Inspection on 23/09/05 for Hookstead Resource Centre

This inspection was carried out on 23rd September 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Hookstead Resource Centre 02/02/07

Hookstead Resource Centre 01/03/06

Hookstead Resource Centre 14/12/04

Hookstead Resource Centre 22/06/04

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

CARE HOMES FOR OLDER PEOPLE Hookstead Resource Centre Goldsmith Avenue Crowborough East Sussex TN6 1RH Lead Inspector Judy Gossedge Unannounced Inspection 23rd September 2005 13:10 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 Hookstead Resource Centre DS0000041399.V259196.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. Hookstead Resource Centre DS0000041399.V259196.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Hookstead Resource Centre Address Goldsmith Avenue Crowborough East Sussex TN6 1RH 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) 01892 667855 01892 655862 East Sussex County Council Ms Carol Howie Care Home 22 Category(ies) of Dementia - over 65 years of age (18), Old age, registration, with number not falling within any other category (4) of places Hookstead Resource Centre DS0000041399.V259196.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The maximum number of service users to be accommodated is twenty two (22). That service users must be aged sixty five (65) years and over on admission. That a maximum of eighteen (18) service users with a dementia type illness to be accommodated. That accommodation is provided as follows: Willow Suite, seven (7) service users with dementia, receiving respite care for periods up to six weeks, or periods of short term care up to six months, with one place for a service user between the age of fifty five (55) and sixty four (64). Maple Suite, four (4) service users who are older people not falling within any other category, receiving assessment for a period of up to two weeks and rehabilitation on the Living at Home Programme, with one place for a service user between the age of fifty five (55) and sixty four (64). Cypress Suite, four (4) service users with dementia, receiving respite care for periods up to six weeks, or periods of short term care up to six months, with one place for a service user between the age of fifty five (55) and sixty four (64). Cedar Suite, seven (7) service users with dementia, receiving respite care for periods up to six weeks, or periods of short term care up to six months, with one place for a service user between the age of fifty five (55) and sixty four (64). That one named service user who is under the age of fifty five (55) can be accommodated on the Cedar Suite, Willows Suite or Cypress Suite for periods of respite care. 5. Hookstead Resource Centre DS0000041399.V259196.R01.S.doc Version 5.0 Page 5 Date of last inspection 14th December 2004 Brief Description of the Service: Hookstead is run by East Sussex County Council (ESCC), and is a purpose built property on three floors, set in its own grounds located a short distance from the centre of Crowborough. Service user accommodation comprises of twenty-two single bedrooms situated on the first and second floor in four self-contained units each with a lounge and dining area. The registration for the home details that three units provide respite care or short term care of up to six months for service users with a dementia type illness. One unit is part of the Living at Home Programme a rehabilitation scheme, where older people who may have suffered a period of illness or hospitalisation can have up to a two week period of assessment, or are rehabilitated for a period of up to six weeks in preparation for their return home. There is a five-day, day care service on site, which service users can access when there is a vacancy. Level access is facilitated in the home by the provision of a passenger lift. There is a very attractive garden at the rear of the home Hookstead Resource Centre DS0000041399.V259196.R01.S.doc Version 5.0 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over five and a half hours on 23 September 2005. This is the first statutory inspection of this year. A tour of the unit took place including communal areas and service users bedrooms. Rotas and care records were also inspected. Twenty-two service users were resident and seven service users were spoken with individually, and seven generally in the lounges. Four service users were case tracked as part of the inspection process. Due to communication difficulties it was not possible to speak to all service users individually, and so the opportunity was also taken to observe the interaction between staff and service users in the communal areas. The Manager was not present during the inspection but two senior care officers and eight care workers were spoken with. Four relatives were spoken to in the home and comment cards were left for service users and their relatives/representatives to complete after the inspection if they wished. The CSCI has also sent separate correspondence to the Responsible Individual for ESCC to raise concerns at the recruitment processes and lack of evidence of recruitment documentation in place on site for all its registered services. What the service does well: A Statement of Purpose is in place and a Service Users Guide is available to view in each service user’s bedroom. But the Statement of Purpose needs to be kept up-to-date and detail the care being provided. The home provides a safe, well-maintained, comfortable and homely environment. Staff were observed to deliver care with dignity and respect. Relatives and feedback from service users was that they were pleased with the overall care provided in the home. There is a detailed complaints procedure in place, which the service users and relatives felt comfortable about using if they needed to. Hookstead Resource Centre DS0000041399.V259196.R01.S.doc Version 5.0 Page 7 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. Hookstead Resource Centre DS0000041399.V259196.