Inspection on 15/05/07 for Hazelwood Care Home

This inspection was carried out on 15th May 2007.

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

Hazelwood Care Home 31/05/06

Hazelwood Care Home 07/12/05

Hazelwood Care Home 27/07/05

Hazelwood Care Home 31/01/05

Hazelwood Care Home 21/06/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Hazelwood Care Home Skeavingtons Lane Cotmanhay Ilkeston Derbyshire DE7 8SW Lead Inspector Andrew Sales Key Unannounced Inspection 15th May 2007 10:00 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 Hazelwood Care Home DS0000035716.V336874.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. Hazelwood Care Home DS0000035716.V336874.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hazelwood Care Home Address Skeavingtons Lane Cotmanhay Ilkeston Derbyshire DE7 8SW 0115 9098100 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) www.derbyshire.gov.uk Derbyshire County Council NA Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30) of places Hazelwood Care Home DS0000035716.V336874.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 31st May 2006 Brief Description of the Service: Hazelwood is a care home currently registered to provide personal care and accommodation for 30 older people. The single-storey home is owned by Derbyshire County Council and is situated in the village of Cotmanhay on the outskirts of the town of Ilkeston. The Home comprises of separate wings, each with a lounge and dining area. There is also a larger communal lounge area situated near to the main entrance and the administration offices. All bedrooms are single occupancy. There is separate bath/shower and toilet provision (no bedrooms are equipped with en-suite facilities). The Home has a hairdressing salon. Support services include General Practitioner, district nurse, chiropodist, dentist and optician. The home has a rehabilitation centre, which has been developed using one of the wings of the home. This service is operated independently of the home. The fees for the home range between £98.60 and £325.05 per week Hazelwood Care Home DS0000035716.V336874.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and started on Tuesday 15 May 2007 with a visit to the site conducted on 16 May 2007 at 10.00am. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for people and their views of the service provided. This process considers the home’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provisions that need further development. Where possible, we include evidence from other sources, notably District Nurses and Social Workers. We also use information gathered throughout the year, to support our judgements. This may include notifications from the provider, complaints or concerns and the pre-inspection questionnaire, which the provider is required to complete prior to a visit to the service. On this occasion we did not receive the pre-inspection documentation, which should be completed by the provider prior to inspection. We were therefore unable to include any evidence from resident’s surveys. The primary method of inspection used during the visit to this service was ‘case tracking’. This involved selecting three people and tracking the care they receive through review of their records, discussion with them, the care staff and observation of care practices. We also spoke with one other person and one relative, who were able to give us their views about the service. We also spoke with two members of the care staff and one member of the domestic staff team, who were also very helpful. We spent part of the day discussing records, documents and policies with the acting manager and deputy manager. All of the key standards were inspected on this occasion. What the service does well: There are clear referral, assessment and review processes, which are used positively to respond to the needs of people. Staff are particularly aware of people’s specific requirements and how these are to be met. People commented that the attitude and approach of the staff is “marvellous”. Hazelwood Care Home DS0000035716.V336874.R01.S.doc Version 5.2 Page 6 Managers and staff are competent and knowledgeable about health and safety requirements and legislation and their practice routinely protects and promotes the safety of people. The manager’s provide good leadership to the staff team and ensure that the staff team are appropriately resourced, trained and supported. There are effective methods and systems for staff and people’s views to be heard and there is evidence of management action to address identified areas for improvement. 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. The summary of this inspection report can be made available in other formats on request. Hazelwood Care Home DS0000035716.V336874.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 Hazelwood Care Home DS0000035716.V336874.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3,4,6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are fully assessed prior to moving into Hazlewood and the people are confident that the home is able to meet their needs. EVIDENCE: All the people assessments we looked at were detailed and enabled staff to find out what people needed and what their preferences were, prior to meeting them. We spoke with three people. They all feel that the service is well co-ordinated, they are kept well informed and have access to information, help and advice. They also said the staff were polite and very helpful, this was also supported by observations made throughout the inspection. Hazelwood Care Home DS0000035716.V336874.R01.S.doc Version 5.2 Page 9 The staff we spoke with, demonstrated a sound understanding of the needs of older people and a thorough commitment to their role. They described in detail the assessment and review process, the benefits of good management support and the comprehensive training on offer. People told us that they felt the home’s care staff were well trained and ‘excellent’ in their approach. We looked at the induction program and training schedule. This will help to ensure that staff are able to meet the needs of people admitted. People told us that the staff are well trained and felt they were in competent hands. The staff commented that the induction to the homes procedures and following training equipped them to provide a good standard of care. The home does not provide intermediate care. Hazelwood Care Home DS0000035716.V336874.