Inspection on 07/09/07 for Hawthorne House

This inspection was carried out on 7th September 2007.

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 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

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

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

CARE HOME ADULTS 18-65 Hawthorne House 133 The Village Strensall York North Yorkshire YO32 5XD Lead Inspector Karen Ritson Key Unannounced Inspection 7 September 2007 10:00 th Hawthorne House DS0000068921.V335870.R01.S.doc Version 5.2 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 House DS0000068921.V335870.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 Adults 18-65. 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 House DS0000068921.V335870.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hawthorne House Address 133 The Village Strensall York North Yorkshire YO32 5XD 01628 602003 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) Milewood Healthcare Limited ****Post Vacant**** Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Hawthorne House DS0000068921.V335870.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either; whose primary care needs on admission to the home are within the following categories: 2. Learning Disability - Code LD The maximum number of service users who can be accommodated is: 9 New Service. Date of last inspection Brief Description of the Service: Hawthorne House is a semi- detached property with gardens in Strensall, near York. The house is located within walking distance of local shops, and is close to transport links into York. The home is registered to accommodate up to 9 adults who have a Learning Disability. Information about the services the home provides are made available to prospective clients and/or their representatives and to placing authorities though the provision of a written Statement of Purpose and Service Users Guide and through CSCI reports. At the time of this report the range of fees are from £1012 to £1643 a week. Additional charges may be made for client’s personal toilet requisites, hairdressing, chiropody, eye care and dental treatment as is required. Hawthorne House DS0000068921.V335870.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection for this service took 12 hours. This includes time spent gathering information and examining documentation before and after two unannounced site visits and in writing the report. The site visits took place on 07/09/07 and 10/12/07,the first between 15:00 and 16:00 and the second between 10:00 and 15:30. Information for this inspection was gathered from the following: • A tour of the premises • Observations of care throughout the day of the site visit. • Speaking with service users. • Speaking with the manager • Speaking with staff. • Case tracking service users on the day of the site visit. • Looking at information provided by the manager in a pre inspection questionnaire. • Notifications sent to the commission from the home since the last inspection. • Examining policies, procedures and records kept at the home. • Examining information regarding the home on the file kept by CSCI. • Considering comments made by relatives, health care and social services staff. All key standards were looked at during this inspection. The manager was present throughout the day of the second site visit. What the service does well: Hawthorne House offers a comfortable home with a good level of care for up to nine residents who have a learning disability. The home is good at assessing service users needs, and only offers a place when it can be sure these can be met. A detailed written plan of care is prepared, based on the assessment. The home is good at assessing what risks there may be for the service user and planning to make sure these are minimised. As service users needs may often change, these plans are kept under regular review. The home is good at involving the service users in decision made about the way in which care is offered. Health care professionals are consulted for advice on how to provide the best care. One health care professional said: “The staff at Hawthorne house do a good job. They know their clients well.’’ Service users are supported to lead fulfilling and interesting lives. Staff ask service users what their interests are and efforts are made to ensure that there are opportunities to get involved in hobbies, educational activities or jobs. Hawthorne House DS0000068921.V335870.R01.S.doc Version 5.2 Page 6 Service users also get involved in choosing menus and the home promotes a healthy eating plan. The staff place the service users at the centre of all planning for care. This is evident in the way service users are supported with their daily lives, their health care needs, the way their medication is handled and in how they are consulted about all areas of their lives. 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. The summary of this inspection report can be made available in other formats on request. Hawthorne House DS0000068921.V335870.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hawthorne House DS0000068921.V335870.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 People who use the service experience good quality outcomes in this area. They have the information needed to choose a home, which will meet their needs, and their needs are well assessed. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: Assessment documentation is thorough and includes a pre-admission form with detailed information about the care needs of each individual and a person centred profile. This means the home is clear about whether it can meet the needs of service users prior to offering a place. Service users are encouraged to visit the home before making a decision about admission, and their care needs are considered carefully alongside those of the other service users living at the home. Risk is considered and all restrictions are well documented along with strategies for reducing risk where possible. The assessment considers the required assistance from health care professionals and the needs and wishes of the service user, family members or others involved in the care of the person. This ensures that the person and the network of people important to that person have all been consulted, which creates the best opportunity for current and anticipated care needs to be met. Hawthorne House DS0000068921.V335870.