Random inspection report
Care homes for adults (18-65 years)
Name: Address: Hesley Village and College Village Green Hesley Village and College Stripe Road Tickhill Doncaster DN11 9HH one star adequate service 01/06/2009 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: Sarah Powell Date: 0 1 1 2 2 0 0 9 Information about the care home
Name of care home: Address: Hesley Village and College Village Green Hesley Village and College Stripe Road Tickhill Doncaster DN11 9HH 01302866906 01302865473 craig.hardy@hesleygroup.co.uk www.hesleygroup.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Jeffrey David Cox Type of registration: Number of places registered: Conditions of registration: Category(ies) : The Hesley Group Ltd care home 43 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: 43 The maximum number of service users who can be accommodated is: 43 The registered person may provide the following category of service only: Care Home only Code PC To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following category: Learning Disability, Code LD Date of last inspection Brief description of the care home Hesley Village and College; Village Green is located in extensive grounds in a rural setting. It is just outside the village of Tickhill and approximately 8 miles from Doncaster.
Care Homes for Adults (18-65 years) Page 2 of 11 0 1 0 6 2 0 0 9 Brief description of the care home Within the grounds there is one other registered service that provides care and accommodation for people with learning disabilities and other complex needs. People can access the sites college facilities; these are available for people from across the entire site. The college facilities are within the grounds and a short walk from peoples accommodation. Hesley Village has a small shopping Mall with bakery and grocery. There is a facility for people to collect their weekly monies and cash. The Hesley group operate and audit this service. People at the village call this the post office and it is set up to look like a bank or post office building. The Village has a hairdressing and beautician salon, small cinema, and a restaurant. There is a medical room for people to use, to see visiting doctors and dentists. The Hesley Group manage and employ staff to run these services. The fees range from 178,810 to 249,492 pounds per year. This depends on peoples needs and level of support. Information about additional fees such as transport and other services is included in the service user guide. People who are interested in this service can get information by contacting The Hesley group. The organisation will provide a copy of the statement of purpose and service users guide, and the latest inspection reports. Care Homes for Adults (18-65 years) Page 3 of 11 What we found:
This was an unannounced visit which took place on 1 December 2009. The visit carried out by Sarah Powell Regulatory Inspector, Sharon Kelly Assessor, Steve Baker Pharmacy Inspector and Steven Robinson expert by experience. We also emailed relatives surveys to most parents we had five completed and returned. The reason for this inspection was to determine progress with the requirements from the previous inspection carried out on 1 June 2009 and to look at medication, as there had previously been some safeguarding referrals regarding medication errors, although none of these were recent. Medication issues had also been raised at a parents forum meeting and CQC had told the group a pharmacist would visit. The outcome is as follows We looked at six peoples plans of care and other supporting documentation in detail to determine compliance with previous requirements. Only one of the six requirements had not been complied with, which showed good progress to ensure the service improved outcomes for people. Care plans had been developed and the six we looked at showed peoples needs had been identified and measures developed to meet the persons need. Assessments had been carried out under the Mental Capacity Act and we saw these assessments in the plans we looked at, reviews had been carried out by the Primary Care Trust and there was no deprivation of liberty identified, however there were some restrictions of liberty due to peoples needs. A risk assessment tool had been developed this was not in use in all care files, however Janet Poulain Quality and Compliance Manager told us these would be completed for all people by the end of February 2010. Peoples health care needs had been identified, however in plans we looked at there was lack of detail when a risk had been assessed as high risk and very high risk. More detail regarding risk management protocols was required to ensure people were protected. For example One persons care plan included a large number of risk assessments relating to activities carried out by this person, although some of these documents did not appear to be adequately completed. For example, this persons health action plan instructs staff to exercise vigilance when the person is in water in case they experience an epileptic seizure, however there is no reference to this in the risk assessment specifically for swimming. Daily journals were completed for everyone by the support worker each shift. We looked at six daily journals they were very good gave clear details of what people did each day, ensuring peoples needs were met. Health care professionals were used and evidence was seen in plans we looked at that they visited people and gave recommendations. However visits from dieticians were recorded but advice was not always followed. For example One person care plan showed some contradiction regarding this persons diet within the records. Her care plan stated
Care Homes for Adults (18-65 years) Page 4 of 11 that a healthy eating diet, put in place by a dietician and on a three week rotation was in place. However, the food records within the daily journal did not appear to indicate that a three week rotation was being followed. Further to this, this persons health action plan for nutrition did not refer to guidance from a dietician, and instead stated that a healthy, varied and nutritious diet should be followed. Another example was, a persons food preferences in their care plan recorded that they would tolerate only a very limited number of foods, and the diet offered to them reflected these preferences. However, the persons health action plan included recent guidance from a dietician about offering other food types and recording what was rejected, which did not appear to be happening. It is accepted that staffs knowledge and experience of this person would conclude that this approach may simply result in food waste, but there was no indication within the persons records that a formal decision not to undertake the dieticians advice had been made. Further to this, the persons health action plan included a plan to develop his food preferences, and again this did not appear to be currently implemented. One other example was a person had been identified as at risk of bolting food and chocking, however no guidance had been obtained from a speech and language therapist to determine what measures should be in place to minimise the risk and meet the persons needs. Steps had been taken to reduce incidents where people were at risk of abuse or physical harm. We reviewed the incidents from 1 July 2009 to 1 November 09 for Woodland View and Village Green. For the two sites there had been 43 incidents referred to Doncaster Safeguarding by Hesley. 18 of these were taken as safeguarding referrals, of the 18 only 10 are still open. This is a considerable reduction in referrals. A pharmacist inspector examined the current medication administration record charts (MARs) and reviewed the medication storage, ordering and disposal arrangements in three of the units. All MARs are accompanied by guidance notes to help make sure staff respect each persons personal preferences when taking their medicines. This good practise helps to reduce the number of doses refused or omitted. Staff now have access to up to date information about medicines used in the home. Those medicines prescribed to be taken as and when needed are given according to a prepared protocol and records are made each time such medicines are given. There are no administration gaps on the MARs indicating people are given their medication correctly as prescribed. However, more care should be taken when writing new MAR charts and when checking hand written entries to make sure all essential information has been recorded accurately. This will help to make sure that all staff are able to give these medicines correctly. All medicines examined were stored securely at temperatures recommended by the manufacturer. One container of liquid medicine was found available for use despite an expiry date of April 2009 printed on the label. All medication kept in the home, especially oral liquids and skin care products should be checked regularly to make sure it is still fit to use. Monthly prescriptions are checked for any changes and to make sure all medicines needed are listed. This helps to make sure people are not without any of their medicines each month. The findings of the expert by experience that accompanied us on the inspection are detailed below.
