Random inspection report
Care homes for older people
Name: Address: Hawthorne Lodge 164/166 Hawthorne Road Bootle Liverpool Merseyside L20 3AR zero star poor service 19/08/2009 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Claire Lee Date: 0 6 0 1 2 0 1 0 Information about the care home
Name of care home: Address: Hawthorne Lodge 164/166 Hawthorne Road Bootle Liverpool Merseyside L20 3AR 01519333323 Telephone number: Fax number: Email address: Provider web address: Lea@hawthornelodge.co.uk Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Stirrupview Limited Property & Estates care home 25 Number of places (if applicable): Under 65 Over 65 25 old age, not falling within any other category Conditions of registration: 0 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: Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 25 Date of last inspection Brief description of the care home Hawthorne Lodge is registered to provide personal care for twenty five 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 small back garden. Bedrooms are either single or double rooms. The home
Care Homes for Older People Page 2 of 14 0 6 1 0 2 0 0 9 Brief description of the care home has a passenger lift and there are chair lifts to access rooms that have a number of stairs to them. 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. Bathrooms have equipment to help residents with bathing arrangements. Residents have the use of a call bell with an alarm facility. CCTV cameras view public areas only. There is car parking space to the side of the premises. The weekly fee rate is three hundred and eighty three pounds a week. Care Homes for Older People Page 3 of 14 What we found:
The key inspection was conducted on the 19th August 2009 and following this inspection the home was rated by the Commission as poor, zero stars. An unannounced random inspection took place on 6th November 2009 to monitor progress in relation to requirements issued at the key inspection. Following this inspection we still had concerns as to how the service was being managed. We subsequently issued two legal Statutory Requirement Notices on 4th December 2009. These were in respect of the following: The home failing to provide sufficient information in the service users care plans to monitor the service users health and well being. Recruitment practices which are not sufficiently robust to protect the service users. This random inspection was carried out to follow up on the Notices served by us. People accommodated at the home must receive a safe service. This inspection will not change the Commissions rating of the home. People accommodated at the home like to be called residents and this term is used in this report. The random inspection was conducted by two inspectors for a duration of approximately four hours. The manager, Ms Joanne Gledhill was present for the inspection and we looked at service user care files and staff recruitment files. Our findings from the inspection are noted under what the service does well and what the service could do better. There are a number of requirements which were not assessed at this inspection. These are in relation to medicine administration, safeguarding procedures, the environment, equipment, infection control, staff training, fire safety and quality assurance reports for the home. These will be assessed at future inspections prior to March 2010. What the care home does well:
Health and Personal Care Residents care files were looked at to see if there had been improvements made. Four care files contained a number of care documents and these provided good detail of the residents care needs. They were person centred and evidenced how staff were to provide the support they needed. This was seen in areas of daily living, for example, personal hygiene, mobility, communication and eating and drinking. Associated documents included risk and dependency assessments. These evidenced the risk to the resident and the level of support staff provided to help ensure their welfare to help keep them safe. For example, diet, communication, moving a service user safely, falls and care of their skin which may be vulnerable due to age and their medical condition. The assessments were linked to a plan of care, so that staff had the information they needed to provide the necessary support. Care documents seen had been reviewed regularly. The information recorded was up to date and staff therefore had the information they needed to provide care according to need. The manager is also meeting with residents and their families to gain consent to their plan of care and to encourage them to be part of the review process. This helps to
Care Homes for Older People Page 4 of 14 ensure they are aware of the care they are receiving and that it is given in accordance with their wishes. With regards to health monitoring the care files showed that the staff had contacted external health professionals at the appropriate time. Appointments with GPs were recorded in detail and staff had acted upon the advice received. This demonstrates a good awareness and understanding of the residents needs, so that they remain in good health. Social assessments are now being carried out and this provides staff with details of social interests, family involvement and the residents personal preferences. For example, dietary likes and dislikes and how they wish to spend their day. This information was not in all the care files, however the staff are meeting with the residents and families to obtain this. Accident reports were seen in relation to residents who had fallen and these recorded good detail as to the incident and treatment needed to ensure their welfare. The same information was also found in the daily progress/record sheets which the staff complete. This helps to ensure everyone is aware of the incident any treatment that may have been needed. To summarise, it is now evident that the staff have improved the recording the health care needs of the residents and are monitoring their welfare. The health care needs of the residents appear to be managed more effectively, so that the residents receive the care and attention they need. Staffing: This was looked at in relation to the home providing adequate procedures for the safe recruitment of staff, so that people in the home are protected. Four staff files were looked at, including the managers at the last random inspection. The same staff files were examined on this occasion. There have been no new staff employed since our last visit in November 2009. At the previous inspections there was no evidence of a police check for the manager or a member of staff. The managers staff file now provides evidence of a CRB (Criminal Record Bureau) enhanced disclosure as part of the necessary checks needed for her to work at Hawthorne Lodge. The CRB has been obtained from CQC (Care Quality Commission), as part of her application for the position of registered manager for the home. The manager said that that her CRB obtained through an umbrella body (organisation for processing CRBs) for Hawthorne Lodge was at her own home. She was advised to bring a copy of this to the home to provide current details of police clearance. The staff file seen for a member of staff also now has evidence of a CRB. One staff file at the last inspection evidenced only one reference and two are required as part of the necessary recruitment checks. The second was obtained from a past employer at the time of the inspection for this employee. Two staff files seen at the last inspection and at this inspection remain incomplete with regard to references required for their employment. Details of this are stated under What the service could do better.
