Inspection on 21/02/06 for Hazelwood House Residential Home

This inspection was carried out on 21st February 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 but made no statutory requirements on the home.

Other inspections for this house

Hazelwood House Residential Home 08/06/07

Hazelwood House Residential Home 09/08/06

Hazelwood House Residential Home 10/08/05

Hazelwood House Residential Home 25/11/04

Hazelwood House Residential Home 15/06/04

Hazelwood House Residential Home 12/02/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Hazelwood House Residential Home 58-60 Beaufort Avenue Kenton Middlesex HA3 8PF Lead Inspector Ms Sue Barker Unannounced Inspection 27th February 2006 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 Hazelwood House Residential Home DS0000054194.V270904.R01.S.doc Version 5.1 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 House Residential Home DS0000054194.V270904.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Hazelwood House Residential Home Address 58-60 Beaufort Avenue Kenton Middlesex HA3 8PF 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) 020 8907 7146 020 8907 7146 Mr Ramnarain Dyanan Sham Mr Ramnarain Dyanan Sham Care Home 15 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia - over 65 years of age (0), Old age, of places not falling within any other category (15) Hazelwood House Residential Home DS0000054194.V270904.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th August 2005 Brief Description of the Service: Hazelwood House is a registered care home providing personal care and accommodation for a maximum of 15 older people aged over 65 years with mental disorder. The home is located in a quiet residential road in Kenton. It is fairly close to shops, pubs and other community facilities in Kenton. The home is on two floors and was originally 2 semi-detached houses. It has a passenger lift. The home offers a mixture of shared and single bedrooms. Most have en-suite facilities. The home has gardens to the rear that are well maintained and accessible through the building. Hazelwood House Residential Home DS0000054194.V270904.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out during the afternoon and lasted into the early evening. The home was full and the inspector was able to meet with and speak to a number if the residents in the lounge and dining area. An entertainer was playing the piano and the residents were joining in a singsong when the inspector arrived in the afternoon. A review was being held with one resident and their social worker at the time of the inspection. There were two staff and the manager on duty on the afternoon shift. The inspector looked at care files, medication and other records, health and safety matters and staff files as well as following up on the requirements from the last inspection. The inspector spoke to the staff in duty. The inspector would like to thank the staff for their help during the inspection process. What the service does well: What has improved since the last inspection? What they could do better: There were two minor shortfalls in the standards inspected and two good practice recommendations. The manager must ensure that key workers include details about resident’s personal routines in their care plans as well as more detailed information about resident’s activities and dietary choices. The manager must ensure that residents, whose falls have increased, be reassessed and advice sought from the appropriate professionals. The manager is advised to review staffing levels, as matter of course should residents needs become more demanding as result of frailty or their mental disorder worsening. The manager should record who is the deputy and senior staff member on the rota Hazelwood House Residential Home DS0000054194.V270904.R01.S.doc Version 5.1 Page 6 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. Hazelwood House Residential Home DS0000054194.V270904.R01.S.doc Version 5.1 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 House Residential Home DS0000054194.V270904.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Residents are fully assessed prior to their admission to the home to ensure the home can meet their needs. EVIDENCE: There had been one recent new admission to the home since the last inspection. At the time of the inspection the resident was participating in their six week review of the placement with Social Services and the key worker and family. The care file was assessed and found to contain a full care plan and review carried out by Social Services in January after admission. There was also an assessment of need carried out by social services on the file. The home was in the process of compiling the care plan for the resident based on the information given. The inspector spoke to the resident after the review that stated that she liked the home and was glad to be there. Hazelwood House Residential Home DS0000054194.V270904.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,9,8,10 The residents care plans identify their personal and health care needs. Staff treat the residents with respect and medication practices are safe EVIDENCE: Two care plans were sampled and found to contain detailed information on all aspects of the individual’s personal and health care needs. The care plans are written in booklets, which cover a full year and included the monthly evaluations and reviews. One person had signed their care plan. Risk assessments were in place for falls, moving and handling, mental health and behaviour, tissue viability etc. There was a personal profile on each person in the booklet. Following an additional visit in September 2005 in relation to an anonymous complaint, the manager had been required to include details of residents personal care and getting up and going to bed routines, choices of food and activities. These had not been achieved within the required timescales and are restated within this report. One care plan sampled had details of the person’s particular health care needs and information for staff. Health care appointments and outcomes of these appointments are recorded in the homes daily handover book. A record of recent visits was seen with clear details of outcomes. There are no pressure Hazelwood House Residential Home DS0000054194.V270904.R01.S.doc Version 5.1 Page 10 sores in the home at the time of the inspection. Residents are ambulant and are able to attend to personal care needs with staff support. Staff were observed to be caring and respectful when escorting residents to the bathroom. The home manages continence issues well; there were no odours in the home. Individual’s continence needs are recorded on their care plan. One care plan sampled had recorded that one person had a low risk falls assessment but records identified that this person had had several falls this year. The manager must ensure that residents who have a significant number of falls must be reassessed and reviewed regularly to ensure they are kept safe. Advice from the Borough’s falls adviser must be sought to support the resident. The care plans were seen to be evaluated regularly. The residents are weighed monthly and a record was seen in the care plan booklets sampled. The home had received a visit from the CSCI pharmacy inspector in September 2005 following the last inspection. It was a good practice assessment and some recommendations and requirements had been made. These were assessed during this inspection and found to have been met in full. Hazelwood House Residential Home DS0000054194.V270904.