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, and 9 People who use the service experience good quality outcomes in this area. Individuals are involved in decisions about their lives, and play an active role in planning the care and support they receive. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The manager develops a plan in consultation with each service user. This includes all area of each person’s life. There are detailed procedures for those service users who may have challenging behaviour. These focus on positive behaviour, strengths and capacity. The plans are updated to take account of changing needs. This is done with the knowledge of the service user. Service users are consulted in reviews about choices, lifestyle preferences, privacy, how they wish to be treated, personal Hawthorne House DS0000068921.V335870.R01.S.doc Version 5.2 Page 10 appearance and other areas of care. This ensures that the home updates information from the service user, which is used to develop the plan. The home has a key worker system, which provides each individual with a specific person who knows his or her needs particularly well. The service users know who is involved in their care and they are consulted about health care and other professional support. They have access to advocacy if they wish and are helped to understand medical conditions or the need for medical interventions. All service users choices are recorded. Those who have capacity manage their own finances, and assistance is offered when needed. This promotes independence. Service users are encouraged to live as full as life as possible, according to their choice, where risks are identified and minimised. A service user said: They’re all lovely and let me do what I want but sometimes they say do something else if it’s better for me.’‘ A health care professional said: ‘When the home first opened there a few staff changes and information was not always passed on as it should have been. This now seems to have settled down.’ Another said. ‘The staff follow advice given and are not shy about ringing for support if they have a query. Staff accompany service users to health reviews and know about the needs of the person they represent.’ Hawthorne House DS0000068921.V335870.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 People who use the service experience good quality outcomes in this area. They are able to make choices about their life style, and are supported to develop their life skills. Social, educational, cultural and recreational activities meet individual’s expectations. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The staff help service users take part in fulfilling activities, education or jobs as appropriate. Evidence for this was seen on care plans and in daily notes. It was also evident on the day of inspection that many of the service users had a day out arranged either at an educational establishment or accompanied on a one to one basis with a care worker. Service users said they had opportunities to go out every day if they wished and that they were helped to pursue their interests. The home can offer this support because it has a good ratio of staff to service users. Hawthorne House DS0000068921.V335870.R01.S.doc Version 5.2 Page 12 One service user spoke enthusiastically about her work caring for animals at nearby Askham Bryan College. Others attend ‘Green-works’ a day centre where service users are involved in activities they choose such as cooking, gardening and woodwork. Service users have the opportunity to go out to the cinema or the pub. They also have the opportunity to follow educational courses such as computing or literacy skills and have the choice to go on holiday. The latest holiday was to a caravan park in Scarborough and there are plans to visit a holiday cottage in the Lake District. Family and friendship links are promoted and service users said they receive support to keep in touch with those they care about. Service users spoke about their plans to visit family and friends over the Christmas period. Those who have capacity are encouraged to become involved in the daily routines of living such as cleaning, shopping and laundry. Service users said that their privacy was respected and that they could stay in their room undisturbed if that is what they wished. All the service users spoken to said they enjoyed the meals, that they were involved in choosing menus and that they would help with shopping sometimes. Menus showed that individual preferences were taken into consideration and that a good balance had been achieved between choice and best nutrition. Service users are also offered the opportunity to go out to cafes either with staff or on their own. Hawthorne House DS0000068921.V335870.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19,and 20 People who use the service experience good quality outcomes in this area. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: Service users indicated they received good personal care support from staff in the way which was preferable to them. Their daily routines could be flexible within the risk assessment framework in their care plan. Care plans and daily notes also showed that service users were supported to have their healthcare needs met. One health care professional said: ‘The people living at Hawthorne House are helped to understand their medical needs in a way which appropriate to them. Staff have a good understanding of what each person is able to take on board.’ Medication is kept stored, administered and is returned according to policy and procedure. Controlled drugs are appropriately handled. Staff who administer Hawthorne House DS0000068921.V335870.R01.S.doc Version 5.2 Page 14 medication have received training in safe handling of medication. This approach protects service users health. Hawthorne House DS0000068921.V335870.