Inspection on 25/10/05 for Hickling House

This inspection was carried out on 25th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Hickling House 19/08/09

Hickling House 17/03/09

Hickling House 29/07/08

Hickling House 22/05/07

Hickling House 26/09/06

Hickling House 24/02/06

Hickling House 29/11/04

Hickling House 16/06/04

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

CARE HOMES FOR OLDER PEOPLE Hickling House Town Street Hickling Norwich Norfolk NR12 0AY Lead Inspector Ann Catterick Unannounced Inspection 25th October 2005 9:45 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 Hickling House DS0000027434.V249930.R01.S.doc Version 5.0 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. Hickling House DS0000027434.V249930.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Hickling House Address Town Street Hickling Norwich Norfolk NR12 0AY 01692 598372 01692 598372 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) Mr Rhoderick Smart Mrs Frances Smart Angela Marlow Care Home 29 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (28) of places Hickling House DS0000027434.V249930.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Up to twenty-eight (28) service users, over 65 years of age with dementia may be accommodated. One (1) adult with dementia may be accommodated The total number not to exceed twenty-nine (29). Date of last inspection 29th November 2004 Brief Description of the Service: Hickling House is a care home providing personal care and accommodation for 29 older people with dementia. Mr Rhoderick Smart and Mrs Frances Smart own the home and the registered manager is Mrs Angela Marlow. The home is situated on the outskirts of the village of Hickling, close to Hickling Broad, less than 5 miles from the Norfolk Coast. Originally a Victorian Inn, the premises has been extended and modernised to provide residential accommodation on two floors. There are 25 single rooms, 24 of which have en suite facilities, and 2 double rooms, both with en suite facilities. A shaft lift and separate stair lift provide access to the upper floor and there are two outside fire escapes. Day care is provided to a small group of people and they are accommodated during the day in the general communal areas. Hickling House DS0000027434.V249930.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over a 6.5hr period. The inspector was able to meet with service users, the manager, some staff as well as look at documents and files and have a tour of the building. Those service users who were spoken to spoke very positively about the home. Those service users who were unable to say how they felt about the home appeared relaxed and settled, relating well to staff and the activities being offered. Staff spoken to said that they enjoyed their work and spoke positively about the management and staff team within the home. What the service does well: What has improved since the last inspection? The home is in the process of improving the format of care plans. Hickling House DS0000027434.V249930.R01.S.doc Version 5.0 Page 6 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. Hickling House DS0000027434.V249930.R01.S.doc Version 5.0 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 Hickling House DS0000027434.V249930.R01.S.doc Version 5.0 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 and 6 Prospective service users and their families are given all of the information needed enabling to make an informed decision on whether or not the home would meet their needs. Prospective service users needs are assessed prior to their admission to the home. The home does not provide intermediate care. EVIDENCE: The home has a comprehensive and informative Statement of Purpose and Service User Guide that has been commended. The manager asks for assessments from the placing professional and completes her own assessment prior to admission. The placement is then reviewed after four weeks to ensure that the home is meeting the service user’s needs. At the time of inspection a service user was being reassessed as Hickling House DS0000027434.V249930.R01.S.doc Version 5.0 Page 9 following admission further assessment concluded that their needs could not be met in the home. All appropriate procedures were being used. The home has no intermediate care placements. Hickling House DS0000027434.V249930.R01.S.doc Version 5.0 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 and 10 All service users have individual care plans that outline their care needs. Service users are treated with respect and their privacy is promoted EVIDENCE: Some care plans were looked at and the manager informed the inspector that the system for care plan is being changed. The new care plan system will be fully completed by the time of the next inspection and this will looked at in some detail at that time. The care plans seen were adequate and gave relevant information although social and cultural information was limited. Those service users who were spoken to said that the staff were all very kind and very friendly. They said that staff treated them well. When observing staff working with service users throughout the day of inspection this was confirmed. Hickling House DS0000027434.V249930.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 and 15 The home aims to ensure that service user’s lifestyle matches their preferences and interests. The home provides good quality food that is eaten in pleasant surroundings. EVIDENCE: The home offers care to service users who have dementia who cannot always express their preferences and choices. It is therefore important that if service users cannot share this with staff the information is gathered from friends and family. The care plans only had limited information with regard social and cultural preferences and a recommendation has been made in this area. The home has an activity person who provides entertainment and activities on several days of the week. One service user said that she would like to be taken out of the home more often, even if this was a walk out in the wheelchair. The home does not have its own transport but hires transport when needed. Those service users spoken to were very positive about the food offered within the home saying that it was tasty and varied. The kitchen was seen and there was evidence of home cooking and fresh vegetable with and interesting and varied menu. There has been much written with regard food and people with Hickling House DS0000027434.V249930.R01.S.doc Version 5.0 Page 12 dementia and it has been recommended that some of these publications are made available to staff in the home to ensure that they are kept up to date with modern thinking in this area. Hickling House DS0000027434.V249930.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 The home has a policy that aims to protect service users from abuse. EVIDENCE: The home has an adult abuse policy and staff are made aware of this. The staff spoken to were aware of the whistleblowing policy and were clear that they would always report poor practice. Staff have had some training in regard to adult abuse and this is covered in NVQ level 2. The manager was advised to make herself more familiar with the local Protection of Vulnerable Adults Policy. A recommendation has been made in this area. Hickling House DS0000027434.V249930.