Inspection on 23/01/06 for Hawthorne Lodge

This inspection was carried out on 23rd January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 22/09/05

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 Road Bootle Liverpool Merseyside L20 3AR Lead Inspector Ms Lorraine Farrar Unannounced Inspection 23rd January 2006 01:10 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 Lodge DS0000005377.V281518.R01.S.doc Version 5.1 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 Lodge DS0000005377.V281518.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Hawthorne Lodge Address 164/166 Hawthorne Road Bootle Liverpool Merseyside L20 3AR 0151 933 3323 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) Stirrupview Limited Property & Estates Mrs Lea Jones Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places Hawthorne Lodge DS0000005377.V281518.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 25 OP Date of last inspection 22nd September 2005 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 twenty-four 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 DS0000005377.V281518.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection included talking with 5 residents, 3 relatives and 3 members of staff, discussion also took place with the registered manager. Files and records were examined and parts of the building toured. What the service does well: What has improved since the last inspection? Since the last inspection the home has had their second external quality audit and have improved their star rating for the care they provide. Work has commenced on replacing all bathroom fittings and décor and is planned for the hallway and stairs. Of the ten requirements given to the home at the last inspection they have met 7, this includes involving residents in their care plans, and providing training in manual handling and health and safety. The home also met an Hawthorne Lodge DS0000005377.V281518.R01.S.doc Version 5.1 Page 6 immediate requirement given at the last inspection, which related to management of residents monies. 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. Hawthorne Lodge DS0000005377.V281518.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hawthorne Lodge DS0000005377.V281518.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 Before anyone moves to the home an assessment is obtained from the persons Social Worker and the home carry out their own assessment to make sure that they can meet the person’s needs. EVIDENCE: Three care plans were looked at, two of which belonged to residents who had moved to the home fairly recently. Care plans for both residents contained copies of assessments that their social worker had completed which identified the type of care and support they needed and copies of assessments completed by the home. The assessments completed by the home identify further information about the type of support the person needs and how this is to be provided. The manager explained that she meets with prospective residents to carry out the assessment and this was confirmed by one resident who explained they visited the home and talked with the manager about what they needed. All care plans looked at were up to date and regularly reviewed. Hawthorne Lodge does not provide an intermediate care service. Hawthorne Lodge DS0000005377.V281518.R01.S.doc Version 5.1 Page 9 Hawthorne Lodge DS0000005377.V281518.R01.S.doc Version 5.1 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 the following standard(s): 10 Residents do feel that staff treat them with respect and their right to privacy generally upheld. There are some practical matters in the home, which require attention to make sure residents have the privacy and dignity they require. EVIDENCE: Standards around medication were not fully looked at, however a requirement given at the last inspection was checked. This requirement stated that the home must keep a written record of all medication obtained. The medication Administration sheets (MAR) in use were checked and did not contain a record of the last medication received by the home. Both the Senior Carer and Manager stated that in previous months a record had been obtained and the Senior confirmed that this is usually recorded on the MAR sheets. If medication is not counted and recorded 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. It was noted that at times the home use a sticky label printed with the medication, name and does received. As this can be removed from the MAR Hawthorne Lodge DS0000005377.V281518.R01.S.doc Version 5.1 Page 11 sheets it is recommended that the home stop this practice and where a typed sheet is not available, the entry is handwritten and signed by two competent staff. This will ensure that a permanent record is kept. Two resident’s spoken with confirmed that staff always knock on their door before entering their room, given them their mail unopened and that the choice of when to get up or go to bed was theirs. During the inspection staff were seen to knock on residents doors and wait for permission before entering. It was also noted that staff spoke quietly and respectfully to residents and took time to understand what they were saying. One resident said that a bathroom they used did not have a lock fitted and this made them uncomfortable. Bathroom doors were checked and two did not have locks in place. The manager said that this was due to the work being carried out in these rooms and she would arrange for them to be fitted later that day. One resident’s bedroom was visited and their bedroom drawers had been labelled ‘pads’ etc. This was discussed with the resident who did not appear to know why this had been done. The manager said that relatives had requested this to help the resident. It was noted that labels had not been used in any of the other bedrooms visited. It is recommended that the home discuss the use of these