Inspection on 16/01/08 for Hazlewell

This inspection was carried out on 16th January 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Hazlewell 03/03/10

Hazlewell 02/06/09

Hazlewell 18/12/08

Hazlewell 23/06/08

Hazlewell 16/07/07

Hazlewell 21/04/06

Hazlewell 26/08/05

Hazlewell 14/04/05

Hazlewell 01/09/04

Hazlewell 22/04/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Hazlewell 29-31 Hazlewell Road Putney London SW15 6LT Lead Inspector Sharon Newman Key Unannounced Inspection 16th January 2008 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Hazlewell DS0000019097.V348454.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. Hazlewell DS0000019097.V348454.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hazlewell Address 29-31 Hazlewell Road Putney London SW15 6LT 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) 020 8788 8753 020 8248 5954 Mr D Patel Rosemary Carmen Molloy Care Home 29 Category(ies) of Dementia - over 65 years of age (2), Old age, registration, with number not falling within any other category (29) of places Hazlewell DS0000019097.V348454.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Dementia The home may provide accomodation and care for two named service users with dementia. The category DE(E) must be removed once these named service users are no longer accomodated. 16th July 2007 Date of last inspection Brief Description of the Service: Hazlewell is a twenty-nine bedded care home providing nursing care for older people. The property consists of two semi-detached Victorian houses that have been joined together to make one home. The home is on three storeys and has been extended to the rear with a large conservatory. There is a large rear garden with a patio area available. Hazlewell is situated in a quiet residential street reasonably close to available shops and transport links in Putney. Information about the home is provided to residents in a written guide. The current fees are £650.00 per week. Hazlewell DS0000019097.V348454.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. The inspection of this service included an unannounced visit to the home on 16th January 2008 by two regulation inspectors. The manager was available for discussions about the service. We also spoke to some staff and residents. The manager and staff were welcoming and helpful throughout the inspection. A pharmacy inspector will also visit the home to look at medication and will write a separate report. We looked at information including staff recruitment information, residents care plans and health and safety documentation. We also looked at the premises. An annual quality assessment (AQAA) was completed by the manager and sent to us, this is a self assessment of the service. We sent surveys to the home before this visit for staff and the people who live at this home to complete and return to us. However only four were returned before this report was finished. These responses were positive about the home. What the service does well: What has improved since the last inspection? Two bedrooms have had their ceilings repainted and re-plastered. Wound care documentation has improved so that the progress of wounds can be more clearly seen. Hazlewell DS0000019097.V348454.R01.S.doc Version 5.2 Page 6 Staff training has improved and the induction programme has been updated. 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. The summary of this inspection report can be made available in other formats on request. Hazlewell DS0000019097.V348454.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 Hazlewell DS0000019097.V348454.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The needs of residents are assessed prior to admission to help make sure that the home can meet these. The written guide for residents and the Statement of Purpose both need updating to provide good information to residents. EVIDENCE: The manager carries out an assessment of potential residents needs prior to them coming to the home. She reported that potential residents are invited to come and visit the home with their relatives to see if they think that the home will meet their needs. She was heard talking on the phone to relatives advising them that they should come to the home to see what it can offer. Information about the home is given to people when they come to visit. However the residents guide has not yet been updated, it contains out of date Hazlewell DS0000019097.V348454.R01.S.doc Version 5.2 Page 9 information about the Commission for Social Care Inspection (CSCI). It also includes out of date information about making complaints and ‘a typical day’ at the home. The guide must also accurately state the choice on offer to residents at mealtimes. The Statement of Purpose also needs to be updated. The complaints policy within this document has not been updated. It also reports that the home offers ‘intermediate care’ which is a specialised service requiring on-site physiotherapy and occupational therapy in a dedicated gym. This entry needs to be removed. The fees stated are out-of date. The Statement of Purpose also states that fresh fruit is not included in the fees. A relative commented “I would recommend (the home) to anyone wanting a warm, homely atmosphere with kind caring people.” Hazlewell DS0000019097.V348454.