Inspection on 23/11/05 for Hazelwood Nursing Home

This inspection was carried out on 23rd November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Hazelwood Nursing Home 07/10/08

Hazelwood Nursing Home 25/10/06

Hazelwood Nursing Home 04/05/05

Hazelwood Nursing Home 16/11/04

Hazelwood Nursing Home 17/05/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Hazelwood Nursing Home Main Road Longfield Kent DA3 7PW Lead Inspector Helen Martin Announced Inspection 23rd November 2005 11:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Hazelwood Nursing Home DS0000026177.V253509.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Hazelwood Nursing Home DS0000026177.V253509.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Hazelwood Nursing Home Address Main Road Longfield Kent DA3 7PW 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) 01474 573800 01474 573801 Smartmove Homes Limited Mrs Valerie June Setrem Care Home 50 Category(ies) of Dementia (30), Old age, not falling within any registration, with number other category (20) of places Hazelwood Nursing Home DS0000026177.V253509.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Mrs Valerie Setrem obtains a recognised management qualification by 1 April 2005 Patients detained under Sections of the Mental Health Act are not to be admitted to the home 4th May 2005 Date of last inspection Brief Description of the Service: Hazelwood is a home providing nursing care and accommodation for up to fifty older people, some of whom may also have Dementia. Smartmove Homes Limited own the home. Hazelwood is purpose built and located in the village of Longfield, which is accessible by public transport. The house is a large detached property with good parking facilities to the front and a garden to the rear. The home is divided into two units, ‘Hazel’ and ‘Wood’. On the ground floor twenty people requiring general nursing care can be accommodated, whilst on the first floor, there are facilities for thirty people who require nursing and Dementia care. All bedrooms are connected to the call bell system. Hazelwood employs nursing and care staff, working a roster, which gives 24hour cover. Ancillary staff cover all housekeeping, laundry, catering, administration and maintenance duties. Hazelwood Nursing Home DS0000026177.V253509.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place on 23rd November 2005 between 11.00 and 17.30. The visit included talking with a Director from the owning company, the Manager, staff, relatives and residents. Some judgements about the quality of life within the home were taken from observations and conversation. Some records were looked at and a tour of the home and garden was undertaken. In addition numerous comment cards were received as part of the inspection process from residents, their relatives and health and social care professionals. Some comments have been included within the main body of the report where appropriate. The home currently has forty-seven residents with three vacancies. What the service does well: What has improved since the last inspection? Since the last inspection improvements have been made to the care planning system to ensure that reviews are undertaken on a regular basis. A review had been undertaken and that sufficient occasional tables in communal areas have been provided for residents. Improvements have been made regarding hygiene and the eradication of offensive odours. The manager assured the inspector that the staff call system is in full working order. Hazelwood Nursing Home DS0000026177.V253509.R01.S.doc Version 5.0 Page 6 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. Hazelwood Nursing Home DS0000026177.V253509.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hazelwood Nursing Home DS0000026177.V253509.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5, 6, Prospective residents and their representatives are given the information they need, to ensure the home is suitable to meet their needs, before they decide to move in. EVIDENCE: A statement of purpose together with a residents’ handbook give information about the home. Each resident has a contract between themselves and the home. Before a resident is admitted, detailed assessments are undertaken by the manager and/or senior staff to ensure that the home can meet their needs. The manager demonstrated a clear understanding regarding the category and needs of residents that the home could meet. The manager explained that residents and their representatives have the opportunity to visit the home before they decide to move in. This was confirmed by a resident spoken with at the time of inspection. Comment cards received stated that ‘our expectations for Hazelwood have all been realised’. Hazelwood Nursing Home DS0000026177.V253509.R01.S.doc Version 5.0 Page 9 The home does not currently offer any respite or intermediate care. Hazelwood Nursing Home DS0000026177.V253509.