labels with the resident and if she is not finding them useful that they are removed, as their use is a breach of confidentiality. The home provides a pay phone in the corner of the dining area, which can be used in private at certain times of the day. Screens are available for use in double bedrooms. Hawthorne Lodge DS0000005377.V281518.R01.S.doc Version 5.1 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 the following standard(s): These standards not looked at during this inspection. EVIDENCE: Hawthorne Lodge DS0000005377.V281518.R01.S.doc Version 5.1 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16&18 The home has an appropriate complaints procedure in place however not all residents and their relatives are made aware of this or of the action they can take in the event they have a complaint. The home has polices in place for dealing with adult protection issues, however staff have not received training in this area and the home have failed to comply with a requirement to carry out a Criminal Records Bureau check for the responsible person. The home are therefore failing to fully protect residents. EVIDENCE: The home has an appropriate complaints procedure in place and a copy of this is made available to residents via the homes welcome pack. However a resident and a relative spoken with said that they had not received this information. The manager explained that the current practice in the home is to give this information out after the resident has completed their trial period. The home must provide this information to all residents and their representatives, before or as soon as, they are admitted, so that they are aware of the action they can take in the event they are unhappy with the service. The home does keep a record of complaints but this does not contain complaints that have been investigated by the Commission for Social Care Inspection and were not upheld. The home must keep a record of all past and future complaints and the outcome so that a clear audit trail can be established. Hawthorne Lodge DS0000005377.V281518.R01.S.doc Version 5.1 Page 14 There has been an outstanding requirement for the home in previous inspections that the responsible person provides the Commission for Social Care Inspection (CSCI) with sight of a current Criminal Records Bureau (CRB) check. At this inspection the manager said that the forms had been completed and once signed would be sent later in the week. The manager was advised that the CSCI would seek advice regarding this, as the requirement had not been met on several occasions. Since the inspection the home has provided proof that this check has been applied for, the CSCI will monitor the homes compliance with this requirement closely. A requirement was given at the last inspection that the home arrange training for staff in adult protection issues. This requirement had not been met; the manager advised that she had spoken with the Adult Protection Coordinator for Sefton who had agreed to provide training in the home. It is important that staff receive this training so that they are able to identify any potential adult protection issues and deal with them correctly. There have been no adult protection investigations within the home in the past year. Copies of the local authority adult protection procedures are available and the manager has an understanding of these. Hawthorne Lodge DS0000005377.V281518.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 26 The home is clean and hygienically maintained, however there are no polices in place for dealing with infection control and staff do not receive training in this area. This increases the risk of an outbreak of infection in the home. EVIDENCE: The standard around aids and adaptations was not fully assessed, however it was noted that in one residents bedroom her call cord was located at the bottom of the bed. She confirmed that she would not be able to reach this when in bed. The home are required to ensure that all residents can reach their call cord when in bed. Several residents spoken with remarked that the home was very clean with one explaining “they come in every day, cleaning out”. Areas of the home visited were clean and odour free. The home have a separate laundry room, which contains an industrial dryer and washing machine with sluice facility. Supplies of disposable gloves and Hawthorne Lodge DS0000005377.V281518.R01.S.doc Version 5.1 Page 16 aprons were available and the home has a contract for disposing of potentially infectious waste. The laundry room was clean and well organised with systems in place to help prevent the possible spread of infection. A member of staff spoken with was able to explain the system used with laundry to separate clean, used and potentially infectious linen. The home has a policy in place for dealing with clinical waste, but no infection control policy is available. No formal training is provided to staff in managing infection control. The home must provide an infection control policy and should provide training for staff, this will provide staff with the information they need to prevent on outbreak of infection or quickly deal with one should it occur. Hawthorne Lodge DS0000005377.V281518.