Inspection on 04/08/05 for Hulton Care Home

This inspection was carried out on 4th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

Hulton Care Home 07/06/07

Hulton Care Home 16/08/06

Hulton Care Home 12/01/06

Hulton Care Home 01/02/05

Hulton Care Home 16/08/04

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 Hulton Care Home Hulton Drive Off Halifax Road Nelson BB9 0EY Lead Inspector Pat White Announced 4 th August 2005 09:30 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 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. Hulton Care Home F57_F07 HultonCare S22503 V230762 130705 Stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Hulton Care Home Address Hulton Drive Off Halifax Road Nelson Lancashire BB9 0EY 01282 617773 01282 614445 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) Highfield Care Homes Ltd Deborah Johnston Mrs Donna Oldham Care Home (CRH) 30 Category(ies) of Dementia - DE - 2 registration, with number Dementia over 65 years of age DE(E) - 5 of places Old Age, not falling within any other category - OP - 22 Physical disability PD - 1 Hulton Care Home F57_F07 HultonCare S22503 V230762 130705 Stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: within the overall registration of 30, a maximum of 22 service users requiring personal care who fall into the category OP shall be accommodated. Within the overall registration of 30, a maximum of one service user who falls into the category of PD shall be accommodated. Within the overall total of 30, a maximum of 5 service users (over 65 years) requiring personal care who fall into the category of DE(E) Within the overall total of 30, a maximum of 2 service users (under 65 years) requring personal care who falls into the category of DE The registered provider, shall at all times, employ a suitably qualified manager who is registered with the COmmission for Social Care Inspection. Date of last inspection 1st February 2005 Brief Description of the Service: Hulton Care Centre is a purpose built care home situated in a residential area on the outskirts of Nelson. It is owned by a national organisation called Southern Cross. The grounds to the front of the home are pleasant and accessible. Extensive lawned areas surround the home and there is adequate car parking space. The home is able to accommodate up to thirty people, both men and women. Twenty-two places are available for older persons who require personal care and one is for a physically disabled service user who is under 65 years. There is a seven-bed unit, for service users over 65 years who have dementia. All the bed rooms in the home are single rooms, and include en-suite toilet and hand basin. Many of the bedrooms were personalised with small items belonging to the residents and they are bright and comfortable. There are a number of lounges, including a smoking lounge, and dining areas. These communal areas are pleasant and homely. The home was decorated and furnished to a high standard. An activities organiser was employed in the home and there was a programme of interesting and lively activities. A manager and deputy manager were responsible for the day to day running of the home. Hulton Care Home F57_F07 HultonCare S22503 V230762 130705 Stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. SUMMARY OF THE INSPECTION ON THE 4TH AUGUST 2005 This inspection was an announced inspection, and as such the home had a number of weeks to prepare for it. The purpose of the inspection was to assess important areas of life in the home that should be inspected over a 12 month period, check the progress of previous legal requirements and good practice recommendations, and check other matters in the home which came to the inspector’s notice. The inspection took 12 hours and comprised of, talking to residents, a tour of the premises, looking at resident’s care records and other documents, and discussion with the manager, Mrs Donna Laird. Written information about the home (the “pre – inspection questionnaire”) was provided before the inspection, and some of that information is included in the report. A member of staff was interviewed. Ten residents were spoken with, and others were observed in their routine daily activities. Three relatives were also spoken with. Nineteen residents, four relatives and one general practitioner completed comment cards. The significant views expressed by all the people involved have been summarised in the report. What the service does well: The records of resident’s needs were well written, and covered all the important matters regarding health and personal care needs. Members of staff were praised for their kindness, commitment and patience. Residents said they were well looked after. One resident stated that she could not “praise the staff enough”. All residents who took part in the inspection stated that staff treated them properly – with respect and dignity. The written plans for residents’ care were detailed and well written, and contained useful information regarding the residents’ health, personal and social care needs. These plans for care were regularly reviewed and