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are assessed with careful consideration to their preferences. This results in people being treated with respect. EVIDENCE: Assessments and care plans contain suitable action plans for support staff. Resident’s plans contain details of each individual’s health care needs, including tissue viability and continence risk assessments. There is evidence that people have been appropriately referred to health care professionals. Care plans viewed, contained records of visits by district nurses, General Practitioners and other professionals. Healthcare professionals were observed visiting on the day. We saw that plans of care are reviewed by managers and key support staff on a regular basis. We observed risk assessments in relation to maintaining independence and risks for all areas of daily living. Staff who spoke with us Hazelwood Care Home DS0000035716.V336874.R01.S.doc Version 5.2 Page 11 abilities and demonstrated a good understanding of the care planning process and the management of risk. The homes medication administration systems are well maintained. There is a policy and procedures for receiving, recording, storing, handling, administering and disposing of medicines. The home is registered with the local pharmacist and support and advice is obtained as and when needed. We observed medication records and noted evidence of medication reviews and updates. The people we spoke with were able to describe what they were supported with and how the staff approached this. All the feedback we received from people suggests that the staff are courteous and understanding when supporting them with any task, whether personal care or practical tasks and that the standards overall were ‘excellent’. Some people were keen to point out that staff would always do extra tasks when asked, but were always mindful of their independence. We observed care staff throughout the day undertaking a variety of support tasks with a professional and courteous manner. Staff commented that they felt the home promoted the independence of people consistently, throughout the induction, training programs and policies and practices. Hazelwood Care Home DS0000035716.V336874.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People feel they retain much of their independence after moving into the home. Resident’s are helped to maintain contact with family and friends. EVIDENCE: Resident’s commented that the philosophy of the home and the attitude of the staff enabled them to make choices and felt they were generally well respected. They also felt that staff were always willing to sit and talk with them when they had time away from essential duties. The staff reported that they encourage people to participate in events and outings. Planned trips and events are organised within the home. We saw notices in communal areas and in resident’s rooms with details of forthcoming events. Hazelwood Care Home DS0000035716.V336874.R01.S.doc Version 5.2 Page 13 We observed some people spending long periods of time sitting in the lounge. Whilst some social preferences are recorded on care plans there is no structure to assess people wishes and allocate resources to meet these needs. There are some people who have various levels of Dementia, who may need extra support or supervision. The current ratio of staff deployed is one to ten. Managers and staff agreed that they are struggling to provide adequate support. We observed one resident becoming very agitated because he could not get assistance in his room. We were told that on person with dementia was having medication increased to assist with her condition. Another resident told us that the ‘staff are run ragged and are exhausted”. Staff were observed throughout the day making every effort to engage people when they had time away from essential duties. The staff we spoke with, were well aware of people’s individual preferences and respect people choice on occasions where they chose not to participate in events. We spoke with the two kitchen staff on duty. They described and showed us appropriate cleaning schedules in place and how the temperatures of food and equipment were monitored and recorded. We observed meals being prepared and served. This was well organised and unhurried. People told us they enjoyed the food and were given choices at each mealtime. Hazelwood Care Home DS0000035716.V336874.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are safeguarded by the homes complaints and adult protection procedures. EVIDENCE: We observed an appropriate complaints policy and procedure. We looked at records, which are held on a central register. These are well maintained and few complaints are received. People told us they would raise concerns with the manager or staff, if they felt the need to. We saw an appropriate Whistle Blowing Policy and a policy detailing Adult Protection Procedures. The homes policies and procedures for responding to suspicion or evidence of abuse, or neglect, are satisfactory. The home has comprehensive policies regarding resident’s money and financial affairs. People told us they felt safe at the home. The staff told us they had received training in adult protection issues and were fully aware of their responsibilities to safeguard older people. We also saw certificates for this training on staff files. Hazelwood Care Home DS0000035716.V336874.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,22,25,26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Hazlewood is well maintained and furnished, providing people with a homely and spacious environment. EVIDENCE: We looked at all of the communal areas and found them to be well furnished and maintained. All of the people we spoke with told us how pleased they were with the homes facilities and accommodation. One person also said the home is ‘calming and relaxing’. Hazelwood Care Home DS0000035716.V336874.R01.S.doc Version 5.2 Page 16 We looked at bathrooms, bedrooms and communal areas including lounges and the kitchen. These are all well kept, clean and free from any odours.. We looked at two bedrooms, which were well presented and personalised with resident’s personal possessions including photographs and ornaments. Each room viewed was well decorated and very clean. People spoken with stated they liked their rooms and they were comfortable. Hazlewood provides its people with specialist equipment to meet their needs. This includes grab rails in the bathrooms, hoist and other lifting aids and adapted toilet facilities. Some of these were observed in use and staff were able to describe how they supported people with this equipment. The laundry area viewed was well organised and clean. The laundry facilities included appropriate equipment. We spoke with domestic staff who described cleaning and maintenance schedules. Hazelwood Care Home DS0000035716.V336874.