Inspection on 28/11/07 for Hornegarth House Nursing Home

This inspection was carried out on 28th November 2007.

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

Hornegarth House Nursing Home 13/07/06

Hornegarth House Nursing Home 28/11/05

Hornegarth House Nursing Home 28/06/05

Hornegarth House Nursing Home 21/02/05

Hornegarth House Nursing Home 21/09/04

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

CARE HOMES FOR OLDER PEOPLE Hornegarth House Nursing Home 204 Walsall Road Great Wyrley Walsall West Midlands WS6 6NQ Lead Inspector Joanna Wooller Key Unannounced Inspection 09:00 28th November 2007 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 Hornegarth House Nursing Home DS0000022342.V344225.R01.S.doc Version 5.2 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. Hornegarth House Nursing Home DS0000022342.V344225.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hornegarth House Nursing Home Address 204 Walsall Road Great Wyrley Walsall West Midlands WS6 6NQ 01922 701702 01922 411115 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) www.southerncrosshealthcare.co.uk Southern Cross Care Homes No 2 Limited Mrs Heather Ann Hunter Care Home 45 Category(ies) of Dementia (45), Mental disorder, excluding registration, with number learning disability or dementia (45) of places Hornegarth House Nursing Home DS0000022342.V344225.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide personal care with nursing and accommodation for service users of both sexes whose primary care needs on admission to the home are within the following categories: Mental disorder excluding learning disability or dementia, MD, 45; Dementia, DE, 45. The maximum number of service users to be accommodated is 45. 2. Date of last inspection 13th July 2006 Brief Description of the Service: Hornegarth House offers nursing care to 42 service users with mental health problems and long-term mental illness. The home has 38 bedrooms with en-suite facilities. There are 34 single bedrooms and 4 double bedrooms. The home promotes and encourages full community involvement. The home is situated within a thriving village on a bus route between Walsall and Cannock. It is within easy walking distance of the main Stafford to Birmingham railway line. This purpose built home has wide corridors and ramps for easy access by wheelchair users. The home is on two levels and has access via the stairs or a passenger lift. There are two lounges, a large dining room and a conservatory. A secure garden is planted out with bushes and plants and has seating. Many recreational and diversional activities are carried out daily and this is displayed on the notice boards and in the homes Newsletter. £338 to £ 550 Hornegarth House Nursing Home DS0000022342.V344225.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 28th November by the lead inspector. The Manager was at another care home at the start of the visit and the deputy manager assisted the inspector prior to the manger returning to the home. The Deputy manager was in charge supported by two trained nurse and seven carers. The inspection included the following elements; A tour of the building, Observation and inspection of records relating to provision of care, Discussions with several service users, Discussions with several of the staff members on duty, Observation and sampling of other services provided such as catering and laundry, and an inspection of the managerial aspects such as staffing issues, training, recruitment and health & safety. The Inspector was made very welcome in the home and all assistance was given to gain the evidence required for the report. No complaints had been dealt with by Commission for Social Care Inspection since the last inspection. Service Users spoken to at the visit were complimentary about the home. Quality assurance reporting was very positive and the relatives were welcoming the new managers injection of enthusiasm into the home. They were pleased with the atmosphere in the home and the peaceful surroundings which had had a huge effect on the service users well being. The service users spoken to were very content, happy and settled in the home. Some service users were exceptionally bright characters that the staff were able to interact well with and have some positive conversations. What the service does well: The service offers a warm and friendly caring environment, which is staffed by dedicated, well-trained staff. The company have recruited a very enthusiastic manager who has already made her mark on the home. The staff have responded to her well and she is very positive about the future of the home and where she wants to take it with the support of her excellent deputy manager and her team of care and ancillary staff. Hornegarth House Nursing Home DS0000022342.V344225.R01.S.doc Version 5.2 Page 6 The manager holds an open door policy and supports the staff at all times to ensure she is familiar with the service users and the quality of care being delivered on a daily 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. The summary of this inspection report can be made available in other formats on request. Hornegarth House Nursing Home DS0000022342.V344225.R01.S.doc Version 5.2 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 Hornegarth House Nursing Home DS0000022342.V344225.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users only move into the home following full assessment by the manager ensuring their individual needs can be met. EVIDENCE: The manager ensures that all service users and their relatives have a copy of the Statement of Purpose and Service User Guide. Prospective service users receive a complaints procedure, home newsletter, a menu and a company brochure. The offer of a home visit is also available at a time to suit them or the manager will visit them at their home before a decision is made. The new manager has stabilised the home and her previous experience has resulted in the home being service users led and standards of care and management have improved greatly. Hornegarth House Nursing Home DS0000022342.V344225.R01.S.doc Version 5.2 Page 9 Copies of the documents mention previously were all on display in the homes’ entrance hall. The staff spoken to at the visit was aware that each service users has a full assessment prior to admission and they understand the importance of meeting the service users individual documented needs. Hornegarth House Nursing Home DS0000022342.V344225.