Inspection on 23/05/05 for Hoylake Cottage Hospital

This inspection was carried out on 23rd May 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 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 11/07/07

Hoylake Cottage Hospital 20/06/06

Hoylake Cottage Hospital 14/12/05

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 23 May 2005 10:20am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Hoylake Cottage Hospital F52 F02 S000020909 Hoylake Cottage V230212 230505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Hoylake Cottage Hospital Address Birkenhead Road Hoylake Wirral CH47 5AG 0151 632 3381 0151 632 4454 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) Hoylake Cottage Hospital Trust Limited Maureen Keymer CRH - Care Home with Nursing 40 Category(ies) of OP - Old Age registration, with number of places Hoylake Cottage Hospital F52 F02 S000020909 Hoylake Cottage V230212 230505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: One named adult under the age of 65 years Date of last inspection 5 January 2005 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. Twenty-eight of the bedrooms are for single occupancy with six double rooms being available. Plans have been prepared to replace this home with a purpose built, modern building, to provide a high quality facility for the care of elderly people. The new building is not expected to be completed until summer 2006. Hoylake Cottage Hospital F52 F02 S000020909 Hoylake Cottage V230212 230505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place in one day over a period of five hours. During the inspection, the views of five staff, nine service users and three relatives were sought to give an objective overview of the home and the service provided. 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. Hoylake Cottage Hospital F52 F02 S000020909 Hoylake Cottage V230212 230505 Stage 4.doc Version 1.30 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Hoylake Cottage Hospital F52 F02 S000020909 Hoylake Cottage V230212 230505 Stage 4.doc Version 1.30 Page 7 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 3 The homes Statement of Purpose and Service User Guide are good providing service users and prospective service users with details of the services the home provides enabling an informed decision to be made about admission to the home. Detailed pre admission assessments are undertaken to ensure that the home can meet the service users needs. The home does not provide intermediate care. EVIDENCE: The Statement of Purpose and Service User Guide have recently been updated to reflect the changes within the home. These documents are informative and give all necessary information. Copies of these documents are held in the home and are available on request. The care manager, or one of the qualified nurses, undertakes a pre admission assessment to ensure that the home can meet the specific needs of each prospective service user. These assessments identify the social and care Hoylake Cottage Hospital F52 F02 S000020909 Hoylake Cottage V230212 230505 Stage 4.doc Version 1.30 Page 8 needs together with any special diets or equipment that the service user would need on admission. Care plans are prepared, based on the outcome of the pre admission assessment. Hoylake Cottage Hospital F52 F02 S000020909 Hoylake Cottage V230212 230505 Stage 4.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9, 10 Care plans are detailed and up to date to provide full information to enable individual care to be given to service users. Medications are dealt with in accordance with the homes policy and procedure for the protection of service users. EVIDENCE: Individual care plans are prepared for each service user. These plans give all the necessary information for the staff to give the necessary care to each service user. These are reviewed on a regular basis to ensure that the service users changing needs are met. Nine care files were inspected and all were found to contain the necessary information. The home is divided into three areas and it was noted that the format of recording differed slightly in all areas, although the information was recorded. Discussion took place regarding the different methods of recording and the care manager intends to work with the staff to develop and single format. The staff complete a daily report on each service user to provide evidence of the care given. These reports continue to improve. Hoylake Cottage Hospital F52 F02 S000020909 Hoylake Cottage V230212 230505 Stage 4.doc Version 1.30 Page 10 The medication administration process has improved since previous inspections. The care manager regularly reviews and audits the medication to ensure that accuracy of administration and recording is maintained. Service users spoken to confirmed that staff did all they could to protect service users privacy and dignity, despite some of the facilities within the home not being conducive to retaining these values. Hoylake Cottage Hospital F52 F02 S000020909 Hoylake Cottage V230212 230505 Stage 4.doc Version 1.30 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15, Links with the community are good and support and enrich service users’ social opportunities. The meals in this home are good offering both choice and variety and catering for special dietary needs. EVIDENCE: Discussion with service user confirmed that they are given every opportunity to participate in social activities. The home employs an activities co-ordinator for 30 hours each week. She is currently working to improve the identified room for activities within the provision available. This room would benefit from redecoration and made more specific for its purpose. Service users spoke of the activities that had taken place which include visits to the pub and theatre, art groups and games. Details of the daily activities are displayed on the notice board. Ministers visit the home regularly to provide for service users spiritual needs. Visitors are welcome at any time and some service users are taken out by their relatives and friends. Staff take service users out to shops and the local promenade when time allows. Hoylake Cottage Hospital F52 F02 S000020909 