeast hospital Fareham with 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 facilites. Other facilities include a visitors lounge, activities lounge, hairdressing salon, smoking lounge and medical rooms. Hawthorn Court Nursing Home v231458 h54 s62645 hawthorn court v231458 070605.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report reflects the assessed situation with regards to standards inspected at the time of the visit. This visit was the home’s initial inspection subsequent to registration February 2005. This inspection took place over one day, a total of six and a quarter hours between 9-45 a.m. and 4 p.m. Opportunity was taken to look around the home, view records and talk with, residents, staff and relatives. Mrs Biggs, the Registered Manager informed the inspector that admissions have been stopped due to the number of residents the home is being asked to accommodate with high dependency needs. Current maximum operational level is forty. Revised staffing requirements are being discussed with senior management within Hampshire County Council before further residents are admitted. The inspector was assured that numbers would not exceed forty until staffing requirements have been agreed. At the time of this inspection, thirty eight residents were accommodated. Standards not inspected on this occasion will be assessed during future visits. Five requirements were made resulting from this inspection. What the service does well: The home is well managed. The staff team are highly motivated and have good relationships with residents. Staff were observed to respect residents and explain aspects of care before carrying it out. The home has been operational for three months therefore the inspector acknowledged that arrangements for social activities are in the developmental stage. It was noted however, that substantial work has been carried out in this area. Residents spoken with felt that they are treated very well and respected by staff. Comments made included - “They really care”, “They don’t rush you” and “Staff like a laugh”. Hawthorn Court Nursing Home v231458 h54 s62645 hawthorn court v231458 070605.doc Version 1.30 Page 6 Visitors spoken with had nothing but positive remarks with regards to the manner in which the home is run. Comments made included – “They are so helpful here”, “Folk are so friendly” and “Nothing is too much trouble”. 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 Court Nursing Home v231458 h54 s62645 hawthorn court v231458 070605.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Hawthorn Court Nursing Home v231458 h54 s62645 hawthorn court v231458 070605.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3,4 and 5. The admission process is well managed with residents and their representatives being provided with clear information regarding the home and ability to make pre admission visits. EVIDENCE: Discussions and records seen indicated that the home’s management staff are involved with prospective residents pre admission assessments. Further information is obtained when the potential resident visits the home. This includes, for example - communication, mobility, dietary requirements and medication. Mrs Biggs informed the inspector that admissions have been stopped due to the unpredicted number of residents the home is being asked to accommodate with high dependency needs. Current maximum operational level is forty. Revised staffing requirements are being discussed with senior management within Hampshire County Council before further residents are admitted. The inspector was assured that numbers would not exceed forty until staffing requirements had been agreed. Hawthorn Court Nursing Home v231458 h54 s62645 hawthorn court v231458 070605.doc Version 1.30 Page 9 A sample of 2 comprehensive pre admission assessments were seen. There was evidence to confirm that residents and/or relatives are involved in the assessment process. Records, observations and discussions indicated that several residents were unable personally to contribute to the pre admission process due to their high dependency needs. Relatives spoken with however, stated that they were fully involved and supported to visit the home prior to making a decision. They commented that staff were so kind and helpful throughout the admission process. Hawthorn Court Nursing Home v231458 h54 s62645 hawthorn court v231458 070605.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, and 10. The health and personal care needs (including medication) of residents is provided in a manner which ensures respect, dignity and rights. EVIDENCE: The home has been operational for three months therefore the inspector acknowledged that care/nursing plans are in the developmental stage of production. A sample of 2 care/nursing plans were seen. Whilst required information is recorded, Mrs Biggs acknowledge they need to be more specific in detail. For example, when stated requires two staff to assist with bathing, the what and how needs to be included. It was agreed with immediate effect to record the checking of the more frail residents who are unable to use the call bell system as part of care plans. As well as the home’s compliment of nurses, a community psychiatric nurse and a community occupational therapist are assigned to the home eighteen hours weekly respectively. Hawthorn Court Nursing Home v231458 h54 s62645 hawthorn