Inspection on 30/01/09 for Hazeldown Care Home

This inspection was carried out on 30th January 2009.

CSCI found this care home to be providing an Adequate service.

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

Hazeldown Care Home 11/06/08

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Hazeldown Care Home High Street Foulsham Dereham Norfolk NR20 5RT     The quality rating for this care home is:   one star adequate service 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 assessment of the service. We call this a ‘key’ inspection. Lead inspector: Alan Buttery     Date: 3 0 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 23 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 23 Information about the care home Name of care home: Address: Hazeldown Care Home High Street Foulsham Dereham Norfolk NR20 5RT 01362683307 01362683257 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Devaglade Limited care home 18 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is 18 The registered person may provide the following categories of service: 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: Mental Disorder, excluding Learning Disability - code MD Date of last inspection Brief description of the care home Hazeldown is a care home providing personal care and accommodation for 18 adults with mental health support needs. It is owned by Devaglade Limited who oversee the general management with additional management responsibility given to staff employed within the Home. 18 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 23 Brief description of the care home The Home is situated in the village of Foulsham close to local shops, pubs, post office and certain other local amenities. The original building provides accommodation on two floors, with a newer single floor extension to the rear of the building. As a result, there are several changes of level within the home and there is no lift or other assistance to access first floor bedrooms. At this time there are 13 bedrooms, nine of which are for single occupancy and four for shared occupation. One of the shared bedrooms has en-suite facilities. Bedrooms are located on both the ground and first floors. There are two lounges, a dining room and a small kitchenette for the use of people living in the Home. There is enclosed outdoor space at the rear of the building, with a patio area. Some of the external space is also given over to (limited) car parking. There is some access to public transport in the village, but the services are fairly limited. There is a vehicle for transporting residents if required. The service charges fees ranging from 495 to 750 per week. Care Homes for Adults (18-65 years) Page 5 of 23 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was an an unannounced visit, and the second inspection of the current year. During our visit, we looked specifically at areas that were identified as needing improvement at our last visit, but looked at other key areas as well. We spent around 4 hours in the home, speaking with the new manager of the service, and with staff and residents. we also looked around the home, and were given the opportunity to look at two of the residents rooms. We looked at records held by the home including individual care plans, staff files, policies and procedures and maintenance records. Care Homes for Adults (18-65 years) Page 6 of 23 What the care home does well: What has improved since the last inspection? 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 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 23 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 23 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Procedures are in place to ensure that anyone moving into the home has had their needs fully assessed and be confident these needs will be met in a manner suited to them as individuals. Evidence: Although registered for up to 18 residents, the service presently has 13, ranging in age between 30 and 80. Procedures are in place to manage any new admissions, and these were discussed with the manager and staff members working on the day of our visit. The process would include a full assessment of need and visits to the service, and evidence was seen on three files that we examined that the process is followed, in particular on the file for a person who was admitted to the home in July 2008. The Statement of Purpose and service user guide are now in a format that the people living in the home are able to follow, and staff are available to help people read through the documents. Care Homes for Adults (18-65 years) Page 9 of 23 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individual plans are in place which detail the support required and the way individuals prefer it to be provided. Evidence: The service has detailed individual plans in place, and during our visit we looked at three of the individual plans for people living in the home. The new manager of the home audits these plans monthly, although the senior carers are responsible for keeping them up to date. The plans involve the person they relate to, wherever possible, although some people living in the home are less interested in discussing them than others. If possible, family members are also involved in providing information. The plans that we looked at contained detailed information, although some of this is in a second personal file, and a detailed record of the support given. The plans cover both health and social care needs of the people. Care Homes for Adults (18-65 years) Page 10 of 23 Evidence: The plans also include information about the family of the people living in the home, and contact and visiting details. The records show the activities that the people living in the home take part in, and evidence of review, and contain risk assessments. However some of the documentation was unsigned. Care Homes for Adults (18-65 years) Page 11 of 23 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A range of activities are available to people living in the home, and home cooked food served. Evidence: All of the people living in the home have a key worker, and they assist in planning activities with the resident concerned. Some of the people living in the home attend structured local day services, and others take part in more ad hoc activities, which include shopping, meals out, karaoke and bingo. The manager is trying to involve the residents in more community activities and clubs, although does find it difficult to motivate some of the residents to take part in activities. Meals are served in a separate dining room, and the food is home