CARE HOMES FOR OLDER PEOPLE
Hazlehurst 1 Dyche Drive Jordanthorpe Sheffield S8 8DN Lead Inspector
Jayne Barnett-Middleton Unannounced Inspection 09:15 16 February 2006
th 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 Hazlehurst DS0000035749.V254883.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. Hazlehurst DS0000035749.V254883.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Hazlehurst Address 1 Dyche Drive Jordanthorpe Sheffield S8 8DN 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) 0114 203 7703 0114 203 7703 Sheffield City Council Mrs Linda Dutton Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places Hazlehurst DS0000035749.V254883.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. All areas of the care home used by Service Users must by in good repair internally and externally and be furnished, decorated, heated and lit to the levels required by the Care Home Regulations 2001 and stated in the National Minimum Standards for Older People by 01/09/04. A call system with an accessible alarm facility must be provided in all rooms used by Service Users by 01/09/04. Minimum staffing levels providing direct care to service users must be maintained as described in the Handbook of Giudance on Registration, Inspection and Management of Residential Care Homes in Yorkshire and Humberside dated 13/09/91 Pre-set valves of a type unaffected by changes in water pressure and which have fail safe devices must be fitted to water outlets which Service Users have access to, to provide water close to 43 degrees centigrade by 01/09/04. Lighting in rooms used by Service Users must meet recognised standards (lux 150) and be domestic in character by 01/09/04. The kitchen area must be refurbished and decorated to the standards required by relevant legislation by 01/05/04. The laundry floor finish must be impermeable and wall finishes must be readily cleanable by 01/05/04 Where additional services are provided eg day care, outreach, escort duty, staff for this must be over and above that required by condition 3 Intermediate Care, if provided must be on the basis stated in 6.1 to 6.5 of the National Minimum Standards for Older People by 01/05/04. 7th July 2005 2. 3. 4. 5. 6. 7. 8. 9. Date of last inspection Brief Description of the Service: Hazlehurst is a single story purpose built home, in the Jordanthorpe area of Sheffield. The home provides a service on long term and short term basis. Ten beds are used by the NHS, 4 beds for people discharged from hospital and awaiting packages of care to allow them to return home, 4 beds for people receiving rehabilitation, which involves input from the physiotherapist and occupational health, the remaining 2 beds are used for those assessed as vulnerable and to prevent hospital admission. The home has 3 long-term care beds and 7 short term care beds mainly used for stays on a rolling programme or to meet other short term needs. All the bedrooms are single; there are
Hazlehurst DS0000035749.V254883.R01.S.doc Version 5.0 Page 5 dining rooms, lounges, toilets and bathrooms sufficient to meet the needs of the service users, all of which are easily accessible. The home is close to public transport, shops and community facilities. Hazlehurst DS0000035749.V254883.R01.S.doc Version 5.0 Page 6 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out from 9.15 am to 2.00 pm. Most of the residents were seen during the inspection. Seven residents, five staff, two visitors and the operations manager were spoken to. A sample of records was examined and a partial inspection of the building was carried out. Throughout the inspection positive and professional relationships were observed between staff and service users. The inspector wishes to thank the operations manager, staff and service users for their time and co-operation throughout the inspection process. What the service does well:
All service users spoke highly of the care and service that they received. Comments included “it’s a good service”, “The staff will do anything for you” and “The service is splendid”. Service users were regularly surveyed. In relation to the healthcare provided, all service users had rated the healthcare that they had received as 100 . One service user spoke in detail about how, due to the care and support that they had received, they would soon be leaving the home to live independently within the community. They praised the service commenting, “The staff have been supportive and have given me the confidence to remain independent”. Service users said that the routines within the home were flexible and that they were able to spend their day as they wished. Service users commented, “I can do as I wish” and “its nice here, the routines are flexible”. Service users were satisfied with the quality of food offered commenting; “There is always plenty”; “Good home cooking” and “The food is good”. Service users and visitors spoke positively about the staff team and described them as “good and approachable”, “supportive” and “ they are helpful and welcoming”. The home was clean, tidy and odour free. The home has recently undergone a programme of refurbishment and all areas seen were well maintained and pleasantly decorated. The operations manager confirmed that over 50 of the staff team had achieved the NVQ level 2 in care and that the remaining staff was in process of undertaking the award. Hazlehurst DS0000035749.V254883.R01.S.doc Version 5.0 Page 7 The atmosphere within the home was relaxed and the day-to-day management of the home appeared well organised. Staff morale appeared good and all staff spoke positively above the support that they received from the management team. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Hazlehurst DS0000035749.V254883.R01.S.doc Version 5.0 Page 8 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 Hazlehurst DS0000035749.V254883.R01.S.doc Version 5.0 Page 9 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 and 5. Service users were not admitted to the home without their needs being assessed, to ensure the home was able to meet their health, social and care needs. Prospective service users and their relatives were invited to visit the home to assess the quality, facilities and suitability of the home. EVIDENCE: Two service user files were checked and both contained a full needs assessment which had been carried out prior to their admission. Staff said that these assessments were received prior to someone moving into the home. This confirmed that the service was appropriate for the service user and provided staff with the information to formulate an individual plan of care. Two service users who received short-term periods of care at the home said that they had been invited to visit the home prior to their first stay there. Both said that their first impression of the home was good commenting, “ The staff were very nice” and “The staff were sociable and the home was very clean”.
