CARE HOMES FOR OLDER PEOPLE
Hooklands Nursing Home West Bracklesham Drive Bracklesham Bay Chichester West Sussex, PO20 8PF Lead Inspector
Liz Driver Unannounced 3 May 2005 V222061 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 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. Hooklands Nursing Home H60-H11 S24158 Hooklands V222061 030505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Hooklands Nursing Home Address West Bracklesham Drive, Bracklesham Bay, West Sussex, PO20 8PF Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01243 670621 Mr Mohammed Saleem Chaudhry Mrs Jeanette Lousie McDowell Care Home 27 Category(ies) of OP Old Age registration, with number of places Hooklands Nursing Home H60-H11 S24158 Hooklands V222061 030505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 8th December 2005 Brief Description of the Service: Hooklands is a care home providing personal, social and nursing care for 27 service users over the age of 65. It is situated on the seafront at Bracklesham Bay, West Sussex. All rooms are situated on the ground, first and second floor. The home has a vertical lift. There is a garden that has direct access to the beach. Access to the home is via a residential road and the home provides a small number of car parking spaces. There is a ramp for easy access into the home. There are a handful of shops near by and restricted public transport serves the village. Hooklands has been a registered care home for 15 years. Mrs J McDowell is the registered manager who is in charge of the day to day running of the home. The providers are Mr Chaudhry and Dr Ezad. Hooklands Nursing Home H60-H11 S24158 Hooklands V222061 030505 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection was done as part of the inspections required to be carried out over each inspection year by CSCI. The inspector talked with residents and the manager and carried out a tour of the home. Records were also looked at. The inspector also looked at outstanding concerns that were identified last year to ensure that they had been completed. Four residents were happy to talk with the inspector. The inspector spent 4 hours at the home in total. Pre inspection work consisted of reading through the last report to make sure all outstanding work was checked at this inspection. There has been one letter of concern received by CSCI since the last inspection that CSCI asked the Registered Manager to respond to, and she has done so to a satisfactorily standard. What the service does well: What has improved since the last inspection?
Hooklands Nursing Home H60-H11 S24158 Hooklands V222061 030505 Stage 4.doc Version 1.30 Page 6 All the north facing windows have new double glazed windows installed. These have replaced rotten frames and broken panes of glass that now provide residents with no leaking frames or draughts. Extra grab rails have been installed in the small toilets and shower to provide help for the residents who are independent. An outside storage unit for electric buggies has been built and is almost ready for use, freeing up storage space in the home and making access easy for residents. The recent Environmental Health Officers inspection resulted in few recommendations, which is an improvement on the last inspection. The manager has worked hard to make sure cleaning schedules are in place and carried out. Staff appraisals have been done and any training identified for each member of staff is to be actioned. This will give residents care by staff who continue to up date their practice. What they could do better:
The providers and manager need to make sure that all remaining radiators not covered are done so by the end of August 2005. These are radiators in the corridors and communal rooms. The last report required the home to have all these covers in place by 30th Jan 2005. This has not been done and now CSCI have given the home until the end of August 2005 to do so. The manager did state there were some difficulties in finding the correct covers as it would decrease the girth measurements in the corridor needed for wheelchairs. All radiators need to be covered as they may pose a risk to some residents of burning or scalding if very hot. The manager needs to make sure that all risk assessments for residents are easily accessed in their care plans. This will enable staff to see them and provide the necessary care resulting from the assessments ensuring residents get the correct all round care. The manager would benefit from having access to budgets for areas such as staff training to prevent staff from having to pay for their own training in some cases. The manager needs to ensure that all maintenance issues are addressed within suitable timescales to provide a safe and pleasant environment for residents at all times. Hooklands Nursing Home H60-H11 S24158 Hooklands V222061 030505 Stage 4.doc Version 1.30 Page 7 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. Hooklands Nursing Home H60-H11 S24158 Hooklands V222061 030505 Stage 4.doc Version 1.30 Page 8 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 Standards Statutory Requirements Identified During the Inspection Hooklands Nursing Home H60-H11 S24158 Hooklands V222061 030505 Stage 4.doc Version 1.30 Page 9 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 standard(s) 1,3 and 5. People who use this service receive clear information to enable them to make a choice about whether or not they wish to live in the home. EVIDENCE: The homes Statement of Purpose clearly states the facilities and care the home can give to enable residents to make a choice as to whether the home can meet their needs. This Statement needs to be updated to reflect the recent additions of new windows, electric buggy store and staffing changes. Two of the residents spoken with stated they were able to visit the home prior to coming in and were given written information about the home. Records show that the manager does assessments on prospective residents to ensure the home can meet their care and social needs. Residents stated they felt their care needs and social needs were met by very pleasant staff who are always asking what they would like to do other than what the home provides. One resident stated that staff are always encouraging him to take part in activities he would not other wise do so. Residents confirmed that they and their family were able to visit the home prior to making a decision to ensure the home could meet their needs.