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users health, personal and social care needs are met in well-documented care records to ensure service users needs are met. The staff following the homes medication policy and procedure safeguard service users. Service users are treated with respect and their privacy is maintained. EVIDENCE: All care records are written in the style of Roper, Logan and Tierney, which incorporates the individual service users activities of daily life. The detailed care plan is service users led which enables the staff to record the individual needs to ensure that they are met when they are reviewed at least on a monthly basis. Care records seen were well documented, meaningful and up to date. All information required by the Commission For Social Care Inspection was incorporated into the care plan and through case tracking the inspector was able to ascertain that individual care needs were being met in a constructive way. Hornegarth House Nursing Home DS0000022342.V344225.R01.S.doc Version 5.2 Page 11 Other healthcare professionals input into the care records such as the GP, social worker and nurse specialists. Named nurses and key workers are responsible for several service users each and they have certain responsibilities to ensure care needs are being met. Trained staff that administer medication follow the policy and procedure laid down by the company and they sign to say they have read and understood the policy. All service users are supported with their medication at the present time and the staff was observed to follow a safe and robust procedure. The manager and the dispensing pharmacy audit the medication supply, stock and storage. A new dementia strategy for the home has been introduced to ensure the service users can make choices. A separate smoking area has been organised, along with reorganisation of the lounges to allow service users the choice of where they sit and whom they sit with. Doorknockers have been placed on all bedroom doors to allow extension of service users privacy on entering their personal space. Hornegarth House Nursing Home DS0000022342.V344225.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12 to 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users recreational and religious needs are met in the home and they have full contact with family and friends as preferred. Service users have choice and control over their lives within safe limits and they receive a balanced and appealing diet. EVIDENCE: A dedicated activity organiser is employed at the home to assist the service users in meeting their individual recreational needs. The service users follow a robust activity programme with a variety of suitable activities for the abilities of the service users. There is no restrictions on visiting and service users enjoy their family and friends joining them at social events and seasonal parties such as Halloween and Christmas. The service users spoken to in the dining area told the inspector that they “love the activities” and one man started to sing. Individual social care plans are sited in the service users care records and these are updated as necessary. Personal likes and dislikes are noted and hobbies and interests are documented. Hornegarth House Nursing Home DS0000022342.V344225.R01.S.doc Version 5.2 Page 13 The activity organiser has spent many hours assisting the service users mental health needs by creating peaceful areas and interesting paintings and “touchy/feely” areas. The corridors are now bright and interesting and the service users were seen observing the ‘pick up’ soft toys and interacting with other service users. Activities are displayed on the notice boards with photographic evidence of previous events. The service users receive the newly introduced ‘Nutmeg’ menu, which ensures each service users receives their favourite foods that are nutritionally balanced. Meal times were observed to be varied and unhurried with staff offering discreet assistance to those service users who required it. Plans for Christmas were well underway and the manager was ensuring that the service users would all have a Christmas to remember. Presents were ready for wrapping and the entertainment and parties were arranged. Hornegarth House Nursing Home DS0000022342.V344225.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are confidant that complaints will be dealt with competently and action taken regarding the issues. Service users are protected from abuse by the staff training and staff awareness. EVIDENCE: The complaints procedure is sited in the entrance hall of the home and all service users and their families are issued with the procedure on admission. The manager states that she would deal with complaints promptly following the policy and procedure. She maintains that the open door policy supports the service users and their families, which avoids any issues becoming complaints. The home has had no complaints in the last six months and the manager ensures that all the staff knows the importance of listening to service users and their families. The Staffordshire adult protection policy and procedure is available in the home for all staff to become familiar with and this is discussed as part of the staff awareness training. All staff have received training in abuse that is relevant to care delivery and the staff are fully aware that the home and the manager will not tolerate any forms of abuse. No adult protection meetings have been held in the previous 12 months. Hornegarth House Nursing Home DS0000022342.V344225.