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10, 11, Residents are treated with respect. Their health and social care needs are met, although this could be better reflected by recording activities in greater detail. EVIDENCE: There are detailed care plans for each resident, which reflect individuals’ personal and health care needs and provide guidance for staff. Documentation includes regular reviews and risk assessments. Residents’ activities are recorded in a designated file, although these could be recorded in greater detail and better reflect progress in individuals’ ‘social care plans’. The promotion of residents’ health care is maintained. They have access to all local NHS community services, including GPs and specialist health care professionals. Residents are offered appropriate exercise on a regular basis. Relatives and residents spoken with at the time of inspection said that the care provided by the home was very good. Comment cards received stated that ‘the (residents) have always looked well cared for…’ Hazelwood Nursing Home DS0000026177.V253509.R01.S.doc Version 5.0 Page 11 Procedures are in place for the storage and administration of medication within the home. Medication records are completed appropriately and drug storage is secure. Arrangements are in place to maintain residents’ privacy and dignity. Staff were observed to speak with residents in a respectful and appropriate manner at the time of inspection. Comment cards received stated that ‘everyone has been very kind and considerate’. A hairdresser comes to the home on a regular basis. The manager demonstrated sensitivity about issues surrounding the aging and death of a resident. It was mentioned relatives could visit and stay as often and for as long as they wished and specialist nurses are accessed if required. The home has a written policy, which is available for staff. Comment cards received stated that ‘I have been very impressed by the care (and) respect of staff towards my (relative) during (their) final illness…and towards myself and my family. It was faultless’. Hazelwood Nursing Home DS0000026177.V253509.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Residents are able to exercise choice and benefit from the range of leisure activities and meals available. EVIDENCE: The routines of daily living and activities made available aim to be flexible. One resident spoken with said that they could choose when to get up and when to retire. It was mentioned that staff asked them in the mornings if they were ready to get up or not. A range of activities are available for residents to choose from. The manager said that residents enjoyed reminiscing, quizzes and spelling games. Other activities provided include skittles, ball games, exercise, gardening, one-to-one time, singing, painting, collage making, sing-a-longs, discussions and crosswords. Framed collages were seen in the home made by residents. Residents on the first floor enjoy the sensory and reminiscence rooms containing many objects, wall paintings and murals. Staff spoken with at the time of inspection confirmed that different activities are provided for residents on a daily basis. It was mentioned that ministers of religion visit the home and offer communion to residents. One resident spoken with at the time of inspection confirmed that they enjoyed the activities provided by the home, especially the quizzes. One relative spoken with said that musical Hazelwood Nursing Home DS0000026177.V253509.R01.S.doc Version 5.0 Page 13 entertainment was provided on a monthly basis and that they were always invited to join in events and activities. Residents are encouraged to keep contact with their relatives and friends if they wish. One resident spoken with described how their relatives are able to visit them on a regular basis at the home. One resident spoken with said that they liked the food provided by the home and that they always got a choice. It was mentioned that staff asked them for their choice of meal the day before. Written menus offering choice, variety and hot alternatives were seen. Information seen in the kitchen included a record of special diets, such as diabetic and soft, and residents’ likes and dislikes. The home provides a kitchen area on both floors where staff are able to provide snacks and drinks for residents at any time. There are notices provided to residents outlining the food available in the evenings. Comment cards received stated that ‘the (residents) have always looked…well nourished’. Hazelwood Nursing Home DS0000026177.V253509.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17, 18 Residents’ views are listened to and receive proper consideration. Procedures are in place, which protect residents from abuse. EVIDENCE: Residents are at ease talking with staff who listen to their views and concerns; any complaints receive proper consideration. There have been two complaints received during the last year. Records of these and their investigations are maintained appropriately. There is a written complaints procedure available for residents and their representatives, together with a suggestion box and forms to complete. All permanent residents are on the electoral role and are able to vote if they wish. The manager demonstrated an understanding of the procedures in place within the home for the protection of residents from potential abuse. Written policies and procedures are available for staff. Hazelwood Nursing Home DS0000026177.V253509.