court v231458 070605.doc Version 1.30 Page 11 Observations, discussions and available training records indicated that staff have the skills and experience to deliver care effectively. Staff were observed to inform residents what they were going to do with regards to care before carrying it out. Staff were also observed to be courteous and respectful, ensuring residents dignity and privacy at all times. Residents and visitors echoed this in discussions. Hawthorn Court Nursing Home v231458 h54 s62645 hawthorn court v231458 070605.doc Version 1.30 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 standard(s) 12, 13 and 15. Social activities are being organised to provide creative stimulation and interest for people living in the home. Visitors are made welcome at all times. Meals are nutritious and balanced offering a healthy and varied diet. EVIDENCE: The home has been operational for three months therefore the inspector acknowledged that arrangements for social activities are in the developmental stage. It was noted however, that substantial work has been carried out in this area. For example, residents’ interests and hobbies form an integral part of personal care/nursing plans. The Arts and Heritage organisation have been requested to develop suitable activities for individuals. External entertainers have provided various performances and staff engage residents daily in light recreational activities like armchair skittles. The latter was observed during the visit. Relatives spoken with readily informed the inspector of the “open house” attitude with regards to visiting arrangements commenting they are always made welcome. It was noted during the inspection that there was a constant flow of visitors. Mrs Biggs informed the inspector that relatives have portrayed a keenness to set up a league of friends. Hawthorn Court Nursing Home v231458 h54 s62645 hawthorn court v231458 070605.doc Version 1.30 Page 13 The kitchen is managed by a subsidiary department of Hampshire County Council quite separate to that of the home. They are responsible for assessing residents’ nutritional requirements and menu planning. Other responsibilities through four house keeping staff includes liaising on a daily basis with the home’s management to monitor residents food intake, likes and dislikes and maintaining provisions in the eight kitchenettes. Available menus indicated a varied and balanced diet is provided. A record of food provided that varies from the main menu was seen. Residents readily expressed their satisfaction with regards to the quality, quantity, and choice of food provided Hawthorn Court Nursing Home v231458 h54 s62645 hawthorn court v231458 070605.doc Version 1.30 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 standard(s) 16 and 17. Residents and their relatives are confident that their complaints will be listened to, taken seriously and acted upon. Policies and procedures are in place to ensure residents are protected from abuse. EVIDENCE: The home’s complaints procedure is included in the residents’ handbook. Residents spoken with and their relatives are aware of how to report any concerns and are confident any complaint will be taken seriously. The inspector was advised of a complaint that had recently been received and that it was planned to meet with the person to discuss concerns expressed. The Commission for Social care Inspectorate have not received any complaints with regards to the home subsequent to it opening in March 2005. The home has Hampshire County Council’s a policy and procedure document with regards to the protection of vulnerable adults in place. Records seen and discussions indicated that the protection of vulnerable adults forms part of staff training. Discussions with staff indicated a good awareness in respect of the protection of vulnerable adults. Hawthorn Court Nursing Home v231458 h54 s62645 hawthorn court v231458 070605.doc Version 1.30 Page 15 On the day prior to this inspection care staff had expressed concerns to the home’s management with regards to the conduct of a senior towards a resident. Appropriate action had been taken and a Protection of Vulnerable Adults planning meeting arranged through the local social services area office. Hawthorn Court Nursing Home v231458 h54 s62645 hawthorn court v231458 070605.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 22 and 24. The property is a new purpose built home providing a safe and comfortable environment with specialist equipment. Residents are permitted to bring in their own possessions EVIDENCE: Currently only half of the home is occupied due to Hampshire County Council reviewing operational policies and staffing requirements. The inspector toured the building un escorted. Décor and furnishings throughout the home was in good order. A sample of four residents bedrooms were seen. They were well decorated and equipped. It was noted residents had personalised rooms with their own possessions. The home provides a variety of adaptations and equipment to enable residents to maximise their independence. Hawthorn Court Nursing Home v231458 h54 s62645 hawthorn court v231458 070605.doc Version 1.30 Page 17 It was noted however, that doors to provide access to the enclosed garden via the entrance hall have not been installed. The inspector was informed that the work has been approved and contactors instructed to complete