Hooklands Nursing Home H60-H11 S24158 Hooklands V222061 030505 Stage 4.doc Version 1.30 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 standard(s) 7,8,9 and10 The Health and Personal Care needs of residents are fully met with residents being allowed dignity and respect. EVIDENCE: Individual care plans set out the health, personal and social care needs of residents enabling staff to ensure all residents to receive the correct care. Three care plans were looked at and all three showed all areas to be covered. Residents spoken with stated they felt they received the care they needed and one resident stated that staff were always encouraging him to participate in social activities he may other wise not do so. Evidence of regular assessments to include any changes were seen. All care plans are reviewed on a monthly basis, as seen in the plans during the inspection which enables staff to give the correct care needed to the residents. Risk assessments for the use of cot sides were not seen for all residents who have them and those who did were not easily available for staff to access to ensure the correct use and checks in place. The manager stated she would carry out risk assessments on all residents who have cot sides and ensure they are made available for staff to access. All the residents spoken with stated they were treated with respect and dignity. They stated they had privacy with all staff generally knocking before entering their door. One resident stated that staff do help him with washing
Hooklands Nursing Home H60-H11 S24158 Hooklands V222061 030505 Stage 4.doc Version 1.30 Page 11 and dressing but he likes to be as independent as possible and staff respect this by offering minimal assistance when he asks for it. Hooklands Nursing Home H60-H11 S24158 Hooklands V222061 030505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13 and 15 The home supports residents contact with family. Links with the community are good. EVIDENCE: All residents spoken with stated their friends and family can visit at any time they wish and there were no restrictions on visiting times ensuring important contact is maintained. One resident stated the home often provides lunch for his relative when visiting which he finds very enjoyable. Religious and cultural beliefs are met as on the day of the inspection Holy Communion was being held in the dining room for those residents who wished to join in. Residents stated they can access religious services in the home or outside of the home, which ever they choose. One stated that staff have taken residents to a local church for religious services in the past and will do so if asked. The home currently provides in house services for both Roman Catholic and Church of England faiths with many residents attending them. All residents were complimentary about the food provided. The home has experienced some difficulty in employing catering staff but the current catering team provide a varied choice, as seen in records and stated by residents. Hooklands Nursing Home H60-H11 S24158 Hooklands V222061 030505 Stage 4.doc Version 1.30 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 standard(s) 16 and 18 The home has satisfactory procedures for protecting residents from abuse. The complaints procedure is accessible. EVIDENCE: Records show no adult abuse incidents in the home have occurred since the last inspection resulting in maximum protection for all residents in place. Residents stated they are cared for with gentleness and one resident stated that she was fond of the staff and in no way scared of them. Staff are to have updated training on adult abuse in the near future, and the manager confirmed she is currently negotiating with an external company to provide this training. This will ensure that all staff are up to date with new legislation and will result in continued protection for residents. The home has a complaints procedure clearly on display in the entrance of the home enabling easy access for family and friends. Residents stated they would voice any concerns or complaints directly to the manager, and stated they would be at ease in doing so. The complaints file was empty except for one letter of concern raised The Commission for Social Care Inspection, and was dealt with effectively by the manager. Hooklands Nursing Home H60-H11 S24158 Hooklands V222061 030505 Stage 4.doc Version 1.30 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 standard(s) 19,20,21,23,24 and 26 People who use this service live in a reasonably well maintained environment which is in most parts safe and clean providing a pleasant living environment for residents. The Registered Person must continue to provide investment to keep up the work that has started to upgrade the home. EVIDENCE: A tour of the home showed evidence of maintenance work being carried out with the installation of new double glazed windows, extra aids being installed in toilets and new carpets to some rooms. All the bedrooms were clean and pleasantly decorated with evidence of personal possessions and radiator covers in place. The lack of radiator covers in communal areas and corridors could result in problems for residents. The home was asked to install these covers by Jan 2005 which has not happened. Following this inspection the home has until the end of August 2005 to install them to ensure the safety of residents over the next winter months. The manager stated that installation of radiator covers in corridors would decrease the width of the corridors making wheelchair access more difficult. This needs to be carefully looked at when installing the covers and placing residents in certain rooms. The tour of the home also