updated. There were good links between the “risks” identified, for example the risk of pressure sores, and the action taken by carers to reduce the risks. The residents’ health was monitored carefully and appropriate action taken. Hulton Care Home F57_F07 HultonCare S22503 V230762 130705 Stage4.doc Version 1.30 Page 6 The home had a complaints procedure that was understood and used by residents and relatives. Routines were flexible enough to suit individual preferences. The home employed an activities organiser, and there was a wide programme of interesting and enjoyable activities, including regular trips out. Hulton Care Home provided modern, pleasant, bright and well - maintained accommodation throughout, which was decorated and furnished to a high standard. Residents said they appreciated their bedrooms, all of which were en suite, and the outside areas. A high proportion of the staff in the home had gained the qualifications recommended for people working in care homes. What has improved since the last inspection? What they could do better: The assessment of those residents admitted to the dementia unit should be improved so that psychological needs relating to dementia can be clearly identified and understood. Assessments of residents’ needs carried out by social workers should also be obtained by the home. The plans for the care of the people living in the dementia unit could be improved to include useful information about behaviour and psychological issues. Some practices and procedures with respect to the administration of residents’ medication must be improved to further safeguard the residents’ health. Hulton Care Home F57_F07 HultonCare S22503 V230762 130705 Stage4.doc Version 1.30 Page 7 The home should ensure that there are enough staff on duty at all times so that the needs of the residents can be met. The supervision of staff in the home could be improved so that individual staff meet with a manager at regular intervals to discuss their work and receive guidance. 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. Hulton Care Home F57_F07 HultonCare S22503 V230762 130705 Stage4.doc Version 1.30 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Hulton Care Home F57_F07 HultonCare S22503 V230762 130705 Stage4.doc Version 1.30 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3 & 4. Standard 6 was not applicable. Useful information about the home was given to all residents. The admission procedures included an assessment of prospective resident’s needs to determine whether or not Hulton Care could meet their needs. However these procedures must be improved to determine clearly whether or not people are appropriately placed in the dementia unit. Staff had the necessary experience and training to meet the residents’ needs. EVIDENCE: There was information about the home, which was available to residents and relatives. The service user guide was given to all the residents and contained useful information about the home. The statement of purpose needed updating with respect to the change of ownership and still did not include all the information recommended about bathrooms, WCs, assisted baths and ensuite bedrooms. The registered person must also ensure that those residents having respite care are also issued with “terms and conditions” appropriate for their stay. Hulton Care Home F57_F07 HultonCare S22503 V230762 130705 Stage4.doc Version 1.30 Page 10 Records viewed showed that pre – admission in house assessments had been undertaken with residents recently admitted to the home. These assessments covered all the matters listed in standard 3.3. However the registered person needs to ensure that social work assessments are obtained for those residents admitted under care management arrangements. Also residents must not be admitted to the dementia unit without a pre admission assessment and medical diagnosis that support a placement in a specialist dementia unit. It is strongly recommended that all references to “nurse” in the documentation is changed to a term(s) more appropriate for a residential care home. At the previous inspection it was established that following an assessment the manager confirmed, in writing, to the prospective resident that the home was able to meet their needs. Discussion with staff and service users and review of documentation indicated that staff had the necessary experience and training to meet residents’ needs. Training records indicated that staff attended relevant courses. All those residents who were spoken with and who were able to give their views stated that they were well looked after by kind and caring staff. All those residents who completed comment cards stated that they felt well cared for and were treated well (see standard 27). Hulton Care Home F57_F07 HultonCare S22503 V230762 130705 Stage4.doc Version 1.30 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 & 10 The care plans were detailed and well written and contained useful information about all aspects of residents’ health, personal and social care needs, to assist the care staff in providing care to residents. This could be improved in