Inspection on 11/07/07 for Hoylake Cottage Hospital

This inspection was carried out on 11th July 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

Hoylake Cottage Hospital 20/06/06

Hoylake Cottage Hospital 14/12/05

Hoylake Cottage Hospital 23/05/05

Hoylake Cottage Hospital 05/01/05

Hoylake Cottage Hospital 24/08/04

Hoylake Cottage Hospital 23/02/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Hoylake Cottage Hospital Birkenhead Road Hoylake Wirral CH47 5AG Lead Inspector Jeanette Fielding Unannounced Inspection 11th July 2007 10:30 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 Hoylake Cottage Hospital DS0000020909.V335469.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. Hoylake Cottage Hospital DS0000020909.V335469.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hoylake Cottage Hospital Address Birkenhead Road Hoylake Wirral CH47 5AG 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) 0151 632 3381 0151 632 4544 director@hoylakecottage.co.uk Hoylake Cottage Hospital Trust Limited Linda Cooke Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Hoylake Cottage Hospital DS0000020909.V335469.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Four named persons under the age of 65 years The home is registered for a maximum of 40 service users to include:*Up to 40 services in the category of OP (Old age not falling within any other category) Six existing service users may be accommodated in bedrooms on the first floor. 16th January 2007 Date of last inspection Brief Description of the Service: Hoylake Cottage Hospital is a nursing home for elderly people set within the Cottage Hospital environment. It is registered to provide nursing care to forty elderly people. The home is located on the main thoroughfare through Hoylake and is fully accessible by public transport. The building is a former hospital that has had some internal modifications to enable it to operate as a nursing home. A new, purpose built nursing home is currently being built to replace the current home and the building work is well underway. The fees for the home are £462 - £500 per week plus the assessed nursing fee. Hoylake Cottage Hospital DS0000020909.V335469.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was conducted in one day over a period of six hours. During the inspection, the care plans for a selection of service users were inspected together with records held in relation to the care afforded to service users. Staff records were inspected to ensure that recruitment procedures are robust to ensure the protection of service users. Discussion took place with the manager, staff, service users and visitors to the home. A full tour of the premises was undertaken. What the service does well: What has improved since the last inspection? What they could do better: The home should continue to monitor and review care service provision through regular audits. Hoylake Cottage Hospital DS0000020909.V335469.R01.S.doc Version 5.2 Page 6 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. Hoylake Cottage Hospital DS0000020909.V335469.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 Hoylake Cottage Hospital DS0000020909.V335469.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): 1 and 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Full information regarding prospective service users needs is gathered prior to service users admission to the home to enable staff to be fully informed about their care needs. EVIDENCE: The statement of purpose has recently been reviewed and updated to reflect changes that have taken place within the home. The document is detailed and informative to give current and prospective service users a full picture of the services and facilities offered. Copies of this are displayed at the foyer of the home and are available on request. Inspection of care files of service users who have recently been admitted to the home showed that a detailed assessment of their needs and preferences had Hoylake Cottage Hospital DS0000020909.V335469.R01.S.doc Version 5.2 Page 9 been recorded. This enables the staff in the home to prepare a plan of care in preparation for their admission. The form identifies any specialist equipment necessary to meet the service users needs and enables the home to access these prior to admission. A new care manager has been identified from within the staff team and is working with the registered manager to further develop the format of the preadmission assessment form to enable additional information to be gathered and recorded. Service users who are admitted for respite care are assessed prior to the initial stay at the home. Many of the respite service users are accommodated on a regular, and often frequent basis. The records of previous stays at the home are held and discussion takes place with the service user and their carers to identify any changes in their care needs since their previous stay. The home does not offer intermediate care. Hoylake Cottage Hospital DS0000020909.V335469.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): 7, 8, 9, 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Detailed care plans are prepared for all service users to ensure that staff have full information about their care needs to enable those needs to be met. EVIDENCE: Individual care plans are prepared for each service user. The initial plan, prepared on admission, uses details gathered during the pre-admission assessment and is reviewed on a monthly basis or as the service users needs change. All risks are identified and recorded and plans put in place to reduce or remove those risks. Detailed plans for the care of the service users are prepared to give the staff full information regarding the care that is to be given. Daily records are made of the actual care given are made by the staff. The care plans are used as a working tool and are written in plain language so that they can easily be understood. Service