Inspection on 08/11/05 for Hazelmere Nursing Home

This inspection was carried out on 8th November 2005.

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

Hazelmere Nursing Home 06/08/07

Hazelmere Nursing Home 06/09/06

Hazelmere Nursing Home 25/05/05

Hazelmere Nursing Home 17/01/05

Hazelmere Nursing Home 25/06/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Hazelmere 9 Warwick Road Bexhill On Sea East Sussex TN39 4HG Lead Inspector Melanie Freeman Unannounced Inspection 8th and 11th November 2005 11:00 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 DS0000013994.V263979.R01.S.doc Version 5.0 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 DS0000013994.V263979.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Hazelmere Address 9 Warwick Road Bexhill On Sea East Sussex TN39 4HG 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) 01424-214988 Mr Rodney Gadsden Mrs Corinne Gadsden Mrs Corinne Gadsden Care Home 23 Category(ies) of Old age, not falling within any other category registration, with number (23), Physical disability (23) of places Hazelmere DS0000013994.V263979.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. That the maximum number of service users/residents/individuals to be accommodated at any one time is twenty three (23). That the care home provides general nursing care to older people aged sixty five (65) or over on admission and can provide care to people with a physical disability. 25th May 2005 Date of last inspection Brief Description of the Service: Hazelmere Nursing Home is situated in a residential area approximately half a mile from Bexhill town centre. The main-line station, seafront and local bus services are close by. The home has a large, pleasant and well-maintained garden with an ornamental fishpond to the rear of the building. There are car parking facilities on site and unlimited parking facilities outside the Nursing Home in Warwick Road. There is a pleasant lounge overlooking the garden that is also used as a dining room. The home is registered to provide general nursing care for older people and older people with a physical disability. Both private and socially funded service users are cared for by the home. This home is owned and managed as a family business. Hazelmere DS0000013994.V263979.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001 often use the term ‘service user’ to describe those living in care home settings. For the purpose of this report those living at Hazelmere Nursing Home will be referred to as ‘residents’. This report should be read in conjunction with the report of the inspection that took place on 25 May 2005 for an overview of the core standards inspected over the year. This was an unannounced inspection carried out on a weekday in November a follow up visit with the home manager was carried out at the end of the week. The inspection focussed on meeting and talking to residents and visitors to the home and in accessing the homes progress in meeting the requirements made at the last inspection. The inspector was able to speak to 6 visitors and observed staff while working in the communal areas. The care documentation relating to 3 residents was reviewed along with the recruitment files and training records of 2 staff members. The homes statement of purpose and service users guide was also reviewed. What the service does well: What has improved since the last inspection? The homes statement of purpose and service users guide has been improved since the last inspection and pre admission assessments were seen to identify resident’s needs. Hazelmere DS0000013994.V263979.R01.S.doc Version 5.0 Page 6 Some improvements have been made to the social activity in the home and this is providing a basis for further improvement. Staff training continues and the home manager/owner confirmed that she had completed her NVQ level 4 in management. 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 DS0000013994.V263979.R01.S.doc Version 5.0 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 DS0000013994.V263979.R01.S.doc Version 5.0 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): 1,2,3 and 6 Hazelmere Nursing Home has appropriate information within the home about the facilities and services it offers. Pre-admission procedures confirm the suitability of admissions to the home. EVIDENCE: The home provides a combined statement of purpose and service user guide and a copy of this document was found to be available in the office and the communal sitting/dining area. Although this document has been improved it stall does not contain all the information required and this was again highlighted and discussed with the home owner/manager. This document should include resident’s views and the number and size of rooms in the home. During this inspection it was confirmed that all residents or their representatives are issued with a contract or terms and conditions of residency. All prospective admissions to the home are assessed by the owner/manager who visits them wherever they are residing. The assessment completed on a Hazelmere DS0000013994.V263979.R01.S.doc Version 5.0 Page 9 recently admitted resident was reviewed as part of the inspection and although this confirmed his basic nursing needs it did not demonstrate a multidisciplinary approach