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The residents files contain detailed nursing care plans, to help staff to meet their health care needs. However they are not person centred and do not contain enough information about residents social needs. The recording of wound care has improved. Staff have now received training in wound care and still require up-to-date training in diabetes care and continence care. EVIDENCE: The residents care plans that we looked at contained a lot of information. The nursing care plans were detailed and regularly updated. This enables staff to meet residents’ health care needs. However we discussed with the manager and deputy manager that they need to be more person centred. There also needs to be more detailed information about residents’ likes, dislikes, life histories and the activities that they enjoy participating in. The daily care notes Hazlewell DS0000019097.V348454.R01.S.doc Version 5.2 Page 11 consisted largely of entries such as “washed, dressed and toileted.” These need to contain more information about how the residents social needs are being met. In one file a form regarding arrangements after death had not been completed. The assessment form was completed by the manager, regarding areas such as respiration, circulation and mobility, it states that resident ‘likes to wash their own face’. The ‘lifestyle’ page asks the time the resident likes to get up/ go to bed, food likes/ dislikes and these were not all completed. In one resident’s file the form for the relative to sign to say that they agree with the care plan was not signed. The care plans need to show that the residents and/or their relatives have been involved in their plan of care and agree. One care plan looked at was more individualised and contained instructions such as ‘speak slowly, quietly and calming.’ Risk assessments were in place for a nebuliser, lamp, TV and falls. Wound care recording has improved since the last inspection visit. Comprehensive documentation was seen in residents files regarding wound care and photographs have been taken to demonstrate the progress of a wound. Evidence was seen to show that staff training has taken place in wound care. However, training in diabetes care and continence care has not yet taken place and staff need to be aware of best practice in these areas. They must also be aware of the current best practice guidelines in relation to wound care from the National Institute of Clinical Excellence (NICE) and the local PCT. Evidence was seen in the residents’ files of visits from health care professionals including GP’s. A relative commented that their family member was “clean and always in a clean nightdress with clean hair” whenever they visited. Hazlewell DS0000019097.V348454.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Activity provision remains limited and only some activities meet the needs of the people who live here. Residents are able to maintain contact with family and friends. Residents are not always offered choice with regard to meal times or when to rise in the morning or go to bed. This service does not provide sufficient quantities of fresh food for residents including fruit and vegetables. This may have an impact on their health. EVIDENCE: The only activity to take place during our visit was when staff played some music to the residents. The TV was left on during this time with the sound turned down. Staff informed us that activities on offer include occasional karaoke and singalongs. They reported that some residents like watching the squirrels in the Hazlewell DS0000019097.V348454.R01.S.doc Version 5.2 Page 13 garden. Staff reported that music was played during the day for the residents as ‘an activity.” One resident told us “ I like watching the nurses dancing and jumping, it’s better than doing nothing.” Another said “There’s not much to do here.” There was little evidence that external activities are arranged for residents and the manager spoke of the difficulty of arranging these activities without sufficient staff numbers. This service must try to offer a choice of outside activities for residents. Residents meetings are not held at the home and this is an area that the home need to improve upon. Residents and relatives choice and wishes must be taken into account regarding the running of the service. The manager reported that relatives are welcome at the home. Some residents told us that they are woken very early and given their breakfast. One reported being woken at five–thirty in the morning. They reported that they “have to get up whenever they come to get you, I can’t do anything so I have to wait for them.” They also told us that after being given their breakfast they then lie in bed until a staff member comes to get then up later in the morning. Another resident reported that they were given their breakfast at six o’ clock and that they were “starving” by lunchtime. Some