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21 and 25 The environment of the home is well maintained, however a requirement relating to the safety of radiators has not been met. Although the home has sufficient bathing facilities these are not all utilised as bathrooms. EVIDENCE: Generally the home is well decorated and maintained offering a pleasing and comfortable environment. The home has 4 bathing facilities. One bath on the first floor is not functional as there is a problem with the flow of water in the bathroom. Downstairs there is a non-assisted bathroom attached to the laundry room and this bathroom has not been used for at least 12 months. The shower is used by one person. The outcome is that 27 service users use one bathroom and this is not seen as good practice. A requirement has been made in this area. Hickling House DS0000027434.V249930.R01.S.doc Version 5.0 Page 15 The radiators in the home are not of low temperature or covered and are a risk to the service users. This was a requirement from the last inspection and this had not been met. The home offers care to service users who have dementia and it is imperative that radiators are made safe. An immediate requirement has been made in this area. Hickling House DS0000027434.V249930.R01.S.doc Version 5.0 Page 16 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 and 30 The amount of staff on duty at any one time appeared to meet the needs of the service users. EVIDENCE: The rota was looked at and there appeared to be adequate staff on duty at any one time to meet the needs of service users. There were, at times less staff on duty at weekends than during the week and this matter needs to be addressed. For twenty-one hours a week an additional member of staff is on duty to offer activities to service users. A temporary member of staff was in the home working a significant number of hours, such as would be seen as excessive by most people. The member of staff concerned was spoken to and gave assurance that she was fit and well, able to work many hours throughout the week and remain a safe and alert practitioner. She only works at the home for a two or three-week period five or six times a year. A requirement to risk assess this situation has been made. Some new staff had recently been appointed. Those staff spoken to were very positive about working in the home and were happy in their role. The staff have induction and foundation training. There is no specific planned training available for all staff with relation to working with people with dementia. The home has no general publications relating to working with people with dementia. There is now much varied and informative training opportunities relating to working with people with dementia and it would be Hickling House DS0000027434.V249930.R01.S.doc Version 5.0 Page 17 expected that staff who work in a home that cares for people with dementia have as much access to these courses as possible. A recommendation has been made in this area. Hickling House DS0000027434.V249930.R01.S.doc Version 5.0 Page 18 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, 37 and 38 Service users live in a home that is well run and managed by a person who is fit to be in charge. The quality assurance system within the home could be further developed. The home keeps most records but the proprietor needs to complete Regulation 26 visits as stated in the Care Home Regulations 2001. An immediate requirement with regard radiators was not met from the last inspection and this area continues to place service users at unnecessary risk. Hickling House DS0000027434.V249930.R01.S.doc Version 5.0 Page 19 EVIDENCE: The manager has been in post for about one year and is continuing to gain experience, develop her skills and improve her knowledge. She is completing the Registered Manager Award and is hoping to have this completed by June 2006. The manager has some ways of measuring the quality of the service but plans to develop this area further. At the present time the home does not publish its findings. On the day of inspection it was half term and the manager’s daughter was in the home. This could have safety and confidentiality issues for the child and service users and a risk assessment should be completed. A recommendation has been made in this area. The inspector was disappointed to find that the requirement from the last inspection about the safety of radiators had not been met. An immediate requirement was made on the day of inspection. The home offers care to service users with dementia and all radiators to which they have access should be made safe by being of low temperature or by being covered. Hickling House DS0000027434.V249930.R01.S.doc Version 5.0 Page 20 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 4 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 3 2 x 1 x x x 1 x STAFFING Standard No Score 27 3 28 x 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x x x 2 3 Hickling House DS0000027434.V249930.R01.S.doc Version 5.0 Page 21 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 OP21 Regulation 23j Requirement Timescale for action 01/12/05 2 OP25 13 (4)a 3 OP37 26 4 OP38 19(5)C The registered person must ensure that there are sufficient numbers of usable bathing facilities to meet the needs of service users. The registered person must 01/11/05 ensure that all parts of the home to which service users have access are so far as reasonably practicable free from hazards to their safety. This relates specifically to the radiators in the home. An immediate requirement was made in this area. The registered person must 01/12/05 ensure that they visit the home and complete a report as stated in regulation 26 and forward the report to Commission as stated in the regulation. The registered person must 01/12/05 ensure that staff are physically and mentally fit for the purposes of the work, which they perform in the care home. This relates specifically to members of staff who work significant more hours per week than is seen as usual. DS0000027434.V249930.R01.S.doc Version 5.0 Hickling House Page 22 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 OP12 Good Practice Recommendations It would be seen as good practice to gather as much relevant social and cultural information as possible about service users to enable staff to promote and support and areas of particular interest of preference that service users may have. This is particularly important when working with people with dementia. It has been recommended that the registered manager ensure that she has a good knowledge of the local Norfolk County Council Policy and Procedures for the Protection of Vulnerable Adults. It would be good practice for the proprietor to purchase some publications with regard food and people with dementia to ensure staff are able to keep up with modern thinking and current knowledge in this area. On the day of inspection the Registered Manager’s daughter was in the home and it would be good practice to risk assess this situation to ensure the safety of service users and the child have been considered and acted upon. 2 OP18 3 OP15 4 OP38 Hickling House DS0000027434.V249930.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 Hickling House DS0000027434.V249930.R01.S.doc Version 5.0 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. 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