Random inspection report
Care homes for older people
Name: Address: Hazlewell 29-31 Hazlewell Road Putney London SW15 6LT one star adequate service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Sandy Patrick Date: 0 3 0 3 2 0 1 0 Information about the care home
Name of care home: Address: Hazlewell 29-31 Hazlewell Road Putney London SW15 6LT 02087888753 02082485954 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr D Patel care home 29 Number of places (if applicable): Under 65 Over 65 29 old age, not falling within any other category Conditions of registration: 0 The maximum number of service users who can be accommodated is: 29 The registered person may provide the following category of service only: Care home with nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Date of last inspection Brief description of the care home Hazlewell is a 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 Care Homes for Older People Page 2 of 13 Brief description of the care home links in Putney. Information about the home is provided to residents in a written guide. The current fees are £650 per week. Care Homes for Older People Page 3 of 13 What we found:
We visited the home to look at issues raised by the London Borough Wandsworth following a recent investigation into the safety and wellbeing of people who live at the home. The inspection team included a pharmacy inspector who looked at medication practices. He looked at the way medication was stored, administered and recorded. The local authority have made an assessment of the moving and handling needs of people who live at the home. They have assessed staff skills, individual needs and the equipment used at the home. They have shared their findings with us. They have found that the home needs a wider range of equipment to meet the needs of people who live there and that the staff need further training to make sure they are supporting people safely. The Occupational Therapists who assessed the needs of people living at the home have recommended 8 additional electric profiling bed and 3 additional hoists are purchased or hired, and 20 new slings and 6 new slide sheets are purchased. At the time of our visit one of the hoists at the home was not working and had not been working for sometime because it needed a replacement battery. Staff have been using hoists which require them to pump the mechanism by hand. This may put the staff at risk of strain or injury. Not everyone living at the home has their own wheelchair which has been assessed for their needs, and some people are using wheelchairs which may the wrong size or design and this may put them or those supporting them at risk. Not everyone at the home has the correct slings to be used when they are hoisted and staff are using the wrong slings which may put them at risk of injury. Not everyone who needs one has a bed that can move up and down. This means that the staff who are supporting them to get in and out of bed may be working in an unsafe position putting themselves and the people they support at risk. Health care professionals who have visited the home have observed staff supporting people inappropriately when they are moving them. This may put the people they are supporting and the staff at risk of injury. We looked at three peoples care plans and risk assessments around moving and handling. We saw that these people had care plans and risk assessments about their mobility. There were also risk assessments to indicate why some equipment was used. However, we found that not all the care plans and risk assessments gave clear instructions of how staff were to support each person with their needs. We found that some of the information was contradictory and confusing. Some information needed updating. If information is not clearly and accurately recorded the staff may support people in the wrong way and this could put them and the people they are supporting at risk. Some of the radiators and hot water pipes are not adequately covered and there are
Care Homes for Older People Page 4 of 13 exposed areas which get very hot. One radiator in the second floor bathroom has no cover. We found that the surface of this was extremely hot. People may be at risk of scalding from these exposed surfaces and the registered person must take appropriate action to make them safe. There are cracks on the walls and ceilings of two of the bedrooms at the home. Some of these are very large and could be an indication of subsidence or other problems. The Registered Person must employ and appropriately qualified person to undertake an assessment of these cracks and must take appropriate action to make sure people are not at risk and the cracks are made good. There are two areas of the home, on the first and second floors, where ceilings have been damaged by water and water enters the building during heavy rain and snow fall. People are at risk from this and the problem may lead to the ceilings collapsing posing further risks. One area of water leaking is close to an electrical light fitting. The Registered Person must repair the damage caused by the leaks and must take appropriate action to minimise the risk of the leaks reoccurring. One of the fire exits on the ground floor cannot be securely closed. The door is into a bedroom. This is a security risk as some one could enter the premise this way and it is also inappropriate that some one has a door from their bedroom to the outside which cannot be closed as this affects the temperature of the room. The Registered Person must take appropriate action to secure this fire exit door. We saw that some of the furniture and fittings were damaged. In one bedroom we saw that the wardrobe door had been removed. The manager told us that this was because it had been hanging off and was a risk to the person in the room. We saw that the window catches on one window were missing. We saw that the radiator cover in the lounge had come loose. The seal around one of the dining room windows has broken and the window cannot close fully letting in a draught. The Registered Person must take appropriate action to repair this window so that it closes properly. What the care home does well:
