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Inspection on 07/02/07 for Hazel Court Nursing Home

Also see our care home review for Hazel Court Nursing Home for more information

This inspection was carried out on 7th February 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Hazel Court has a committed staff team who are resident focused. Food provided reflects resident choice and is available in suitable portions. The home continues to have a proactive relationship with the CSCI. The home has a good relationship with the general practitioners and the surgery provides training and advice.

What has improved since the last inspection?

The staff team have worked hard to make sure the majority of requirements from the previous inspection have been met. Improvements have been made in mealtimes, activities and dealing with sensitive issues, such as death and dying. Training given was observed to have been put into practice. Residents` nutritional needs are being met, as evidence in stability of body weight. Care plans indicate residents` needs and there are clear directions for how to carry out care, but this is not evidenced as being followed through.

What the care home could do better:

Residents daily records need to reflect the actual care given, to make sure that needs are evidenced as being met. Recording of wounds needs improvement to show healing progress.

CARE HOMES FOR OLDER PEOPLE Hazel Court Nursing Home Haydon Way Wandsworth Off St Johns Hill London SW11 1YF Lead Inspector Janet Pitt Unannounced Inspection 7th February 2007 10:00 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 Hazel Court Nursing Home DS0000019096.V329550.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 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. Hazel Court Nursing Home DS0000019096.V329550.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hazel Court Nursing Home Address Haydon Way Wandsworth Off St Johns Hill London SW11 1YF 020 8870 6933 020 8871 0824 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) Shaw Healthcare Limited Post Vacant Care Home 24 Category(ies) of Dementia - over 65 years of age (24) registration, with number of places Hazel Court Nursing Home DS0000019096.V329550.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Hazel Court is a purpose built single storey care home. The home provides care for persons who have dementia. Hazel Court is situated off St Johns Hill in Battersea. It is approximately twenty minutes walk from Clapham Junction Station and is accessible by bus. All accommodation is provided in single rooms, which have a hand basin and are situated near bathrooms and toilets. The home has two self-contained units, with their own kitchenettes and lounge areas. There is a conservatory and a garden area. In the centre of the home is an enclosed courtyard with seating for service users. A Primary Care Trust funds all service users. Hazel Court Nursing Home DS0000019096.V329550.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector undertook this unannounced inspection. The site visit lasted a total of eight hours over two days. Staff records, complaints records and medications were examined. Case tracking was undertaken on four residents. Lunchtime was observed on both visits. The inspector spoke with four members of staff, two residents and two relatives. What the service does well: What has improved since the last inspection? What they could do better: Residents daily records need to reflect the actual care given, to make sure that needs are evidenced as being met. Recording of wounds needs improvement to show healing progress. Hazel Court Nursing Home DS0000019096.V329550.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Hazel Court Nursing Home DS0000019096.V329550.R01.S.doc Version 5.2 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 Hazel Court Nursing Home DS0000019096.V329550.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Assessments undertaken are completed fully and reflect residents’ preferences. Residents are provided with a statement of terms and conditions, which gives information on what is included in the fee. EVIDENCE: There has been significant improvement in assessing residents on admission. Details from pre admission information is included in these assessments. Assessments examined indicated social interests and background, such as employment. There was evidence of residents being involved in the process. One assessment included details of sexuality, the resident being quoted as saying:’ likes ladies but knows how far to go.’ Which indicated that residents Hazel Court Nursing Home DS0000019096.V329550.R01.S.doc Version 5.2 Page 9 are being viewed as people with specific needs. All assessments on admission were seen to be residents focused, with carer preferences noted. Guidelines are available for staff when completing assessments, which covers the requirements of the Standards. All four assessments were completed fully and care needs were identified. All files had a copy of the service agreement in place, detailing what is included in the fee. Hazel Court Nursing Home DS0000019096.V329550.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 and 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Significant improvement has been made in care planning; these now reflect residents’ choice. Spiritual, relationships and issues relating to end of life care are sensitively addressed. Residents are protected from harm by clear medication procedures and audit trail. EVIDENCE: Residents looked neat and tidy. Attention had been paid to making sure that peoples hair and nails were clean. Care had been taken to make sure that residents wear wearing appropriate clothing. Hazel Court Nursing Home DS0000019096.V329550.R01.S.doc Version 5.2 Page 11 One resident spoken with said they were happy with the care received and had formed friendships with other residents. Significant improvement has been made in care planning. All four care plans examined lead from assessment of identified care needs. There was good detail on how to provide care, with specific details. There was information on what residents were like as people. For residents who had dementia, it was noticeable that care plans were focused on this condition. The use of the word ‘ prefers’ was common place, such as ‘prefers one teaspoon of sugar in tea or coffee’ and ‘prefers to go to bed early.’ However, there was evidence of specific details within daily records, for example, amount of urine voided. Daily records contained bland statements such as: ‘ she had a good nights sleep’ and fine no problem’. Staff need to make sure that care given is recorded accurately and whether the interventions are relevant for the resident. Individualised risk assessments were appropriate and reviewed regularly. There was good information on skin integrity. Interventions by other health professionals were sought when required, such as the dietician and tissue viability nurse. Wound recording should be improved to show measurements or photographs of changes, in accordance with Royal College of Nursing Guidance. Medications are kept securely and there is a clear audit trail in place. One member of staff requested that the visiting general practitioner wrote specific instructions for the administration of a newly prescribed medicine. Residents end of life care and wishes for death and dying were sensitively recorded, with the involvement of the resident or their representative. This was also apparent in the care plans as a whole. Staff were observed to address and treat residents with respect throughout the site visits. Hazel Court Nursing Home DS0000019096.V329550.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Mealtimes are a sociable occasion for residents and staff make sure that they are attentive to residents needs. Residents were seen to enjoy the organised activities. The activities programme reflected resident choice. EVIDENCE: Improvement has been made to activities provision and details of individual likes and dislikes are now recorded in care documentation. On one of the site visits residents were enjoying dancing and singing to music. Staff were participating and the atmosphere was happy and comfortable. Activities residents have undertaken are recorded daily and reflected their interests. On Valentines Day, all residents were given a card, a heart shaped biscuit and a rose by the staff. There was lots of positive interaction between staff and residents. Hazel Court Nursing Home DS0000019096.V329550.R01.S.doc Version 5.2 Page 13 Mealtimes were noted to be unhurried and staff made sure that residents had finished prior to removing crockery. When one resident asked what was for pudding a member of staff responded immediately. One relative spoken with stated that they ‘felt [the resident] was safe, but still worried’. The relative visits daily and said they were made welcome and is able to assist with caring for the resident. They said that they had been able to accept the resident’s diagnosis of dementia and were being supported by staff. Another relative said that they were ‘satisfied with the care’ given. Hazel Court Nursing Home DS0000019096.V329550.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaints procedure meets the Standards and residents or their representatives know how to make a complaint. There have been no referrals relating to Adult Protection, which is due to lack of incidents. Staff have an understanding of when incidents should be reported. EVIDENCE: The home and CSCI have received not complaints since the previous inspection. A record of compliments is maintained. There have been no Protection of Vulnerable Adults investigations since the previous inspection. Staff spoken with were aware of the need to protect residents. Hazel Court Nursing Home DS0000019096.V329550.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The décor of the home is tired and old, but staff try to make sure that rooms are personalised and the home is kept clean and tidy. EVIDENCE: The home was clean and tidy and free from unpleasant odours on the two sites visits. Residents live in a building, which is on one level, which allows a safe environment for walking around. Two residents were seen walking hand in hand around the home. The décor and fabric of the buildings continue to look tired and old. The company, which runs the home, is looking at options for the building. Hazel Court Nursing Home DS0000019096.V329550.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are appropriately training, it was noted that training is put into practice. Residents are protected from harm by a good recruitment procedure. EVIDENCE: Residents are supported by sufficient numbers of staff. Training records and planned training indicates that staff are supported by the home to be competent in their practice. Residents are protected from harm by the homes recruitment process. Examination of staff files showed that appropriate checks are carried out prior to employment and a thorough recruitment process is followed. Staff training records are maintained on a computer date base system. This makes sure that mandatory training is updated when required. Hazel Court Nursing Home DS0000019096.V329550.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Lack of a permanent manager has meant that quality assurance is not routinely carried out. The staff team is strong and continue to work in the best interests of the residents. EVIDENCE: The home did not have a manager at the time of inspection. A manager was providing support from a sister home. The strong and committed staff team have made sure that residents receive appropriate care. Hazel Court Nursing Home DS0000019096.V329550.R01.S.doc Version 5.2 Page 18 No issues with health and safety were identified during the inspection. Hazel Court Nursing Home DS0000019096.V329550.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 2 2 X 3 X X 3 Hazel Court Nursing Home DS0000019096.V329550.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? Yes 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 OP7 Regulation 17 (1) (a) & Sch 3 Requirement The registered person must ensure that daily records reflect the actual care given. (previous timescale of 30/09/06 not met.) The registered person must ensure that wound monitoring is undertaken according to current guidance. Timescale for action 30/05/07 2. OP8 17 (1) (a) & Sch 3 (3) (k) 30/05/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Hazel Court Nursing Home DS0000019096.V329550.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG 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 Hazel Court Nursing Home DS0000019096.V329550.R01.S.doc Version 5.2 Page 22 - 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. 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