users or their next of kin are requested to sign the plans to indicate their agreement with them. Hoylake Cottage Hospital DS0000020909.V335469.R01.S.doc Version 5.2 Page 11 Records are held of visits to and by other healthcare professionals i.e. doctors, dietician, tissue viability nurse, speech and language therapists, optician and chiropodist. Care files contain full information regarding service users abilities and areas where they need staff assistance to maintain their independence. The home operates to a well developed and efficient medication policy, procedure and practice guidance. Staff all have access to the written information and understand their role and responsibilities. All medications inspected were found to be ordered, stored, administered, recorded and disposed of in accordance with good practice. A risk management plan has been prepared for those service users who wish to administer their own medications. The care manager now holds full responsibility for ordering, disposing and auditing of medications, together with undertaking audits on falls, pressure sores, bed rails and wounds. This is to ensure that service users are protected at all times. Service users are accommodated in single or double bedrooms. Screens are provided in shared rooms to protect the privacy and dignity of service users. Staff were observed to speak to service users discreetly regarding personal issues. Hoylake Cottage Hospital DS0000020909.V335469.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): 12, 13, 14, 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. A wide range of activities are available which provide service users with stimulation to promote social interaction. EVIDENCE: Service users are offered a high number of activities in which they can participate. An activities co-ordinator is employed to provide stimulation and detailed records are held of each service users involvement with the activities. Records held in the home provide evidence that social preferences have been discussed with the service users and also show that every effort has been made to meet those preferences. The home has an active resident’s forum where events are discussed and provide evidence that service users are actively involved in making decisions regarding activities. A restaurant style high tea is offered to service users away from the main dining areas on a regular basis. Other activities include a reading group, and entertainments group, a reading group, pottery classes and poetry sessions together with Hoylake Cottage Hospital DS0000020909.V335469.R01.S.doc Version 5.2 Page 13 board games. One to one activities are provided for those service users who do not wish or are unable to participate in group activities. One service user attends a day centre and some service users are taken out on a regular basis by their relatives, friends or staff. Ministers of religion visit the home on a regular basis and provide services for service users in small groups or on an individual basis as requested. The home has details of ministers of other religions who can be contacted to meet service users specific needs as necessary. Service users take their meal in the dining areas or in their bedroom as they choose. A selection of meals is offered and the meals observed were attractively served and presented. The menus showed that a balanced and varied diet is offered to service users. Special and ethnic diets can be provided on request or on the advice of the GP or dietician. One service user said that the meals were really good and sometimes found it hard to choose which meal to take because they were all wonderful. Hoylake Cottage Hospital DS0000020909.V335469.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): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff have a good understanding of adult protection issues and their own role within this to ensure that service users are protected from harm or abuse. EVIDENCE: The home has a comprehensive complaints procedure which has recently been reviewed and updated. Information on how to make a complaint against the service is detailed in the Statement of Purpose and Service User Guide and is also displayed on the notice board within the home. No complaints had been received by the service since the last inspection. Training has been given to all staff on adult protection and staff spoken to were aware of the whistle blowing policy. Staff spoken to said that the manager had an open door policy and was available to speak with them at any time. Staff were also able to demonstrate their knowledge and understanding of adult protocols and of their own role within this. Hoylake Cottage Hospital DS0000020909.V335469.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): 19, 20, 24 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Continued investment has improved the appearance of the home and has created a comfortable and safe environment for those living there and visiting. EVIDENCE: The majority of bedrooms are located on the ground floor of the home, with an additional six bedrooms now located on the first floor. These additional six rooms have been registered to replace rooms that have had to be taken out of use on the ground floor due to the building of the new home. Lift access is provided to the first floor and gives full access to all areas. Hoylake Cottage Hospital DS0000020909.V335469.R01.S.doc Version 5.2 Page 16 A programme of redecoration has taken place since the last inspection, with bathrooms and toilets being redecorated and improved. Worn and damaged carpets have been replaced. New furniture has been provided in some of the bedrooms and some service users have been provided with profiling beds following a risk assessment of their needs. A new hoist has been provided and a stair lift fitted on the stairs giving additional access to the first floor. New bed rails and bumpers have been provided