CARE HOMES FOR OLDER PEOPLE
Hazlehurst 1 Dyche Drive Jordanthorpe Sheffield S8 8DN Lead Inspector
Shirley Samuels Unannounced 7 July 2005 14:45 -19:15
th 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. Hazlehurst J55 S35749 Hazlehurst V230032 07.07.05 UI Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Hazlehurst Address 1 Dyche Drive Jordanthorpe Sheffield S8 8DN 0114 2037703 0114 2037703 Not known Sheffield City Council 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) Mrs Linda Dutton PC Care Home Only 24 Category(ies) of OP Old age - 24 registration, with number of places Hazlehurst J55 S35749 Hazlehurst V230032 07.07.05 UI Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: Conditions of this registration are listed on the registration certificate displayed at the service. Date of last inspection 7th December 2004 Brief Description of the Service: Hazlehurst is a single storey purpose build home, in the Jordanthorpe area of Sheffield. The home provides a service on a 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 hospital 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 dining rooms, lounges, toilets and bathrooms areas sufficent 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 J55 S35749 Hazlehurst V230032 07.07.05 UI Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out over four and a half hours. Seven service users, one visitor, five staff and the manager of the home were spoken to. A notice was displayed in the entrance to the home informing visitors that an inspection was taking place, and inviting them to make comments about the service if the wished. Observations were made of the care provided and the interaction between service users and staff. A selection of records was examined and an inspection of the building was made. What the service does well:
Before admitting someone into the home, the staff made sure they had the information they needed to make a judgement about whether they could support a person or not. Health care needs were met. Service users who lived permanently at the home received regular visits from chiropodist, dentist, opticians, etc. For service users on various short-term stays, health professional were requested as needed. Some service users said while on a short stay at the home they were able to see their own Doctor even though the home was out of the area. Service users were treated with respect and their right to privacy was upheld. Those spoken to said, “The staff are excellent” “ I don’t know what I would have done without them they do their work in a caring way” “they spoil me just like I used to spoil those I used to look after”. The routines and lifestyle experienced in the home was what service users expected. Contact with friends and family were encouraged and all visitors were made welcome. Service users said they were able to choose how to spend their time. They said they were involved in planning the self-help activities they needed to do to prepare themselves for returning home. The meals provided were wholesome appealing balanced and were served in pleasing surroundings. Service users knew how to make a complaint and felt they would be listened to. An extensive refurbishment had been completed, the home was well decorated, safe and clean. There was in the main, enough staff on duty to meet service user needs. Service users said they felt safe and reassured by the staff. Staff said they felt the environment was safe for service users to live in and for them to work in. Hazlehurst J55 S35749 Hazlehurst V230032 07.07.05 UI Stage 4.doc Version 1.30 Page 6 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 J55 S35749 Hazlehurst V230032 07.07.05 UI 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 Hazlehurst J55 S35749 Hazlehurst V230032 07.07.05 UI 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) 3 Service users did not move into the home without having their needs assessed and being assured that these need could be met. EVIDENCE: Three service user files were checked all included an assessment, which detailed service users needs. Staff said these assessments were always received prior to someone moving into the home. Enabling the staff to make a judgement about whether or not they could meet the individuals needs. Service users said they were aware that an assessment was completed, they were told about the home and knew what to expect. Others had been in the home many times and said, “ it’s like my second home” “ I always look forward to coming it gives my daughter a break and she can relax because she knows I an safe”. Hazlehurst J55 S35749 Hazlehurst V230032 07.07.05 UI 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) 8 &10 Service users health care needs are fully met, they feel they are treated with respect and their right to privacy upheld. EVIDENCE: Service users were encouraged to maintain independence in line with their assessment and care plan. They were assisted to obtain appointments with health care professionals. With the aim of preparing them for independent living outside of the home. Some service users said they were able to see their own GP even though they were out of the area. Promoting confidence and a sense of wellbeing. Equipment needed for the safe moving and handling of service users was provided. Staff said records were kept of health appointments and treatment promoting service users and staff health and wellbeing. Staff said they respected the privacy and dignity of service users by “knocking on doors”, “offering choices and explaining options”, “ Providing dignity and being sensitive while providing personal care”. To reduce the risk of embracement.
Hazlehurst J55 S35749 Hazlehurst V230032 07.07.05 UI Stage 4.doc Version 1.30 Page 10 Service users said “I can do most thinks for myself but if I do need help staff are very sensitive”, “I trust the staff, they do seem to know what they are doing” “there is always staff when I need them”, “they always knock they are well mannered and polite”. Staff said they always offer service users a choice of male or female carer. One service user said she was not given a choice. No complaints were received about how the male carer assisted her but said she felt embarrassed and would have preferred a female. This was feedback by the inspector to the person in charge. Hazlehurst J55 S35749 Hazlehurst V230032 07.07.05 UI 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, 14 &15 The lifestyle experienced at the home matched with service users expectorations and preferences. They were able to maintain contact with friends and family and were helped to exercise choice and control over their lives. Service users received a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. EVIDENCE: Service users said they were told about the home before they moved in. In each bedroom there was written information about the home as well as information on how to make a complaint. Ensuring that service users knew what to expect. Service users said they were able to spend their time as they wished, that staff respected their choices and preferences. Ensuring service users were able to exercise control over their lives. Service users said visitors were always made welcome and offered a drink. One visitor who completed a questionnaire confirmed this. Service users maintained links with friends and family. This promoted their sense of wellbeing and belonging.
