Inspection on 14/11/06 for Hazelwood House

This inspection was carried out on 14th November 2006.

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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hazelwood House 12/07/07

Hazelwood House 27/06/06

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 Hazelwood House 22 Newbarn Road East Cowes Isle Of Wight PO32 6AY Lead Inspector Janet Ktomi Unannounced Inspection 14th November 2006 12.15 Hazelwood House DS0000065137.V311017.R01.S.doc Version 5.2 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 House DS0000065137.V311017.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 Adults 18-65. 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 House DS0000065137.V311017.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hazelwood House Address 22 Newbarn Road East Cowes Isle Of Wight PO32 6AY 01983 280039 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) The Regard Partnership Limited Mrs Joanne Lorraine Parry Care Home 11 Category(ies) of Learning disability (11) registration, with number of places Hazelwood House DS0000065137.V311017.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th June 2006 Brief Description of the Service: Hazelwood House is a registered care home providing care and accommodation for up to eleven younger adults with Learning Disabilities. The home provides all single bedrooms, some on the ground floor suitable for people with mobility needs. The home has communal areas, lounge and dining room and pleasant enclosed gardens. The home is situated in East Cowes with good public transport links to Newport, Ryde and the mainland. The Regard Partnership purchased the home in December 2005. Registered Manager, Mrs Joanne Parry, manages the home. Weekly fees range from £418.17 and are dependant on individual service users assessed needs for additional 1-1 support. Hazelwood House DS0000065137.V311017.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report contains information gained prior to and during an unannounced visit to the home undertaken on the 14th November 2006. The inspector would like to thank the people who live at the home and the staff for their full assistance and co-operation with the unannounced visit. The visit to the home was undertaken by one inspector and lasted approximately six hours commencing at 12.00 midday and being completed at 6.00 p.m. All core standards and a number of additional standards were assessed. The inspector was able to spend time with the care staff on duty and was provided with free access to all areas of the home, documentation requested and service users. The home was previously inspected in June 2006, prior to which a new service questionnaire was completed by the home and comment cards returned from most of the service users and their relatives. No concerns or issues were raised in either the comment cards or home’s questionnaire and therefore this process was not repeated as only four months had elapsed. The improvement plan submitted by the provider following the previous inspection was assessed during this inspection visit. Information was also gained from the link inspector and the home’s file containing notifications of incidents in the home. During the visit to the home the inspector was able to meet with and talk to many of the people who live at the home who also showed the inspector their private accommodation. What the service does well: All service users stated that they liked living at the home and that the staff and manager were all kind and helpful. Service users have active lives and are supported to follow their interests and maintain contact with family and friends. The home works well with external professionals to ensure service users’ health needs are appropriately managed. Most service users have lived at the home for many years and have highly individual private accommodation (bedrooms). The home has an ongoing programme of redecoration and replacement of fixtures and fittings as necessary. Hazelwood House DS0000065137.V311017.R01.S.doc Version 5.2 Page 6 Staff receive mandatory and service specific training to ensure they are able to understand and meet service users’ needs. What has improved since the last inspection? What they could do better: As stated many of the requirements made following the inspection undertaken in June 2006 have been met, however there are a few outstanding environmental issues yet to be rectified. The thermostatic valves fitted to baths have not yet been serviced/replaced and continue to allow very hot water into baths. Staff continue running and checking bath water for all service users, which restricts the independence of more able service users who would otherwise be able to bath unaided. The manager and key workers should ensure that there are guidelines for all service users to say when as required medication may be required. It is recommended that the provider consider options to increase the space available in the dining room and adjacant service user’s bedroom. Hazelwood House DS0000065137.V311017.R01.S.doc Version 5.2 Page 7 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 House DS0000065137.V311017.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hazelwood House DS0000065137.V311017.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 and 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users have the information they need to make an informed choice about where they live. The manager is aware that following changes to the Care Homes Regulations 2001 in September 2006 that additional statements must be added to the service users’ guide. The home would only admit people whose needs it could meet and who would be compatible with the people already living at the home. EVIDENCE: The home has a brochure that provides information in a format suitable for service users including pictograms and supporting text. The service users’ guide contains more detailed information in typed format that could be read to and discussed with a prospective service user by their relative or care manager. The manager is aware that following changes to the Care Homes Regulations 2001 implemented in September 2006 that she must amend the service users’ guide to incorporate the