Hazlehurst DS0000035749.V254883.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 and 10. Care plans were in place for all residents. These were detailed and identified individual needs. Service users spoke positively about the healthcare that was provided and all said that their healthcare needs were met. Service users received personal support, which promoted their privacy, dignity and independence. A policy and procedure to ensure that staff adhered to the safe administration of medication was in place. EVIDENCE: Care plans were in place for all service users. Two care plans were checked and both set out in detail the action that was required by staff to ensure that all aspects of the service users care needs were met. Service users confirmed that their healthcare needs were met and were able to describe in detail the visits that they received from healthcare professionals.
Hazlehurst DS0000035749.V254883.R01.S.doc Version 5.0 Page 11 One service user spoke in detail about how, due to the care and support that they had received, they would soon be leaving the home to live independently within the community. They praised the service commenting, “The staff have been supportive and have given me the confidence to remain independent”. Service users were regularly surveyed, enabling them to comment on the service that they received. Results of these surveys were displayed within the home. In relation to the healthcare, all service users had rated the healthcare that they had received as 100 . There was a medication policy and procedure to ensure that staff adhered to safe practices. Service users were encouraged to continue to administer their own medication, enabling them to maintain their independence. The medication was checked on a sample basis. Medication checked was stored and had been administered appropriately. Daily checks were carried out and staff responsible for administering medication had received medication training, all promoting the safe administration of medication to service users. Throughout the day staff were observed to treat service users with dignity and respect. All service users confirmed that the staff respected their privacy. Service users commented, “ If my door is shut, the staff know not to disturb me” and “The staff always respect my privacy and dignity”. One service user spoke highly of the care that she received. However, she commented that she would prefer her personal care to be provided by a female carer. She clearly stated that the personal care offered by male carers was, “good, but it doesn’t feel right”. This was feedback by the inspector to the person in charge. The care plans checked did not record service users preferences as to whether they preferred a male or female carer to attend to their personal needs. Including this information will ensure that wherever possible service users will be given a choice about receiving care from a male or female carer. Hazlehurst DS0000035749.V254883.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 and 15. Routines with the home were flexible and service users were encouraged to spend their day as they wished. Activities were available for service users. The majority spoken to preferred to spend their time within the privacy of their room. Service users were able to receive visitors at any reasonable time. A good choice of menu was offered and specific dietary needs were catered for. The lunchtime meal was well organised and relaxed. EVIDENCE: Service users were observed to be following their preferred routines. The majority of residents had chosen to spend time in the privacy of their bedroom. Service users said that the routines within the home were flexible and that they were able to spend their day as they wished. Service users commented, “ I can do as I wish” and “its nice here, the routines are flexible”. Activities including Bingo and Dominoes were available for service users. Service user said that they were aware of the activities available, should they wish to join in, however the majority spoken to said that they preferred to
Hazlehurst DS0000035749.V254883.R01.S.doc Version 5.0 Page 13 spend time in their bedroom, “ I watch TV, “ I enjoy reading”, “ I prefer my own company”. Service users said that their family and friends were able to visit them at any reasonable time. Two visitors said that they always found the staff to be “helpful and welcoming”. A good choice of menu was offered and special dietary needs were catered for. The cook said that she was kept well informed of any new service users being admitted to the home and any specific dietary requirements. The lunchtime meal observed was relaxing and service users were given sufficient time to eat their meal. The meals provided looked appetising and were well presented. Service users were satisfied with the quality of food offered commenting; “There is always plenty”; “Good home cooking” and “The food is good”. Hazlehurst DS0000035749.V254883.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 and 18. The complaints procedure was clear and accessible. Complaints made by service users and their relatives were listened to and action was taken to deal with complaints promptly. There was an adult protection procedure in place at the home. Staff had an understanding of the procedures to be followed should they suspect any abuse at the home. EVIDENCE: A complaints procedure was displayed at the home and copies were available in service users bedrooms. The complaints procedure ensured that service users and their relatives were aware of how to make a complaint and who would deal with them. Service users spoken to confirmed that they had no complaints. All service users spoke positively about the attitude of the staff and manager and were confident that they would always listen to any concerns that they may have. The home had received one complaint, which was ongoing. The C.S.C.I had been informed, and the manager had dealt with the complaint promptly and appropriately. There was an adult protection policy and procedure that promoted the protection of service users from harm or abuse. The staff spoken to had a good understanding of the action that they would take should they suspect any abuse at the home. Hazlehurst DS0000035749.V254883.