Inspection on 04/07/05 for Hazelmere House Nursing Home

This inspection was carried out on 4th July 2005.

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 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

Hazelmere House Nursing Home 26/06/07

Hazelmere House Nursing Home 12/10/06

Hazelmere House Nursing Home 07/02/06

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 Announced 4 July 2005 09:30 th 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 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 F51 F01 S18772 Hazelmere House V229389 040705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Hazelmere House Nursing Home Address Pinewood Road Summerfields Wilmslow Cheshire SK9 2RS 01625 536400 01625 536534 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Goldsborough Limited Susan Lowe Care Home 50 Category(ies) of OP Old age (50) registration, with number of places PD Physical disability (10) Hazelmere House Nursing Home F51 F01 S18772 Hazelmere House V229389 040705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Within the maximum of 50, 3 OP beds are provided for persons requiring personal care only. 2. Within the maximum of 50, 10 Service Users may be in the category PD and aged between 55 and 65. Date of last inspection 15th March 2005 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, 42 single and 4 double bedrooms. All the bedrooms have en-suite toilet and bathing facilities. Separate adapted bathrooms and toilets are throughout the home. Bedrooms are situated on both the ground and first floors of the home and a passenger lift is provided. Hazelmere House Nursing Home F51 F01 S18772 Hazelmere House V229389 040705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over 8 hours. The inspector spoke with five residents, four relatives and three members of staff as well as the home manager. Four completed CSCI comment cards were received from residents and four from relatives. The comments are reflected throughout the body of the report. What the service does well: What has improved since the last inspection? What they could do better: Although care plans were found to be satisfactory in the main, staff need to make sure that residents care plans are reviewed and revised as necessary following a change in their condition or on discharge from hospital. Hazelmere House Nursing Home F51 F01 S18772 Hazelmere House V229389 040705 Stage 4.doc Version 1.30 Page 6 Care plans must be stored in a more secure location to avoid the possibility of them been viewed by unauthorised persons. Staff are charging batteries in a bathroom and are using a wedge as a means of keeping one residents door open. This could compromise the safety of other residents. The manager must consult with the fire safety offer to make sure that residents are not placed at risk. The recording of the administration of medicines need to be improved to ensure that residents receive their medication as prescribed. 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 F51 F01 S18772 Hazelmere House V229389 040705 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Hazelmere House Nursing Home F51 F01 S18772 Hazelmere House V229389 040705 Stage 4.doc Version 1.30 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 standard(s) 3 & 6 Assessments of people’s care needs are carried out before they move into the home so there is information to show that their needs can be met at the home. EVIDENCE: Four care files were examined. The files belonging to residents new to the home contained good assessments which were carried out before they moved into the home. The assessment covered all aspects of personal care, and any specialised care that might be needed. A registered general nurse confirmed that she or the manager visit residents before they move into the home. Intermediate care is not provided at this home so standard 6 does not apply. Hazelmere House Nursing Home F51 F01 S18772 Hazelmere House V229389 040705 Stage 4.doc Version 1.30 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 standard(s) 7,8,9 & 10. Although most residents care plans were of a very good standard with up to date information in place, one care plan had not been reviewed following the discharge of a resident from hospital so the resident could be at risk of his needs not being met by staff. The GP, physiotherapist and other professionals are contacted when residents condition changes so that residents receive the most appropriate medical care. Improvement in the recording of medication is needed to make sure that residents are given their medicines as prescribed. EVIDENCE: Four residents files were examined. Each had an individual care plan, which sets out their needs and guides care staff on the action to be taken to meet these needs. Three of the files were reviewed regularly to make sure that they are still relevant to the individual resident and where necessary they were changed and updated to make sure that the most appropriate care is being given. The fourth file belonged to a resident recently re-admitted from hospital. His file had not been updated following his change in condition after discharge from the hospital. Hazelmere House Nursing Home F51 F01 S18772 Hazelmere House V229389 040705 Stage 4.doc Version 1.30 Page 10 However there was evidence that staff had contacted the General Practitioner and physiotherapist about his condition. See Requirement 1. Risk assessments are done and updated regularly. Wound