additional information required. A requirement is not made in respect of this, however the manager should supply the Commission link inspector with a copy of the amended service users’ guide. Hazelwood House DS0000065137.V311017.R01.S.doc Version 5.2 Page 10 At the time of the visit to the home the service had no vacancies and had been fully occupied for in excess of twenty-two months. The inspector discussed with the manager the procedure she would undertake should the home have a vacancy. The service users’ guide states the home’s admission procedure. This includes contact with care managers and prospective service users visiting the home for a day and weekend. Discussions with the manager indicated that the views of the people who already live at the home would be sought and taken into consideration when deciding whether to admit a new person to the home. The manager discussed with the inspector the level of need the home can meet and confirmed that should a new service user have any special needs then training for staff would be organised. Hazelwood House DS0000065137.V311017.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All care plans and risk assessments have been reviewed and updated to ensure that they accurately reflect service users’ needs. Records of care received (daily diaries) are now fully recorded providing a full record of service users’ lives. Service users are encouraged to make choices and their personal finances are appropriately managed. EVIDENCE: Following the previous inspection the home was required to review all care plans to ensure that they accurately reflected service users’ skills and support/care needs. The manager showed the inspector the new care plans that have been completed for all service users. The inspector viewed three Hazelwood House DS0000065137.V311017.R01.S.doc Version 5.2 Page 12 care plans. These appeared to accurately reflect service users’ needs. As care plans were all new none had been reviewed, the manager stating that every month service users meet with their key worker to discuss various issues including care plans and life goals and ambitions. Records of theses meetings were seen in care plans. The manager stated that a full care plan review, with or without the care manager would occur every six months. Discussions with service users indicated that some were aware they had care plans others were not. This was a similar response to previously and it is the inspector’s opinion that this is due to the service users’ memory/interpretation of the question. The manager explained that some service users are reluctant to attend meetings and that discussions about care plans occur in less formal situations such as when relaxing in the lounge or when on 1-1 activities. The manager explained that each service user has a diary which records support/care provided, activities undertaken and any other relevant information specific to the person. These records were viewed. During the previous inspection daily diaries for some service users had not been fully completed. On this inspection all daily diaries seen were fully completed with care staff seen to update daily diaries prior to going off duty following their morning shift. The home has also reviewed all risk assessments as required following the previous inspection. These were now all dated and signed with relevant risks identified and action taken to minimise risks clearly recorded. Discussions with the people who live at the home indicated that they are able to make choices in respect of most aspects of their lives. People are able to choose what they eat, how they spend their time and whom they spend time with. Service users are encouraged to participate in the normal domestic activities in the home however if they choose not to this is respected. On the afternoon of the inspector’s visit the service user who should have been helping with preparation of the evening meal had helped to prepare the vegetables in the morning but chosen not to assist staff with the cooking of the evening meal. Some service users stated they kept their rooms clean with others informing the inspector that the staff did this for them. Service users are supported to save or spend money appropriately. Service users stated that they decide what to spend their money on. Service users showed the inspector things in their bedrooms they had purchased. The inspector discussed service users’ personal finances with the manager who confirmed that the arrangements were the same as previously. Individual records are maintained for each service user. The arrangements and records would appear to be appropriate and well maintained. Service users’ benefits are paid into an account held by the provider. The home withdraws the service user’s personal allowance every week and this is paid into the service user’s own named bank or building society account. Hazelwood House DS0000065137.V311017.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users have varied and active lives, are able to participate in their local community and have visitors to the home. Service users are offered a healthy diet and enjoy their meals and mealtimes. EVIDENCE: The inspector was able to meet with and talk to most of the people who live at the home and viewed records relevant to service users’ daily life and social activities. Service users talked with the inspector about what it is like living at Hazelwood House. Service users talked about their weekly activities and holidays undertaken. Service users all have individual weekly plans containing a range Hazelwood House DS0000065137.V311017.R01.S.doc Version 5.2 Page 14 of external activities (day services, college and supported work placements) as well as leisure activities in the evenings and at weekends. All service users have at least one day at home each week when they are supported to undertake their domestic activities such as cleaning their bedrooms and doing laundry. Some service users support care staff to complete the weekly shop for the home. As previously stated service users are encouraged to undertake domestic tasks but can opt out if they choose to do so. As well as planned weekly activities the home also organises ad hoc activities such as trips to