residents also told us that they are put to bed very early, - some as early as five-thirty in the afternoon. Residents must be given choice about when to rise and go to bed, they must also be given choice about the times they would like to take their meals and this information must be recorded in their care plans. Comments about the food varied, one resident told us “the food is ok” another said that they were given “one portion of very dead vegetables” with their main course. When we looked at the food kept in the kitchen we saw a large proportion of frozen food. We spoke to the cook who reported that the only fresh vegetables provided were cabbages and occasionally carrots. They said that the only fruit offered to residents was tinned fruit. We were informed that the Provider organises the purchases of food and that “he buys a bag of grapes every now and then…”This is not acceptable and residents must be offered a range of fresh fruit and vegetables daily. One resident was observed to have brought in their own fruit and salad. We observed that the desserts were plated up alongside the main course on trays at lunchtime. This meant that the icecream was melting. This course should be served after the main course. This is again an institutional practice and must stop. The residents do not have a separate dining area and this does not promote a sociable atmosphere at mealtimes. They have to sit in their armchairs in the lounge and use small individual tables. The manager wrote in the AQAA (the Hazlewell DS0000019097.V348454.R01.S.doc Version 5.2 Page 14 self assessment survey) that they are going to look at providing an area where residents can sit at a table to eat if they wish. Hazlewell DS0000019097.V348454.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The complaints procedure that is supplied to residents on admission to the home still needs updating. Not all staff are aware of the procedures to be followed with regard to an allegation of abuse despite training in this area. This may present a risk to the people who use this service. However a staff training programme is taking place in the area of safeguarding vulnerable adults. EVIDENCE: As found at the previous inspection visit the home keeps a record of complaints however the complaints procedure contained in the guide for residents requires updating as this refers to the National Care Standards Commission which is no longer in existence. This requirement remains outstanding. This out of date complaints procedure was seen hanging in many resident’s bedrooms. An up-to-date copy of the new Wandsworth Safeguarding Vulnerable Adults Procedures (SOVA) was available and many staff have now attended the Safeguarding Vulnerable Adults training provided by the London Borough of Wandsworth. However two staff spoken to were unaware of the procedures to follow. This could place residents at risk. All staff must know the procedures to follow when an allegation of abuse is made. The manager reported that she Hazlewell DS0000019097.V348454.R01.S.doc Version 5.2 Page 16 would ensure all staff are aware and that those who have not attended training in safeguarding vulnerable adults will attend this year. Hazlewell DS0000019097.V348454.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 Quality in this outcome area is poor This judgement has been made using available evidence including a visit to this service. This service still does not present as homely due to the environment which looks tired, shabby and dated. This home is poorly maintained and decorated. Standards of cleanliness need to improve. EVIDENCE: As stated in the previous inspection report there are many areas that need to be addressed regarding the environment and requirements from previous inspection visits have still not been met. Many carpets throughout the home look dirty and marked/stained. Some of the carpets in the bedrooms do not completely cover the floor and look unsightly. Some carpets may present a trip hazard to residents, visitors and staff as they are peeling away from the floor. Hazlewell DS0000019097.V348454.R01.S.doc Version 5.2 Page 18 Paintwork throughout the home is peeling and some walls are stained with brown marks. Flooring in bathrooms and toilets is stained and marked. Again as stated in the previous inspection report the beds in many of the bedrooms throughout the home are very old fashioned and make the home feel institutional. These need to be replaced. This issue has also been raised by inspectors at previous inspection visits. Storage throughout the home continues to be a problem as wheelchairs, mattresses and bed equipment are stored in communal areas throughout the home. This gives the home an institutional feel. We were informed that the top floor bath is still not working. We were informed that there is an issue that the “…bath takes hours to fill up…”, residents have to be brought down to first floor to bathe. The manager also said the hoist in the bathroom is ‘dangerous’. As stated in the previous inspection visit this facility would benefit from being turned into an adapted shower or bath for the residents use. At present residents have to be taken down to the next floor for a shower. The broken bath panel in this room and in the first floor bathroom need to be fixed. In one bathroom the adapted toilet surround is in need of replacing, along with the ‘patched-up’ arm rest. The plug socket in room 21 needs to be looked at by a qualified electrician as it looks poorly fitted and there are gaps in the wall surrounding it. The area in the bedroom where ceiling plaster fell onto a resident has now been re-plastered which is an improvement. The garden is a good size and has the potential to look good, however it looks poorly maintained. A resident reported that they are only taken out there ‘twice a year.’ A resident said that they “like it here but it is shabby and could do with a facelift.” The bin in the kitchen was broken as there was no foot pedal. This must be replaced as it is not hygienic. Attention need to be paid to cleanliness - in bedroom 17 the metal strip to hold flooring on entry to the room was broken and covered with thick dirt. The flooring in the toilet/ shower room on the first floor is stained and needs replacing, along with making good the gap on the floor in front of the shower. The shower was also dirty and needs cleaning. Hazlewell DS0000019097.V348454.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Staff are appropriately trained to help ensure that they can carry out their roles. They also have a caring attitude. Residents and relatives speak highly of staff. Staff files do not contain all required information and this may place residents at risk. EVIDENCE: As found at the last inspection visit staff at the home were observed to behave in a courteous and professional manner and they help to create a friendly atmosphere at the home. Residents spoke highly of the staff. A relative told us that “the care (their relative) receives is very good. The staff are very good at providing all the help and care he needs to help (them) get through the day.” They also commented that the staff are “friendly and caring.” A resident said that “nothing is too much trouble for the staff to do for them, to enhance their comfort.” A visitor wrote, “ I always notice how caring the staff are. They are so kind and patient with the elderly people who are made to feel at home.” Hazlewell DS0000019097.V348454.R01.S.doc Version 5.2 Page 20 Many of the residents at this home require a lot of care and attention from the staff. There are only two members of staff on at night to look after up to twenty-nine residents. We were informed that there are currently twenty-two residents living at the home. The organisation must ensure that there are sufficient numbers of trained, competent and permanent staff on duty at all times. This is to help ensure continuity of care for residents and that their needs are met. There must be enough staff to ensure that residents can rise and go to bed at the times that suit them and have breakfast at times that suit them and not the needs of the service. A resident said that they get ‘excellent care” but that the home “could do with more staff.” There is a clear training log that indicates all the training that staff have undertaken such as moving and handling, first aid and health and safety. Staff have also received training in dementia care to help them carry out their roles more effectively. They are also offered the opportunity to attend NVQ training programmes. Staff spoken to reported that they received good training at this home. The induction programme for new staff has been updated and this now conforms to Skills for Care standards. We looked at a sample of staff recruitment files. We found no evidence of colour photos or contracts in the files looked at and these must be obtained. In one file the application form was incomplete and not signed by applicant, also there was no opportunity to declare any previous convictions. It contained evidence of induction and two references. However there was no copy of identification. The contract of employment was blank - not signed by provider, manager or staff member. Another file was similar however it did contain a copy of their passport which includes a copy of their residence permit which states ‘limited leave to remain’, though there was no record of limitations from the Home Office in their file. We looked at their Criminal Record Bureau (CRB) list however some entries stated ‘mislaid’, or were ticked ‘yes’, with no record of date of issue, some CRB’s were issued in the names of different employers. The home must provide evidence that CRB checks have been obtained by this service and they must be obtained for all employees to help to ensure that residents are not placed at risk. The manager wrote in the self assessment of the service (AQAA) that she tired to: “inspire motivation among the staff – aspire to a high standard of care, boost morale and maintain a harmonious atmosphere which is important and crucial to the tranquillity and well being of the residents.” Hazlewell DS0000019097.V348454.