care is documented in the care plans, however staff should document clearly the condition of the wound when they change the dressing, for example; the colour of the wound, size and depth and whether there is any evidence of healing. Good daily records are kept which provide information to staff on the residents condition. There were several entries in the care plans indicating that the dietician, speech therapist, and social workers visit when necessary. Residents spoken with were very complimentary about the staff and the care provided. One relative said that she felt her mum was very well cared for. Another relative said that she thought that things at the home had improved since the manager has come into post. Four residents ticked ‘yes’ under the question ‘Do you feel well cared for’ on the CSCI comment cards. Three of the four comment cards received from relatives indicated they are kept informed of important matters affecting their relative/friend. One suggested that it took over 12 hours to gain an answer to a query she had. The recording on the administration of medicines to residents is in need of improvement. There were two incidents where a signature on residents’ medicine administration record (MAR) sheets identified that they had been given a medicine on a day that they were not prescribed to have it. However the nurse in charge said that this was an error in recording as the medication is only dispensed for certain days and therefore would not have been given in error. There were also signatures missing on some of the MAR sheets which would suggest that residents are not getting their medicine as prescribed. See Requirement 2. Stocks of controlled drugs are checked regularly and signed as checked in red ink. It is good practice to write in black ink as this can be photocopied if needed. See Recommendation 1. Hazelmere House Nursing Home F51 F01 S18772 Hazelmere House V229389 040705 Stage 4.doc Version 1.30 Page 11 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 standard(s) 12,13,14 &15. Activities to keep residents stimulated and active are provided by the home. Visiting can take place at any reasonable time so that residents can keep in touch with their relatives and friends. Meals are varied and balanced providing adequate nutrition for residents to keep them healthy. EVIDENCE: Residents said that activities are provided at the home which keep them stimulated and active. An activity organiser is employed to work 25 hours per week. An outside entertainer visits weekly. Four of the residents ticked ‘yes’ to the question ‘does the home provide suitable activities’ on the CSCI comment cards. One suggested more activities should be available for residents confined to their rooms. Visitors confirmed that they can visit at any reasonable time. Residents said that they can do as they please in the home and that staff respected their wishes. Hazelmere House Nursing Home F51 F01 S18772 Hazelmere House V229389 040705 Stage 4.doc Version 1.30 Page 12 All of the residents and the relatives spoken with said that the food was good. One relative made a comment that ‘she would get fat’ if she lived at the home as the food was so good. The menu was submitted to the CSCI before the inspection. This appeared to be varied, containing a choice of food. Three of the residents ticked ‘yes’ to the question ‘do you like the food’. One ticked ‘sometimes’. on the CSCI comment cards. Carers and nursing staff assist residents with eating and drinking where necessary. Hazelmere House Nursing Home F51 F01 S18772 Hazelmere House V229389 040705 Stage 4.doc Version 1.30 Page 13 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 standard(s) 16 & 18 Information about the complaints process for the home is readily available so residents and their relatives know how to make complaints and who to make them to. Staff knew what action to take if an allegation of abuse was made so that residents are not placed at risk. EVIDENCE: There is a clear complaints procedure both on display in the entrance hall and in the service user guide, which identifies the action to be taken in the event of a complaint. Residents knew who to go to if they wished to make a complaint. The company is currently investigating a complaint. The manager confirmed that a response will be made directly to the complainant. Members of the care staff spoken with knew what action to take should an allegation of abuse be made. Hazelmere House Nursing Home F51 F01 S18772 Hazelmere House V229389 040705 Stage 4.doc Version 1.30 Page 14 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 standard(s) 19 & 26 The home is well maintained, safe and comfortable and provides suitable living space and facilities for all of the residents The home was clean and tidy. EVIDENCE: The home is well maintained. There is a large reception area on entering the home. This is well decorated and furnished and provides a comfortable space for visitors and residents to use. A partial tour of the building took place on the day of the inspection. Rooms were well maintained and had adequate furniture. There are plans to extend the facilities at the home to provide a further ten bedrooms and create additional lounge and recreational areas. The home was clean and tidy on the day of the inspection. One relative commented on the fact that the cleanliness of the home has improved since the new manager has come into post. Hazelmere House Nursing Home F51 F01 S18772 Hazelmere House