pubs and places of interest. Each service user has a diary in which activities and the service user’s views/responses to the activities are recorded. During the previous inspection these records were viewed and found to be incompletely recorded with one viewed not having been completed for four weeks. During this inspection daily diaries for three service users were viewed and found to be fully completed with entries each day. If completed these would provide a record of activities undertaken by the service user. Service users stated in the comment cards returned prior to the previous inspection that they have lots of things to do and that they enjoyed living at the home. The inspector believes that service users have a good lifestyle with records now reflecting this. Service users informed the inspector that they had enjoyed a recent holiday to Butlins. Two of the people who live at the home have lease cars via their mobility allowance. The arrangements for this were discussed during the previous inspection. The people who lease the cars have first call on the use of the cars. Should the cars be used for other people who live at the home then a record of the miles travelled is maintained and at the end of the month these are added up and charged at 20 pence per mile. The money paid goes to the person who is leasing the car. The Regard Partnership pays the petrol costs for all service users. Service users who lease the cars do not pay a mileage amount. This arrangement appears satisfactory as the people who lease the car get priority use and are not financially disadvantaged by using all their mobility money towards the cost as some is repaid by other service users depending on miles used. Various travel costs were seen within the individual records of service users’ personal finances, indicating that service users are only charged for travel they have used. During the visit the inspector spoke with most of the people who live at the home and all stated that they could have visitors, either family or friends. During the visit to the home the inspector was able to talk to staff and observe the meal preparation for people at home during the visit. Individual sandwiches and lunch options were provided based on what people had said they wanted. The main meal is in the evening as many service users are out during the day and take a packed lunch. Staff stated that service users decide menus, and service users confirmed they are asked what they would like on Hazelwood House DS0000065137.V311017.R01.S.doc Version 5.2 Page 15 menus. Staff on duty eat with the service users to provide role models and assistance if necessary. Staff were aware of individual likes and dislikes of the people who live at the home. Service users stated they liked the food, were able to choose what they wanted and could eat where they wished. One service user has his own kitchen area in a bed-sit arrangement, and organises his own breakfasts and lunch. The plan being to develop his cooking skills as part of an independence programme. The home has a dining room with adequate tables and seating for all service users and staff to eat at the same time. The room is relatively small and once all service users and staff are in the dining room it is quite cramped. There is the possibility of increasing the size of the dining room by the removal of a large chimney/fireplace and a food store cupboard. It is recommended that the provider consider options to increase the space available in the dining room. Hazelwood House DS0000065137.V311017.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home receive appropriate support to meet their care and health needs. The home uses a key worker system and all service users now have a Health Action Plan. Medication is appropriately stored within the home and administered by senior care staff that have undertaken training. The manager should ensure that there are guidelines as to when as required medication should be administered to individual service users. EVIDENCE: Discussions with the people who live at the home indicated that they receive the level of care and support they require. Discussions with staff indicated that they have a good knowledge of the people who live at the home and are aware of their individual support and care needs. Service users confirmed that they Hazelwood House DS0000065137.V311017.R01.S.doc Version 5.2 Page 17 are able to get up and go to bed at whatever time they wish although they are encouraged to get up in time for day services or work. Service users stated that the staff would organise for them to see a doctor if they were ill. They also told the inspector that they had been to opticians and dentists within the previous year. At the previous inspection it was noted that whilst most service users had a Health Action Plan one did not as his key worker had been on extended leave. The manager informed the inspector that all service users now had a Health Action Plan and the previously missing one was seen on this visit. Comment cards received from care managers and relatives prior to the previous inspection completed in June 2006 indicated that service users are appropriately cared for. The community learning disability nurse and GPs who returned questionnaires were positive about the home’s ability to meet all healthcare needs. During the inspection visit the manager discussed the changing health and care needs of one service user. The discussions and records seen indicated that relevant external professionals had been included in the planning of care to meet this service user’s needs. The manager was mindful of the effect the extra care needs were placing on care staff and other service users and was aware of the actions she would need to take should the home no longer be able to meet the service user’s needs. The manager stated that the community nurses have provided specific training to meet one service user’s new health needs and that training in epilepsy is also to be provided in late November 2006. Autism training has also been requested by the manager and this will be provided in 2007 by the Regard trainers. The arrangements for medication were reviewed. The home uses a blister pack system for all drugs that can be stored