and could have been more comprehensive. The assessment process was discussed with the owner/manager. Intermediate or rehabilitative care is not provided at Hazelmere nursing home. Hazelmere DS0000013994.V263979.R01.S.doc Version 5.0 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): 7,9,10 and 11 The health and personal care needs of residents are fully met although these are not set out in a plan of care. The medicine administration practice is in the home does not ensure best and safest medicine administration. The privacy and dignity of residents is respected. EVIDENCE: The care documentation of two residents were reviewed in depth and although these demonstrated that a nursing assessment is completed and plans of care are devised the information within them should be much fuller to provide clear guidance for staff to follow. It was also noted that a resident who was assessed as being at high risk of developing pressure damage did not have a corresponding plan of care. It was confirmed that he had a pressure-relieving mattress on his bed but this was not recorded in the care documentation. The plans of care reviewed did not demonstrate that the resident or their representative were involved in the planning of care. All residents and visitors spoken to indicated that they were very happy with the way the needs of residents were being met and the way that they were treated. Hazelmere DS0000013994.V263979.R01.S.doc Version 5.0 Page 11 During the inspection the medicine administration practice was observed and found not to be in accordance with the homes policy or to follow best practice as medicines had been pre-dispensed into pots and the medicine charts were not being signed at the time of administration. This was identified and discussed with the home manager\owner. Staff were seen to be respectful and considerate to all residents and visitors, although it was clear that routines were given a high priority in the home possibly at the expense of resident’s choices. The home has recently cared for a resident who was dying and was able to provide a high standard of care within the resident’s home environment. Hazelmere DS0000013994.V263979.R01.S.doc Version 5.0 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 and 15 Resident’s opportunities for stimulation through leisure and recreational activities are not fully developed in the home to meet individual needs. The home facilitates residents to receive visitors in the home. The control residents have over their life can be undermined by the homes routines. Residents receive a wholesome and appealing diet. EVIDENCE: Some improvements have been made to the social activities in the home and the home manager/owner confirmed that these improvements are to be developed, with the involvement of a social and health care professionals. During the inspection seven visitors were spoken to and they all confirmed that they were always warmly welcomed and encouraged to spend time in the home. Residents are able to personalise their rooms and are able to make choices around how they spend their day, although some routines seem to be followed before choice is given to individuals. Hazelmere DS0000013994.V263979.R01.S.doc Version 5.0 Page 13 The home has employed two new chefs since the last inspection. Residents, staff and visitors were complimentary of the new chefs and the food tasted by the inspector during the inspection was found to be very good. Hazelmere DS0000013994.V263979.R01.S.doc Version 5.0 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): 18 Procedures and training in the home ensure that any allegation or suspicion of abuse is managed appropriately. EVIDENCE: A senior registered nurse in the home is completing a training course on adult protection and is providing staff with training sessions. This registered nurse is aware that the homes policy and procedure needs to be updated and confirmed that this would be done when she had completed her course. Hazelmere DS0000013994.V263979.R01.S.doc Version 5.0 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): 19,20,21,23,25 and 26 The home provides residents with a comfortable safe environment that has a home like feel and meets the stated purpose of the home. EVIDENCE: Hazelmere Nursing home is a converted premise that has retained a home like environment. Accommodation is provided on two floors with disabled access to the first floor via a passenger shaft lift. There is a large garden with a fishpond and this is kept well maintained and is accessible to wheelchair users. The communal space is found on the ground floor and is used as a lounge and dining area, this room is well used although it was again noted that residents eat their meals at individual tables rather than at the communal dining table. The home has suitable and sufficient toilets and bathing facilities for residents. Hazelmere DS0000013994.V263979.R01.S.doc Version 5.0 Page 16 Hazelmere has 15 single rooms and 4 rooms registered as doubles, however although room 15 is registered as a double it is not suitable and is not used and the home manager\owner confirmed that she is considering it’s deregistration. The home was found to be clean and free from offensive odours. Staff ensure a high standard of hygiene and cleanliness and hand washing