Inspection on 12/07/06 for Hazlemere Lodge

This inspection was carried out on 12th July 2006.

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

The inspector 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

Hazlemere Lodge 24/07/08

Hazlemere Lodge 22/11/05

Hazlemere Lodge 27/07/05

Similar services:

St Vincents

The Cotswold Home

Winton House

Newbeech House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Hazlemere Lodge Cedar Avenue Hazlemere High Wycombe Buckinghamshire HP15 7DW Lead Inspector Mrs Caroline Roberts Unannounced Inspection 12th July 2006 10:15 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 Hazlemere Lodge DS0000064210.V302554.R01.S.doc Version 5.2 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. Hazlemere Lodge DS0000064210.V302554.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hazlemere Lodge Address Cedar Avenue Hazlemere High Wycombe Buckinghamshire HP15 7DW 01494 767800 01494 767888 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) www.heritagecare.co.uk Heritage Care Manager awaiting registration Care Home 64 Category(ies) of Dementia (16), Old age, not falling within any registration, with number other category (16) of places Hazlemere Lodge DS0000064210.V302554.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd November 2005 Brief Description of the Service: Hazlemere Lodge is a care home providing nursing care to 32 older people, 16 frail elderly residents and 16 residents with a diagnosis of dementia. The home is divided into 4 groups of 16; each group has a good-sized lounge, dining area and small kitchen area. All of the bedrooms are single occupancy and have ensuite facilities. The home is comfortably furnished and well decorated. The gardens have been landscaped and provide a safe and attractive area for residents to enjoy in the better weather. The home is situated next to a school and within walking distance of shops and the bus route. Hazlemere Lodge DS0000064210.V302554.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the summary of the un-announced inspection carried out at Hazlemere Lodge on the 12th July 2006. The majority of all inspections conducted by The Commission for Social Care Inspection will be unannounced. The lead inspector was Mrs Caroline Roberts. The inspection consisted of meeting with residents, staff and visitors, viewing records and documents pertaining to the provision of care and the running of the home. Evidence gained from this has formed the judgements for this report. The inspector toured the building, gaining permission from a number of residents to enter their bedrooms and viewing a further number from the doorway. The inspector met and discussed the inspection findings with the manager and regional manager prior to leaving. The inspector found staff polite, helpful and welcoming, and would like to thank them for their co-operation and assistance throughout the course of the inspection. The inspector would especially like to thank the residents for their time and for allowing the inspector into their home. What the service does well: What has improved since the last inspection? Hazlemere Lodge DS0000064210.V302554.R01.S.doc Version 5.2 Page 6 The home has only been open for 1 year and the staff have gone through a period of great change from transferring from the old Catherine Knapp home, which was not purpose built and much smaller than Hazlemere Lodge. At this inspection the staff team appeared co-hesive and well organised. A lot of time has been spent updating Care plans and admitting new residents this has been very well managed by the home. 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. Hazlemere Lodge DS0000064210.V302554.R01.S.doc Version 5.2 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 Hazlemere Lodge DS0000064210.V302554.R01.S.doc Version 5.2 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): 1,3,6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All of the assessments evidenced were completed fully and clearly and demonstrated that the home was able to meet the identified needs of the individual prior to admission to the home. Intermediate care is not provided at this service. EVIDENCE: The home has developed a service user guide as part of the welcome pack for new residents. Copies of this are available in the entrance area of the home. This document contains information about the Organisation and details about the home, to enable the resident to make an informed choice about moving into the home. All residents have an assessment undertaken by the manager or one of the senior staff prior to admission and are only offered a trial placement if they feel that all of their needs can be met at Hazlemere Lodge. For residents referred through care management (Social Services or the Primary Care Trust) a health Hazlemere Lodge DS0000064210.V302554.R01.S.doc Version 5.2 Page 9 and social service assessment is also obtained to ensure that the needs of the individual can be met. Intermediate Care is not provided in this home. Hazlemere Lodge DS0000064210.V302554.R01.S.doc Version 5.2 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 Quality in this outcome area is Good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. There is a clear care planning system in place to adequately provide staff with the information they need to satisfactorily identify and meet resident’s individual needs. There are clear medication policies and procedures for staff to follow to ensure that residents are safeguarded with regards to medication. Residents are treated with respect and the arrangements for their personal care