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25, 26 Residents benefit from living in a clean and comfortable environment, which is suitable to meet their needs. EVIDENCE: The home is well decorated throughout and suitable for residents’ needs. The garden is attractive and has a patio area available for all residents in warmer weather. It was stated that raised beds are provided and plans were in process for a scented garden next year. Discussion took place with both the manager and director regarding potential plans for extension. A variety of lounge and dining facilities are provided throughout the home. There are three lounges and a dining room on the ground floor. The first floor offers two lounges and two smaller communal rooms, one of which is for sensory equipment, whilst the other is dedicated to reminiscence. The smaller rooms contain wall paintings and murals. There is a kitchen area for the preparation of drinks and snacks both on the ground and first floors. The manager stated that, since the last inspection, a review had been undertaken Hazelwood Nursing Home DS0000026177.V253509.R01.S.doc Version 5.0 Page 16 and that sufficient occasional tables in communal areas have been provided for residents. Adequate communal toilets and bathrooms are provided. Residents’ rooms seen were pleasant and personalised, each with their own individual sign and name on the door. All are for single use and are provided with an en-suite facility. One resident spoken with at the time of inspection said that they liked their room very much. Comment cards received stated that ‘ my (relative) is very contented and comfortable at Hazelwood…’ Various aids and adaptations are provided throughout the home. Four hoists are available. Accommodation for residents is over two floors accessed by a lift. A staff call system is provided. The manager assured the inspector that this system was in full working order. External doors are alarmed. Hot water temperatures are checked regularly and records are kept. A specialist has checked water storage within the home. The general ventilation and temperature of the home was appropriate on this occasion. The premises are clean, hygienic and free from offensive odours throughout. Arrangements are in place for the maintenance of infection control. The laundry room contained suitable facilities and included a hand washing facility. Soiled and clean items are kept separately. Soiled items are dealt with appropriately. Sluice rooms are maintained in a hygienic manner. Hazelwood Nursing Home DS0000026177.V253509.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Residents benefit from an adequate number of appropriately recruited and trained staff on duty. Minor amendment to recruitment records would better ensure residents’ protection. EVIDENCE: The manager stated that the home currently has forty-seven residents with three vacancies. At the time of inspection sufficient staff were available to meet the needs of residents. The home runs adaptation training for some nurses in conjunction with Greenwich University. It was stated that most staff work on both the general nursing and dementia units in order to develop individuals’ skills and experience. Ancillary staff cover all housekeeping, laundry, catering, administration and maintenance duties. Staffing rosters are maintained. Residents spoken with said that staff are very kind and that they are assisted when they need help. Comment cards received stated ‘I have always found the staff very approachable and accommodating’. The recruitment procedure in place within the home aims to ensure that suitable staff are appointed to meet the needs of residents. The manager described the system for pre-employment checks. Two staff files were seen to contain all of the necessary documentation, including an application form, proof of identity, references and evidence of criminal records bureau checks. It was mentioned that any gaps in employment would be explored and recorded. The manager said that an amendment would be made to the application form to request the self-disclosure of any police cautions in addition to convictions. Hazelwood Nursing Home DS0000026177.V253509.R01.S.doc Version 5.0 Page 18 Equal opportunities are monitored. Set questions are asked at interview, although these are not currently recorded. The home has a training programme, which aims to enable members of staff to update their levels of competence, gain new skills and insights. Training undertaken since the last inspection includes food hygiene, challenging behaviour, mental health, dementia, first aid, infection control, fire health and safety, medication, care planning and moving and handling. Additional courses are planned including adult protection, loss and bereavement and nutrition for older people. The manager said that all permanent staff undertake training in dementia. Documentation and certificates were seen. Staff spoken with confirmed regular and appropriate training. The manager explained that the home employed eight carers in addition to qualified nurses and those undertaking adaptation training. Of the eight carers, four have obtained an NVQ qualification, two at level 2 and two at level 3. Hazelwood Nursing Home DS0000026177.V253509.R01.S.doc Version 5.0 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36, 37 Residents benefit from a competent manager and