is encouraged through the appropriate provision of facilities. Appropriate protective clothing was also noted at the time of this inspection. Hazelmere DS0000013994.V263979.R01.S.doc Version 5.0 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): 29 and 30 The homes recruitment procedures were found to be poor and did not ensure resident’s safety. Staff training promotes staff competencies. EVIDENCE: On the day of this inspection 21 residents were living in the home. The recruitment records for 2 care staff were reviewed in depth and these were found to be incomplete in respect of one carer recently employed. The records indicated that this carer had not completed an application form, did not have a current CRB/ POVA first check or any references or proof of identity. This was a serious shortfall and the an immediate requirement form was left with the manager/owner who was required to address this shortfall and she agreed not employ this carer directly until the necessary checks were completed. This carer had been working in the home via an agency. The CSCI have confirmed in writing that any future serious shortfalls with recruitment practice could lead to enforcement action. Staff training continues to be developed and induction training is documented within records examined in the home. Hazelmere DS0000013994.V263979.R01.S.doc Version 5.0 Page 18 Hazelmere DS0000013994.V263979.R01.S.doc Version 5.0 Page 19 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 and 38 Hazelmere is managed in a competent manner with residents care needs being identified as the priority. Quality assurance measures need to be used to ensure the home is run in the resident’s best interest. Health and safety are good and ensure staff and resident’s safety. EVIDENCE: The home manager is also the registered provider and has owned and managed Hazelmere for six years. She is a registered general nurse and has experience in managing homes prior to Hazelmere. The home manager\owner has completed an NVQ level 4 in management and it was clear following discussion with staff residents and visitors that she is well respected and makes time for anyone wishing to speak to her. Hazelmere DS0000013994.V263979.R01.S.doc Version 5.0 Page 20 Systems for monitoring the quality of care and services have been used in the past and need to be re-established to ensure the home is being run in a responsive way. All records relating to health and safety matters were found to be full and thorough. Hazelmere DS0000013994.V263979.R01.S.doc Version 5.0 Page 21 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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 3 3 3 X 3 X X 3 STAFFING Standard No Score 27 X 28 X 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X X X X 3 Hazelmere DS0000013994.V263979.R01.S.doc Version 5.0 Page 22 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. 1. Standard OP7 Regulation 15(2) Requirement Timescale for action 01/01/06 2. 3. OP7 OP8 4 5 OP9 OP12 6 7 OP14 OP29 That the individual plans of care are full and reflect all the care needs and includes residents or their representative’s involvement. 17(1)a) That a photograph of each service users is retained in the home. 13(6) That an up to date procedure and guidelines based on recent research for the care and the prevention of pressure sores is provided and implemented.(outstanding from last inspection) 13(2) That the medicine policies are updated and best and safest practice is followed at all times. 16(2)m)n) That the current provision and time available for activities and entertainment is improved, to ensure all service users have their social, cultural, religious and recreational interest and needs met. 12 That the homes routines are reviewed to ensure individual choice is given a priority. 19(1) That a thorough recruitment DS0000013994.V263979.R01.S.doc 01/12/05 01/12/05 01/12/05 01/02/06 01/01/06 01/11/05 Page 23 Hazelmere Version 5.0 8 OP33 24(1) procedure is operated and includes securing two authentic references and the retention of documentation as identified in schedule 2.(outstanding from previous 2 inspections) That a full quality assurance system is established and used to maintain and improve the provision of care and services in the home. That all the homes policies are reviewed and updated to underpin best practice. 01/03/06 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 3 4 5 Refer to Standard OP1 OP3 OP8 OP11 OP22 Good Practice Recommendations That the service users guide includes resident’s views and the room number and sizes. That the pre-admission assessment is fuller and demonstrates a multi-disciplinary approach. That a means of weighing service users who are unable to stand is provided. That a full policy and procedure for the care of the dying service user is implemented That an assessment of the premises and facilities should be undertaken by a suitably qualified person, or qualified Occupational Therapist, to advise on the suitability of disability equipment and environmental adaptations. Hazelmere DS0000013994.V263979.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Hazelmere DS0000013994.V263979.R01.S.doc Version 5.0 Page 25 - 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. 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