Inspection on 12/10/06 for Hazelmere House Nursing Home

This inspection was carried out on 12th October 2006.

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.

Other inspections for this house

Hazelmere House Nursing Home 26/06/07

Hazelmere House Nursing Home 07/02/06

Hazelmere House Nursing Home 04/07/05

Hazelmere House Nursing Home 02/03/05

Hazelmere House Nursing Home 07/07/04

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 Hazelmere House Nursing Home Pinewood Road Summerfields Wilmslow Cheshire SK9 2RS Lead Inspector Helena Dennett Unannounced Inspection 12th October 2006 09:00 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 Hazelmere House Nursing Home DS0000018772.V307501.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. Hazelmere House Nursing Home DS0000018772.V307501.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hazelmere House Nursing Home Address Pinewood Road Summerfields Wilmslow Cheshire SK9 2RS 01625 536400 01625 536534 caldwelb@bupa.com www.bupa.co.uk BUPA Care Homes (GL) Ltd 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) Mrs Beryl Caldwell Care Home 60 Category(ies) of Old age, not falling within any other category registration, with number (60), Physical disability (10) of places Hazelmere House Nursing Home DS0000018772.V307501.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 60 service users to include: • Up to 60 service users in the category of OP ( old age not falling within any other category) • Up to 10 service users in the category of PD (physical disability), aged between 55 and 65 years. The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidance which may be issued through the Commission 7th February 2006 2. 3. Date of last inspection Brief Description of the Service: Hazelmere House is a two-storey care home providing nursing and personal care to residents. It was built in 1991. It is a detached, brick built property in private grounds with landscaped gardens for residents to enjoy. The home is situated in a residential area close to Wilmslow town centre. Hazelmere is a BUPA care home operated by Goldsborough Limited. The accommodation is comprised of three lounges, a conservatory, two dining rooms, 52 single and 4 double bedrooms. All the bedrooms have en-suite toilet and bathing facilities. Separate adapted bathrooms and toilets are situated throughout the home. Bedrooms are situated on both the ground and first floors of the home and a passenger lift is provided. The scale of charges range from £500 - £1190 per week. The latest inspection report can be obtained from the manager. Hazelmere House Nursing Home DS0000018772.V307501.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection took place over 7.5 hours. An ‘expert by experience’ assisted the inspector. She stayed for approx 3.5 hours. An ‘expert by experience’ is a person who, because of their experience of using services, and/or ways of communicating, visits a home with an inspector to help them get a picture of what it is like to live in or use the service. Before the inspection a number of surveys were received from relatives and residents. Comments from these are included in the inspection report. The inspector spoke to the manager, some members of staff, residents and relatives. The ‘expert by experience’ spoke to several residents in the lounge and dining room and had lunch with residents. Four residents’ records were examined as part of the inspection process, in respect of the care they receive. Records of medication, care plans staffing rotas and training were also examined, as were the home’s policies and procedures. What the service does well: Prospective residents are visited by a senior member of staff before they come to live at the home. This means that the resident and staff are confident that the care provided at Hazelmere House Nursing Home is suitable for their needs. Residents and relatives were very positive about the care and facilities provided at Hazelmere House Nursing Home. Some of the comments made were: ‘This is an excellent home’ ‘I have never had to complain about care’ ‘wonderful staff, always friendly and supportive’ ‘I would recommend this home to everyone as care is brilliant’ ‘Gardens very pleasant and situation of home – overlooking the green much appreciated’ ‘Staff are always cheerful’ There is good information available about different cultures and customs to ensure that staff will be able to meet the diverse needs of residents. Good links have been established with a rabbi to give some residents support with their religious customs and practice. Hazelmere House Nursing Home DS0000018772.V307501.R01.S.doc Version 5.2 Page 6 The dining room provides a very pleasant place for residents to eat in. There is a choice of menu and the food provided is good so residents’ dietary needs are catered for. Good adult protection procedures mean that residents are not placed at risk of harm or injury. Staff are provided with training to make sure that they are competent to care for the residents. Recruitment practices are good so residents can be confident that the staff employed are suitable for their role. There is a strong management structure in place so residents, relatives and staff feel well supported. What has improved since the last inspection? 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. Hazelmere House Nursing Home DS0000018772.V307501.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 Hazelmere House Nursing Home DS0000018772.V307501.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Assessments of people’s care needs are carried out before they move into the home so they can be confident that their needs will be met at Hazelmere House Nursing Home. EVIDENCE: There was evidence that a senior member of staff had visited residents before they moved into Hazelmere House Nursing Home. The assessment done during that visit covered all aspects of care needed so that the manager and the prospective resident could make an informed decision whether this was the right home for them. One relative commented that information was provided and a visit made to the home before a decision was made whether the prospective resident wished to live there. Hazelmere House Nursing Home DS0000018772.V307501.R01.S.doc Version 5.2 Page 9 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): 7, 8, 9 & 10 The quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care records were generally well maintained but some there were some problems with the management of medicines could put residents at risk. EVIDENCE: Residents said that they felt staff looked after them well. They said that they felt well cared for and