Hoylake Cottage V230212 230505 Stage 4.doc Version 1.30 Page 12 Service users take their meal in the dining areas or in their bedroom as they choose. A selection of meals is available at each meal time and inspection of the menus provides evidence that a varied and balanced diet is offered. Special diets can be provided either on request or on the advice of GP or dietician. The kitchen area was clean and well stocked. Hoylake Cottage Hospital F52 F02 S000020909 Hoylake Cottage V230212 230505 Stage 4.doc Version 1.30 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, 18 Staff have a good knowledge and understanding of Adult Protection issues which protects service users from abuse. EVIDENCE: The home has a comprehensive complaints procedure. Information on how to complain is detailed in the Statement of Purpose, the Service User Guide and is displayed on the notice board within the home. No complaints have been received by the home since the last inspection. Training has been given to staff on all aspects of adult protection and staff spoken to were aware of the whistle blowing policy. The care manager, and the staff spoken to were able to demonstrate their knowledge of adult protection protocols and of their own role within this. Hoylake Cottage Hospital F52 F02 S000020909 Hoylake Cottage V230212 230505 Stage 4.doc Version 1.30 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 21, 26 Recent investment has significantly improved the facilities for service users creating a more comfortable environment for service users. EVIDENCE: All bedrooms and communal areas are located on the ground floor of the building and are fully accessible. The home now provides 28 single bedrooms and six double room. Six rooms are provided with en-suite facilities. The washing and toilet facilities in some areas remain unsatisfactory. Some bedrooms do not have a washbasin and so service user are required to wash in bathrooms or at the washbasins located behind curtains. This issue will be addressed by the provision of the new home. It is evident that staff strive to provide a homely environment with the confines of the existing building. The home was found to be clean throughout with appropriate infection control procedures in place. Hoylake Cottage Hospital F52 F02 S000020909 Hoylake Cottage V230212 230505 Stage 4.doc Version 1.30 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 29, 30 Staff morale is high resulting in an enthusiastic workforce that works positively with service users to improve their quality of life. EVIDENCE: The home employs qualified nurses who are supported by care staff at all times. In the morning, two qualified nurses are supported by eight care staff, two qualified nurses with six care staff later in the day and one qualified nurse with five care staff at night. The hours worked by the manager and deputy manager/care manager, are supernumerary. 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. The home is committed to ensuring that staff training continues. Records are held of all training undertaken by staff and a list of forthcoming training opportunities was displayed. Hoylake Cottage Hospital F52 F02 S000020909 Hoylake Cottage V230212 230505 Stage 4.doc Version 1.30 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 35, 38 The systems for service user consultation are good with a variety of evidence that indicates that service users views are both sought and acted upon. The manager has a clear development plan and vision for the home which she has effectively communicated to the service users, staff and relatives. EVIDENCE: Regular questionnaires are sent to service users to obtain their views. The most recent questionnaire was in relation to food and the meal provision. This generated suggestions from service users which have now been implemented. Questionnaires on other subjects are being prepared and will involve family members and other health care professionals. The home holds Investors In People quality monitoring accreditation. Hoylake Cottage Hospital F52 F02 S000020909 Hoylake Cottage V230212 230505 Stage 4.doc Version 1.30 Page 17 The home does not deal with service users personal allowances and so any purchases made on service users behalf are invoiced to them or their family/advocate. Health and safety is the responsibility of all staff and so training has been given. Most issues are addressed by the manager, care manager, administration staff or the caretaker. Risk assessments have been undertaken on service users and the premises to ensure service users protection. Safety records and certificates were inspected and found to be up to date. Records are held of all safety checks made and these too were found to be up to date. Health and safety issues raised at the last inspection have been addressed. Copies of reports made by a representative of the Trust are held in the home and were available for inspection. Hoylake Cottage Hospital F52 F02 S000020909 Hoylake Cottage V230212 230505 Stage 4.doc Version 1.30 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x 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 3 15 3 COMPLAINTS AND PROTECTION 3 x 2 x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x 3 x x 3 Hoylake Cottage Hospital F52 F02 S000020909 Hoylake Cottage V230212 230505 Stage 4.doc Version 1.30 Page 19 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 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. 2. Refer to Standard 12 7 Good Practice Recommendations The activities room would benefit from redecoration and made more appropriate for its purpose. The records held in respect of service users would benefit from co-ordination. Hoylake Cottage Hospital F52 F02 S000020909 Hoylake Cottage V230212 230505 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection 3rd Floor 10 Duke Street Liverpool L1 5AS 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. Extracts may not be used or reproduced without the express permission of CSCI Hoylake Cottage Hospital F52 F02 S000020909 Hoylake Cottage V230212 230505 Stage 4.doc Version 1.30 Page 21 - 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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