Inspection on 20/05/08 for Care Homes UK Ltd T A Hazelroyd Nursing Home

This inspection was carried out on 20th May 2008.

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

Care Homes UK Ltd T A Hazelroyd... 21/04/09

Care Homes UK Ltd T A Hazelroyd... 07/11/07

Care Homes UK Ltd T A Hazelroyd... 06/09/06

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Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Hazelroyd Nursing Home 31 - 33 Savile Road Halifax HX1 2EN Lead Inspector Paula McCloy Key Unannounced Inspection 20th May 2008 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 Hazelroyd Nursing Home DS0000065574.V364752.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. Hazelroyd Nursing Home DS0000065574.V364752.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hazelroyd Nursing Home Address 31 - 33 Savile Road Halifax HX1 2EN 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) 01422 362325 01422 300575 hazelroyd@hotmail.co.uk Care Homes UK Ltd Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Hazelroyd Nursing Home DS0000065574.V364752.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 1. One specific service user under the age of 65, named on variation dated 18th January 2007, may reside at the home. 7th November 2007 Date of last inspection Brief Description of the Service: Hazelroyd is a large stone built property that has been adapted and extended for its current use. It is situated on Savile Park Road and is approximately 10 minutes’ walk from Halifax town centre and its amenities. There is car parking to the front and rear of the building. There is a patio area to the rear of the house where people can sit out in fine weather. Hazelroyd is a care home with nursing. It has the provision to accommodate a total of 40 older people. The accommodation is arranged over four floors. Hazelroyd has three lounges, a small dining room and conservatory. One of the lounges is the designated smoking area for people living at the home. There are twelve single bedrooms and fourteen double bedrooms. One of the double bedrooms has an en suite toilet. There are seven bathrooms, four of which have assisted bathing facilities and there are five separate toilets. There is a passenger lift that serves all four floors. The current charges at Hazelroyd range from £339 - £454 per week. Additional charges are made for hairdressing, chiropody and newspapers. Hazelroyd Nursing Home DS0000065574.V364752.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. The last key inspection took place in November 2007 and the service was assessed as being poor. We met with the provider following that visit to look at how they were going to make improvements. This inspection was carried out to assess the quality of care provided to people living at the home. The inspection process included looking at the information we have received about the home since the last key inspection as well as a visit to the home, which lasted 6.5 hours. During the visit we spoke to 8 people living in the home, 5 members of staff and 2 relatives. We also observed staff delivering care, looked at various records and looked around the home. The home completed a self assessment form which provided us with some information about the service. We have used some of that information in this report. Comment cards were sent to 10 people living in the home, 10 relatives, 10 staff and 5 health care professionals; these cards provide an opportunity for people to share their views of the service with us. Information received in this way is shared with the home without identifying who has provided it. Eight people living in the home and six relatives wrote to us with their comments. Their comments have been used in this report. What the service does well: Anyone thinking of moving into Hazelroyd can go and look around and get written information about the home within the Service User Guide. If they Hazelroyd Nursing Home DS0000065574.V364752.R01.S.doc Version 5.2 Page 6 decide to move in, staff from the home will carry out an assessment to make sure that they can meet that person’s needs and arrange a day for admission. Staff are quick to involve GPs and other health care professionals to make sure people’s health care needs are met. The medication system is well managed. This means that people get their medication at the right times. Relatives and friends are made to feel welcome and can visit at any time. People living at the home said that the meals are good. Staff are dealing with complaints and adult protection issues properly. This means that any concerns are sorted out and that people living at the home are being kept safe. Improvements to the environment are ongoing. People said that the home is always clean and fresh. People living at the home like the staff. Staff are well trained and competent to do their job. We asked people what they thought the home does well. These are some of their comments: ‘In this particular home we have no concern about the care given to our relative who is well cared for by a cheerful and caring staff.’ ‘My mother is always clean and tidy and is encouraged to get involved in any in house pastimes.’ What has improved since the last inspection? Staff are more aware of maintaining people’s privacy. Doctor’s appointments are made either before or after mealtimes so that people are seen in their own room. Staff are also making sure that they use toilet facilities that are big enough to accommodate a wheelchair. This makes sure that they can close the door. Meal times are more organised and not as rushed, which makes them a more social occasion. An activities co-ordinator has been employed. This means that activities are available for people on a regular basis to keep them stimulated. Hazelroyd Nursing Home DS0000065574.V364752.R01.S.doc Version 5.2 Page 7 Staffing levels have been increased to make sure that people’s needs can be met consistently. 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. The summary of this inspection report can be made available in other formats on request. Hazelroyd Nursing Home DS0000065574.V364752.R01.S.doc Version 5.2 Page 8 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 Hazelroyd Nursing Home DS0000065574.V364752.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 & 5 (standard 6 does not apply) People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People get written information about the service and can visit to see for themselves if they think it is suitable. No one moves into the home unless staff are sure that they can meet their needs. EVIDENCE: There is a Statement of Purpose and Service User Guide, which gives people information about Hazelroyd and the service they offer. Copies of these documents are readily available in the main entrance and there is a copy of the Service User Guide in every bedroom. This means that people get information about the home before they move in. People told us that they had received enough information about the home before they moved in, so they could decide if it was the right place for them. Hazelroyd Nursing Home DS0000065574.V364752.R01.S.doc Version 5.2 Page 10 One person said ‘I came and looked around with my son.’ Another person said ‘a nurse came to see me and told me all about the home.’ We asked people living in the home if they had a contract. In the surveys, six people said they had received a contract, two said they hadn’t. When we looked at people’s files we found copies of the home’s terms and conditions of residence. For two of the most recent admissions, these documents had been prepared and were awaiting signatures. This means that people are receiving information about their rights and responsibilities. A member of staff from the home will go and assess anyone thinking of moving into Hazelroyd. There is a very comprehensive document that staff complete, which means that people’s needs are identified and that staff are sure they can meet those needs before people move in. Following a recent meeting with the nursing staff it has been decided that for any future admission to the home an additional nurse will be on duty to just deal with the admission and help the person settle in and complete the care plan. The home does not provide intermediate care. Hazelroyd Nursing Home DS0000065574.V364752.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People’s health and personal care needs are met. EVIDENCE: We looked at a selection of care plans because we wanted to see what individual needs had been identified and what action staff are expected to take to meet these needs. We asked people living in the home if they receive the care and support they need and if staff listened to them. From the surveys everyone said that they did. People made the following comments: ‘Every single thing has been dealt with as soon as it has been possible.’ ‘Nothing is too much trouble for them.’ Relatives that completed a survey told us that the home was meeting the Hazelroyd Nursing Home DS0000065574.V364752.R01.S.doc Version 5.2 Page 12 needs of their relative. People made the following comments: ‘The carers are very helpful and appear to treat the residents as individuals with their own personal needs.’ ‘I am satisfied that Hazelroyd does a very good job looking after my relative.’ We asked people living in the home if they receive the medical support they need. All of the people that completed a survey said they did. We looked at three care plans. We could see from some of the plans that people are receiving health care from a range of people such as doctors, tissue viability nurses, dentists, chiropodists and opticians. Details of any visits are clearly documented in the care plan together with the advice given. Not all of the care plans were up to date. The nurse in charge is fully aware of this and arrangements are already in place for some of the nurses to work additional hours to go though each care plan and bring them up to date. This would also be an ideal opportunity to involve people and/or their relatives in reviewing their care and support. In the surveys relatives told us they were kept up to date with important issues affecting their relative. We did not observe a full medication round. We did look at the medication records and found that these were being completed properly. This means that people are getting their medication at the right time. Hazelroyd Nursing Home DS0000065574.V364752.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. There are some activities on offer to keep people stimulated. Relatives are welcome to visit at any time. Meals at the home are good. EVIDENCE: People told us that they can follow their own routines. One person told us that she had stayed up late the previous night to watch a TV programme and had stayed in bed longer that morning. We saw that people were getting up at various times during the morning. Staff still need to make sure that care plans contain information about people’s life history and their preferred routines. This will help staff to support them in an individual and appropriate way. Whilst there is some information about people’s hobbies and interests, there are no care plans about how people’s social care needs will be met. Hazelroyd Nursing Home DS0000065574.V364752.R01.S.doc Version 5.2 Page 14 Since the last inspection an activities co-ordinator has started working in the home on weekday afternoons. She is providing activities for individuals and for groups, this is helping to keep people stimulated. The relatives we spoke to told us that they can visit at any time and that they are made to feel welcome. People told us that generally they like the meals. The menu is on display and gives people information about what the choices are. We looked at the lunchtime meal being served. Some people were eating in the lounges, some in the dining room and some in their bedroom. The meal was well organised and people got their food in a timely fashion. Staff need to keep working on how to make meal times a social occasion. Hazelroyd Nursing Home DS0000065574.V364752.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. Complaints and adult protection issues are being dealt with properly. This means that staff are listening to people and keeping them safe. EVIDENCE: The home’s complaints procedure is included in the Service User Guide, which every person has a copy of in their bedroom. We asked people living at the home, and their relatives, if they knew who to talk to if they are not happy and if they knew how to make a complaint. Everyone said that said they did. One person said ‘there is always someone in charge who will sort out anything. One relative said ‘I have never needed to raise any concerns.’ We also asked them if the home had responded appropriately if they Hazelroyd Nursing Home DS0000065574.V364752.R01.S.doc Version 5.2 Page 16 had raised any concerns. One relative said ‘The home has always dealt with any issues I have raised immediately. I have no reason to doubt that they would do otherwise on any further occasion.’ Most of the staff at the home have completed adult protection training. This means that they know about the different types of abuse and what they need to do to keep people safe. Since the last inspection there has been one allegation made by a person living at the home. This was properly reported and dealt with. Staff are following the procedures and this means that people are being kept safe and protected. Hazelroyd Nursing Home DS0000065574.V364752.