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,14,15 The residents are able to enjoy a range of activities provided by the home. Where possible residents are supported to make decision and choices. They are able to choose the meals they prefer. EVIDENCE: The residents were being entertained by a pianist, who was playing old time songs for the residents to join in with. A number were singing along to the music and appeared to be enjoying themselves very much. A number commented afterwards that they had enjoyed the music very much. There is a list of the week’s activities up on the homes notice board. This included a list of proposed trips out and activities such as barbecues etc during the spring and summer months. The owner has purchased a mini bus since the last inspection to use for trips etc. A number of the residents suffer from mental disorder and are not always able to comment upon the activities etc with in the home. Those that did were quite positive about the meals and activities provided. The menu is kept in the kitchen diary and recorded what the residents had chosen for their meals. There had been a requirement from the additional visit in September to record the residents breakfast choices. A list of resident’s preferences was in place. Hazelwood House Residential Home DS0000054194.V270904.R01.S.doc Version 5.1 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 There is a complaints policy in place for residents and relatives to use. EVIDENCE: An anonymous complaint had been made about the home to the CSCI office in August 2005. An additional visit had been carried out in September by the lead inspector to follow up the complaints. There was not enough evidence to substantiate all the complaints but the outcome of the visit was that four requirements and two recommendations were made for the home to meet in order to improve practice. It was positive to note that all but one had been achieved by the time of this inspection. One person who spoke to the inspector was quite vocal in his complaints about not being allowed to go out on his own “like he used to ten years ago”. This was discussed with the manager who stated that this person was quite frail and unable to walk far or go out alone. He stated that this person had been offered the opportunity to go out with staff but had declined. The manager also said that the residents are taken out in the mini bus for trips out. Hazelwood House Residential Home DS0000054194.V270904.R01.S.doc Version 5.1 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 Residents bedrooms are appropriately furnished and odour free. EVIDENCE: The inspector did not tour the premises on this occasion. The manager had been required to replace the flooring in one ground floor bedroom with more appropriate flooring to reduce the odour in the bedroom. The new flooring was washable carpet and was judged to be satisfactory to ensure that good hygiene standards were maintained in the bedroom. Hazelwood House Residential Home DS0000054194.V270904.R01.S.doc Version 5.1 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 The residents are supported by a stable staff group who have received appropriate recruitment checks and training. EVIDENCE: At the time of the inspection there were two carers in duty and the manager who also works regular shifts to support staff and carry out some personal care for male residents as necessary. This corresponded to the rota. The home does not currently employ dedicated ancillary staff. This was discussed with the manager who was advised to review staffing levels as matter of course should residents needs become more demanding as result of frailty or their mental disorder worsening. The manager stated that there is a deputy and senior staff member in Hazelwood House. This was not clear on the rota and should be recorded. Some of the staff in the home also work in one of the other local homes. Their hours in the other home were seen to be clearly recorded on the rota. One staff member informed the inspector that she had recently completed her NVQ 2 and was looking forward to starting NVQ 3. She said she had enjoyed the course very much. The manager stated that two other staff had also started NVQ2. Recruitment records for the more recently appointed staff were examined. One person was waiting for CRB check to be completed before starting work in the home. All other information as required by Schedule 2 was in place. Hazelwood House Residential Home DS0000054194.V270904.R01.S.doc Version 5.1 Page 15 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 The home has a clear management structure. Residents and relatives views of the home are sought and inform the homes annual plan. Resident’s finances are kept safe and the home ensures that resident’s safety is promoted EVIDENCE: The manager is also the owner of the home and stated that he has two other homes (not in the Harrow area) both of which have a manager. There is a deputy in post in Hazelwood House who is available when he is absent. The manager always informs the CSCI office if he to be absent from the home for any length of time. He stated that he visits the other two regularly. The home’s quality assurance policy was made available for inspection. It is detailed and quite robust. Questionnaires are sent to the relatives and residents each year. Their responses were seen. The resident’s meetings folder did not have recent minutes. The homes annual development plan for 2006-07 was also in place and made available for inspection. There was a training plan in place for the next financial year. Hazelwood House Residential Home DS0000054194.V270904.R01.S.doc Version 5.1 Page 16 The manager stated that apart for one person the home does not manage any if the resident’s personal benefits or finances. One person has small sums of money given to the home by a relative, which the home keeps for him. There was a clear record of these sums and when they were given to the resident. The home had been required to hold quarterly fire drills at the last inspection. These have now been carried out and records were seen. The home is prompt in reporting any significant events to CSCI. There were clear records in place of all accidents/ incidents/ hospital admissions and any action taken by the home. Hazelwood House Residential Home DS0000054194.V270904.R01.S.doc Version 5.1 Page 17 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 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X X X X X 3 X X X STAFFING Standard No Score 27 3 28 3 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Hazelwood House Residential Home DS0000054194.V270904.R01.S.doc Version 5.1 Page 18 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 OP7 Regulation Reg 12 (2) Requirement Timescale for action 30/04/06 2 OP8 13(4) Review resident’s morning routine in Hazelwood House to ensure that their choices in terms of the time they are woken and get up in the morning are where possible ascertained and implemented through the care home’s care planning processes. This must also include further details on dietary preferences and activities (Previous timescale of 14/12/05 not met) The manager must ensure that 31/03/06 residents who have a significant number of falls must be reassessed and reviewed regularly to ensure they are kept safe. Advice from the Boroughs falls adviser must be sought to support the resident Hazelwood House Residential Home DS0000054194.V270904.R01.S.doc Version 5.1 Page 19 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 OP27 Good Practice Recommendations The manager is advised to review staffing levels, as matter of course should residents needs become more demanding as result of frailty or their mental disorder worsening. The manager should record who is the deputy and senior staff member on the rota. 2 OP27 Hazelwood House Residential Home DS0000054194.V270904.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Harrow Area office Fourth Floor Aspect Gate 166 College Road Harrow HA1 1BH National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Hazelwood House Residential Home DS0000054194.V270904.R01.S.doc Version 5.1 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!