Hazlehurst J55 S35749 Hazlehurst V230032 07.07.05 UI Stage 4.doc Version 1.30 Page 12 Service users said the food was “excellent”, “plentiful”, “varied”, “ I had lost my appetite, look at me now I’m putting on weight, it’s wonderful”, “I love the food, dinners are smashing”. Hazlehurst J55 S35749 Hazlehurst V230032 07.07.05 UI 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 Service users and their relatives and friends are confident that their complaints will be listened to and taken seriously. EVIDENCE: Each service user had written information on how to make a complaint. Service users said they did have someone to talk to if they were unhappy. Staff said if a service user made a complaint they would report it to the person in charge, and reassure the service user that it would be taken seriously and action would be taken. Service users said they were more than satisfied with the service and had no complaints. Demonstrating that the services being provided were meeting service users expectation and needs. Hazlehurst J55 S35749 Hazlehurst V230032 07.07.05 UI 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 & 26 Service users live in a safe well-maintained environment, which is clean pleasant and hygienic. EVIDENCE: Service users said the home was “Lovely and clean” “ my room is very comfortable, it has all the facilities I need”. Refurbishment had recently taken place, and all areas were well decorated and furnished. Providing a comfortable, light and airy environment. Hazlehurst J55 S35749 Hazlehurst V230032 07.07.05 UI Stage 4.doc Version 1.30 Page 15 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) 27 & 30 The numbers and skill mix of staff meet service users needs, Staff are trained and competent to do their jobs. EVIDENCE: Staff rotas were checked these showed that sufficient staff were being rostered to work. Staff said that on many occasions they were taken from the home to cover escort duty for the day centre. Reducing the staff available to support service users in the home. Staff said the impact on service users was minimal as the home was often not at full occupancy and team leaders would assist where needed. The manager said there were staff vacancies which were being covered by agency staff, they were unable to recruit to some vacancies as staff from another home were due to be redeployed. Existing part time staff did what they could to cover the rota where needed, but last minute absences sometimes caused shortages. Staff said they received statutory training e.g., moving and handling, first aid, health and safety etc. Specialist training was provided in relation to rehabilitation, physiotherapy and independent living skills. Enabling staff to provide the support to help service users return home. Some staff had achieved the NVQ level 2 in care, for others it was ongoing with plans for the remaining staff to commence in the near future.
Hazlehurst J55 S35749 Hazlehurst V230032 07.07.05 UI Stage 4.doc Version 1.30 Page 16 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) 38 The health, safety and welfare of service users and staff are in the main promoted and protected EVIDENCE: Service users said they felt safe at the home, security measures were in place to prevent intruders, and staff had received health and safety training. Records showed that the fire system was checked at the required frequency, and that staff received fire instruction. Records showed that one member of staff had not received training in the last six months. Records of the last fire drill did not detail the date and the person conducting the drill. The manager in charge was served with an immediate requirement to check the records and ensure that all staff receive fire training at six monthly intervals. Hazlehurst J55 S35749 Hazlehurst V230032 07.07.05 UI Stage 4.doc Version 1.30 Page 17 All hazardous substances were appropriately and safely stored ensuring a safe environment. Staff said the environment was safe for them to work in and for service users to live in. Hazlehurst J55 S35749 Hazlehurst V230032 07.07.05 UI 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 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 2 28 x 29 x 30 3 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 2 Hazlehurst J55 S35749 Hazlehurst V230032 07.07.05 UI Stage 4.doc Version 1.30 Page 19 Are there any outstanding requirements from the last inspection? NO 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 10 Regulation 12 Requirement Wherever possible service users must be given a choice of recieving personal care from a male or female carer. Where additianal services are provided eg day care, outreach, escort duty, staff must be over and above that required for the care home. Aqurate records must be kept of fire drills, these must include the date and who conducted the drill. All staff working at the home must receive fire instruction twice yearly. Timescale for action 16/6/05 As required on the day of the inspection. 20/7/05 2. 27 18 3. 38 17 20/7/05 4. 38 23 16/6/05 as required on the day of the inspection. 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.
Hazlehurst J55 S35749 Hazlehurst V230032 07.07.05 UI Stage 4.doc Version 1.30 Page 20 Refer to Standard Good Practice Recommendations Commission for Social Care Inspection 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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