Inspection on 22/09/05 for Hawthorne Lodge

This inspection was carried out on 22nd September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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 Lodge 08/06/10

Hawthorne Lodge 10/05/10

Hawthorne Lodge 17/02/10

Hawthorne Lodge 06/01/10

Hawthorne Lodge 30/11/09

Hawthorne Lodge 06/11/09

Hawthorne Lodge 06/10/09

Hawthorne Lodge 19/08/09

Hawthorne Lodge 07/04/08

Hawthorne Lodge 11/05/07

Hawthorne Lodge 12/06/06

Hawthorne Lodge 23/01/06

Hawthorne Lodge 30/03/05

Hawthorne Lodge 05/08/04

Hawthorne Lodge 23/03/04

Similar services:

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

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

CARE HOMES FOR OLDER PEOPLE Hawthorne Lodge 164/166 Hawthorne Lodge Bootle Liverpool L20 3AR Lead Inspector Lorraine Farrar Unannounced 22nd September 2005 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. Hawthorne Lodge F53 F03 S5377 Hawthorne Lodge V248716 220905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Hawthorne Lodge Address 164/166 Hawthorne Road Bootle Liverpool L20 3AR 0151 933 3323 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) Stirrupview Limited Property & Estates Mrs Lea Jones Care Home 25 Category(ies) of Old Age OP (25) registration, with number of places Hawthorne Lodge F53 F03 S5377 Hawthorne Lodge V248716 220905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Service users to include up to 25 OP Date of last inspection 30/03/05 Brief Description of the Service: Hawthorne Lodge is registered to provide accommodation and personal care without nursing for 25 older people. The home is a mock Tudor style building located on the corner of two busy streets in Bootle. Due to its location there is good access to public transport, and many local facilities are a short journey away. The shared areas include two lounges, a dining room and walled back garden. Bedrooms are either single or double rooms, screens are provided in double rooms for privacy. To the front of the home there is a small-grassed area with a small patio area at the side of the building, which residents can use to sit outside during the summer months. There is a keypad fitted to the front door and other doors are alarmed so that staff are aware of and can offer assistance to any resident who wishes to go out. The home provides twentyfour hour personal care to residents , meals and laundry costs are included in the basic fee. They will arrange for newspapers, hairdressers, private chiropodists and dry cleaning, the cost of which are met by the service user. Hawthorne Lodge F53 F03 S5377 Hawthorne Lodge V248716 220905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. During the inspection discussion took place with several residents, relatives and members of staff including the Manager. Care files and safety records were looked at and parts of the building examined. What the service does well: What has improved since the last inspection? What they could do better: The home need to make sure staff training in some areas of health and safety is up to date. They also need to make sure residents are as safe as possible this includes, providing a Criminal Records Bureau check for the responsible Person and training for staff in adult protection. Some areas of the building need attention to lessen the risk of accidents. They need to further improve their care plans to make sure staff have written information about how to provide suitable care for each resident and that the resident and with permission their relative is regularly consulted about their care. Hawthorne Lodge F53 F03 S5377 Hawthorne Lodge V248716 220905 Stage 4.doc Version 1.40 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Hawthorne Lodge F53 F03 S5377 Hawthorne Lodge V248716 220905 Stage 4.doc Version 1.40 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 Hawthorne Lodge F53 F03 S5377 Hawthorne Lodge V248716 220905 Stage 4.doc Version 1.40 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 The home obtains copies of Social Services assessments and carries out their own assessment to make sure they can meet a persons needs before they offer a place. EVIDENCE: Residents files contained copies of the assessment carried out by their Social Worker and the Manager explained that she always meets people hoping to move into the home and makes sure she has enough information to decide if the home can meet their needs. A Resident and relative spoken with explained that the home had spoken with them to find out their care needs before they moved in. Hawthorne Lodge F53 F03 S5377 Hawthorne Lodge V248716 220905 Stage 4.