Inspection on 07/06/05 for Hothfield Manor Centre

This inspection was carried out on 7th June 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Hothfield Manor Centre 01/06/09

Hothfield Manor Centre 02/04/09

Hothfield Manor Centre 02/03/09

Hothfield Manor Centre 15/05/07

Hothfield Manor Centre 15/11/05

Hothfield Manor Centre 11/03/05

Hothfield Manor Centre 14/12/04

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

CARE HOME ADULTS 18-65 Hothfield Manor Centre Church Lane Hothfield Ashford Kent TN26 1EL Lead Inspector Sue Gaskell Unannounced 7 June 2005 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Hothfield Manor Centre H56-H05 S23445 Hothfield Manor Centre V229079 070605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Hothfield Manor Centre Address Church Lane Hothfield Ashford Kent TN26 1EL 01233 643272 01233 611433 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) Hothfield Manor Limited Mr Keith Lionel Hutchinson CRH 21 Category(ies) of Care Home for people with Physical Disabilities registration, with number of places Hothfield Manor Centre H56-H05 S23445 Hothfield Manor Centre V229079 070605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. One (1) person with a date of birth of 18.09.1937. Date of last inspection 11th March 2005 Brief Description of the Service: Hothfield Manor Centre is a care facility registered to provide accommodation, personal care and support for up to 21 adults with a physical disability. The Centre specialises in the provision of care to people who have an acquired brain injury and offers the accommodation in two specific areas, these being 11 single bedrooms in the Manor House and 10 single bedrooms within 5 terrace chalet bungalows within the grounds. The Manor House is a large two-storey building set in extensive, wellmaintained landscaped grounds. Facilities are located on 2 levels, with individual bedrooms for residents. The communal areas include a large dining room, lounge, kitchen, laundry, games/exercise room, offices and a conference room. There is a passenger lift as well as two stairs to gain access to first floor rooms. The newer purpose-built bungalows provide 5 self-contained two-bedroom units for residents. Each unit has a kitchen, bathroom, and lounge/dining area. A 6th unit provides staffing facilities and a craft area for residents. Each unit has patio doors leading to patio/garden area. The Centre is located on the outskirts of the village of Hothfield, which is located approximately 5 miles from the town of Ashford. Local amenities are within walking distance and consist of a post office / shop and pub. The Home has its own transportation; a public bus route services the village. Hothfield Manor Centre H56-H05 S23445 Hothfield Manor Centre V229079 070605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Hothfield Manor provides a comfortable, spacious environment. 2 residents said that the care and services provided by the home are good, and that the staff are helpful, kind and cheerful. Whilst staffing numbers were adequate for meeting basic needs of residents, increased staffing would enable residents to participate in a wider range of activities. Staff had a good knowledge of sound care practices and of individual residents’ likes, dislikes and needs. Some care plans have been reviewed but there is an urgent need for more detailed risk assessments, guidelines on how to minimise risk, and more detail on medication. The home is clean, well maintained and decorated, and generally there is a high regard and awareness of health and safety issues. Staff recruitment and employment systems were satisfactory, and training and supervision of staff takes place. Records relating to residents’ finances were not inspected on this occasion, but other records and administration procedures inspected were satisfactory. What the service does well: 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. Hothfield Manor Centre H56-H05 S23445 Hothfield Manor Centre V229079 070605 Stage 4.doc Version 1.30 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Hothfield Manor Centre H56-H05 S23445 Hothfield Manor Centre V229079 070605 Stage 4.doc Version 1.30 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 Prospective residents’ health care, emotional and social needs are assessed prior to their admission to the home. EVIDENCE: The individual records which are kept for each resident included a preadmission carried out by the home with input from other health care professionals.. One senior staff member told the inspector that she has assisted the manager in this process. Hothfield Manor Centre H56-H05 S23445 Hothfield Manor Centre V229079 070605 Stage 4.doc Version 1.30 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,9,10 Some improvement have been made to the recording and care planning system, but there remain shortfalls which have a potential to place residents at risk through not having their needs monitored or fully met. EVIDENCE: Of the 3 care plans inspected, only one had been reviewed recently. One particular care plan, which was discussed in detail at the previous inspection, had not been reviewed and did not contain the risk assessments identified as necessary during the last inspection. Daily recording has improved, with the introduction of a system which should ensure that personal or sensitive information on residents remains confidential. Hothfield Manor Centre H56-H05 S23445 Hothfield Manor Centre V229079 070605 Stage 4.doc Version 1.30 Page 9 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,15,16,17 Residents have the opportunity for some leisure activities but the choice may be limited due to lack of staff. Meals are nutritious and offer a healthy, balance and varied diet for residents. EVIDENCE: The home has extensive grounds for the use of residents and their visitors and there is a dedicated games room in addition to the communal areas. The nature of the equipment in the games room may mean that staff supervision is necessary for some residents and the games room was not in use at the time of the inspection. The food served during the inspection was nutritious and appeared