the dementia unit. The residents’ health care needs were promoted and maintained, but some aspects of medication management in the home must be improved to safeguard residents. Care practices ensured that the residents’ rights to respect privacy and dignity were upheld. EVIDENCE: The records viewed showed that residents had care plans generated from an assessment. The documentation enabled comprehensive information to be recorded and in general the care plans contained detailed information to help staff to meet the resident’s needs. Appropriate risk assessments were in place, including those for risk of falling, risk of pressure sores, moving and handling and nutrition. Care plans had been reviewed and updated regularly. There was evidence that the residents’ health was monitored and maintained and residents had access to all the health care services. Most health matters Hulton Care Home F57_F07 HultonCare S22503 V230762 130705 Stage4.doc Version 1.30 Page 12 were recorded in detail on the care plans, including pressure areas and continence issues. There were nutritional assessments. However mental health and psychological issues need to be documented in more detail and addressed according to clinical guidelines, especially in the dementia unit. There were good links between the risk assessments, the measures identified to reduce the risks and the details on the care plans, for example pressure areas. There was appropriate intervention and treatments by the district nurses, including that for pressure areas, and there was evidence of intervention by the specialist continence advisor. However the registered person must ensure that bed rails are always of a suitable height and fitted properly. The General Practitioner who completed a comment card stated that there was good communication with the home and that staff understood his patients’ needs. There were detailed policies and procedures for the safe handling and administration of medication, and which included a procedure to facilitate self medication. However these policies and procedures need to be developed further to include, home/leave visits, homely remedies, oxygen, PRN medication, verbal changes and non – prescribed medication. Clear records were kept of medication entering, leaving the home and being administered. Prescriptions were seen prior to dispensing and those senior staff who administered medication had attended appropriate training in medication management. However systems and procedures must be improved to further safeguard the residents from mishandling of medication. A number of legal requirements have been made which must be addressed. The inspection methods indicated that residents were treated with respect, and that their right to privacy and dignity was upheld. Residents who took part in the inspection, in conversation and through completed comment cards, confirmed that this was the case. All stated that staff treated them well and that staff were very kind and looked after them appropriately. Some residents chose to spend a lot of time in their bedrooms and some had their own telephones. All bedrooms were single. Hulton Care Home F57_F07 HultonCare S22503 V230762 130705 Stage4.doc Version 1.30 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 & 15 Routines were flexible enough to suit individual preferences. Enjoyable and interesting activities and outings were frequently arranged which benefited the residents and encouraged contact with the local community. The visiting arrangements encouraged and enabled residents to maintain contact with family and friends. The food served was appetising, wholesome, enjoyed by most residents and afforded them choices. EVIDENCE: Routines in the home were flexible to meet residents’ individual expectations and preferences. For example residents confirmed that they could rise and retire at a time of their own choosing, and could eat in their bedrooms if they wished. Church ministers of different denominations visited the home. The home employed an activities organiser and records kept showed that a variety of enjoyable and interesting activities were arranged, including monthly trips out. All residents stated that the home provided suitable activities. An informative Newsletter was produced at intervals. Links were encouraged with the local community, and residents were helped and encouraged to keep in contact with friends and relatives. The home had an “open visiting” policy that was explained in the service user guide. Visitors who completed comment cards, and those spoken with, confirmed that they were made welcome at any reasonable time and that they could visit their Hulton Care Home F57_F07 HultonCare S22503 V230762 130705 Stage4.doc Version 1.30 Page 14 friend/relative in private. The activities organised ensured contact with the local community, for example a Summer Fayre was planned, and Ministers from the local churches visited the home. The meals served at the time of the inspection appeared wholesome and appetising and suited residents’ tastes. The menus viewed indicated that wholesome and nutritious food was served. Appropriate