the task. Hawthorn Court Nursing Home v231458 h54 s62645 hawthorn court v231458 070605.doc Version 1.30 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 and 30 Residents’ needs are met by the number and skill mix of staff. The home has a good recruitment policy and practices in place. EVIDENCE: Due to the number of residents the home is being asked to accommodate with high dependency needs, staffing levels are being reviewed before the home is fully opened. The inspector was assured that until this has been resolved with senior management within Hampshire County Council, the operational occupancy level would not exceed forty residents. The inspector was informed that a full time Operations Manager has been appointed to oversee all non clinical/resident related requirements. Discussions, observations and available rota indicated the following current deployment of nurse/care staff From 7-30 am to 3 pm., three nurses and eight care staff are on duty. From 3 pm. To 9-15 pm 2 nurses and five/six care staff are on duty. From 9-15 pm to 7-30 am. awake staff – two nurses and 5 care staff. Hawthorn Court Nursing Home v231458 h54 s62645 hawthorn court v231458 070605.doc Version 1.30 Page 19 Hampshire County Council have a recruitment policy based on equal opportunities. A sample of 2 staff files were seen, both of which contained the required information. At the time of this visit there were not any staff vacancies. Staff spoken with confirmed that they had to complete an application form, CRB check, obtain two written references and attend a formal interview before being appointed. Post appointment they were “shadowed” by experienced staff and completed an induction programme before being assessed competent. Hawthorn Court Nursing Home v231458 h54 s62645 hawthorn court v231458 070605.doc Version 1.30 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 36, 37 and 38. Residents live in a home which is well managed with an ethos of being open and honest. There are concerns with regards to the health and safety of residents and staff. EVIDENCE: The registered manager is appropriately qualified, competent and experienced to run the home and meet its stated purpose, aims and objectives. Discussions and observations indicated there are clear lines of accountability within the home. Hawthorn Court Nursing Home v231458 h54 s62645 hawthorn court v231458 070605.doc Version 1.30 Page 21 Observation and discussions indicated that the management approach of the home creates an open, positive and inclusive atmosphere. Minutes of staff meetings were available. Mrs Biggs informed the inspector that although the structure is in place, one to one staff supervision has not yet commenced. Residents’ spoken with had nothing but positive comments to say about staff which included – “They are really kind”, “They don’t rush you” and “Staff like a laugh”. Visitors spoken with had nothing but positive remarks with regards to the manner in which the home is run. Comments made included – “They are so helpful here”, “Folk are so friendly” and “Nothing is too much trouble”. Minutes of staff meetings were available. Mrs Biggs informed the inspector that it is planned to arrange relatives meetings through the league of friends to compliment those of residents. It was noted that ventilation in the nurse stations is poor. There is not any natural source of fresh air or mechanical air conditioning. The inspector was informed that this has been reported to the appropriate department within Hampshire County Council. The inspector was also informed that contractors have yet to install the security alarms to the fire exit doors. Hawthorn Court Nursing Home v231458 h54 s62645 hawthorn court v231458 070605.doc Version 1.30 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x 3 3 3 x x 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 Standard No 16 17 18 Score 3 3 3 3 3 x x x 2 3 2 Hawthorn Court Nursing Home v231458 h54 s62645 hawthorn court v231458 070605.doc Version 1.30 Page 23 Not applicable. Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 7 Regulation 15 (1) Requirement Residents care plans are to contain more detailed information with regards to how aspects of care are to be carried out. It was agreed with immediate effect to record the checking of the more frail residents who are unable to use the call bell system as part of care plans. One to one staff supervision has not yet commenced. Contractors have yet to install the security alarms to the fire exit doors. A plan of action is required by the stipulated date. It was noted that ventilation in the nurse stations is poor. There is not any natural source of fresh air or mechanical air conditioning. A plan of action is required by the stipulated date. Timescale for action 30/09/05 2. 7 15 (1) 07/06/05 3. 4. 36 38 18 (2) 13 (4a) 30/09/05 19/07/05 5. 38 23 (3a) 19/07/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Hawthorn Court Nursing Home v231458 h54 s62645 hawthorn court v231458 070605.doc Version 1.30 Page 24 No. 1. Refer to Standard Good Practice Recommendations Hawthorn Court Nursing Home v231458 h54 s62645 hawthorn court v231458 070605.doc Version 1.30 Page 25 Commission for Social Care Inspection 4th Floor- Overline House Blechynden Terrace Southampton Hampshire 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. 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