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8,9 There are care plans in place for all Residents and the home carries out regular reviews and assessments of their needs. Not all plans contain enough information about the support staff need to provide. Staff are aware of and support Residents with their health care needs. Medication is generally well managed but the home need to make sure they follow their systems for recording at all times. EVIDENCE: The home has care plans for each Resident and three of these were read during the inspection. The Manager explained that they had recently noticed some information had gone missing from files and were in the process of replacing this. Care plans contained information about the persons likes and dislikes, their medical and personal history and some support needs. Monthly assessments are completed for each person for, pressure areas, continence care, moving and handling and their dependency levels. Where an assessment shows the person had a high level of need or risk there is not always a full plan in place explaining how the staff should care for the person. One care plan assessment showed that the lady had a high risk of her pressure areas breaking down. Hawthorne Lodge F53 F03 S5377 Hawthorne Lodge V248716 220905 Stage 4.doc Version 1.40 Page 10 There was no written plan in place to say how the home are lessening this risk, although there is equipment in place and the Manager was able to give a good explanation. The home must make sure that where an assessment shows care or support is needed there is a care plan written explaining how the staff should provide that care. This will help any staff unfamiliar with the Resident to provide good care and will make sure all staff are aware of what they need to do. All care plans had been regularly reviewed by the home but the involvement of Residents and their families was out of date, one care plan had not been signed by the Resident since 2004 and by their family since August 2003. The home must make sure that the Resident and their family, if the Resident agrees, are consulted about the plan and their agreement to it is written down. Two relatives spoken with did tell the inspector that staff talk to them and inform them about their relatives care. Residents and the Manager explained that the home arranges for a Chiropodist to visit regularly and for an Optician to carry out home visits, and that Dentist visits are arranged as and when needed. Assessments of health care needs are carried out regularly and updated and the home will support Residents to make health care appointments. All of the staff who deal with Residents’ medication have had recent training in dealing with this. The home uses a blister pack system for storing and giving medication, records of medication given had been signed for and it was stored correctly. No record had been made of the medication last received into the home. If medication is not counted when received errors can occur if there doses are wrong or there is not enough for the month. To prevent this, the home must make sure that they record the type and amount of medication they received. Hawthorne Lodge F53 F03 S5377 Hawthorne Lodge V248716 220905 Stage 4.doc Version 1.40 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,15 The home encourages Residents’ visitors to call at all reasonable times and makes herm welcome. There are few planned activities apart from those found in a domestic home, however this suits the people currently living there. Staff are aware of the need to help Residents stay as independent as they can and support them with this. A varied diet is offered with choices available and staff support if needed. EVIDENCE: Care plans contain information about the things the person likes and does not like to do. A Resident spoken with said that they can get up / go to bed when they chose and that there is a choice of meals with the cook always willing to make something different if they don’t like what is on the menu. There are not many organised activities in the home, however Residents spoken with said that they were happy with this and spent time reading, chatting or watching TV. There were several visitors in the home during the day, one relative explained that staff always give a “good welcome”. Relatives were seen to visit in private or using shared rooms as the Resident preferred. Another Relative confirmed that the home keep them informed of any changes to their parents health etc and said “you couldn’t get a better place”. Hawthorne Lodge F53 F03 S5377 Hawthorne Lodge V248716 220905 Stage 4.doc Version 1.40 Page 12 Residents are assessed and asked to see if they want to look after their own money and can have a locked drawer in their room and a key to their bedroom if they wish. They are also encouraged to bring some of their own possessions with them if they wish. In a morning there is a choice of cereal, toast or a cooked breakfast, the main meal is served at lunchtime and a lighter meal at teatime. On the day of the inspection there was gammon for lunch and tea consisted of sandwiches and cakes. The Cook has a good knowledge of what each person does and doesn’t like and will make something different if they do not like the menu. There were enough stocks of food available including, fruit vegetables and meat. Staff were seen to offer afternoon drinks served as Resident’s liked them and support