Care Homes for Older People Page 5 of 14 What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 6 of 14 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action 1 9 13 Put in place effective 12/11/2009 arrangements to ensure that any service user who selfmedicates is assessed to ensure that they can do so safely This will help to ensure the health and welfare of the residents 2 9 13 Put in place effective systems for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home This will help to ensure the health and welfare of the residents 12/11/2009 3 9 13 Put in place effective 12/11/2009 arrangements to ensure that staff responsible for the admininstration of medication are competent to do so safely This will help to ensure the health and welfare of the residents 4 9 13 Effective systems must be 12/11/2009 put in place to ensure that prescriptions and instructions from medical professionals
Page 7 of 14 Care Homes for Older People Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action are properly recorded and followed so that administration errors do not arise. This will help make sure medicines are handled safely. 5 9 13 Put in place effective 12/11/2009 arrangements to ensure that all medications received into the home and any medication administered, disposed of or returned to the pharmacy is recorded This will help to ensure the health and welfare of the residents 6 9 13 There must be a legally compliant controlled drugs cupboard available in the home. This will help prevent mishandling and misuse. 7 18 13 The manager must ensure 17/12/2009 that all senior staff who may be left in charge of the home are aware of the local safeguarding policy and how to contact the safeguarding team This will help to ensure that any allegation of abuse is reported and managed appropriately 8 19 13 A risk assessment must address all risks within the 30/09/2009 09/01/2010 Care Homes for Older People Page 8 of 14 Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action environment. For example, trip hazards, window restrictors, damp and general maintenance This will help to ensure residents have safe, well maintained accommodation 9 19 23 A programme of maintenance and decoration of the home is needed as areas are in need of repair and attention This will help to evidence work undertaken and planned to improve the environment for the residents 10 20 23 Suitable furnishings and fittings are required in the communal areas This is to help ensure the comfort and safety of the residents 11 22 13 All equipment / aids used for 09/11/2009 people living in the home must be maintained and used in accordance with safety requirements. All wheelchairs in use should therefore have footrests fitted when moving people in them. This will help to ensure the equipments used safely 12 24 16 Residents require new 19/10/2009 furniture and fittings for their
Page 9 of 14 30/09/2009 30/09/2009 Care Homes for Older People Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action private rooms This will help to ensure residents live in private accommodation to assure their comfort and privacy 13 26 13 All areas of the home must be kept clean This will help to ensure residents live in a clean environment where the risk of cross infection is minimised 14 26 13 The manager must ensure 09/11/2009 that there are suitable procedures in place for the management of the laundry which follow good practice guidelines regarding infection control This will help to ensure that the management of laundry does not present as an unnecessary source of infection 15 26 13 All equipment used to care 09/11/2009 for people living in the home must be kept in a clean and hygienic state.This includes wheelchairs in use and the trolley in the dining area This will help to reduce the risk of cross infection and protects people living in the home 16 29 23 All bedrooms must be checked to ensure that 17/12/2009 30/09/2009 Care Homes for Older People Page 10 of 14 Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action windows provide for easy and safe ventilation of the home and can be opened and closed when necessary. This is with particular reference to those rooms identified on the inspection visit This will help to ensure people living in the home can moderate the temperature in their rooms 17 29 17 Staff must be recruited safely This will help to ensure the ongoing protection of people who use the service 18 33 26 The provider [owner] or 17/12/2009 representative of the provider must visit and complete a report which complies with the requirements of this regulation. The report should be made available to the manager This will help to ensure that the home is being monitored by the provider to help ensure standards are effectively maintained and that the manager has appropriate feedback to ensure further improvements 19 38 13 There must be suitable arrangements for the training of staff in first aid This helps ensure that care
Care Homes for Older People Page 11 of 14 19/10/2009 17/12/2009 Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action staff have the ability to deal with accidents and health emergencies 20 38 23 The fire door on the ground 17/12/2009 floor corridor and to the kitchen must have the closing mechanisms fixed, so that the doors close correctly This will help to protect people in the event of a fire 21 38 18 Staff require training in safe 19/10/2009 working practice areas. These are particualy specified for infection control, first aid, and health and safety This will help to ensure they have the skills and knowledge to undertake their work safely Care Homes for Older People Page 12 of 14 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 13 of 14 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 14 of 14 - 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!