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People who use the service experience good quality outcomes in this area. Service users complaints are listened to and acted on, they are consulted about their care and their safety is well protected. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The home has a suitable complaints procedure and policy. Service users said the staff would listen to them if they had any complaint and would do something about it. Staff have received comprehensive training in keeping service users and themselves safe. One health care professional said: ‘The staff seem to work well with the service users to prevent situations from escalating. They have the skills needed to deal with challenging behaviour and know the signs to watch out for.’ Another said: ‘My patient has not had a success story in any other care setting but at Hawthorne House they manage the behaviour well.’ A service user said: ’I feel comfortable living here. Everyone is very nice. If someone gets upset the staff look after them. I don’t feel frightened.’ Hawthorne House DS0000068921.V335870.R01.S.doc Version 5.2 Page 16 A staff member said: ‘We understand what needs to be done for each individual living here. We have quickly got to know triggers for challenging behaviour and I feel confident that we manage situations well so that people and those around them keep out of harm.’ Hawthorne House DS0000068921.V335870.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 People who use the service experience good quality outcomes in this area. The physical design and layout of the home enables residents to live in a safe, well-maintained and comfortable environment, which encourages independence. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: A tour of the premises showed the home is well decorated and maintained. Rooms are individually decorated to service users taste. Service users spoken to said they liked their rooms, and had been involved in planning and choosing decoration. The laundry meets the needs of the service users. Those spoken to said they could help with the laundry and that their clothes were well cared for. Recommendations from the latest environmental health visit have been implemented and the home has a comprehensive infection control policy and procedure. Hawthorne House DS0000068921.V335870.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 People who use the service experience good quality outcomes in this area. Staff in the home are trained, skilled and in sufficient numbers to support the people who use the service, in line with their terms and conditions, and to support the smooth running of the service. They are well recruited. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: Staff are well recruited according to policy and procedure. The home plans to involve service users in the recruitment of staff in future. All staff receive detailed induction and foundation training in which health, safety and protection are emphasised. LDAF training is planned for all staff. 50 of staff have achieved NVQ at level 2 or above. Service users commented that the staff were supportive. One service user said: ‘They know all about what I need. They’re there whenever I need help’ Hawthorne House DS0000068921.V335870.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 People who use the service experience good quality outcomes in this area. The management and administration of the home is based on openness and respect. There is a developing quality assurance system which ensures service users are consulted about their care. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The manager has very recently been appointed and has not yet had chance to apply to CSCI for registration, although this is planned for the near future. Mr Tomkinson has previous management experience in a care setting. Staff, service users and others all made positive comments about his ability to manage the home, saying he was approachable and easy to talk to. Health care and other professionals remarked that the management of the home had not been so reliable when the home first opened and that it was difficult to Hawthorne House DS0000068921.V335870.R01.S.doc Version 5.2 Page 20 speak to the right person. This is now resolved and communication is much improved. The home has a developing quality assurance system. The company carry out comprehensive internal quality audits, and service users have recently been surveyed. Questionnaires are also planned for health care professionals, relatives and others involved in the care of service users. An annual plan is to be drawn up based on information gained. The surveys will be discussed in team meetings and shared with service users. Service users are kept safe by the health and safety practice and policies at the home. The home has an up to date fire risk assessment, and complies with the requirements of the local fire authority. Staff are trained in safe working practices and risk assessments are carried out for all safe working practices. This ensures service users welfare is protected. Hawthorne House DS0000068921.V335870.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 2 X 2 X X 3 X Hawthorne House DS0000068921.V335870.R01.S.doc Version 5.2 Page 22 N/A 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 Refer to Standard YA39 YA37 YA35 YA34 Good Practice Recommendations The quality assurance system should be developed to show that service users and others views underpin all selfmonitoring, review and development by the home. The manager should be registered with CSCI. The manager should ensure that staff have LDAF training. The manager should implement his plan to involve service users in the recruitment of staff. Hawthorne House DS0000068921.V335870.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 House DS0000068921.V335870.R01.S.doc Version 5.2 Page 24 - 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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