appropriately supervised staff within a relaxed and inclusive atmosphere. Their welfare would be better protected by improvements to the systems for record keeping and quality assurance. EVIDENCE: The manager is competent to run the home, has been in post for several years and has had previous experience of nursing care. They are in the process of undertaking the Registered Managers’ Award. It was mentioned that, due to assessment issues, the course would now be completed in 2006. The home is welcoming and has a relaxed and inclusive atmosphere. Residents are able to approach the staff with ease. Staff spoken with said that they are able to ask the manager for advice and found them supportive and helpful. Comment cards received stated that ‘ the staff and matron at Hazelwood are Hazelwood Nursing Home DS0000026177.V253509.R01.S.doc Version 5.0 Page 20 extremely kind and caring. I know that my (relative) is in extremely capable hands…All homes should be run on the lines of Hazelwood’ and ‘I am always welcome at Hazelwood, they are very professional’. The home has a quality assurance system in place and individuals are able to express their views. It was said that questionnaires are sent to residents and their relatives and a corporate annual development plan is undertaken. The manager explained that the quality assurance system would be expanded to include the views of social and health care professionals. The home has been awarded ‘Investors in People’. Written policies and procedures are available to provide guidance for staff. An up to date insurance certificate is displayed within the home. Business accounts were not inspected on this occasion. The manager explained that they are not an appointee for any resident. The home holds small amounts of cash on behalf of some residents. This is stored individually and securely. Receipts are kept and accounts of all transactions maintained, although these were not signed. One resident’s cash tallied with the records kept. A staff supervision system is in place. Staff spoken with at the time of inspection said that they received regular supervision, which they found supportive and helpful. Staff supervision is a combination of group, informal and formal, the latter being regular recorded one-to-one sessions. The manager described how nurses under adaptation training are appropriately supervised and assessed. The home has a system for the maintenance and storage of information pertaining to residents. Records are stored in a manner that preserves confidentiality. Certificates seen reflect the regular maintenance and testing of systems and equipment within the home. The fire logbook is completed appropriately with the exception of records of drills and false alarms. Arrangements are in place for the maintenance of food hygiene. The kitchen is clean. Records are kept for cleaning, fridge, freezer and hot food temperatures, although gaps were noted. Discussion took place with the manager regarding this. It was mentioned that the necessary checks were undertaken but that it was not always possible to record them; a new system would be put in place in order to do this; the Environmental Health Officer has visited recently and is aware of the situation. The programme of staff training includes relevant aspects associated with health and safety and general aspects of care provision. Hazelwood Nursing Home DS0000026177.V253509.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 3 2 3 2 2 Hazelwood Nursing Home DS0000026177.V253509.R01.S.doc Version 5.0 Page 22 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 OP37OP38 Regulation 17(2) Schedule 4.14 Requirement The registered person shall maintain in the home, the records specified in Schedule 4: A record of every fire practice drill or test of fire equipment (including fire alarm equipment) conducted in the home and of any action taken to remedy any defects. In that, all fire drills and false alarms must be recorded. Timescale for action 06/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP7 Good Practice Recommendations It is recommended that residents’ activities are recorded in greater detail and better reflect progress in individuals’ ‘social care plans’. Hazelwood Nursing Home DS0000026177.V253509.R01.S.doc Version 5.0 Page 23 2 OP29 With regard to staff recruitment procedures, it is recommended that: • Self-disclosures in the application form should include any police cautions in addition to police convictions. Questions asked and answers given at interview should be recorded. • 3 OP33 It is recommended that the quality assurance system should be expanded to include the views of health and social care professionals. It is recommended that all transaction records regarding cash held on behalf of residents should be signed. It is strongly recommended that the manager complete their stated intention to introduce a system whereby all the results of fridge, freezer and hot food temperature checks undertaken can be recorded. 4 5 OP35OP37 OP37OP38 Hazelwood Nursing Home DS0000026177.V253509.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Nursing Home DS0000026177.V253509.R01.S.doc Version 5.0 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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