CARE HOMES FOR OLDER PEOPLE
Hook Hall High Street Hook Goole East Yorkshire DN14 5PL Lead Inspector
Mary Slattery Unannounced Inspection 24th February 2006 10:30a 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 Hook Hall DS0000019683.V276309.R01.S.doc Version 5.1 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. Hook Hall DS0000019683.V276309.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Hook Hall Address High Street Hook Goole East Yorkshire DN14 5PL 01405 767891 01405 767891 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 James Douglas Ford Mrs Margaret Elizabeth Wrightson Care Home 21 Category(ies) of Dementia - over 65 years of age (21), Old age, registration, with number not falling within any other category (21) of places Hook Hall DS0000019683.V276309.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection Brief Description of the Service: Hook Hall is a privately owned care home that lies within its own grounds on the edge of the quiet village of Hook, and is a listed building. The home is registered to provide care and accommodation for 21 older people, including those with dementia. The property is extremely well maintained both inside and out, and shared accommodation is in keeping with the original features of the hall. All bedrooms are single, and sixteen of these have en-suite facilities. Service users are able to access all areas of the home via the use of a passenger lift and ramps. There is a car park to the front of the building. Services in the village are limited to a post office/shop and a village pub, but the registered provider frequently transports service users into the nearby town of Goole for shopping and for visits to health professionals, family/friends and social events. Hook Hall DS0000019683.V276309.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This report related to an unannounced inspection carried out on the 24th February 2006. The inspection took four hours plus 2 hours preparation time. A tour of the premises was carried out, which included private accommodation. Time was spent observing the activity in the home talking and listening to the service users to establish if they were satisfied with the care and support they received. The focus of the inspection was on a number of key standards, inspecting the case records of a number of service users to establish if they corresponded with their experiences of life in the home. The registered manager was available throughout the inspection and the findings were discussed and agreed at the close of the inspection. What the service does well:
Hook Hall provides personal care and accommodation for older people some of who have dementia. The service users are given the support and guidance they need to maintain their independence and to make choices about their daily lives as far as they are able. Lots of opportunities are made for them to continue to be involved in the local community and to maintain good contact with their families and friends. The atmosphere was relaxed and the service users contributed to the inspection by expressing their views of the care they are given and the kindness of the staff. There was a lot of laughter and good interaction between the service users and the staff. The statement of purpose and the service user guide gives a lot of information about the home, the facilities, the staff and the type of care service users should expect to receive and there was information about how to make a complaint about any aspect of the service. Hook Hall DS0000019683.V276309.R01.S.doc Version 5.1 Page 6 The staff gather good information about the service users before they are admitted to the home and a care plan is produced to ensure that all staff are fully aware of each individual need and how each need is to be met. Records of all care reviews are kept and details of any contact service users have with external health care professionals. Relatives are kept fully informed and are invited to attend care reviews. All of the staff have a training and development programme and they are supervised on a regular basis. What has improved since the last inspection? 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. Hook Hall DS0000019683.V276309.R01.S.doc Version 5.1 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 Hook Hall DS0000019683.V276309.R01.S.doc Version 5.1 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): 2 and 4. The outcomes of the assessments are shared with the service users and their representative to show that the home can meet their assessed needs. EVIDENCE: Service users are provided with a contract and terms and conditions document and when this has been agreed and signed a copy is placed on the service user’s file. The outcomes of the assessments are discussed with the service users and/or their representative to show that their needs can be met by the home. The assessment records showed that service users and/or their representatives sign to agree the outcomes. The policy and practice of the registered manager is to keep accurate records of all information that is shared with the service users and their relatives. Hook Hall DS0000019683.V276309.R01.S.doc Version 5.1 Page 9 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): EVIDENCE: These standards were not assessed at this inspection. Hook Hall DS0000019683.V276309.R01.S.doc Version 5.1 Page 10 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, 14 and 15. Service users are enabled to exercise choice and to be as independent as possible within a safe environment. EVIDENCE: A number of the service users living in the home have levels of cognitive impairment due to dementia and therefore need the support and guidance from their families or their representative in making a decision to move into the home. The care staff knew each person well and demonstrated skills in enabling the service users to make choices about daily living, choice of food and social activities. Time was spent with service users at lunchtime, this was very relaxed and people were chatting and laughing. The food served looked appetising and the service users ate heartily. The menus looked at showed that the service users are provided with a healthy, nutritious diet with plenty of choice. Nutritional assessments are carried out and a check is kept on people’s weight. Food and drinks are available at any time.Service users are encouraged to be as independent as possible at meal times and staff are available to assist where needed.
Hook Hall DS0000019683.V276309.R01.S.doc Version 5.1 Page 11 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): EVIDENCE: These standards were not assessed at this inspection. Hook Hall DS0000019683.V276309.R01.S.doc Version 5.1 Page 12 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): 19,20,21,22,23,24 and 25. The standard of the environment is good providing the service users with a bright, clean, homely place in which to live. EVIDENCE: The home was warm, bright and clean and the service users are provided with a variety of communal space with comfortable seating suitable to their needs. There was plenty of space for service users to move around the home independently and remain safe. Many were sat looking at the lovely grounds and the surrounding countryside. The bedrooms are decorated to a high standard and service users had personalised them with their favourite belongings and pictures of family and friends. The home is well equipped with assisted baths and toilets and equipment to assist people with their mobility. Some of the service users have bed safety rails in place and these need to be reassessed. The bed safety rails were not of sufficient height above the pressure-relieving mattress and therefore could place service users at risk. The safety rails were being protected with quilts rather than bumpers.
Hook Hall DS0000019683.V276309.R01.S.doc Version 5.1 Page 13 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 service users receive a high standard of care from a motivated and welltrained staff group. EVIDENCE: All staff have a training portfolio and training achieved includes NVQ Levels 2 and 3 and 4, medication training, dementia awareness, health and safety and POVA. There is a staff supervision policy in place and an annual appraisal system. The home has the required numbers of staff on duty during the day and overnight. Hook Hall DS0000019683.V276309.R01.S.doc Version 5.1 Page 14 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, 32, 33, 37 and 38 The service users benefit from a well managed home where their needs and wishes are put first. EVIDENCE: The registered manager is a qualified first level nurse and has completed the Registered Manager’s Award. She has managed the home for a number of years and continues to update her practice and skills through training. Meetings take place on a regular basis enabling the staff and the service users to voice their opinions about all aspects of the service provided and to contribute to any future changes. The home is run in the interests of the service users to make sure that they receive the care they need and live life to the full. The required records policies and procedures were in place and found to be in good order and up to date and available to the staff. The home has a health and safety policy and procedure and staff are subject to health and safety training.
Hook Hall DS0000019683.V276309.R01.S.doc Version 5.1 Page 15 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 X 3 X 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 2 3 3 3 3 3 3 X STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X X 3 3 Hook Hall DS0000019683.V276309.R01.S.doc Version 5.1 Page 16 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. Standard Regulation Requirement Timescale for action 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 OP19 Good Practice Recommendations It is recommended that an assessment is carried out on the bed safety rails and that arrangements are made to fit safety rails of a suitable height on beds where pressure relieving mattresses are used. To use bumpers on all bed safety rails. Hook Hall DS0000019683.V276309.R01.S.doc Version 5.1 Page 17 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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