in this way. Medications are stored in an appropriate lockable cupboard in the office that is secure when not in use. The home has purchased a new medications fridge that incorporates a maximum/minimum thermometer. The medication administration records were viewed and found to be fully completed with no gaps left. The manager informed the inspector that the home now incorporates a check of the medication administration sheets as part of the staff handover procedure. Most of the people living at the home are prescribed PRN (as needed) medications such as mild analgesics. The home does not have clear guidelines when these should be given. Many service users would inform staff that they have a pain however others may give non-verbal indicators that they may require Paracetamol etc. for, say, a headache. The manager and key workers should ensure that there are guidelines for all service users to say when PRN medication may be required. At the time of the visit there were no controlled medications in the home. The manager and staff Hazelwood House DS0000065137.V311017.R01.S.doc Version 5.2 Page 18 stated that all staff that administer medication have completed a BTEC certificate in medication administration. Hazelwood House DS0000065137.V311017.R01.S.doc Version 5.2 Page 19 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who live at the home are able to make complaints that would be appropriately investigated and resolved. Service users are protected from abuse, neglect and harm. The home would respond appropriately to adult protection concerns. EVIDENCE: The home’s complaints procedure is detailed in the service users’ guide with the information available in pictorial format in the home’s brochure. Discussions with the people who live at the home indicated that they would tell a member of staff or the manager if they had any complaints. Most of the people who live at the home attend external day services, college or sheltered work placements and would be able to discuss any concerns or complaints with people outside the home. Observations of the interactions between the people who live at the home and care staff indicated that they would be able to discuss any concerns or make complaints with the staff or their key workers. The manager stated that the home had not received any complaints since the previous inspection. The home follows the Isle of Wight Adult Protection policy and procedure. A quick reference policy was seen on the office wall as to the actions staff should Hazelwood House DS0000065137.V311017.R01.S.doc Version 5.2 Page 20 take should they suspect that an incident of adult abuse might have occurred. Discussions with the manager and care staff indicated that they were aware of the actions they should take. Training information supplied by the manager indicated that many of the staff have attended adult protection awareness training and all staff will attend adult protection training in February 2007. Staff will also attend De-Escalation Workshop in February 2007. The home’s policies and procedures in relation to the management of service users’ personal finances have been described within a previous section of this report and should ensure that service users are protected from the risk of financial abuse. Recruitment records and pre-employment checks were viewed for new staff and found to be complete. The home’s recruitment procedures should now ensure that unsuitable people are not employed at the home. Service users stated that they felt safe living at the home. Hazelwood House DS0000065137.V311017.R01.S.doc Version 5.2 Page 21 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is generally well maintained, with some areas redecorated since the previous inspection. The Regard Partnership must ensure that the remaining issues identified in their own health and safety audit undertaken in April 2006 are fully completed. The manager must ensure that the thermostatic bath water temperature valves are working correctly. The manager and provider should consider how additional space might be provided in the dining room and adjacent small bedroom to benefit the lives of service users. EVIDENCE: Hazelwood House DS0000065137.V311017.R01.S.doc Version 5.2 Page 22 The premises is suitable for its stated purpose and meet service users’ individual and collective needs in a comfortable and homely way. Since the previous visit by the inspector many of the health and safety concerns identified by the Regard Partnership Health and safety manager during an inspection of the home in April 2006 have now been rectified. The manager stated that she has consulted with the local fire officer in respect of the issues related to fire safety and that some of these are not considered essential. New handrails have been provided to the back and front stairs and a ramp has been provided to access the rear garden for wheelchair users. One bedroom has been redecorated and another was being decorated at the time of the inspector’s visit. The manager stated that the lounge and dining room are to be redecorated soon. One bedroom has a new carpet and another four have been measured for new carpets. One service user has been provided with a new mattress and another is due to have a new bed base. Issues remaining from those identified by the Regard health and safety officer included thermostatic controls to baths, PAT Testing, the removal of carpets and provision of non-slip washable floor coverings to bathrooms and the provision of sanitary towel bins in bathrooms and WCs. These are all important safety issues. The Regard Partnership must ensure that the issues identified by its own health and safety audit are fully completed and provide the Commission with written confirmation that this has occurred. A number of the people who live at the home showed the inspector their private accommodation. Bedrooms seen were very individual and people stated they liked their bedrooms. Bedrooms contained all the required fixtures and furniture and were equipped with a washbasin, one having an en-suite shower. Bedrooms are mainly located on the first floor with two on the second floor and several on the ground floor suitable for people with limited mobility. All bedrooms are for single