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 and 26. The home was clean, comfortable and well maintained. Service users were provided with an environment that was safe, accessible and homely. EVIDENCE: The home was clean, tidy and odour free. The home has recently undergone a programme of refurbishment and all areas seen were well maintained and pleasantly decorated. Service users said that they liked their environment “ its very clean”. The grounds to the home were well maintained. The operations manager said that funding had been agreed to improve the exterior of the home, this would include new shrubs, extension of the car park and a water feature. It was anticipated that a local garden centre and a learning disabilities gardening group would maintain the grounds. This will improve the grounds and exterior
Hazlehurst DS0000035749.V254883.R01.S.doc Version 5.0 Page 16 of the home and also provide a good opportunity for the home to build links with groups within the local community. Hazlehurst DS0000035749.V254883.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): 29 and 30. Service users spoke positively about the attitude of the staff and the care that they provided. Staff had received training to meet the service users general and specific needs. The home operated a recruitment policy that promoted the protection of residents. Staff files were well maintained and included all of the required information. EVIDENCE: Service users spoke positively about the staff team and described them as “good and approachable”, “supportive” and “they will do anything that you ask”. At the previous inspection sufficient staff were being rostared to work. However, there were occasions when staff were taken from the home to cover escort duty in the day centre. The operations manager confirmed that this was no longer an issue as several staff had been redeployed to the home, which had improved the staffing levels within the home and day centre. A training and induction programme for staff was in place enabling them to meet the assessed and changing needs of service users. Staff confirmed that they had attended various training courses that included food hygiene, adult
Hazlehurst DS0000035749.V254883.R01.S.doc Version 5.0 Page 18 protection, moving and handling and First aid. Staff commented that a good range of training was available appropriate to their job role to ensure that they were up to date with all the statutory training required by the regulations. The operations manager confirmed that over 50 of the staff team had achieved the NVQ level 2 in care and that the remaining staff were in process of undertaking the award. A robust recruitment policy and procedure was in place. Two files checked contained a good range of information including two references, declaration of health and qualifications/training. All staff employed had undertaken a Criminal Records Bureau Check at the enhanced level to promote the protection of service users. Hazlehurst DS0000035749.V254883.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): 31,35 and 38. Staff morale appeared good and all staff spoke positively above the management team. Service users financial interests were safeguarded by the procedures at the home. The homes policies and procedures promoted the health, safety and welfare of service users and staff. EVIDENCE: The atmosphere within the home was relaxed and the day-to-day management of the home appeared well organised. Staff said that they were supported by the management team and commented that all were “helpful and approachable”.
Hazlehurst DS0000035749.V254883.R01.S.doc Version 5.0 Page 20 Arrangements were in place for residents who were unable to or chose not to manage their monies. Monies were securely stored and records checked evidenced that service users were able to access their monies for hair care and personal items as they wished. Systems were in place to protect service users from financial abuse and the senior staff carried out regular checks. The home was well maintained and all areas seen were clean and safe. Records of fire drills were improved. The records checked detailed the date of the drill and the person conducting the drill. All staff had received fire training at the required frequency. The staff had received regular training to promote the health, safety and welfare of service users and their colleagues. Hazlehurst DS0000035749.V254883.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 X X 3 X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 3 10 2 11 X 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 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X 3 X X 3 Hazlehurst DS0000035749.V254883.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? Yes. 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 12 Requirement Care plans must include service users preferences as to whether they prefer a male or female carer to attend to their personal needs. Wherever possible service users must be given a choice about receiving care from a male of female carer. Timescale for action 30/03/06 2 OP10 12 16/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Hazlehurst DS0000035749.V254883.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Sheffield Area Office Ground Floor, Unit 3 Waterside Court Bold Street Sheffield S9 2LR National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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