The manager and majority of staff have worked at the home for many years and are clearly committed to caring for the people who live there. They showed genuine affection and kindness towards people. Each floor of the home has a medicines trolley securely tethered and dedicated to the storage of medication for residents with accommodation on that floor. With each trolley is kept patient information leaflets and CQC professional guidance documents on medication. The disposal of waste medication is well documented and regularly taken from the home by a designated medicines waste contractor. Care Homes for Older People Page 5 of 13 What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 6 of 13 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action 1 9 13(2) That the auditing process is continued to maintain the improvement in medicines management, so that the residents well being is maintained. 01/10/2009 2 9 13(2) That controlled drugs are 25/01/2010 kept in the CD cupboard at all times and when disposed of made irretrievable using a Doop kit and disposed of with the homes clinical waste 3 12 16 (2) (m) The home must offer a wider 25/01/2010 range of structured activities to those living at the home. They must consult with the residents about what they would like to be offered. 4 19 23 (2) (b) (c) The rubbish and old furniture 25/01/2010 (d) (j) stored in the garden must be removed. The radiator on the ground floor must be painted. The area in the ground floor toilet that requires plastering must be completed. Care Homes for Older People Page 7 of 13 Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action 5 30 18 Copies of certificates to evidence all training undertaken by staff must be kept at the home. Previous timescale of 31/01/09 not met 25/01/2010 6 30 18 All staff must receive up-todate training in moving and handling to help to ensure the safety of the residents. 25/01/2010 7 35 16(2)(l), Such Residents monies must be 4 (9) paid directly to them and made out in their name. 25/01/2010 Care Homes for Older People Page 8 of 13 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 7 15 The registered person must 09/04/2010 make sure care plans and risk assessments are accurate, up to date and give clear instruction for staff. Because people who live at the home may be at risk and may not get the care and support they need if information is inaccurate or not clearly recorded. 2 8 13 The registered person must 30/04/2010 make sure the staff are all trained to use the equipment safely and are assessed as competent at supporting people to move. Because the people who live at the home and the staff supporting them may be at risk if the staff do not have the skills and competency to move them safely. 3 8 13 The registered person must make sure the correct moving and handling equipment is purchased so 09/04/2010 Care Homes for Older People Page 9 of 13 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action that everybody who lives there is safe when they are supported to move. Because people who live at the home and the staff who support them may be at risk if the wrong or inappropriate equipment is used. 4 9 13 The registered person must arrange a medication audit to identify issues and take remedial action without delay. 17/03/2010 5 19 23 The registered person must 30/04/2010 repair or replace the damaged furniture and fittings listed in the summary of this report. Because people may be at risk from damaged furniture and fittings. 6 38 23 The registered person must take action to repair the broken fire exit door so that it can be safely opened and closed. Because people may be at risk from an intruder entering the building through this unsecured door and because this is the door in one persons bedroom and they are not able to regulate the temperature in the room while the door is permanently open. 31/03/2010 Care Homes for Older People Page 10 of 13 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 7 38 13 The registered person must 31/03/2010 repair the water damaged ceilings on the first and second floor and take action to prevent the risk of further flooding. Because people may be at risk from water damaged areas and potentially unsafe ceilings. 8 38 13 The registered person must arrange for a suitably qualified person to assess the damaged cracks in the walls and ceilings of two of the bedrooms and should take action to prevent further damage and repair the existing damage. Because people may be at risk if further damage takes place. 09/04/2010 9 38 13 The registered person must make sure all hot water pipes and radiators are appropriately covered. Because people may be at risk of scalding if hot surfaces are exposed. 31/03/2010 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations 1 9 To record the maximum/minimum temperatures of the medicines fridge, in addition to the single current
Page 11 of 13 Care Homes for Older People Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations temperature, to improve assurance of correct storage temperature. 2 9 To administer doses of medicines in sequence from the monitored dosage blister packs to avoid risk of missing doses. To identify photographs of residents to avoid any risk of misidentification by staff administering medication. To enter reference to secondary recording documents where they are used to record the administration of prescribed items such as dressings to aid audit of archived documents. To provide a documented index to the medication policies and procedures to avoid delay in finding information. 3 4 9 9 5 9 Care Homes for Older People Page 12 of 13 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Older People Page 13 of 13 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