cooked and Care Homes for Adults (18-65 years) Page 12 of 23 Evidence: generally the home uses local fresh ingredients. The cook was working on the day of our visit, and we were able to talk to her during our visit. The individual plans detail activities, although more detail would be a benefit. Care Homes for Adults (18-65 years) Page 13 of 23 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Personal healthcare support is detailed in individual plans and provided in way suited to the individual. Evidence: As indicated earlier, the individual plans details health and social care needs, and these were seen during our visit. People living in the home have a range of health needs, and these are met by the service with support from local health professionals. The people living in the home are all registered with the local GP practice, and receive support when needed from the district nurses based there. Procedures are in place to ensure medication is administered safely and staff that are involved with the administration all receive suitable training, and this was discussed with the manager, and evidence seen on records examined. The previous inspection report highlighted a number of areas of concern around medication, and these were discussed with the new manager, who had been working to address the issues raised. Care Homes for Adults (18-65 years) Page 14 of 23 Evidence: Medication is now provided through the boots MDS system, and training provided to all staff who are involved in administering medication. The manager audits the medication records on a weekly basis, and a new medication policy has been prepared. Two residents look after their own medication, and risk assessments are now in place although, one still receives some support. Care Homes for Adults (18-65 years) Page 15 of 23 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are aware of how to make concerns known, and procedures are in place to ensure that any concerns complaints or allegations are appropriately dealt with. Evidence: Everyone living in the home has a copy of the complaints procedure, and are aware of who to speak to with concerns, and a log of complaints kept. There have been no concerns raised since the last inspection.a new complaints policy is now in place. A new policy is also in place detailing the safeguarding procedures followed in the home, but no issues have been raised. Staff all receive safeguarding training including regular updates. Care Homes for Adults (18-65 years) Page 16 of 23 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is clean and provides a safe home on a domestic scale for the people living there. Evidence: The home provides a comfortable and homely environment for the people living there. Communal space is good, with a large lounge and a dining area . The individuals living in the home all have well equipped rooms, and can bring personal items with them. The home retains a domestic feel. The outside space is limited, but at the present time, most of this is used as a car parking area, and there are few opportunities for people living in the home to spend time outside. This was discussed with the manager , who hopes to create a patio area, suitable for all residents, and is looking at the possibility of a garden area that residents can help maintain. The home was reasonably clean on the day of our visit, but the service does not employ domestic staff, and this adds to the care staff workload. Care Homes for Adults (18-65 years) Page 17 of 23 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Procedures are in place to ensure a well trained staff team is available to meet the needs of the people living in the home, and necessary checks are undertaken. Evidence: The recruitment process was discussed with the new manager of the service, and she confirmed that the home is fully staffed. Procedures are in place to ensure that all required checks are made, although no new staff have been employed since our last visit. Records we examined all included the required information, and supervision is now taking place on a regular basis. As discussed earlier in the report, the service does not employ any domestic staff at the present time and it has been recommended that this is done to allow care staff more time with people living in the home. Staff training records were also seen, which showed that all staff receive a variety of training, including safeguarding, moving and handling, fire safety, first aid and infection control. Care Homes for Adults (18-65 years) Page 18 of 23 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is well run, in the interests of the people living there are procedures in place to ensure people living and working in the home can do so safely Evidence: Since the last inspection, a new manager has joined the service, and already introduced a number of new measures to improve the support and administration of the home. These include care plan and medication audits. An application for registration with the commission is in the process of being submitted. During our visit we also looked around the building and observed the interaction between the manager and staff, and residents, which was positive. New Policies and procedures have been introduced, although some that we looked at during our visit, were copies of policies form another service owned by the providers, with the wrong service name. In addition, the policies were not dated, and could not therefore show review. Care Homes for Adults (18-65 years) Page 19 of 23 Evidence: Health and safety procedures are in place and staff are receiving training in all areas of health and safety. The owners of the service visits regularly, and supports the manager in the changes she has introduced. Care Homes for Adults (18-65 years) Page 20 of 23 Are there any outstanding requirements from the last inspection? Yes £ No R 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, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 21 of 23 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, Care Homes 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 1 2 12 40 the service should try and provide a greater range of activity to meet the needs of everyone living in the home Policies and procedures should show issue dates, to facilitate regular review, and be specific to this service Care Homes for Adults (18-65 years) Page 22 of 23 Helpline: 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 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 23 of 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. 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