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. As stated in the previous inspection report there are many areas that require improvement throughout the home The manager is well-liked at the home by residents. Staff speak highly of the manager. There is insufficient evidence to demonstrate that adequate health and safety checks are being carried out at the home. The home has old-fashioned facilities in terms of office equipment. There is no business plan to indicate the future plans for this home. EVIDENCE: Hazlewell DS0000019097.V348454.R01.S.doc Version 5.2 Page 22 The manager has worked at this home for many years and is very experienced. She has achieved the Registered Manager Award. She is very committed to the home, on the day of inspection she had worked the previous day and night and also worked the day of inspection. She reported that she had been unable to replace a member of staff who was unable to come in for their shift so remained at the home to cover the night duty. The manager and deputy manager were very helpful and professional throughout the visit and both displayed a caring attitude to the residents. It is apparent that they work hard but are frustrated that there has not been much progress since the previous inspection. A staff member reported that “Matron is good and tries her best.” A resident told us that the manager was persistent in sorting out any issues they raised even if it meant staying on for hours after her shift had finished. They said that the matron and “weekend” matron were both “excellent.” As stated in the previous inspection report there are no computer facilities at the home. It is recommended that these are installed so that staff can access up-to-date health and social care information that will be of benefit to the residents health and safety. Staff would also benefit from access to the CSCI website for advice and information and also from email to work efficiently with other professionals and organisations for the benefit of the residents. There are also no photocopy facilities at the home. There was evidence of regular supervision for staff and this needs to take place to ensure that staff receive the supervision and direction that they need to carry out their roles effectively. There was no development plan for the home and the manager and deputy manager reported that they “did not know” what the future plan was for this service. As stated in the previous inspection report evidence was seen that quality assurance is carried out to help gain the views of the residents and relatives. Medication audits and care plan audits are also carried out throughout the year. However, there was no evidence to show how the information has been collated and shared with the respondents/residents, or if any changes have been made as a consequence of the quality assurance. This must be carried out. There was insufficient evidence that checks relating to health and safety including portable appliance testing, electrical installation checks, gas safety and legionella were up-to-date. Up-to-date certificates for all these areas need to be obtained to help ensure the safety of the residents and staff. Hazlewell DS0000019097.V348454.R01.S.doc Version 5.2 Page 23 Although records were seen to show that fridge temperatures are checked daily, the fridge temperature on the day of inspection was 12 degrees centigrade. This is too high and fridge temperatures must not rise above acceptable health and safety limits. Food had been decanted into containers in the kitchen, however these were unlabelled. These must be clearly labelled with the contents and the date the ingredients were decanted into the containers. Hazlewell DS0000019097.V348454.R01.S.doc Version 5.2 Page 24 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 2 X 3 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 2 13 2 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 1 X 2 X X X X 2 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 2 Hazlewell DS0000019097.V348454.R01.S.doc Version 5.2 Page 25 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 OP1 Regulation 4 (1) Timescale for action The information in the Statement 01/04/08 of Purpose must be accurate and up to date. This is to ensure that residents have an informed choice when they are deciding whether to come to this home. The information in the Residents Guide must be accurate and up to date. This is to ensure that residents have an informed choice when they are deciding whether to come to this home. Previous timescales of 01/09/07 not met. 3 OP7 12 (1)15 Care plans need to be more person centred and contain more detail about individuals interest and social needs. Daily care notes need to be more detailed and information about how residents social needs are being met. 4 OP8 18 (1) All staff involved in the continence care and assessment DS0000019097.V348454.R01.S.doc Requirement 2 OP1 5 (1) 01/04/08 01/03/08 01/05/08 Hazlewell Version 5.2 Page 26 5 OP8 18 (1) 6 OP13 16 (2) (m) (n) 7 OP14 12 (1) (2) 12 (1) (2) 16 (2) (i) 8 OP15 9 OP15 10 11 OP15 OP15 16 (2) (i) 16 (2) (i) of residents must continue to receive training in this area. To ensure that residents