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Inspection on 04/05/05 for Hazelwood Nursing Home

Also see our care home review for Hazelwood Nursing Home for more information

This inspection was carried out on 4th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home is well maintained. Service users have the benefit of a activities coordinator Monday to Fridays. Service users have access to a sensory room. The majority of the service users said they thought the food was varied and it was well presented Service users had pictures on their doors which reflected the interests or personality.

What has improved since the last inspection?

Gloves and aprons were available to staff to ensure health and wellbeing of service users is maintained. Care plans are slowly being updated to ensure service users care needs are met. There were still some gaps in the mar charts, staff must be more vigilant when helping service users to take their prescribed medication.

What the care home could do better:

The home could provide small tables between chairs so that service users can put cups down safely

CARE HOMES FOR OLDER PEOPLE Hazelwood Nursing Home Main Road Longfield Kent DA3 7PW Lead Inspector Alison Spreadbridge Unannounced 4 May 2005 13:30 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 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 H56-H06 S26177 Hazelwood V223881 040505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Hazelwood Nursing Home Address Main Road Longfield Kent DA3 7PW 01474 573800 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Smartmove Homes Limited Mrs Valarie June Setrem Care Home with Nursing 50 Category(ies) of Old Age - 20 registration, with number of places Dementia - 30 Hazelwood Nursing Home H56-H06 S26177 Hazelwood V223881 040505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Patients detained under Sections of the Mental Health Act are not to be admitted to the home. Date of last inspection 15 January 2005 Brief Description of the Service: Hazelwood is a home for 50 poeple who require nursing care. The home is purpose built and sited in the village of Longfield. The home is divide into two distinct parts. On the ground floor there are 20 beds for people requiring general nursing care and there are beds for 30 people who require nursing and dementia care on the upper floor. All bedrooms are connected to the call bell system The home has good parking facilities and can be reached by public transport. Service users have access to a garden, those service users having nursing needs with dementia have limited access to the gardens Hazelwood Nursing Home H56-H06 S26177 Hazelwood V223881 040505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced inspection was made to the home on the 4th May 2005 the inspectors arrived at 1.50 pm and left at 4.25pm. The lead Inspector Alison Spreadbridge and regulatory Inspector Ruth Bunham carried out the inspection At the time of the inspection there were 47 service users living in the home including one service user who is in hospital. The visit was spent speaking with service users, nurses, support staff, service users friends and the registered manager. Some of the judgements on the quality of life and choices were taken from direct conversation with service users, observation and discussions with staff and evidence from records held at the home. A tour of the premises was also undertaken. What the service does well: What has improved since the last inspection? Gloves and aprons were available to staff to ensure health and wellbeing of service users is maintained. Care plans are slowly being updated to ensure service users care needs are met. There were still some gaps in the mar charts, staff must be more vigilant when helping service users to take their prescribed medication. Hazelwood Nursing Home H56-H06 S26177 Hazelwood V223881 040505 Stage 4.doc Version 1.30 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 H56-H06 S26177 Hazelwood V223881 040505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Hazelwood Nursing Home H56-H06 S26177 Hazelwood V223881 040505 Stage 4.doc Version 1.30 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 standard(s) Not inspected EVIDENCE: Hazelwood Nursing Home H56-H06 S26177 Hazelwood V223881 040505 Stage 4.doc Version 1.30 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 standard(s) 7,8,9,10 Service users are treated with respect and dignity by the support staff. Individual health needs are being supported, but the lack of record keeping is putting service users at risk. EVIDENCE: The service users care plans seen were well written but some were in need of updating. The care plans included a pre-assessment prior to admission. In one of the care plans seen a discrepancy between the pre admission assessment and the homes care plan was identified and this was discussed with the nursing staff. The nurses said that the visiting medical office had been asked to review the service user and they would be updating the care plan. Some service users in the home have pressure sores and require care from the tissue viability nurse. It was noted that the Waterlow score in the service users care plan was not kept up to date. A service users mattress had been upgraded following a visit by the tissue viability nurse. Hazelwood Nursing Home H56-H06 S26177 Hazelwood V223881 040505 Stage 4.doc Version 1.30 Page 10 A service users relative was spoken with who said they were very happy with the care their family member is receiving. Some of the service users spoken to said they were unhappy with the care they received and that some of the nurses were a little abrupt. Matron said was dealing with the issues raised and that perhaps this was due to cultural differences. Others spoken to said they liked the home and enjoyed the activities being provided. A activities coordinator come into the home Monday to Friday but no individual records of activities were seen. Hazelwood Nursing Home H56-H06 S26177 Hazelwood V223881 040505 Stage 4.doc Version 1.30 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 standard(s) 12,13, 15 The meals in the home provides choice and variety and cater for special dietary needs EVIDENCE: On speaking with a service users family and friends it was made clear that they can visit the home at any reasonable time. The service users were happy with the activities being provided, although a friend said she thought more could