alternatives were served to those with diabetes, and the cultural dietary requirements of one resident were met. Of the residents who completed comment cards and talked to the inspector, all but one stated that they enjoyed the food. This person stated he sometimes did. One person stated that she would like her favourite food occasionally. Appropriate assistance was given to those who needed it and meals were served in an appropriate form. Birthday cakes were made to celebrate residents’ birthdays. Hulton Care Home F57_F07 HultonCare S22503 V230762 130705 Stage4.doc Version 1.30 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 18 There was a clear complaints procedure accessible to residents and relatives in the information pack given to people on admission. Residents and relatives knew how to make a complaint. The home had appropriate policies and procedures to protect the residents from abuse. EVIDENCE: The home had a complaint procedure that had been assessed previously as being in accordance with the appropriate Regulation and standard. The records showed that there had been 7 complaints in the last 12 months which had been investigated appropriately. No complaints had been made directly to the CSCI. Those residents spoken with stated that they had no complaints, and those who completed comment cards stated that they knew who to speak to if they were unhappy with their care. Three out of 4 relatives stated that they were familiar with the complaints procedure. Previous inspections showed that the home had an Adult Protection procedure, including “whistle blowing”, which complied with the Public Disclosure Act 1998 and the Department of Health Guidance “No Secrets”. There had been no recent allegations or suspicions of abuse. Some members of staff had undertaken training in “adult Abuse”. All residents who completed comment cards stated that they felt safe living in the home. Hulton Care Home F57_F07 HultonCare S22503 V230762 130705 Stage4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 23, 24, 25 & 26 Hulton Care Home provided pleasant, safe and clean accommodation that suited the residents’ needs. All areas were well furnished and maintained. There was sufficient indoor and outside communal space, and the outside grounds provided attractive areas for the residents to enjoy. EVIDENCE: The premises were modern, purpose built and therefore suitable for their stated purpose. They were well maintained, furbished and decorated. The 7bed unit for people with dementia was self contained and comprised part of the ground floor. It was also attractively furbished and decorated with sensory plaques on the walls. A lift provided access between the ground floor and the first floor. A maintenance person was in post. The grounds appeared well maintained and provided a pleasant area for residents to sit and walk. In the main part of the home communal space on the ground floor consisted of a dining room, a conservatory and two lounges. One of the lounges was designated as a smoking room. The dementia unit also had a lounge and Hulton Care Home F57_F07 HultonCare S22503 V230762 130705 Stage4.doc Version 1.30 Page 17 dining area. Patio doors opened onto a patio, with furniture, and attractive spacious gardens. The outdoor areas are accessible for people in wheelchairs. Lighting in the communal areas was domestic in nature and appeared sufficiently bright to allow service users to take part in activities. Furnishings were domestic in style and of good quality. All the bedrooms were en suite with hand washbasin and toilet. There was an assisted shower in the bedroom of one resident. The bathrooms had the necessary equipment and adaptations but one bath hoist was out of use at the time of the inspection. The bedrooms seen were well furnished and decorated with furniture appropriate to residents’ needs and wishes. Residents were able to bring small items of furniture with them. Residents spoken with remarked on the comfort and pleasant nature of their private accommodation. All bedrooms were single and en suite, met the National Minimum Standard on room sizes and had appropriate locks. All rooms had a chest of drawers with a lockable top drawer. The home was bright and airy. Radiators were of the “low surface temperature type”. Water temperatures tested at random indicated that the temperature at several outlets was considerably higher than the recommended range and the registered person must ensure that residents are safe from water temperatures that are too hot. In general the home was clean and fresh at the time of the inspection but one bedroom viewed by the inspector was mal odorous. Some carpets had been replaced since the previous inspection. Hulton Care Home F57_F07 HultonCare S22503 V230762 130705 Stage4.doc Version 1.30 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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) 27, 28, 29 & 30 Though staffing levels appeared to be at the minimum required by the previous registration authority, there was evidence that this was insufficient for meeting the needs of all the residents at certain times. The