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28&30 The home has met the national standards for staff holding a qualification in care and provides training for staff in some basic areas of care practice and safety. However training identified in previous inspections as required for residents protection has not been provided. EVIDENCE: The home have identified they require three staff on duty during the day, one of whom is an identified Senior Carer, in addition the manager and deputy manager are on duty during the week. There is also a part time handyman, two domestics covering cleaning duties and there is always a cook working during the day. At night there are two waking carers on duty. The homes rota was examined and this reflected the staffing hours identified. Staff spoken with said that they were not too rushed during the day and a resident explained that they get help within a reasonable time and “all you have to do is ask”. All staff providing personal care are over 18 and all Senior staff over 21. Over 50 of the care staff in the home have obtained a care qualification (NVQ) at level 2 or 3 and two staff are currently working towards this qualification at level 4. Recent training in the home has included, health and safety, manual handling, first aid and food hygiene. Some of the certificates for this training were not available, however the manager advised that they were waiting for the company to forward them and three members of staff spoken with said they had attended these courses. Hawthorne Lodge DS0000005377.V281518.R01.S.doc Version 5.1 Page 18 It is recommended that the home puts together a training matrix so that there is a clear record of the dates all staff attended basic courses and when they should be renewed. As identified previously the home has not provided training for staff in adult protection issues. There is an induction programme in place for new staff. Hawthorne Lodge DS0000005377.V281518.R01.S.doc Version 5.1 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33 The home has good quality audit systems in place, which involve obtaining the views of residents and relatives. EVIDENCE: It was identified at the last inspection that the home were not paying residents the correct amount of personal allowance. The Commission For Social Care Inspection visited the home again following the inspection and found that they had complied with the requirement to pay outstanding balances and to ensure the correct amount of personal allowance was paid. For the past two years the home have arranged for a quality assurance audit to be carried out by an external company. This audit involves looking at the service provided in two parts – the care provided and the building. Residents and staff are spoken with and given surveys to complete and paperwork is examined. I December 2005 the home was awarded 4 stars for the care Hawthorne Lodge DS0000005377.V281518.R01.S.doc Version 5.1 Page 20 provided and 3 stars for the building, the maximum that can be awarded is 5 stars. This was an improvement for the home on the previous year when they were awarded 3 stars for both care and the building. The manager explained that the home are continuing to work on improving the building. During the inspection they were in the middle of replacing all bathrooms and providing an assisted bath for ease of use and the manager advised that a decorator had been booked for the hallways and stairs. As well as this yearly audit the home also carries out and records regular checks of the building, all rooms are examined and any work identified is then planned and carried out. Residents care plans are reviewed monthly and feedback is obtained from them via discussion with the manager and some meetings, one resident explained that residents meetings are held “now and again”. During the inspection residents and relatives were given time to talk with the inspector. The home have met some but not all of the requirements from their last inspection. Requirements are based on the national minimum standards for caring for older people and the home must ensure these are met within timescales given as these will help to make sure residents are safe and provided with a quality service. Hawthorne Lodge DS0000005377.V281518.R01.S.doc Version 5.1 Page 21 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 X 8 X 9 X 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 1 17 X 18 1 X X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X X X X X Hawthorne Lodge DS0000005377.V281518.R01.S.doc Version 5.1 Page 22 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 OP18 Regulation 19(b)(ii)S ch 2(7) Requirement The Responsible Person must provide the CSCI with sight of an original CRB check. This is a requirement of previous inspections. The home must arrange training for staff in Adult Protection. This is a previous inspection requirement. The home must make sure that they keep a written record of all medication they obtain. This is a previous inspection requirement. The home must confirm to the CSCI that all bathrooms and toilets have locks with override devices fitted. The home must discuss the use of labels on bedroom furniture with the resident concerned and remove these if they are of no benefit to her. Timescale for action 30/03/06 2 OP18 13(6) 30/03/06 3 OP7 13(2) 03/03/06 4 OP10 23(a) 03/03/06 5 OP10 12(1)(a) 03/03/06 Hawthorne Lodge DS0000005377.V281518.R01.S.doc Version 5.1 Page 23 6 OP16 22(8) The home must maintain a record of all complaints received, regardless of the outcome. The home must ensure all residents and their relatives receive a copy of the complaints procedure on or before admission. They must also ensure all existing residents and their relatives have a copy. The home must ensure all residents can reach their call cord whilst in bed. The home must provide a procedure for the control of infection. 30/03/06 7 OP16 5(1)(e) 03/03/06 8 OP22 13(4)(c) 08/03/06 9 OP22 13(3) 30/03/03 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 OP9 Good Practice Recommendations The home should cease the practice of using labels on medication sheets; this should be replaced by a handwritten entry signed by two competent members of staff. The home should provide training for staff in infection control. The home should compile a training matrix for staff. 2 3 OP26 OP30 Hawthorne Lodge DS0000005377.V281518.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool 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 DS0000005377.V281518.R01.S.doc Version 5.1 Page 25 - 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!