Care Homes for Adults (18-65 years) Page 5 of 11 Environment The houses I saw had three bedrooms with en suites and a staff office upstairs. Downstairs there was a kitchen diner, living room and a dining room. In some houses the dining room was used as a second living room because some people preferred their own space to sharing a space. In peoples homes there were notice boards up in the hallway. This had on pictures of staff that were working, I thought this was a good idea so the people who lived there could see who was working with them that day. There was also how to complain and fire drill procedures explained using pictures so it was easy to understand. There were also two log cabins that peoples families could come and stay in for free. Activities There were a lot of activities based on site. In the sports hall there was a trampoline which they used for rebound therapy. For this, there were two people on the trampoline with a service user and they used things like a big ball and a blanket on the trampoline. I saw one person doing the rebound therapy and he seemed to be really enjoying it because he was laughing and smiling. I think that they need steps to get up onto the trampoline because it would be safer than just using a bench. There was a studio where people made jewellery and decorative frames and mirrors. They also made up bags of pot pourri I was told that they were made by service users and they sold them in the shop. They were also going to sell them at local Christmas fairs. There was a big garden where there was lots of willow. They use it to make different shapes of animals and weave it in, so it looks like there are animals in the garden. I thought these were good. On one persons activity timetable, it said he went off site almost every day to go swimming. In the village hall various activities took place from day to day. This included music groups and wii sessions. There was also a cinema and someone had booked it out for the afternoon so they could watch a film. Conclusion The people I spoke to all said that they liked living at Hesley Village Green. I would like to live here because all the staff were very friendly and I liked the environment, but I would like to do more things outside of the Village. I think the service should arrange to do more things off site, and do more in the community. One of the managers told me that the Village was the service users community and that some of them would not be able to live in other communities. I think the log cabins are a good idea because people can come and spend some time with their family members and see where and how they live. The people I spoke to all said that they liked living here. What the care home does well:
We only looked at outstanding requirements from the visit on 1 June 2009, we were able to identify good progress with these. Care plans had been developed, a risk assessment tool was in use and people had been assessed under the Mental Capacity Act to ensure their needs were met. Care Homes for Adults (18-65 years) Page 6 of 11 Health and safety had improved all incidents and injuries to both staff and residents were being reported, however this was still work in progress and was being further developed to improve the systems. This will ensure effective management of accidents to ensure peoples safety. We had five survey returned from parents the comments received were mostly very positive some comments are listed below. Hesley is a lovely environment and is a very safe place. Hesley provides a high standard of individualised personal care. Communication with staff is good we can ask for a meeting if required and they are arranged. Steven the expert by experience found from talking to people that the activities provided on site were very good. 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 Adults (18-65 years) Page 7 of 11 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 6 15 Care plans must be developed further and staff must understand what actions they need to take to ensure that thay meet poeples needs This will ensure that all peoples needs are met. 31/08/2009 Care Homes for Adults (18-65 years) Page 8 of 11 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 9 12 When areas of risk have been identified in the provision of care to service users, comprehensive risk assessments must be completed, in particular when the risk is assessed as high or very high risk, the course of action to be taken to reduce or eliminate that risk must be detailed. This will ensure staff know how to mange risks and protect people. 31/03/2010 2 19 12 Recommendations and advice obtained from health care professionals must be followed. This will ensure peoples needs are met. 31/03/2010 3 19 13 When peoples health needs 31/03/2010 have been identified in the health action plans sufficient detail must be recorded on how to meet those needs This will ensure all peoples Care Homes for Adults (18-65 years) Page 9 of 11 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 health care needs are met. 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 20 Care should be taken when writing new MAR charts and when checking hand written entries to make sure all essential information has been recorded accurately. All medication kept in the home, especially oral liquids and skin care products should be checked regularly to make sure it is still fit to use. 2 20 Care Homes for Adults (18-65 years) Page 10 of 11 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 Adults (18-65 years) 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. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 11 of 11 - 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!