V229389 040705 Stage 4.doc Version 1.30 Page 15 Although most residents were happy with the laundry facilities, one resident was upset that several of her personal items had gone missing from the laundry. The manager agreed to investigate this issue. Hazelmere House Nursing Home F51 F01 S18772 Hazelmere House V229389 040705 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29 & 30 There are adequate numbers of both qualified and care staff on duty so that the needs of residents are met. The recruitment procedures include all the necessary checks of new staff are carried out before they start working at the home to make sure they are suitable to work in care and that residents are protected. Staff are supported in their training thus making sure that they have the knowledge and skills to care for residents. EVIDENCE: Residents spoken with said that staff attend to them in a caring manner. Comments such as ‘staff are great’, ‘staff are excellent’, ‘very caring’ were made. Relatives spoken with were also very complimentary about the staff . Staff on duty were seen to be caring towards the residents. They appeared to have a good rapport with them. The members of staff spoken with knew the residents, and what care they needed. The staff were positive about the home, felt they worked as a team and that they were supported in their role. The company has recently introduced ‘personal best’ training for all staff members. Hazelmere House Nursing Home F51 F01 S18772 Hazelmere House V229389 040705 Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 37&38 The home is run well for the benefit of the residents. Residents files are not kept in a locked cabinet/cupboard and so could be read by unauthorised persons. Although staff try to maintain residents health and safety as much as possible, the charging of batteries in the bathroom and the use of a wedge on a residents door may put residents at risk. Staff have been advised to seek the advice of the fire safety officer thus making sure that residents are not put at unnecessary risk. EVIDENCE: The manager of the home has applied to be registered with the Commission for Social Care Inspection. This process is not yet complete. Hazelmere House Nursing Home F51 F01 S18772 Hazelmere House V229389 040705 Stage 4.doc Version 1.30 Page 18 A first level Registered General Nurse is always on duty to provide guidance and advice to staff on clinical matters. One relative was complimentary about the current manager and commented that aspects of the home have improved since she came into post. Residents said they felt they could approach the manager if they had any concerns. Staff said they felt supported in their role. Residents meeting are held two monthly. There are also regular health and safety and staff meetings taking place. Staff confirmed that a system of supervision is in place at the home. The residents’ records including medical records are not kept in a locked cabinet or cupboard. This needs to be addressed. See Requirement 3 Resident accidents are monitored regularly so that staff can identify any trends and so reduce the risks of accidents. The manager confirmed that all staff have attended mandatory training. Whilst touring the building the inspector noted that staff charge batteries from hoists and from an electrical wheelchair in one of the bathrooms. Whilst it is not advisable to use electrical equipment in a bathroom, this bathroom also had no natural ventilation and as bathrooms do not have a smoke alarm in place, these issues could be a potential hazard for residents and staff. There was also an entry in a residents care plan that a wedge was to be used to keep a residents door open at the request of the resident and their relative. As part of the action plan it stated that staff were to be made aware of this. There was no record of whether staff closed the resident’s door at night or whether the wedge was still used. This could present as a hazard to other residents if a fire broke out in the room. The manager was advised to seek the advise of the fire safety officer on both of these matters. See Requirement 4. Hazelmere House Nursing Home F51 F01 S18772 Hazelmere House V229389 040705 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x 3 x x x x 2 2 Hazelmere House Nursing Home F51 F01 S18772 Hazelmere House V229389 040705 Stage 4.doc Version 1.30 Page 20 Are there any outstanding requirements from the last inspection? no requirements made at the last inspection. 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 7 Regulation 15 Requirement Staff must review residents care plans revising them as necessary when their condition changes or upon discharge from hospital The registered person must make arrangements for the recording of medicines in the care home. Care files must be stored in a locked cabinet/room/cupboard. The registered person must consult the fire safety officer on the practice of charging batteries in a bathroom and on the use of a wedge on one residents door. Timescale for action 31/8/05 2. 9 13 at all times 3. 4. 37 38 17 23 4/8/05 31/8/05 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 9 Good Practice Recommendations Staff should record all entries into record in black ink. Hazelmere House Nursing Home F51 F01 S18772 Hazelmere House V229389 040705 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection 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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