be done to occupy the service users time as ‘all they did was wander around’. The service users were happy with the meals provided, especially the afternoon cake. A visitor said they are always offered tea and cake by the staff. The home provides a kitchen area on both floors where staff are able to provide snacks in the evening for the service users The home provides books for service users wishing to read. However, chairs had been placed in front of a bookcase preventing service users access. Hazelwood Nursing Home H56-H06 S26177 Hazelwood V223881 040505 Stage 4.doc Version 1.30 Page 12 Hazelwood Nursing Home H56-H06 S26177 Hazelwood V223881 040505 Stage 4.doc Version 1.30 Page 13 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 standard(s) 16, The home has a satisfactory complaints system with some evidence that that service users feel their views will be listened to and acted upon. EVIDENCE: The Service users spoken to and one of the visitor said they felt able to make a complaint to the matron if they needed to. There has been two formal complaints received during the last year relating to the care provided in the home. Steps have been taken by the home to address the issues raised since the last inspection. Service users said their families looked after their financial affairs for them and brought them any money they needed. Hazelwood Nursing Home H56-H06 S26177 Hazelwood V223881 040505 Stage 4.doc Version 1.30 Page 14 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 standard(s) 19, 25,26 The standard of the environment within the home is good providing the service users with an attractive and homely place to live. Improvements in the environment and monitoring will enhance service users quality of life. EVIDENCE: The home is well decorated throughout and a lift is provided to the first floor. While a number of sitting rooms and dinning areas are provided on both floors some service users are choosing to sit in the corridors.. It was observed that the home does not provide sufficient small tables in sitting areas for services users to use. Staff were seen to have difficulty assisting service users to safely manage their drinks as there was nowhere to safely leave drinks and ensure service users could help themselves. Two staff members were required to assist service users with their drinks before continuing with the drinks round. While the kitchen area was reasonably clean and a board clearly showed peoples preferences, on speaking to the kitchen staff during the inspection it was clear that the required record keeping in respect to food provided, deep cleaning, the recording of meat temperatures, and the temperature of the fridges are not being maintained. This was brought to the attention of the Hazelwood Nursing Home H56-H06 S26177 Hazelwood V223881 040505 Stage 4.doc Version 1.30 Page 15 manager following the inspection. The lack of monitoring and record keeping does places service users at risk. There was a distinct smell of urine in the upstairs lounge, toilets seen to lack bins for pads. There was also a lack of bins generally for the disposal of paper hand towels. The laundry area was seen. Appropriate use of red sacks for soiled linen. The ironing bard cover is in need of replacement in line with health and safety. Service users clothes were seen to be clearly marked, and were returned to service users rooms by the support staff during the afternoon.. When checked the water was very hot in a number of areas. A thermometer was seen in the shower room, there was no record available to show that the water temperatures were being formally recorded The pan rack in the sluice room needed to be cleaned. The snack kitchens were stocked with the appropriate food for the evening. There was a number of notices on the wall outlining the food available to service users in the evening. The area was in need of a good clean. The bin was very dirty and had an open top. It was noted during the inspection that when one of the call bells was rung it did not sound in the nurses station. a call bell Hazelwood Nursing Home H56-H06 S26177 Hazelwood V223881 040505 Stage 4.doc Version 1.30 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Not inspected EVIDENCE: Hazelwood Nursing Home H56-H06 S26177 Hazelwood V223881 040505 Stage 4.doc Version 1.30 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: Not inspected on this ocassion Hazelwood Nursing Home H56-H06 S26177 Hazelwood V223881 040505 Stage 4.doc Version 1.30 Page 18 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 2 x x x x x 2 2 STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x x x x x x x Hazelwood Nursing Home H56-H06 S26177 Hazelwood V223881 040505 Stage 4.doc Version 1.30 Page 19 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. 2. Standard OP 7 OP 8 Regulation 15 (2) (b) 12 (1) Requirement The registered person shall keep the service users plan under review The registered person shall ensure that the care home is conducted so as to make proper provision for the and where appropriate, treatment, education and supervision of service users by monitoring recording, and maintaining the care plans The registered person shall suitable arrangements to prevent infection, toxic conditions and the spread of infection in the care home. All parts of the home to which service users have access are so far as reasonably practicable is free from hazards to their safety. The registered person shall having regard to the size of the care home and the numbers and needs of the service users after consultation with the environmental health authority, make suitable arrangements for maintaining satisfactory standards of hygiene in the home. Keep the care home free Timescale for action 30 July 2005 3. OP 25 13 (3)(4) (a) (c) 30 June 2005 4. OP 26 16 (1) (2) (j) ( k) 31 July 2005 Hazelwood Nursing Home H56-H06 S26177 Hazelwood V223881 040505 Stage 4.doc Version 1.30 Page 20 from offensive odours and make suitable arrangements for the disposal of general and clinical waste. 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 Good Practice Recommendations Hazelwood Nursing Home H56-H06 S26177 Hazelwood V223881 040505 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection 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 H56-H06 S26177 Hazelwood V223881 040505 Stage 4.doc Version 1.30 Page 22 - 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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