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People live in a clean, comfortable and well maintained home. Improvements to the home are ongoing. EVIDENCE: The home is close to Halifax town centre and all of its amenities. There is a patio area that people can use safely in fine weather and car parking to the front and rear of the building. The fire officer was visiting whilst we were in the home. building, in line with his requirements, are ongoing. Hazelroyd Nursing Home DS0000065574.V364752.R01.S.doc Improvements to the Version 5.2 Page 18 Improvements to the building continue. Since the last inspection in November some bedrooms have been redecorated and generally refurbished. At the last inspection by environmental health the kitchen was awarded 5 stars for hygiene. Everyone that completed a survey said that the home was kept fresh and clean. The laundry is located in the basement and there is a member of staff working there everyday. People told us that their clothing is well looked after. One person said that there is sometimes a problem with socks being returned but staff always try and sort this out. Hazelroyd Nursing Home DS0000065574.V364752.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. Staff are well trained and competent to do their job. People living at the home like the staff. Staff are properly checked before they start working in the home to make sure they are suitable and safe to work with older people. EVIDENCE: At the time of this visit, there were 27 people living at the home. Since the last inspection in November 2007 staffing levels have been increased. The duty rotas showed that, during the day, there is one nurse on duty with 5 care staff in the mornings and 4 care staff in the evenings. At night, there is one nurse and three care assistants on duty. Staff said that when all the staff turn up for the shift that staffing levels are good, but, when staff call in sick that leaves them short of staff and it is difficult to find cover at short notice. Relatives that we spoke to also said that there are times when the home is short staffed and this means that all of the staff are very busy. The home are trying to build up their own ‘bank’ of staff who will be able to cover in the event of staff sickness. Hazelroyd Nursing Home DS0000065574.V364752.R01.S.doc Version 5.2 Page 20 We looked at some of the records relating to recently recruited staff to see if staff are appropriately checked before they start work at the home. Recruitment procedures are good, references are always taken up and checks are always made with the Criminal Records Bureau to ensure that new staff are suitable to work with older people. This means that people who live there are being appropriately protected. There are 22 care staff working in the home, 11 have completed their NVQ (National Vocational Training) level 2 in care and 4 staff are currently working towards this qualification. This means that staff are trained and competent to do their job. People living in the home like the staff. People said the following: ‘The staff are lovely.’ ‘Nothing is too much trouble.’ ‘The staff are very good.’ Hazelroyd Nursing Home DS0000065574.V364752.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The home is run in the best interests of the people living there. Staff need up to date training in health and safety to make sure they are using safe working practices. EVIDENCE: There has been no registered manager at the home since before the new owners took over in February 2006. After the last inspection in November 2007 a manager was recruited, however, she has recently left the home. At Hazelroyd Nursing Home DS0000065574.V364752.R01.S.doc Version 5.2 Page 22 the moment the home is advertising again for a manager. In the interim the area manager is spending 3 days per week at the home, the administrator is taking on extra duties and two of the nurses are sharing the care management. They are all clear about their roles and are meeting regularly to make sure that the home is running properly. The area manager is aware that they need to appoint a manager and register them with us. This will make sure there is someone legally responsible for the management of the home. The home have got surveys that they give out to people so that they can find out what they think of the service they get. Staff also talk to people informally about their views. The area manager wants to develop resident’s and relatives meetings so they is another forum for people to have their say about how the home is run. The home’s administrator holds money on behalf of people living there for safekeeping. We looked at the records and found them to be accurate with receipts for all purchases. The area manager has completed a training matrix for all of the staff. This has highlighted the need for some staff to update their training in moving and handling, fire safety, health and safety, first aid and infection control. He is currently looking for suitable courses and is confident that all staff will have completed all of the necessary training within 6 months. We looked at some of the test certificates for small electrical appliances, gas installation and the passenger lift. All of these were up to date. We also looked at the fire test records. The fire alarms had not been tested since February 2008. It is important that the fire alarms are tested every week to make sure they are working properly. Hazelroyd Nursing Home DS0000065574.V364752.R01.S.doc Version 5.2 Page 23 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 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 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 X 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 2 X 2 X 3 X X 2 Hazelroyd Nursing Home DS0000065574.V364752.R01.S.doc Version 5.2 Page 24 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 Requirement Timescale for action 30/08/08 2 OP31 10 People’s social care needs must be included in their care plan together with details of how their needs will be met. This will make sure that people receive the support they need to follow hobbies and interests. A manager must be recruited 30/09/08 and registered with the Commission for Social Care Inspection. This will make sure that the home is run in the best interests of the people living there. The fire alarms must be tested on a weekly basis. This will make sure that they are working properly and would work in the event of a fire breaking out. All staff must complete up to date training in: Moving and handling First aid Infection control Health and safety Fire safety This will make sure they are all using safe working practices. DS0000065574.V364752.R01.S.doc 3 OP38 23 14/06/08 4 OP38 13 31/12/08 Hazelroyd Nursing Home Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Hazelroyd Nursing Home DS0000065574.V364752.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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