and fitted to beds where necessary following a risk assessment and agreement from the service user or their relative. A relative’s room has been provided to give a private area where service users can meet their relatives or where relatives can spend time alone if necessary during times of anxiety. Bedrooms are decorated and furnished to a good standard and every effort has been made to ensure that the rooms are homely and comfortable. Service users are encouraged to personalise their rooms with pictures, photographs and items of memorabilia. One visitor spoken to said that his relative loved the room and that the staff did all they could to improve the quality of life and the environment for the service user. All areas of the home were extremely clean and there were no unpleasant odours. Each area of the home has their own lounge and dining area and service users are encouraged to meet with other service users during activities and social events. Hoylake Cottage Hospital DS0000020909.V335469.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): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home employs a well trained staff team to ensure that service users are protected and provided with a high standard of care. EVIDENCE: The home employs qualified nurses and care staff to provide care to service users at all times. The deployment of staff has been reviewed and amended to ensure that staff are available to provide care to service users who are now accommodated on the first floor, whilst ensuring that service users on the ground floor are not disadvantaged. The roles of the care manager and training manager have changed to give them the opportunity to develop their own role whilst ensuring that service users are given a high level of care. The registered manager oversees all aspects of staff training and support together with holding responsibility to ensure that high standards of care to service users is maintained. The home has a robust recruitment procedure and the staff files inspected provided evidence that all checks are made on staff prior to them commencing work at the home. Staff records were found to be in order. All new staff Hoylake Cottage Hospital DS0000020909.V335469.R01.S.doc Version 5.2 Page 18 complete a full induction training programme and evidence of this is held on their individual files. The home continues to be committed to ensuring that all staff are trained to a high standard. Training opportunities are displayed on the staff notice board and evidence is held in staff files of all training undertaken. The home currently employs 58 of staff who hold NVQ qualifications. Additional staff are currently undertaking this training. Volunteers work in the home, mainly on reception duties. These volunteers have been vetted in line with the homes recruitment policy and procedure. Within the service there is evidence of a good awareness and understanding of equalities and diversity. Discussion with staff showed that they are able to translate understanding into positive outcomes for residents in the areas of age, sexuality, gender, disability and belief. Hoylake Cottage Hospital DS0000020909.V335469.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): 31, 33, 35, 37 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager is supported well by the senior staff in providing clear leadership throughout the home with all staff demonstrating an awareness of their roles and responsibilities. EVIDENCE: The registered manager of the home is a qualified nurse who has considerable experience in management of the care of older people. She was able to demonstrate that she has continued to further develop her knowledge and understanding through additional training. The registered manager is Hoylake Cottage Hospital DS0000020909.V335469.R01.S.doc Version 5.2 Page 20 supported by a care manager and training manager who each hold specific responsibilities. The systems and procedures within the home continue to change and develop through regular review to the benefit of service users. Regular reviews of policies and procedures continues to ensure that they provide staff with full details regarding the home and their individual roles and responsibilities. It is evident that service users rights and needs are respected at all times and that they are at the forefront when decisions regarding changes within the home are considered. Regular audits of service provision are undertaken and the views of service users and their relatives is sought. The home does not deal with service users finances but will hold small amounts of money for service users at their request for convenience of access and security. Full records are kept of all monies held on service users behalf and these records are accessible to service users or their representative as appropriate, at all times. Safety certificates were inspected and found to be up to date. Tests on fire detection equipment are made on a regular basis and are duly recorded. All staff are given fire training and a record of this is held in the home. Questionnaires were issued to service users and visitors to the home and all respondents state that they are happy with the care, the staff and the service provided. All stated that they had full information about the home prior to making a decision regarding their care provider. Hoylake Cottage Hospital DS0000020909.V335469.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 3 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 4 13 3 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X X 3 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 4 X 3 X 3 X 3 3 Hoylake Cottage Hospital DS0000020909.V335469.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. Refer to Standard Good Practice Recommendations Hoylake Cottage Hospital DS0000020909.V335469.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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