was offered quietly to those who needed it. Hawthorne Lodge F53 F03 S5377 Hawthorne Lodge V248716 220905 Stage 4.doc Version 1.40 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 The home has policies for dealing with allegations of abuse, however staff have not had training in this area. The Home have failed to provide the CSCI with sight of a CRB check for the Responsible Person. EVIDENCE: There have been no investigations under adult protection policies within the home in the past year. The home has a copy of the local Social Services policy for dealing with any possible abuse of a Resident and the Manager has an understanding of this. All current and new staff have a Criminal Records Bureau (CRB) check carried out. It has been a requirement of previous inspections that both the Manager and Responsible Person must show the Commission for Social Care Inspection (CSCI) a copy of their current CRB check. This has now been seen for the Manager but not for the Responsible Person, Mr Hornby. The Manager said that this had been sent for. The home must make sure that the CSCI are provided with sight of a copy of this as required by regulations. Staff have not had training in Adult Protection, which may lead to the proper steps not being taken in the event of an allegation being made. The home must provide this training to staff. Hawthorne Lodge F53 F03 S5377 Hawthorne Lodge V248716 220905 Stage 4.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,23,24 The home is clean and there is a plan for decoration and maintenance. Some areas of the home appear well decorated and homely others would benefit from decoration and some replacement, they are aware of this and working towards it. EVIDENCE: The home have recently had a new kitchen fitted, which provides plenty of storage space and is easier to keep clean, the Cook explained that there are plans to fit new tiles which will make this room look fresh and be easier to look after. Bedrooms in the home are gradually being decorated, since the last inspection several have been decorated and new carpets fitted. The Manager said that there are plans to decorate the top hall, landing and all bathrooms and replace some of the bathroom suites. There have been a number of incidences in the home of theft in the past year. The Police have been informed and the Manager explained that as a result there are plans to fit CCTV to the corridors. Hawthorne Lodge F53 F03 S5377 Hawthorne Lodge V248716 220905 Stage 4.doc Version 1.40 Page 15 The home must carry out an assessment of this to make sure that it faces entrance areas only and does not intrude on Residents daily lives. The home has carried out a fire risk assessment and this was being followed. A carpet was fitted in the hall earlier in the year, however this was coming loose in some doorways and could cause people to trip, the Manager said she was aware of this and had arranged for the fitters to visit. The home must inform the CSCI that this work has been carried out. The home provides enough shared space, this includes a downstairs dining room, and two lounges one located on the first floor and one on the ground floor. Both lounges are non-smoking but there is a small area at the side of the dining room set aside for this purpose. Furniture and lighting in these rooms appears comfortable and homely. Outside there are small garden areas, which can be used for sitting in, during warmer months. All bedrooms have washbasins fitted and there are toilets throughout the home that are near to the bedrooms and dining room. There are three baths and a walk in shower, one of the baths has a chair to help people who have difficulty getting in. The home has five double bedrooms some of which are used as single rooms at the moment, where two people share a room there are screens for privacy. Bedrooms are adequately furnished and there is an on-going decorating programme. One Resident explained that her room is being decorated and she was able to choose the colours of her walls and carpet. Hawthorne Lodge F53 F03 S5377 Hawthorne Lodge V248716 220905 Stage 4.doc Version 1.40 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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) 28,29 The home has good recruitment procedures in place and provides support to staff in getting care qualifications. EVIDENCE: Over 50 of staff in the home have a care qualification and some staff explained that they are doing or plan to do higher qualifications and this is supported by the Owner and Manager. Several staff files were read, these showed that the home gets all the required paperwork before appointing a member of staff. This includes a completed application form, two written references and a CRB check. All staff have a copy of their terms and conditions of employment on their file. Hawthorne Lodge F53 F03 S5377 Hawthorne Lodge V248716 220905 Stage 4.doc Version 1.40 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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) 31,32,35,36,38 The home has