Hooklands Nursing Home H60-H11 S24158 Hooklands V222061 030505 Stage 4.doc Version 1.30 Page 15 showed that some floor boards in room 23 were loose and could result in a injury to the resident and staff. This needs to be made safe and consideration to renew the carpet needs to be looked at as it was very old. The velux window in room 3 is showing signs of needing repair or renewal. The outside of the building still has green plastic on one of the high fascia boards that spoils the look of the exterior that was painted last year. Toilets and washing facilities are satisfactory with residents stating they were happy with both provision. The upgrading of the shower on the first floor was discussed by the manager and the installation of a shower with no step to get in and out of it would provide easier access for residents. The inspector saw residents rooms that has many personal possessions in them and residents confirmed they are able to bring in their own items if they wish. The home was clean and free from any offensive smells during the inspection and the cleaner was seen working with good hygiene standards. Previous lack of financial input into the home resulted in one of the Registered Persons having a meeting with The Commission for Social Care Inspection and consequently work has been carried out in the home. This needs to continue with the requirements resulting from this inspection being addressed within the timescales given to avoid enforcement action. Hooklands Nursing Home H60-H11 S24158 Hooklands V222061 030505 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 People who use this service are cared for by a staffing team that is led by a very experienced manager who is supported by a friendly team of care staff. Numbers of staff on each duty meet the needs of the residents. EVIDENCE: Staff on duty during the inspection were satisfactory in numbers to care for the needs of the current residents. Residents stated that staffing levels were good with a variety of young and older nurses. All residents were complimentary about the staff and their commitment to caring for them. One resident said they were very kind and always smiling. The manager is a qualified nurse who has a management qualification as well. She is supported by a team of other qualified nurses and care staff. Together they are continually looking at ways to enhance the environment of the home and to help make residents lives happier. Residents stated staff are very gentle and helpful and always encouraging, very rarely in a hurry Hooklands Nursing Home H60-H11 S24158 Hooklands V222061 030505 Stage 4.doc Version 1.30 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31. The home is managed by a very experienced and competent manager who has many years of experience in caring for the elderly. EVIDENCE: The manager of the home is a very experienced qualified nurse with much experience of caring for the elderly that she uses as a role model to other staff for the benefit of the residents. She has a management qualification that helps her to carry out her role to her full potential as far as she is allowed by the providers. She is friendly and approachable, residents stated they feel comfortable asking her anything. She needs to be given more autonomy in the home by the providers to enable her to act quickly and effectively, for example by having a training budget she can access at her wish, as currently she does not have control of any budgets and most training is either paid for by the staff themselves or by attending free courses. Training budgets are held at head office in London. This would ensure that staff receive training applicable to their needs without having to pay for it themselves. Hooklands Nursing Home H60-H11 S24158 Hooklands V222061 030505 Stage 4.doc Version 1.30 Page 18 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 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 1 3 3 x 3 3 x x STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x x x x x x x Hooklands Nursing Home H60-H11 S24158 Hooklands V222061 030505 Stage 4.doc Version 1.30 Page 19 yes 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 8 Regulation 13 Requirement Risk assessments for the use of cot sides need to be in place for each individual resident who has them. All remaining radiators in communal areas and corridors are to have covers installed.(Previous timescale of 30/01/05 not met.) The velux window in room 3 needs repairing or replacing. The floor boards in room 23 need making safe and the carpet renewed Timescale for action 30th June 2005 30th August 2005 2. 19 25 3. 4. 19 19 25 25 30th August 2005 30th May 2005 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. 2. 3. Refer to Standard 1 19 21 Good Practice Recommendations The homes Statement of Purpose should be reviewed and updated to relfect changes that have taken place over the last two years. Green plastic on the high fascia boards on the exterior of the house needs to be removed. Consideration to installing a new shower with easier access for residents needs to be taken.
H60-H11 S24158 Hooklands V222061 030505 Stage 4.doc Version 1.30 Page 20 Hooklands Nursing Home Hooklands Nursing Home H60-H11 S24158 Hooklands V222061 030505 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection 2nd Floor, Ridgeworth House Liverpool Gardens Worthing, West Sussex BN11 1RY National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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