needs are met in this area and they receive the most up-to-date care. Previous timescale of 01/09/07 not met. All staff involved in the care and assessment of residents with diabetes must receive training in this area. To ensure that residents needs are met in this area and they receive the most up-to-date care. Previous timescale of 01/09/07 not met. Any activity programme must be provided to enable residents to engage in local, social and community activities. This work needs to continue. Previous timescales of 01/10/07 not met. Residents must be given choices with respect to when they rise in the morning and when they go to bed. Residents must be offered choice about the times they would like to be served their meals – particularly their breakfast. Puddings must not be plated up with the lunch. This course must be offered after the residents have finished their main course. More fresh food must be offered to residents. This includes a wider choice of fresh vegetables. A wider choice of fresh fruit must be offered to residents daily. Previous timescale of 16/07/07 not met. The complaints procedures for the home must include the correct contact details for the CSCI. DS0000019097.V348454.R01.S.doc 01/05/08 01/04/08 01/03/08 01/03/08 01/03/08 01/03/08 01/03/08 12 OP16 22 (7) 01/04/08 Hazlewell Version 5.2 Page 27 All copies displayed at the home must be updated with this information. Previous timescale of 01/09/07 not met. 13 OP18 13 (6) All staff must be aware of and follow the London Borough of Wandsworths Safeguarding Vulnerable Adults Procedures. A programme of redecoration must take place throughout the home to replace the worn and stained carpets and the stained wall paper/paint. The beds in rooms 6, 10, 16 and 22 must be replaced. Both broken bath panels must be fixed. Previous timescale of 01/10/07 not met. The adapted toilet surround is in need of replacing, along with the ‘patched-up’ arm rest. The broken pedal bin in the kitchen must be replaced. 15 OP21 23 (2) (j) Adequate functioning bathroom facilities must be provided for residents on the second floor. These facilities must be in good working order. Previous timescale of and 01/10/07 not met. 16 17 OP26 OP29 23 (d) 19 (4) (b) Schedule 2 24 The home must be kept clean and hygienic. Staff files must contain all the information required in Schedule 4 of the Care Homes Regulations 2001. An annual development plan DS0000019097.V348454.R01.S.doc 01/03/08 14 OP19 23 (2) (b) (c) (d) 01/05/08 01/05/08 01/03/08 01/03/08 18 Hazlewell OP33 01/04/08 Page 28 Version 5.2 must be put in place for the home. Previous timescale of 01/10/07 not met. A full quality assurance system needs to be implemented. The views of residents and relatives must be taken into consideration. This will help to ensure that they contribute to the running of the home. The Registered Provider must forward copies of the monthly written reports to the CSCI. Previous timescale of 01/08/07 not met. Evidence must be kept at the home to demonstrate that all electrical appliances in use have been tested for safety by a suitably qualified person. Evidence that a gas safety inspection has taken place must be available at the home. Evidence that a five yearly electrical installations check has taken place must be available at the home. Previous timescale of 01/08/07 not met. Evidence that a legionella inspection has taken place must be available at the home. Previous timescale of 01/08/07 not met. Fridge temperatures must remain within safe limits. All decanted food must be labelled with the date they were decanted and clear expiry dates. They must also be clearly labelled with regard to the type of ingredients in each container. DS0000019097.V348454.R01.S.doc 19 OP33 24 (3) 01/05/08 20 OP33 26 01/03/08 21 OP38 13 (4) 01/03/08 22 OP38 13 (4) 01/03/08 23 24 OP38 OP38 13 (4) 13 (4) 01/03/08 01/03/08 Hazlewell Version 5.2 Page 29 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP7 Good Practice Recommendations It is recommended that the systems for care planning be developed to make sure that good quality person centred information is recorded as required about areas such as life history and the individual’s likes and dislikes. It is strongly recommended that activities be provided by a dedicated member of staff. It is recommended that a walk-in shower be provided for residents on the second floor. It is recommended that staffing levels are reviewed to ensure that sufficient numbers of trained and competent staff are on duty at all times. The home should look at the possibility of holding regular residents meetings. The home should consider installing a printer and computer facilities with internet access to improve communications at the home and to ensure staff can access up-to-date health and social care information that will benefit the residents. 2 3 4 5 6 OP12 OP21 OP27 OP33 OP33 Hazlewell DS0000019097.V348454.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Hazlewell DS0000019097.V348454.R01.S.doc Version 5.2 Page 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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