occupation. As stated a programme of redecoration and re-carpeting of some bedrooms has been commenced. One service user has new bedroom cupboards. Bedrooms vary in size. There is potential to increase the size of one small bedroom on the ground floor in which the service user is restricted as to the arrangement and style of furniture that may be accommodated in the room. The manager is to discuss this with the providers in line with suggestions to increase the space available in the dining room. The home has an appropriate number of WCs and bathrooms located around the home. The manager and service users previously confirmed that there is sufficient hot water when they want to have a bath. The manager stated that the baths are fitted with thermostatic valves however these are not functioning and water does come out above 43ºc. This places service users at risk of injury if they get into a bath containing too hot water. The manager stated that staff check the temperature of all baths and service users confirmed this. Service users are not only placed at risk of injury from the hot water but this also prevents their full independence, as even the most able must have staff support to have a bath. The manager must ensure that the thermostatic bath water temperature valves are working correctly. Non-slip flooring must be Hazelwood House DS0000065137.V311017.R01.S.doc Version 5.2 Page 23 fitted in all bathrooms and WCs as identified also by the Regard health and safety audit. The manager must inform the Commission when these health and safety issues have been rectified. The home provides service users with a large lounge and smaller dining room. As previously stated the dining room is barely large enough for all service users and staff to eat at the same time. If service users wished to have friends to stay for a meal there would be insufficient room in the dining room. There is potential to increase the space available in the dining room, the manager is to discuss this with the provider. The dining room was identified by the Regard health and safety audit as being in need of redecoration. The wallpaper in the lounge is also starting to show signs of age and consideration should also be given to redecoration of this room. The manager stated that this should be completed in the near future and should inform the Commission when this is completed. The home does not have a private meeting room however as most service users are out of the home during the day either the lounge or dining room could be used for meetings without adversely affecting people who are in the house. The home has a large private enclosed rear garden and adequate car parking facilities to the front of the home. One of the people who live at the home has additional physical and mobility needs. Service users could have friends or relatives who have restricted mobility visiting them at the home. A ramp has now been fitted to provide suitable access for wheelchair users instead of the step at the back door. On the day of the inspector’s visit to the home the home was found to be clean, hygienic and free from offensive odours. Infection control equipment was available to care staff. The laundry was not observed during the visit to the home. There had been no previous concerns in respect of the laundry and none were raised by the Regard health and safety audit other than the provision of a non-slip floor and that the home should have a maintenance agreement with a local contractor for the commercial washing and drying machines. Service users stated that they are supported to keep their bedrooms clean and tidy. Information supplied by the manager prior to the previous inspection stated that most of the staff has undertaken a BTEC in infection control. Hazelwood House DS0000065137.V311017.R01.S.doc Version 5.2 Page 24 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides appropriate numbers of suitably competent and qualified staff. Recruitment procedures should ensure that unsuitable people are not employed at the home. EVIDENCE: The inspector viewed the home’s duty rota. Some of the people who live at the home have additional 1-1 hours funded by their placing authority. These are detailed on the staffing rotas. Discussions with staff and the people who live at the home indicated that there is sufficient staff to meet service users’ needs. Comment cards received from relatives prior to the previous inspection in June 2006 stated that there are sufficient staff on duty, that they are satisfied with the overall care provided with an additional comment ‘my son is very happy at Hazelwood House where he receives genuine care despite his rather demanding disabilities. The staff should be praised for all they do’. External professionals also stated that they were satisfied with the overall standard of care provided adding ‘excellent person centred approach to care provision’. Hazelwood House DS0000065137.V311017.R01.S.doc Version 5.2 Page 25 Care staff also undertake the cooking within the home with most staff attending food hygiene training in November 2006. The home has a cleaner for two hours per weekday who keeps the communal areas and bathrooms clean. Care staff support service users to undertake their laundry and keeping their bedrooms clean and tidy. The manager explained to the inspector how she covers staff holidays and sickness. The home has a small number of bank staff and their own staff provide additional cover when necessary. All service users have key workers. The Regard Partnership has its own training department who provide training at the home. The manager stated that she is able to request training on any subject relevant to the needs of the home and service user. This summer staff have updated all mandatory training. The manager stated that she has requested training in dementia, autism, role of the key worker. De-escalation and adult protection will occur in February 2007. The manager stated that the community learning disability nurses have provided training to staff in respect of dementia that is relevant to one service user’s new needs. Community nurses are to provide epilepsy training at the end of November 2006. Care staff stated that they felt they had the necessary skills to meet