home’s staff recruitment policies and procedures protected the residents from unsuitable staff. The home’s staff training programme was being developed to meet the needs of the residents and the staff group. EVIDENCE: Staff appeared experienced and well trained (see standard 30). Rotas and discussion with the manager indicated that most of the time the home was staffed according to the minimum levels recommended by the previous registration authority. However comments from staff, some visitors, and a relative who completed a comment card, indicated that this may not be enough to meet the needs of the residents all of the time, when taking into account the dependency levels of some residents. The registered person must review the staffing levels throughout the home and ensure there are enough staff on duty at all times to meet the needs of the residents. Staff were praised by all who were spoken with for their attitude, kindness and commitment to the job. One resident stated that she “couldn’t praise the staff highly enough”. Seventy five percent of care staff was trained to at least NVQ level 2. Therefore the target of 50 to be achieved this year has been exceeded. Hulton Care Home F57_F07 HultonCare S22503 V230762 130705 Stage4.doc Version 1.30 Page 19 The staff files viewed indicated that the home was adopting thorough recruitment procedures. “POVA First” and two satisfactory employment based references had been obtained prior to the most recently appointed member of staff commencing work. However the registered person must ensure that all gaps in applicants’ employment history are fully explored and documented. Staff training records showed that staff had undertaken a variety of short training courses, in addition to NVQ courses, and according to their own needs and those of the residents. The staff working in the dementia unit had undertaken a short course on caring for people with dementia. New staff completed the home’s induction training programme, but it is recommended that and induction programme is developed in accordance with the “Skills For Care” specifications. Hulton Care Home F57_F07 HultonCare S22503 V230762 130705 Stage4.doc Version 1.30 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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) 35, 36, 37 & 38 The manager had very recently been appointed, and therefore her ability and competence in this role could not be assessed at this inspection. Staff supervision procedures could be improved. The health and safety procedures in the home safeguarded the health and safety of the residents and staff, but the fire precautions could be improved. EVIDENCE: At the time of the inspection Mrs Donna Laird had been the manager for only a few weeks. Therefore standards 31 and 32 were not fully assessed. Mrs Laird has some relevant qualifications and had enrolled on the course leading to the Registered Managers Award. She will apply to the CSCI for registration. The management of residents’ finances was discussed and this was managed safely in the home. However the interpretation of the corporate company policies regarding residents’ monies will be discussed with the Provider Hulton Care Home F57_F07 HultonCare S22503 V230762 130705 Stage4.doc Version 1.30 Page 21 Relationship Manager for Southern Cross to ensure a consistent approach throughout the organisation. There was a safe in the home that could be used for the storage of residents’ valuables. The inspection methods used indicated that one to one supervision of care staff with a manager was not taking place. A member of staff stated that she had an appraisal since her time in employment. The home’s records that were viewed were generally up to date, accurate and in accordance with the Regulations. The health and safety procedures in the home safeguarded the health and safety of the residents and staff. There was a rolling programme of moving and handling training. Staff received training in the home’s fire precautions, food hygiene and there was a person competent in first aid on every shift. Certificates of testing of appliances, fire equipment and installations were listed in the pre – inspection questionnaire and were current. However the registered person must ensure that fire drills take place at least every 6 months and that the fire alarm is tested more frequently, for example weekly. Automatic closure devices were fitted on some fire doors. Hulton Care Home F57_F07 HultonCare S22503 V230762 130705 Stage4.doc Version 1.30 Page 22 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 2 2 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 3 x 3 3 2 2 STAFFING Standard No Score 27 2 28 4 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 2 x x x 2 2 3 2 Hulton Care Home F57_F07 HultonCare S22503 V230762 130705 Stage4.doc Version 1.30 Page 23 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. Standard 1 Regulation 4 Requirement The registered person must ensure the statement of purpose includes all information as listed in standard 1 and schedule 1, including information about baths and en- suite facilities and details of the new ownership of the home (Previous 2 timescales not met) Those service users having respite care must be issued with appropriate terms and conditions / contract. Service users must not be admitted to the dementia unit without an assessment, and a diagnosis of dementia, made by a suitably qualified or trained person that support the placement The registered person must ensure that a copy of all social work assessments are obtained by the home prior to admission and that the said assessment for the identified resident is obtained retrospectively The registered person must ensure that residents and relatives were appropriate, are involved in the developing of Timescale for action 30th October 2005 2. 