an experienced Manager who is currently completing qualifications in care. Residents, relatives and staff are confident in her support and leadership skills. The home has not monitored Residents benefit money closely enough and some residents have been underpaid. There are areas of health and safety that need to be addressed particularly around staff training, the home do carry out regular health and safety checks on the building and equipment. EVIDENCE: The Manager is experiencing in managing a care home for older people and advised that she has almost completed her National Vocational Qualifications (NVQ) in care and intends to start a course to assess other staff doing a care qualification. Residents and staff spoke highly of the Manager with one Resident describing her as “very kind”, several relatives said that they can always approach her and she is helpful and “sorts things out”. Hawthorne Lodge F53 F03 S5377 Hawthorne Lodge V248716 220905 Stage 4.doc Version 1.40 Page 18 Many of the staff working in the home have already got care qualifications and the home are supporting them to undertake higher training in this area. Safety checks and certificates for the gas, electrics and lift were in date and a contractor was carrying out a check on all the small electrical appliances. Fire equipment is checked regularly and tests carried out. Staff take part in fire drills and training, they have not had training in basic health and safety recently and training in moving and handling was out of date, although the Manager said that she had plans to arrange these shortly. Staff advised that they have had recent training in other areas of health and safety including 1st aid and food hygiene. Some of the Residents or their relatives look after their money, records were checked of some of the money the home has in the safe belonging to Residents and this was correct. However some Residents should be getting £18.80 personal allowance from their benefits each week once their fees are paid. The home was paying the old rate of £17.50. An immediate requirement was given on the day of the inspection stating that by the 19th October 05 the home must make sure that Residents receive the personal allowance, they should get each week and any money owed to them is paid. The Manager has since written to the CSCI stating that this money is not owed to all Residents and she will correct all payments week commencing 2/10/05. Staff files show that staff have formal supervision to discuss their work with a Senior member of staff and staff spoken with said that this happens regularly. Hawthorne Lodge F53 F03 S5377 Hawthorne Lodge V248716 220905 Stage 4.doc Version 1.40 Page 19 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 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 3 3 x x 3 x x STAFFING Standard No Score 27 x 28 3 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 2 2 3 x x 1 3 x x Hawthorne Lodge F53 F03 S5377 Hawthorne Lodge V248716 220905 Stage 4.doc Version 1.40 Page 20 no 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 18 Regulation 19(b)(ii)S chedule 2(7) 26 Requirement The Responsible Person must provide the CSCI with sight of an original CRB check. This is a requirement of previous inspections. The registered provider must arrange for monthly documented visits to the care home to be carried out. Copies of the report from these visits must be forwarded to the CSCI. This is a requirement of previous inspections. The home must make sure that where a residents assessement shows a need there is a written plan for staff to follow to meet that need. The home must make sure that Residents and relatives are consulted about their care plan regularly. The home must make sure that they keep a written record of all medication they obtain. The home must carry out an assessment before they fit CCTV to make sure it does not effect residents daily lives or privacy. The home must arrange training for staff in Adult Protection Timescale for action 24/11/05 2. 30 24/11/05 3. 7 15(1) 22/12/05 4. 7 15(1) 22/12/05 5. 6. 9 19 13(2) 12(4)(a) 24/11/05 22/12/05 7. 18 13(6) 19/1/06 Page 21 Hawthorne Lodge F53 F03 S5377 Hawthorne Lodge V248716 220905 Stage 4.doc Version 1.40 8. 9. 10. 38 38 38 18(1)(a) 18(1)(a) 13(4)(a) The home must provide training for staff in manual handling The home must provide basic health and safety training for staff. The home must inform the CSCI of the date repair work in carried out on the hall carpet. 19/1/06 19/1/06 28/10/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 15 Good Practice Recommendations The home should keep a full record of meals served, this included alternatives. Hawthorne Lodge F53 F03 S5377 Hawthorne Lodge V248716 220905 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection 2nd Floor Burlington House Crosby Road North Waterloo L22 0LG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Hawthorne Lodge F53 F03 S5377 Hawthorne Lodge V248716 220905 Stage 4.doc Version 1.40 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!