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Hookstead Resource Centre DS0000041399.V259196.R01.S.doc Version 5.0 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 the following standard(s): 1, 2 and 3. Although detailed information about Hookstead is available to be viewed prior to any admission to the home, because of the type of service provided service users have limited choice of placement. Service users are protected by the completion of a written contract/terms and conditions. There are pre-admission procedures in place to ensure that service users care needs can be met at Hookstead. EVIDENCE: A Statement of Purpose is in place and a copy of the Service Users Guide is kept for reference in each service users bedroom. The Statement of Purpose needs to be kept up-to-date and detail the care being provided. Where there are some service users who have been resident for longer than six months and are being provided with long-term care, this should be documented and how Hookstead Resource Centre DS0000041399.V259196.R01.S.doc Version 5.0 Page 10 their care needs are being met. There are forums for service users and their representatives to give their views on the service received, as yet this feedback has not been collated for prospective service users and their representatives to view for further information. It should be ensured that service users, carers/representatives are aware of how to access the latest inspection report. ESCC has a written contract to be used between the home and the service user, and a number of signed contracts were viewed. All service users are assessed by staff from one of ESCC’s Social Services Department’s Assessment Teams and have an assessment completed. Staff spoken with confirmed a copy of this or of the latest review of this assessment is sent to the home for reference. Sample documentation viewed for four service users evidenced this had been received for three of the admissions. Intermediate or rehabilitative care is provided but was not assessed on this occasion. On the day of the inspection there were no staff from the Living at Home Programme, occupational therapists or physiotherapists were not on duty. Service users spoke of these staff and the support given, of the exercises they were working on, of reviews of the care being provided and progress made and home visits prior to going home. All the service users spoke well of the staff and care provided and one service user commented that ‘Staff are very good.’ Hookstead Resource Centre DS0000041399.V259196.R01.S.doc Version 5.0 Page 11 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, 9 and 10. Care plans were in place but the information detailed should continue to be developed to ensure that service users’ health, personal and social care needs are met whilst resident in the home. There are detailed policies and procedures in place to manage medicine to ensure the protection of service users. Service users receive a service which ensures that their privacy and dignity is maintained whilst resident in the home. EVIDENCE: A sample of the service users files were viewed which were well structured. Individual care plans varied in detail, and did not always fully describe service users’ care needs. One service user who had continence issues the supporting documentation detailed the need for support from staff but was not detailed on the plan of care, another had no mention of personal care needs and a third who was diabetic had no reference to dietary requirements. All had a copy of a falls risk assessment and a number of supporting risk assessments were also Hookstead Resource Centre DS0000041399.V259196.R01.S.doc Version 5.0 Page 12 seen to be in place. Where service users had been resident for short or longterm care their individual plans did not appear to have been reviewed to ensure that their care needs were still being met. Not all had their preferred term of address recorded. Medication policies and procedures are in place and being reviewed. Staff confirmed they are in the process of receiving further medication training arranged by the organisation to meet the requirements of the standard. The storage and a sample of the recording of the administration of medication was also viewed on two of the units. Staff and records confirmed that a pharmacist regularly visits. Some service users spoken with were administering their own medication. A generic risk assessment is in place in the home where a service user self medicates. Although this provides a reference point for staff this is not adequate and should be developed to detail individual service users care needs. Staff were observed and feedback from service users and their relatives was that the overall care provided is good and privacy and dignity is respected at all times. One relative commented ‘Everything here is excellent,’ another ‘We both like it here very much.’ Hookstead Resource Centre DS0000041399.V259196.R01.S.doc Version 5.0 Page 13 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, 13, 14 and 15. There are opportunities for service users to participate in activities during their stay, so that service users social care needs are fulfilled. There is flexible visiting in the home and visitors are welcomed. EVIDENCE: There are opportunities for service users to participate in activities in the home. Service users and staff spoke of and records detailed activities they had joined in. During the inspection there was a general discussion/reminiscence group, a quiz and poetry reading. Currently service users social care needs are not included on service users individual care plans. Service users and relatives commented that there is flexible visiting, that staff were always very welcoming, and they are able to meet with their relative in private. Feedback from one relative was that ‘Staff are very good.’ Standard 15 was not inspected on this occasion, but comments were received from service users, and tea was observed on one of the units. This was a selection of sandwiches and cakes and the atmosphere was social and relaxed. All service users spoke very well of the food provided, although one comment was received from one service user who was diabetic and felt that there was Hookstead Resource Centre DS0000041399.V259196.R01.S.doc Version 5.0 Page 14 not enough choices available for diabetics. Also that there were a lot of especially prepared cakes provided on the menu but these were often dry and the service user would not normally eat cakes anyway. The recording of meals served should be further developed and include breakfast. Hookstead Resource Centre DS0000041399.V259196.R01.S.doc Version 5.0 Page 15 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): 16. There is a clear and effective complaints procedure in place, which enables service users and their representatives to raise any concerns that they might have. EVIDENCE: ESCC has a detailed compliments and complaints policy and procedure in place. Any complaints received are monitored through the line management arrangements in place within the organisation. One complaint had been received since the last inspection which had been dealt with appropriately. The CSCI have not received any complaints in relation to the service provided at Hookstead. Service users and relatives confirmed that they would feel comfortable raising any concerns with the staff or the Manager. Hookstead Resource Centre DS0000041399.V259196.R01.S.doc Version 5.0 Page 16 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, 23, 24, 25 and 26. The standard of the environment is good providing a safe, well-maintained and homely environment. EVIDENCE: The standard of décor, furnishings and carpeting in the home is good and provides a comfortable and homely environment. There is a passenger lift between the ground, and first floor within the home. There are twenty-two single bedrooms which all meet the minimum space requirements. Service users are able to control the temperature in their own bedrooms. All bedrooms have an emergency call bell system. Some of the bedrooms seen reflected a range of individual styles and interests. All of the bedrooms have en-suite facilities and there are assisted shower and bathing facilities which have been made homely on each of the units in the Hookstead Resource Centre DS0000041399.V259196.R01.S.doc Version 5.0 Page 17 home. Hot water in five of the wash hand basins and baths used by service users were tested, and were all close to the recommended safe temperature of 43 C. There are separate lounge and dining rooms on each of the units. The home was clean and free from offensive odours. The recording of routine fire checks were seen and were adequate. Hookstead Resource Centre DS0000041399.V259196.R01.S.doc Version 5.0 Page 18 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, 28 and 29. Adequate staffing levels are maintained to ensure that all the care needs, the health safety and welfare of the service users resident are met. ESCC recruitment policies and procedures need to be followed in order to protect service users. EVIDENCE: The staff rota was viewed and staffing was adequate on the day to meet the care needs of the service users resident. The homes relief staff and agency staff were working in the home during the day and there is currently a high reliance on these staff to maintain staffing levels. On the day there were four agency staff on duty out of the six care staff during the afternoon. The four agency staff were spoken with, two were very used to working in the home and the other two were relatively new to the home. Agency staff are also being used to cover ancillary tasks in the home such as domestic duties and two agency chefs are currently cooking the meals in the home. All staff spoken with spoke well of working in the home and comments included ’This is a well run home,’ It’s a good team who work well together,’ and ‘Good team and good environment.’ An update has been requested to ascertain staff progress towards completing an NVQ Level 2 in care or its equivalent. Hookstead Resource Centre DS0000041399.V259196.R01.S.doc Version 5.0 Page 19 All recruitment is co-ordinated by the Personnel Section at ESCC’s head office, which the Inspector has visited and viewed sample documentation across the organisations registered services to support the recruitment process in place. Some gaps in the required documentation were found which need to be addressed. In future recruitment documentation will need to be available at the home as part of any inspection completed. The Manager has not been able to confirm that all the staff have a satisfactory Criminal Records Bureau (CRB) check in place. Hookstead Resource Centre DS0000041399.V259196.R01.S.doc Version 5.0 Page 20 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): EVIDENCE: No standard in this section were assessed on this occasion. The Manager has worked for East Sussex County Council for many years, as a Senior Manager. There have also been opportunities within the organisation to undertake periodic training, and the Manager holds a Certificate in Social Services and is working towards NVQ Level 4 in Management. Although Standard 33 was not fully assessed on this occasion an update on the outstanding requirements was sought. Hookstead Resource Centre DS0000041399.V259196.R01.S.doc Version 5.0 Page 21 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 2 3 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 3 3 X 3 3 3 3 STAFFING Standard No Score 27 3 28 X 29 1 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X X Hookstead Resource Centre DS0000041399.V259196.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? Yes 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 2 3 Standard OP1 OP25 OP29 Regulation 4 (2) 13 (4) 19 (1) (b) (i) Requirement That the Statement of Purpose is kept up-to-date. That individual plans of care are subject to regular review. That evidence is provided to confirm recruitment procedures in place. That all existing staff and relief staff have completed a satisfactory Criminal Records Bureau check. This issue is outstanding since 28.02.05. That an update is provided on the progress of the number of care staff who hold an NVQ Level 2 in care or equivalent. That the results of the service user surveys are made available and feedback sought from other stakeholders. This issue is outstanding since 13.12.03 and 28.02.05. Timescale for action 30/11/05 30/11/05 01/01/06 4 OP28 18 (1) (a) 31/12/05 5 OP33 24 (1) (2) (3) 31/12/05 Hookstead Resource Centre DS0000041399.V259196.R01.S.doc Version 5.0 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Hookstead Resource Centre DS0000041399.V259196.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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. 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