2 5 (1)(b)(c) 14 (1)(a) 30th September 2005 From the time of the inspection. 3. 3 4. 3 14 (1)(b) From the time of the inspection 5. 7 15 From the receipt of the report Page 24 Hulton Care Home F57_F07 HultonCare S22503 V230762 130705 Stage4.doc Version 1.30 their care plans 6. 7 15 The registered person must ensure that the service users plan sets out in detail the action to be taken to ensure all aspects of health needs, including mental health issues, are met. (Previous 2 timescales not met) The registered person must ensure that bed rails are always of a suitable height and fitted properly. All medication administererd, including creams, must be recorded. The temperature of the medication storage areas must be monitored regularly (previous 2 timescacles not met) The registered person must ensure that residents are always given the medication which has been prescribed for them, not medication which is not prescribed. The registered person must ensure that medication prescribed for one resident is never administerered to another resident. The registered person must ensure that the MAR sheets have identical instructions to the labels and that the correct medication/dosages are given The criteria for the administration of PRN medication must be clearly defined and recorded. With respect to the identified idividual, the administration of painkillers and a laxative must be clarified, understood by staff and instructions applied consistently. 30th September 2005 7. 8 13 (4)(a) & (c) 13 (2) & 17 (1) (a), schedule 3 (i) 13 (2) From the time of the inspection. From the time of the inspection From the time of the inspection. From the time of the inspection. 8. 9 9. 9 10. 9 13 (2) 11. 9 13 (2) From the time of the inspection. From the time of the inspection. 30th September 2005 30th September 2005 12. 9 13 (2) 13. 9 13 (2) 14. 9 13 (2) Hulton Care Home F57_F07 HultonCare S22503 V230762 130705 Stage4.doc Version 1.30 Page 25 15. 9 13 (2) 16. 25 13 (4)(a) & (c) 16 (2)(k) 18 (1)(a) 17. 18. 26 27 The medication policies and procedures need to be developed further to include, home/leave visits, homely remedies, oxygen, PRN medication, verbal changes and non – prescribed medication. (previous timescale not met) The registered person must ensure that residents are not at risk from water temperatures that are too high. All parts of the home must be kept free from offensive odours. 14th October 2005 30th September 2005 From the time of the inspection. 30th September 2005 19. 29 20. 30 21. 38 The registered person is required to review the staffing levels within the home and ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of service users. Amended The registered person must Regulation ensure that staff files contain 19, documentary evidence of schedule qualifications, written 2 explanations of gaps in employment. 18 The registered person must ensure that all members of staff undertake induction training in accordance with the Skills for Care specifications within 6 weeks of commencing employment. (Previous timescale of March 2005 not met) 23 (4) (c) However the registered person & (d) must ensure that fire drills take place at least every 6 months and that the fire alarm is tested more frequently, for example weekly. From the date of the inspection. 14th October 2005 From the date of thre receipt of the report. Hulton Care Home F57_F07 HultonCare S22503 V230762 130705 Stage4.doc Version 1.30 Page 26 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 3&7 Good Practice Recommendations It is strongly recommended that all references to “nurse” in the documentation be changed to a term(s) more appropriate for a residential care home. It is recommended that a supply of eye drops is prescribed and used for each eye to prevent cross infection. The registered manager should register for the appropriate NVQ level 4 courses with a vievw to completion by 30th September 2007. It is recommended that formal one to one supervision is undertaken with the care staff six times a year 2. 3. 4. 9 31 36 Hulton Care Home F57_F07 HultonCare S22503 V230762 130705 Stage4.doc Version 1.30 Page 27 Commission for Social Care Inspection Unit 4, Petre Road Clayton Business Park Accrington BB5 5JB 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 Hulton Care Home F57_F07 HultonCare S22503 V230762 130705 Stage4.doc Version 1.30 Page 28 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!