that staff met their needs. Relatives made the following comments: ‘Staff always appear promptly when my relative uses his call bell’ ‘Always respond to requests, service excellent’ ‘This is an excellent home. My relative has resided here after serious illness and I have never had to complain about his care’ ‘Excellent home, wonderful staff always friendly and supportive’. Each resident has a set of records, one of which is an assessment of their needs. Risk assessments are also carried out. From these assessments care plans are written and these identify the care required. Hazelmere House Nursing Home DS0000018772.V307501.R01.S.doc Version 5.2 Page 10 A selection of four residents records were looked at in detail. All had care plans in place, however they were not always updated as resident’s needs changed and so there could be a risk that their needs may not be met particularly if a carer or nurse new to the home is looking after that resident. However, members of staff spoken with knew the residents well and were well informed about their nursing and care needs. A record of the care of a resident’s wound was kept. This was not detailed enough, e.g. size, depth, exudates, to enable staff to monitor their condition and make a judgement on whether the wound was healing. There was evidence in care files that residents are referred to the dietician and other professionals as the need arises. Specialist mattresses are provided for residents who are at risk of developing pressure sores. The privacy and dignity of residents was not always maintained. A member of staff was seen assisting a resident to have a bath. Although there was a curtain drawn around the bath, the door of the bathroom was open and another carer was seen walking in and having a conversation. This is not acceptable. The management of medicines is in need of improvement. The inspector watched a qualified nurse giving out the medicines from the trolley. The nurse entered a resident’s bedroom to give them their medicines leaving the trolley unattended for at least a minute so that anyone could have accessed the medicines whilst the nurse was in the room. The room where medicines are stored was open, as was a cupboard containing blister packs of medicines. The nurse in charge of the unit locked the room and cupboard during the inspection. Some of the record sheets relating to residents medicines were examined. There were a few discrepancies, which meant that staff could not confirm whether the resident had their prescribed medicines. For example: one resident had been admitted to the home the previous day. They had been prescribed Warfarin tablets when at home. The dose of this medicine depends on a blood test taken regularly and recorded in a book for nurses to follow. The nurse was not able to confirm whether this resident had his medicine the previous day and had not given him any on the morning of the site visit, as he stated he would have to ask the nurse that admitted the resident what dose he was on. This information should have been sought before the resident was admitted to the home, or as soon as they were admitted and clear instructions obtained. Hazelmere House Nursing Home DS0000018772.V307501.R01.S.doc Version 5.2 Page 11 After the inspection the manager of the home confirmed that she had addressed these issues with the members of staff and that she is doing spot checks to make sure that staff are keeping to the home’s procedures. Hazelmere House Nursing Home DS0000018772.V307501.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 The quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although activities are provided by the home these do not always cover the needs of the residents and so some residents may be lacking stimulation and exercise. EVIDENCE: The ‘expert by experience’ spoke with several residents and got their views on the activities and the meals provided at Hazelmere House nursing home. Residents gave mixed views about the activities provided in the home. One resident said that he did exercises with ‘Linda’ twice a week then went on to say he would like to go out more. Another resident also said they would like to go out and exercise more and although she had asked the staff she has not yet been given that opportunity. Three residents who had been at the home for a short period of time said that they didn’t think there was much going on in the home. The ‘expert by experience’ asked a group of residents if there was anything for the men to do and they all agreed: “nothing”. Resident/relatives comments indicated that there are always activities to take part in. Hazelmere House Nursing Home DS0000018772.V307501.R01.S.doc Version 5.2 Page 13 One comment was made as follows: ‘many activities provided, however my relative chooses not to take part’. Relatives said that they are made feel welcome into the home. The ‘expert by experience’ joined the residents for lunch. The tables were attractively set with cloth tablecloths and napkins and small vases with sprigs of fresh flowers. The residents were served a three-course meal and there was a choice of menu. The main meal was of a good standard although there was concern over the consistency of the potatoes. One resident told the ‘expert by experience’ that the potatoes are always like that; another resident said to the inspector that ‘something had gone wrong with the potatoes today’. The chef also agreed that ‘something had gone wrong with the potatoes’. One relative commented about the meals at the home: ‘first class – special requests catered for. Food very good, chef visits to arrange special requests’. The ‘expert by experience’ observed two ladies in wheelchairs, who were unable to feed themselves, sat together at one table. Initially a member of staff was helping first one lady and then the other to eat (moving from chair to chair) but after a few minutes she was joined by another staff member and they each helped one of the ladies. While they were doing this they both kept getting up to do other things – bring someone in, move chairs, go to the kitchen. This does not promote the dignity of the residents or enable them to dine in a relaxed way. Hazelmere House Nursing Home DS0000018772.V307501.