Inspection on 27/03/06 for Hazel House Nursing Home

This inspection was carried out on 27th March 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Hazel House Nursing Home 30/05/07

Hazel House Nursing Home 18/10/05

Hazel House Nursing Home 16/03/05

Hazel House Nursing Home 13/07/04

Hazel House Nursing Home 29/03/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Hazel House Nursing Home Hazel House Nursing Home 30 Paradise Lane Moss Side Leyland Preston Lancashire PR26 7ST Lead Inspector Anne Taylor Unannounced Inspection 27th March 2006 09:30 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 House Nursing Home DS0000025562.V278837.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. Hazel House Nursing Home DS0000025562.V278837.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Hazel House Nursing Home Address Hazel House Nursing Home 30 Paradise Lane Moss Side Leyland Preston Lancashire PR26 7ST 01772 452750 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) Hazel House Nursing Home Limited Mrs Lynn Cosgrove Care Home 43 Category(ies) of Old age, not falling within any other category registration, with number (43), Physical disability (10) of places Hazel House Nursing Home DS0000025562.V278837.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The home is registered for a maximum of 43 service users to include: Up to 43 service users in the category of OP. Up to 10 service users in the category of PD aged 60-64. The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the National Care Standards Commission. Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidelines which may be issued through the National Care Standards Commission regarding staffing levels in care homes. 5. Date of last inspection Brief Description of the Service: Hazel House Care Home provides 24 hour nursing and personal care for up to forty-three people of either sex over the age of sixty-five. At the time of inspection forty-two people were living at the home. Hazel House is situated in a quiet cul-de-sac in Leyland close to local amenities. The home provides accommodation mainly in single rooms, although shared rooms are available for married couples, friends or people who prefer to share facilities. Accommodation is provided over two floors and a passenger lift enables wheelchair users and the less mobile access to all areas. There are three separate lounge/quiet areas for residents to join in activities or sit quietly enjoying more solitary pursuits. Hazel House Nursing Home DS0000025562.V278837.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that started at 9.30am and lasted five hours. The inspection involved discussion with the people who lived and worked at the home and visitors, examination of records, policies and procedures and a tour of the premises. As part of the inspection process the inspector used “case tracking” as a means of assessing some of the National Minimum Standards. This process allows the inspector to focus on a small group of people living at the home. All records relating to these people are inspected along with the rooms they occupy in the home. They are invited to discuss their experience of the home with the inspector, however this is not to the exclusion of other people living at the home. What the service does well: What has improved since the last inspection? Since the last inspection some bedrooms have been refurbished so that residents private accommodation continues to be a well-maintained and comfortable environment. Hazel House Nursing Home DS0000025562.V278837.R01.S.doc Version 5.1 Page 6 The amount of training available to staff has increased so their knowledge and skill base is broader and enables them to continue to provide a good standard of care. Some additional pressure relieving equipment has been bought to help with managing the risk of residents developing pressure sores. The way in which residents are consulted about the service they receive has been enhanced by the introduction of residents only meetings. They meet independently and discuss how they feel about living in the home and put forward ideas or suggestions to the manager. 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. Hazel House Nursing Home DS0000025562.V278837.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 Hazel House Nursing Home DS0000025562.V278837.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 A thorough pre admission procedure ensured that prospective residents could be involved in the process and their individual wants and needs properly assessed. EVIDENCE: Standard 6 was not assessed, as Hazel House does not provide intermediate care. Pre admission assessments carried out by the home and or social workers involved prospective residents and or their relatives. This helped residents to know what sort of care they should expect to receive when they came to live at the home. The assessments were detailed and showed the individual needs of each client. The assessments were used to develop a plan of care for each resident that showed how the home would meet individual needs. The deputy manager said that she or the registered manager usually carried out pre admission assessments for prospective residents. This meant that both Hazel House Nursing Home DS0000025562.V278837.R01.S.doc Version 5.1 Page 9 the home and any prospective resident could be sure that an appropriately trained person had done the assessments and residents had the opportunity to meet someone from the home before they came to stay there. Hazel House Nursing Home DS0000025562.V278837.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): 9,10 The systems in place for handling medication were thorough enough to ensure the continued protection of residents. Staff were sensitive to the needs of residents and made sure that residents’ rights to privacy and dignity were upheld. EVIDENCE: Records showed that induction training included instruction on privacy dignity and respect so that staff had knowledge and understanding of this before they started to give care to residents. Staff spoken to were able to discuss how they put into place the home’s policies and procedures relating to maintaining the privacy and dignity of the people they cared for and how this helped to make sure that residents felt respected. Staff were seen to be providing care in a sensitive and caring manner, which promoted residents’ dignity. People living at the home say staff maintained their dignity and treated them respectfully. They commented, “staff are kind Hazel House Nursing Home DS0000025562.V278837.R01.S.doc Version 5.1 Page 11 and friendly, always polite” and “they always knock before coming in my room”. Polices and procedures describing the handling of medication were available within the home so staff had clear guidance to follow. Records of drugs administered were generally up to date and records kept of drugs received and disposed of. However, handwritten medication entries and amendments to the pre-printed dosage instructions were not independently checked and countersigned. New arrangements had been made for the disposal of medicines to reflect recent changes in legislation. A revised procedure was in place and available to staff so they were all aware of the new procedures. Only trained nurses were authorised to administer medication and a sample list of signatures was kept at the front of the medication file. This meant that staff authorised to do this could be easily identified and checks for compliance made. Hazel House Nursing Home DS0000025562.V278837.