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The procedures for the recruitment of staff offer protection to people living in the home. The deployment and number of staff available is not sufficient to meet the needs of the people. EVIDENCE: Staff files did not contain relevant recruitment documents. These are held centrally at the councils Human Resources department. The staff spoken with confirmed all the recruitment procedures had taken place. Staff demonstrated a clear understanding of their roles and responsibilities. The inspector observed training certificates on staff files. These covered mandatory training subjects and other training subjects relating to the different support needs of older people. Staff spoken with, commented that regular training and support were available at the home. Some people said they could not get out when they wanted to, as they had no relatives and staff did not have the time to assist them. Some people were observed spending long periods of time sitting in the lounge. Hazelwood Care Home DS0000035716.V336874.R01.S.doc Version 5.2 Page 18 All of the people spoken with felt that the staff and managers were “wonderful” and “always did their best” but often some very confused people could be left unsupervised and be put at risk. They said staff even went shopping for them in their spare time. We observed staff supporting people with patience and sensitivity. When possible they took every opportunity to engage them with conversation. But people and staff said there was little time for staff to do anything meaningful or stimulating with people due to the time they had and the dependencies of the people living there. As described earlier in this report we observed one resident becoming very agitated because he could not get assistance in his room. We were told that one person with dementia was having medication increased to assist with her condition. She was observed wandering regularly and each time she was escorted back to her chair, after which staff had to return to essential duties. This demonstrates a lack of resources and a lack of person centred care planning. The manager and staff described the difficulties they had experienced with recruiting staff. The delays for starting new employees, is mainly down to late Criminal Records Bureau (CRB) checks. One example showed that one member of staff interviewed in November 2006 had only been able to start work in May 2007. The Council’s policy of not using the Protection Of Vulnerable Adults P.O.V.A first checks should be reviewed in such cases. We have evidence that the lack of staff resources might be placing people at risk. Hazelwood Care Home DS0000035716.V336874.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36,38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed. This results in practices that promote and safeguard the health, safety and welfare of the people using the service. EVIDENCE: People said they felt the home was well run and the management team were always on hand for support and advice. Staff spoken with, confirmed that they felt supported by the acting manager and that they are approachable to discuss any issues. Staff spoken with spoke well of the acting manager and deputy managers and stated they felt well supported within their job role. Hazelwood Care Home DS0000035716.V336874.R01.S.doc Version 5.2 Page 20 A relevant policy with regards to the safe keeping of people’s personal allowances is in place and followed. One person’s account was checked as part of this inspection. The staff confirmed they receive regular supervision and attend regular team meetings. Supervision records were observed. People stated that they felt they were consulted about day to day issues. They said they were asked about the care they received and if there was anything that needed to be put right. A relevant policy with regards to the safe keeping of people’s personal allowances is in place and followed. One person’s account was checked as part of this inspection. Some records of appraisal were viewed. Some staff files contained records of supervision and appraisal. Staff spoken with also supported this process. Staff files showed that staff have undertaken training in mandatory health and safety subjects. Staff spoken with, were aware of health and safety procedures and commented positively on the training provided. Risk assessments were observed on individual files and are in place for the building and individual people. Records for Health and Safety monitoring and the servicing of systems and appliances were inspected on this occasion and were found in general, to be up to date. Hazelwood Care Home DS0000035716.V336874.R01.S.doc Version 5.2 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 X X 3 3 X X 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 3 X X 3 3 STAFFING Standard No Score 27 1 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 3 x 3 Hazelwood Care Home DS0000035716.V336874.R01.S.doc Version 5.2 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 OP27 Regulation 18 (1a) Requirement Ensure that staff are deployed in sufficient numbers to meet the needs of all the people. Timescale for action 30/05/07 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 OP1 Good Practice Recommendations The Statement of purpose and Service user guide should be updated to reflect the changes to the environment and the number of people the home is registered for. The contract / terms and conditions should be updated to include all of the required information. It would be beneficial if the people care files were organised to make it easier to access important DS0000035716.V336874.R01.S.doc Version 5.2 Page 23 2. 3. OP2 OP7 Hazelwood Care Home information. It should be made clear which care plan is the most up to date plan for people. Hazelwood Care Home DS0000035716.V336874.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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. Extracts may not be used or reproduced without the express permission of CSCI Hazelwood Care Home DS0000035716.V336874.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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