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints are taken seriously and acted upon so residents can be confident that they are listened to and they are protected from injury or harm. EVIDENCE: The residents spoken with knew who to approach if they had any concerns. A complaints log is kept together with the action taken by the manager to address any problems or issues. One relative commented: ‘Since my relative came here he has never had cause to complain about anything’. The right action was taken by the manager of Hazelmere House Nursing Home and subsequently by BUPA in relation to one incident that had occurred recently in the home. All staff have had training in adult protection procedures. Staff spoken with knew the action to take should there be an allegation of abuse. The inspector had been notified by the manager of the home about a missing item belonging to a resident. The appropriate action was taken at that time. However there is no provision for keeping items in a locked drawer in some of the rooms. Hazelmere House Nursing Home DS0000018772.V307501.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 24 & 26 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Hazelmere House Nursing home is well maintained, clean and tidy providing a comfortable environment for residents to live in. EVIDENCE: Hazelmere House Nursing home is well maintained. It was clean and tidy on the day of the visit and provides a comfortable place for residents to live in. There is a large lounge area downstairs. Upstairs there is an activity lounge, which is situated at the back of the nurses’ station. This contains books and other items such as games for residents to use. One relative made the following comment: ‘Gardens very pleasant and the situation of the home – overlooking the green is much appreciated.’ Hazelmere House Nursing Home DS0000018772.V307501.R01.S.doc Version 5.2 Page 16 Most of the residents’ rooms looked as if they had been personalised with pictures, ornaments and other small items that residents had brought with them when they moved in. One resident had brought their own furniture in, which meant that the carpet, which had been cut to suit the furniture supplied by the home, had gaps in it. The resident wished to purchase a new carpet for her room, but due to the type of carpets in the home the manager told her this was not possible. Consideration should be given to replacing this carpet. The home was clean and tidy. The maintenance man was in the process of repainting the reception area to enhance its appearance. Hazelmere House Nursing Home DS0000018772.V307501.R01.S.doc Version 5.2 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): 27,28,29 & 30 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are enough staff with the right qualifications and experience working at Hazelmere House Nursing Home to make sure that the needs of the residents are met. EVIDENCE: Residents were very complimentary about the staff and the care provided. One relative commented, ‘the staff always appear promptly when my relative uses their call bell’. Members of staff spoken with said there are plenty of opportunities to attend training. The manager confirmed that all staff have done moving and handling and fire safety training. However the moving and handling training is done inhouse and certificates or records of competencies are not kept so it is not clear how staff are assessed as competent to undertake some tasks. Recruitment processes are good in that all the necessary checks have been done before a member of staff is employed. This means that only people suitable to work in care are employed and residents are not placed at risk of injury or harm. Several of the care staff have achieved an NVQ Level 2 in care award which means that they should have a good understanding into the needs of the elderly person. Hazelmere House Nursing Home DS0000018772.V307501.R01.S.doc Version 5.2 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): 31,33,35 &38 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed so that it is run in the best interests of the residents. EVIDENCE: Most of the residents spoken with said they felt supported by the manager of the home. Comments from relatives were received as follows: ‘Staff are always cheerful which Dad feels is a sign of good management’ ‘On visiting the home I was met by home manager Beryl Caldwell. She is an absolute treasure – nothing was too much trouble’ Members of staff said they also felt supported in their role. Hazelmere House Nursing Home DS0000018772.V307501.R01.S.doc Version 5.2 Page 19 The registered manager is experienced and suitably qualified to run the home, and receives good support from the Company. She operates a quality assurance programme made up of audits and satisfaction surveys. The surveys are published regularly by the company. There is a system in place for managing residents’ monies. Small amounts of money are kept individually for residents to access as needed. Receipts are kept and two signatures obtained before each transaction. Health and safety systems within the home are satisfactory. Records of all essential maintenance and servicing of equipment are kept. Health and safety meetings are held regularly at the home. Fire equipment is tested regularly, fire drills carried out periodically and a record of staff who take part in drills is kept so that the manager can make sure that all staff take part in at least two fire drills per year. Hazelmere House Nursing Home DS0000018772.V307501.R01.S.doc Version 5.2 Page 20 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 2 8 3 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X 3 X X 3 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 3 X 3 X 3 X X 3 Hazelmere House Nursing Home DS0000018772.V307501.R01.S.doc Version 5.2 Page 21 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 15 (1) (2) Requirement Timescale for action 30/12/06 2. OP9 13 (2) 3 OP10 12 (4) (a) Care plans must reflect the residents needs, be accurate, up to date and signed as appropriate. Previous timescale 30/4/05 not met. The registered person must 12/11/06 make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. Previous timescale 14/02/06 not met The registered manager must 12/11/06 make arrangements to ensure that staff respect the dignity and privacy of residents at all times. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP12 Good Practice Recommendations The manager should review the activities on offer in the home to make sure that they meet the needs of all of the DS0000018772.V307501.R01.S.doc Version 5.2 Page 22 Hazelmere House Nursing Home 2 3 OP23 OP18 residents. The manager should review the condition of the resident’s carpet identified and replace if necessary. The registered person should consider providing a locked drawer or cabinet in all rooms so residents can keep their personal belongings safe. Hazelmere House Nursing Home DS0000018772.V307501.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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. 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