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a safe, well-maintained environment, which is clean, pleasant and hygienic. EVIDENCE: The layout of the home allows safe access in most areas for the service users. The home is well maintained and well-kept records support the evidence. The home is comfortable in a homely way with well-lit corridors and cosy seating areas. The lounge/ diners are both well organised and fixtures and fittings have been upgraded on the ground floor. Bedrooms are being upgraded as part of the annual plan and the 1st floor upgrade has commenced. The grounds are safe, tidy and accessible in good weather. The building complies with the requirements of the fire service and the newly required evacuation plan is in place. Hornegarth House Nursing Home DS0000022342.V344225.R01.S.doc Version 5.2 Page 16 The Environmental Health Officer has recently awarded the home with 5 stars for their kitchen management. The premises were exceptionally clean, hygienic and free from malodours. Infection control policy and procedures are well followed in the home by all staff. Laundry facilities have been upgraded and now meet the standards required and the area was inspected and was evidenced as well managed. Hornegarth House Nursing Home DS0000022342.V344225.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27 to 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users needs are met by the numbers and skill mix of the staff which ensures they are in safe hands at all times. Service users are supported by the homes robust recruitment policy and procedure as this ensures staff are suitable to work in the home and they are competent and well trained. EVIDENCE: The manager and her deputy monitor staffing levels to ensure that the needs of the current service users can be met. Staffing rotas were made available for the inspector as evidence of staffing levels and staff competence. Two trained nurses are on duty for each shift along with the manager and her deputy who supernumerary. The care staff supports them in the delivery of care and ensuring service users needs are met. The named nurse and key worker role promotes individualised acre for the service users and ensures that the service users care is closely reviewed. The recruitment policy and procedure is in place, which demonstrates the managers’ commitment to employing and developing highly qualified, professional staff. Training for all employees is recorded and monitored. Hornegarth House Nursing Home DS0000022342.V344225.R01.S.doc Version 5.2 Page 18 The home is hoping to organise a bank of staff to cover sickness and holidays, however no agency staff are working at the home at present. Staff turnover has greatly reduced. Staff training has taken priority in the last few months and the staff training completed exceeds 85 with further training prior to Christmas to increase the percentage. All the staff had been involved in the introduction of the dementia strategy work in the home to ensure a full understanding of the need to address certain mental health issues in a positive and fulfilling way. It has been well received now by all staff, service users and their families. Yesterday, Today and tomorrow training has commenced for some staff and this ‘good practice’ training will be cascaded throughout the complete workforce. Hornegarth House Nursing Home DS0000022342.V344225.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a home, which is run and managed by a person who has strong leadership skills, a wealth of experience and one whom has a positive management approach. The home is run in the best interests of service users. Service users financial interests are safeguarded by the robust financial procedures. The health, safety and welfare of service users and staff are promoted and protected. EVIDENCE: The manager who is very experienced is yet to be registered by the Commission For Social Care Inspection but she has previously been a registered manager in another company home. The documentation for this process has been forwarded to the local office for processing. Hornegarth House Nursing Home DS0000022342.V344225.R01.S.doc Version 5.2 Page 20 The manager operates and promotes an open door policy, allowing service users and relatives time to chat about care issues and the progress of the home. Regular relatives meetings are held with invitations and posters used to advertise the meeting in a timely manner. The positive ethos and strong leadership within the home is welcoming and friendly. The manager and her team are well respected by the service users and their relatives/representatives. Regular support form the operations manager has ensured that action plans for the home have been drawn up and targets for completion met. Robust financial procedures are in place, which follow the guidance of the policies and procedure for dealing with monies. Service users have individual pocket money files, which are closely audited. Freedom of choice for all is expressed throughout the home and the manager employs a multi-cultural group of staff. Staff supervision has commenced and evidence of this will be built up over the next few months. The manager discussed that she is aiming to achieve a robust programme of supervision subjects to ensure that the staff feel valued and experienced in the care environment. The health, safety and welfare of staff and service users is promoted and protected by the rigorous testing, recording and monitoring of systems within the home. Relevant risk assessments were in place for service users and also for actions around the home. Accident records were kept and body maps were used if necessary. Accident levels had reduced due to the dementia strategy introduced at the home and the staff training had also been effective in this reduction. The manager audits the accident records along with many other areas of the home and these are forwarded to head office on a monthly basis. The maintenance person takes pride in his work and maintains the home in a professional manner and the records seen by the inspector evidence this. Hornegarth House Nursing Home DS0000022342.V344225.R01.S.doc Version 5.2 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 Hornegarth House Nursing Home DS0000022342.V344225.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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 OP31 Good Practice Recommendations The manager must become re-registered with the Commission For Social Care Inspection in her new post. Hornegarth House Nursing Home DS0000022342.V344225.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Hornegarth House Nursing Home DS0000022342.V344225.R01.S.doc Version 5.2 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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