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): 12, 15 The daily routines were flexible and residents supported to make choices about their lifestyle. The range of social activities available met the expectation of people living at the home. The importance of providing a well balanced diet was recognised by the home and residents were able to eat healthily and given a choice about what they ate. EVIDENCE: During conversations with residents and staff it was evident that residents were able to make choices about the way they lived within the home and in particular within the privacy of their own room. Rooms had been personalised and some residents had brought some of their own belongings into the home so they could have familiar items around them. Residents spoken to said that they were able to exercise choice about what time they got up and went to bed and what clothes they wore, giving them some control over their lifestyle. When asked how they helped residents to exercise choice staff said, “We always ask what they want to do today, are Hazel House Nursing Home DS0000025562.V278837.R01.S.doc Version 5.1 Page 13 they ready to get up and what they would like to wear, do they want a bath or a wash, things like that”. Records showed that attention was paid to helping residents to take part in valued and fulfilling activities that were already established or developed in the home so that the lifestyle experienced by residents met their expectations and preferences as much as possible. Detailed records were kept of individual likes and dislikes and staff were aware of residents’ dietary needs and personal preferences, which ensured that those living at the home received a nutritional diet in accordance with their needs. The lunchtime meal was relaxed and unhurried with staff available to assist if needed. The meal was hot and well presented. However, the individual components of meals that needed to be liquidised had been blended together so the presentation of those meals was unattractive and unappetising. Some residents had chosen to eat in the dining room, others in their bedroom. One resident said, “I have breakfast in my room and other meals in the dining room”. Residents spoken to were generally satisfied with the range and quantity of food available to them. When asked one resident said, “The food is good, if we don’t like it we can have something else”. Hazel House Nursing Home DS0000025562.V278837.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 The home had a clear complaints procedure that ensured residents knew how and who to complain to. EVIDENCE: A complaints procedure was in place that was accessible to residents and visitors to the home. Resident’s spoken to knew how to complain and felt that they were encouraged to raise any concerns they might have about the home and that they would be listened to and action would be taken on any issues raised. One resident said, “I would tell the manager and she would sort it out, but I don’t have any complaints”. Staff were able to discuss how they would respond if a resident complained to them and realised how important it was to make sure residents felt able to raise concerns and feel that they would be listened to. Hazel House Nursing Home DS0000025562.V278837.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): 19, 26 The standard of accommodation was good and provided an environment that was suitable for it’s stated purpose. EVIDENCE: The home was accessible to all residents. Ramps allowed easy access to the outside and the grounds were tidy and well maintained, providing a pleasant area for residents to enjoy if they wished. Residents spoken to were generally happy with their private accommodation and some had personalised their rooms so that they felt more at home. One said, “My room is nice and sunny it is big enough for me”. A programme for maintenance and refurbishment was in place so that furnishings, fittings and décor in all parts of the home could be renewed and kept up to date when needed. Hazel House Nursing Home DS0000025562.V278837.R01.S.doc Version 5.1 Page 16 The home was clean, well maintained and free from offensive odours. One resident said, “my room is cleaned every day by someone so it is always clean and tidy”. Policies and procedures were in place that identified infection control measures in place at the home. Staff were able to discuss infection control procedures so the risk of cross infection between residents was minimised. Hazel House Nursing Home DS0000025562.V278837.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): 27 The skill mix of and number of staff on duty was sufficient to ensure the needs of residents were met. EVIDENCE: Staff rotas showed the number and skill mix of staff on duty at any time and that enough staff were on duty to ensure the needs of residents could be met. Comments from relatives, present at the time of inspection indicated that there was always sufficient numbers of staff on duty and residents were looked after and attended to properly. One said, “There always seems to be enough people here and my mother is well looked after”. Staff spoken to felt that there was enough staff on duty to enable them to provide a good standard of care to residents. Hazel House Nursing Home DS0000025562.V278837.R01.S.doc Version 5.1 Page 18 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): 38 The management of health and safety was good so that the health; safety and welfare of residents were promoted and protected. EVIDENCE: Certificates were inspected which confirmed that regular servicing had taken place in relation to systems and equipment used by the home to make sure they were safe to use. Discussion with the manager and staff demonstrated a clear commitment to health and safety issues and a number safe working practices were verified at the time of inspection. Training in relation to health and safety issues had been provided for all staff so that they were able to promote the health, safety and welfare of the people they cared for. Hazel House Nursing Home DS0000025562.V278837.R01.S.doc Version 5.1 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X 3 Hazel House Nursing Home DS0000025562.V278837.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP9 OP15 Good Practice Recommendations Handwritten additions or alterations to the MAR should be independently checked and countersigned. The individual components of meals that need liquidising should be liquidised separately and more attention paid to its presentation. Hazel House Nursing Home DS0000025562.V278837.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ 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 Hazel House Nursing Home DS0000025562.V278837.R01.S.doc Version 5.1 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. 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!