appetising. Hothfield Manor Centre H56-H05 S23445 Hothfield Manor Centre V229079 070605 Stage 4.doc Version 1.30 Page 10 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19,20 Personal support in the home is offered in such a way as to promote and protect residents’ privacy, dignity and independence, and to ensure that their needs are met. Whilst the medication system has improved, there remains a requirement for more detail. EVIDENCE: Staff related in residents in a friendly supportive manner, offering appropriate assistance and advice as necessary. The residents appeared comfortable and relaxed with staff. The daily notes contained references to residents’ healthcare needs being identified and monitored, with referrals to a range of healthcare professionals. The medication storage has been improved but there was no record of what conditions the medication had been prescribed for. Hothfield Manor Centre H56-H05 S23445 Hothfield Manor Centre V229079 070605 Stage 4.doc Version 1.30 Page 11 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23 The home has a satisfactory complaints system with some evidence that residents and/or their representatives feel that their views are listened to and acted upon. However lack of adult protection awareness training for staff could mean that staff are not competent at recognising adult protection issues. EVIDENCE: The home has a complaints procedure and there was evidence on file to show that some recent issues raised had been responded to appropriately. Staff were aware of the home’s complaints procedure. Whilst the issue of adult protection awareness training has been referred to in previous inspections, this is not currently listed on the home’s training matrix. Hothfield Manor Centre H56-H05 S23445 Hothfield Manor Centre V229079 070605 Stage 4.doc Version 1.30 Page 12 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,30 The standard of the environment is good, providing residents with safe, well maintained and spacious indoor and outdoor spaces. EVIDENCE: All residents are in single room accommodation that is generally furnished according to their needs and wishes. The home is clean and hygienic and the gardens and grounds are well maintained. Hothfield Manor Centre H56-H05 S23445 Hothfield Manor Centre V229079 070605 Stage 4.doc Version 1.30 Page 13 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,35 Staff turnover and training has improved, resulting in a greater consistency of care. However there are still shortfalls in training and staffing levels. EVIDENCE: Staff said that training has improved, but there are still areas identified by the home where training has not yet been provided. There are also training needs such as adult protection awareness, and conditions appropriate to this particular client group, and which have been discussed at previous inspections, which are not listed on the home’s training matrix. There were 3 care staff in the main house, 3 staff in the bungalow, the manager, and one other staff employed to provided 1:1 assistance to a particular resident, on duty at the time of the inspection. This level of staffing should be reviewed constantly to ensure that there are sufficient staff to assist residents with meaningful activities as well as personal care. Hothfield Manor Centre H56-H05 S23445 Hothfield Manor Centre V229079 070605 Stage 4.doc Version 1.30 Page 14 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39,42 The home reviews aspects of its performance, seeking residents’ views and comments. Health and safety systems are in place which protect and promote the health safety and welfare of residents. EVIDENCE: The home has issued quality monitoring form to residents and there are regular residents’ meetings. Senior staff referred to information in the policies and procedures manual. Another staff referred to various health and safety checks which are carried out and recorded. Individual staff observed various health and safety practices such as using appropriate clothing and marking potential hazards. Hothfield Manor Centre H56-H05 S23445 Hothfield Manor Centre V229079 070605 Stage 4.doc Version 1.30 Page 15 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 2 x x x Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 2 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 2 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score x x 2 x 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Hothfield Manor Centre Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score x x 2 x x 3 x H56-H05 S23445 Hothfield Manor Centre V229079 070605 Stage 4.doc Version 1.30 Page 16 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. 2. Standard 6 9 Regulation 15 13 Requirement Review all care plans on at least a 3 monthly basis or as residents needs change. Prepare written risk assessments for any activity or area where there may be a potential risk or hazard, with appropriate guidelines to minimise risk. Include details of medication and the reason for its prescription in residents care plans. Provide staff with training on adult protection awareness appropriate to issues raised at previous inspections.. Review staffing levels to ensure that there are sufficient staff to provide meaningful actvities for residents. Provide staff with core training and other specialist training appropriate to the needs of the client group. Timescale for action 15.07.05 15.07.05 3. 4. 20 23 13 18 15.07.05 15.10.05 5. 33 18 15.07.05 6. 35 18 15.10.05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Hothfield Manor Centre H56-H05 S23445 Hothfield Manor Centre V229079 070605 Stage 4.doc Version 1.30 Page 17 No. 1. Refer to Standard 12 Good Practice Recommendations Review staffing levels and staffing rota on a continuous basis to ensure that residents are able to participate in a range of leisure activities. Hothfield Manor Centre H56-H05 S23445 Hothfield Manor Centre V229079 070605 Stage 4.doc Version 1.30 Page 18 Commission for Social Care Inspection 11th Floor, International House Dover Place Ashford Kent TN23 1HU 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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