ensure that their right to privacy is upheld. EVIDENCE: Individual plans of care were available for each resident and the records of four residents were examined. The records for these residents were found to be generally detailed and comprehensive and followed on from a full assessment of the residents needs. There was evidence that the care plans are reviewed on a monthly basis and updated to reflect changing needs. The records indicated that residents are seen by other health care professionals such as dentists, chiropodists, GP’s and specialist nurses, for example diabetes nurses. Hazlemere Lodge DS0000064210.V302554.R01.S.doc Version 5.2 Page 11 The specific care plan of one resident suffering from diabetes needed further developing as did not provide adequate information about this particular condition and clear instructions for the homes staff, this was discussed with the manager and a requirement is served. The care plans contain assessments and plans for all health related matters. This includes risk assessments for falls, pressure sores and general dependency. These are regularly updated, and more frequent updates are made when the residents needs change. The home has clear medication policies and procedures for staff to follow. Discussions with staff and a review of medication storage and records show that the majority of staff are following the policies and procedures, however some unexplained gaps were noted on the medication administration sheets, these were for creams administered by staff, the manager needs to ensure that all prescribed medications including creams are signed when given. Medication is stored appropriately with systems in place for the receipt and disposal of medications. All staff responsible for administering medication undertake appropriate training. Staff talked about and were observed to treat residents’ in a respectful and sensitive manner. They understood the need to respect an individuals dignity through practices such as the way they addressed residents and when entering bedrooms and bathrooms. One resident who has lived at the home for about one year commented, “ I am well cared for”. Hazlemere Lodge DS0000064210.V302554.R01.S.doc Version 5.2 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, Quality in this outcome area is good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. Residents interests and previous lifestyle are taken into consideration when developing care packages and contact with family and friends is encouraged. The food is well presented and appeared appetising and nutritious. EVIDENCE: The home employs a dedicated activities organiser. A structured programme of activites is offered on a daily basis, meetings are arranged to include the views and wishes of the residents. Church services are aranged via the local church. Routines in the home are arranged around residents needs as much as possible. The home do not have restrictions on visiting hours, except visiting during the night would need to be pre-arranged and under exceptional circumstances. Family and friends can meet in residents own bedrooms or one of the lounges, family can stay for meals with prior arrangement. Most of the bedrooms in the home show that residents are able to bring items of their own furniture to personalise their rooms. Residents are involved in the care planning process. Hazlemere Lodge DS0000064210.V302554.R01.S.doc Version 5.2 Page 13 Lunch was observed being served and the food was of a good quality. Each group has a dining area, all were pleasant and the mealtime was relaxed. Good interaction was taking place between staff and residents who required support with eating their meal. Hazlemere Lodge DS0000064210.V302554.R01.S.doc Version 5.2 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): 16,18 Quality in this outcome area is good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. The home operates a transparent approach towards complaint investigations. POVA policies are available in the home and staff are trained in this area. EVIDENCE: Complaints are logged by the home and investigated fully with records maintained as was evidenced in viewing the complaint folder. The Complaints policy is available to residents and relatives. Monitoring of any complaints is conducted by the regional manager with a return sent to head office quartelty detailing any complaints made and action taken as a result. Local adult protection polices are in place and made available to staff. Heritage Care appointed its own POVA trainer in 2005 who is responsible for facilitiating this training across all of the homes. Staff spoken with understood the meaning of POVA and had an understanding of ther types of abuse that could occur, and what to do if they suspected any abuse. Hazlemere Lodge DS0000064210.V302554.R01.S.doc Version 5.2 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): 19,26 Qulaity in this outcome area is good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. Residents live in a safe and very well maintained environment EVIDENCE: The home was warm and welcoming, all parts of the home seen were well maintained and tastefully decorated. All furnishings are of a very high quality, clean and well maintained. It is evident that the provider is committed in maintaining the very high standards of décor with particular attention to detail. Residents live in comfortable bedrooms with a vast amount of their own personal belongings. Bedrooms are spacious, personalised and allow for a sitting area. All of the bedrooms have en-suite facilities. The home has bathrooms that are well equipped with assisted