service users’ needs with approximately 80 having an NVQ level 2 or above in care, well above the required 50 . All staff are aged over 21 years and undertake sleep-in duties. The people who live at the home stated that they like the staff and were able to name their key workers. Interactions observed during the visit between service users and care staff were warm and positive. The home has recruited one new member of staff since the previous inspection in June 2006. As recommended the home has reviewed the way it advertises for staff to try to encourage more male applicants. The home has been successful in recruiting a male member of care staff to join the all female staff team. Male service users stated to the inspector that they were looking forward to the new staff member and had met him when he came for his interview. Recruitment records were viewed and all the necessary preemployment checks had been undertaken. The manager showed the inspector the induction booklet that will be used for the new staff member who was due to commence employment the day prior to the inspector’s visit. The induction booklet meets the Skills for Care requirements. Hazelwood House DS0000065137.V311017.R01.S.doc Version 5.2 Page 26 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 41 and 42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is managed by an experienced and qualified manager. The Regard Partnership undertakes quality audit activities however, they must ensure that the information gained from audits is used to improve services. The record keeping within the home is appropriate. Outstanding health and safety issues identified must be resolved. EVIDENCE: The manager was previously the registered manager of the home prior to its purchase by the Regard Partnership. The manager is experienced and has NVQ level 4 in care and the Registered Manager’s Award. The manager stated that she felt supported by the management structure provided by the Regard Partnership and felt able to discus issues or concerns with her direct line Hazelwood House DS0000065137.V311017.R01.S.doc Version 5.2 Page 27 manager. Observations of interactions between the manager and the people who live at the home were warm and friendly; service users stated they would tell the manager if they had any problems or complaints. Since the previous inspection when a number of requirements were made the manager has worked hard both independently and with the relevant departments within the provider organisation to meet many of the requirements. The manager confirmed that she attends update and specific training with care staff. Regulation 26 visits are completed monthly and reports are provided to the manager. The manager showed the inspector the file containing the Regulation 26 reports. These cover the appropriate areas to enable the provider to monitor the service provided. The manager stated that the Regard Partnership, which has now owned the home for ten months, has recently commenced some quality assurance questionnaires. These were completed with service users approximately two weeks prior to the inspector’s visit. The manager had not yet received any feedback from the service users’ questionnaires. As previously stated the Regard Partnership undertook a health and safety audit in April 2006 and identified twenty concerns that should have been rectified within four weeks. These were still outstanding at the time of the visit to the home in June 06, however many had been completed at the time of the second key inspection in November 2006. Issues remaining included thermostatic controls to baths, PAT Testing, the removal of carpets and provision of non-slip washable floor coverings to bathrooms and the provision of sanitary towel bins in bathrooms and WCs. These are all important health and safety issues. When a quality audit such as this is undertaken the provider and manager must ensure that the areas identified are rectified within the timescales. Quality is also monitored by the organisation via three monthly mock inspections, the records for the most recent being seen. Throughout the visit to the home the inspector viewed a number of records. These have been detailed previously in the relevant sections. The standard of record keeping in the home has greatly improved since June 2006. Records were stored securely in a locked office. The Regard Partnership and the registered manager must ensure so far as is reasonably practical the health, safety and welfare of the service users, staff and visitors. The Regard Partnership and the manager must ensure that all remaining concerns identified by the Regard Partnership Health and safety Audit are fully complied with. The outstanding concerns affect a number of very important health and safety issues. Hazelwood House DS0000065137.V311017.R01.S.doc Version 5.2 Page 28 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 2 3 3 3 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 2 28 2 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 3 3 X 2 X 3 2 X Hazelwood House DS0000065137.V311017.R01.S.doc Version 5.2 Page 29 Yes Are there any outstanding requirements from 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 YA20 Regulation 13 (2) Requirement The manager and key workers should ensure that there are guidelines for all service users to say when PRN medication may be required. The Regard Partnership must ensure that the issues identified by its own health and safety audit are fully completed. The manager must ensure that the thermostatic bath water temperature valves are working correctly. Timescale for action 01/01/07 2. YA39 23(2)(b) 01/01/07 3. YA42 23(2)(c) 01/01/07 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 YA24 Good Practice Recommendations It is recommended that the provider consider options to increase the space available in the dining room and adjacent one service user’s bedroom. Hazelwood House DS0000065137.V311017.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Southampton, Portsmouth and Isle of Wight 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 House DS0000065137.V311017.R01.S.doc Version 5.2 Page 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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