baths and equipment to maintain residents independence such as grab rails and hoists. Hazlemere Lodge DS0000064210.V302554.R01.S.doc Version 5.2 Page 16 The home has an internal laundry that was well maintained. Infection control procedures were in place. In particular there was a good system in place for dealing with soiled laundry. Staff were observed to follow these guidelines, equipment such as gloves and aprons were available. The gardens are well maintained and provide ample seating for residents to enjoy the good weather. Hazlemere Lodge DS0000064210.V302554.R01.S.doc Version 5.2 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, Quality in this outcome area is good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. The procedures for the recruitment of staff are robust and provide safeguards for people living in the home. Residents benefit from a committed staff team who have the skills and training to meet their needs. Staffing levels are sufficient to meet the personal and nursing needs of the residents. EVIDENCE: There is a recorded staff rota displaying which staff are on duty throughout the day and night. There is always a senior on each group and a nurse on the nursing unit. Staffing levels are currently: One nurse and 3 carers on each of the nursing units plus a 12-7pm carer who assists on both of the groups. One senior plus 1 or 2 carers on the residential group. One senior plus 2 carers on the dementia care group. Hazlemere Lodge DS0000064210.V302554.R01.S.doc Version 5.2 Page 18 In addition to the staffing levels detailed above the manager, deputy manager and matron all have supernumery hours. A full time administrator supports the management of the home. Support, kitchen and maintenance staff are also employed at the home. The information on the duty rota was consistent with the names and delegations of the staff on duty. Regular meetings are held for care staff and qualified nurses to discuss both clinical practice and care related issues. Heritage Care have a designated employment co-ordinator who is based at Hazlemere Lodge, this person is responsible for co-ordinating all of the employment related issues and ensuring appropriate references and CRB disclosures are received prior to any person commencing employment. There is an in house training programme for carers and nurses. Mandatory training in essential areas such as, manual handling, food hygiene and fire safety is being undertaken at the required intervals. All staff receive individual supervision 8 weekly. Hazlemere Lodge DS0000064210.V302554.R01.S.doc Version 5.2 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): 31,33,35,38 Quality in this outcome area is good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. A very experienced and qualified person manages the home. The homes record keeping safeguards Resident’s best interests. Monitoring visits are undertaken by the organisation to monitor and report on the quality of the service, copies of these visits are forwarded to the Commission. EVIDENCE: The new manager had only commenced her position 3 days prior to the inspection although she has worked for Heritage Care as a manager in another home for 4 years, and had recently been helping the home develop the nursing units. The manager has substantial experience of working at a senior level (for Hazlemere Lodge DS0000064210.V302554.R01.S.doc Version 5.2 Page 20 example manager). She was described as being approachable and caring by the staff. An organisational quality assurance tool is used in the home, this is conducted by other managers within Heritage Care, the action plan following the last quality assurance audit was viewed and a letter to residents and families from the Director of Older Peoples Services thanking them for their assistance with the audit and reporting back the strenghts and weaknesses of the service. The homes financial system is computerised with manual records maintained. The home retains all records of expenditure including reconciliation accounts. Service agreements are in place for safety testing of lifts, hoists, bath hoists, fire alarms, fire equipment, and electrical items for which records are maintained by the manager these include periodic internal Health & Safety checks of the home. Hazlemere Lodge DS0000064210.V302554.R01.S.doc Version 5.2 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 X 3 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 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 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Hazlemere Lodge DS0000064210.V302554.R01.S.doc Version 5.2 Page 22 NO 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 OP9 Regulation 13(2) Requirement Timescale for action 01/08/06 2. OP8 13(3)c 3 OP7 15 The manager must ensure that staff sign the medication administration sheets for all prescribed medications given. The manager must ensure that 01/10/06 staff are fully trained to meet the needs of residents with specific health care needs, (e.g. Diabetes blood sugar monitoring). Care plans addressing specific 01/08/06 healthcare needs, (e.g., Diabetes), are to provide adequate detail to allow the staff to meet this individuals need fully. 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 Hazlemere Lodge DS0000064210.V302554.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Aylesbury Area Office Cambridge House 8 Bell Business Park Smeaton Close Aylesbury HP19 8JR 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 Hazlemere Lodge DS0000064210.V302554.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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