Inspection on 10/04/07 for Hunter Hall

This inspection was carried out on 10th April 2007.

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 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

Hunter Hall 26/08/09

Hunter Hall 10/03/09

Hunter Hall 23/10/08

Hunter Hall 08/04/08

Hunter Hall 17/07/06

Hunter Hall 26/09/05

Hunter Hall 14/06/05

Hunter Hall 22/02/05

Hunter Hall 26/07/04

Hunter Hall 16/02/04

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

CARE HOMES FOR OLDER PEOPLE Hunter Hall Kent Avenue Wallsend Tyne & Wear NE28 OJE Lead Inspector Ian Armstrong Key Unannounced Inspection 10th April 2007 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Hunter Hall DS0000028817.V335153.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. Hunter Hall DS0000028817.V335153.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hunter Hall Address Kent Avenue Wallsend Tyne & Wear NE28 OJE 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) 0191 263 9436 0191 262 3633 hunter.hall@fshc.co.uk www.fshc.co.uk Tamaris Healthcare (England) Limited (wholly owned subsidiary of Four Seasons Health Care Limited) Mrs Valerie Appleby Care Home 46 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (45) of places Hunter Hall DS0000028817.V335153.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named resident in category DE also has a learning disability. Date of last inspection 17th July 2006 Brief Description of the Service: Hunter Hall is a care home with nursing. Providing care for older people with enduring mental health needs. Care in the home is provided by Registered Mental Nurses supported by care staff. The home is owned and managed by Four Seasons Healthcare Limited, a large national care provider for vulnerable client groups. The care home is situated in Wallsend to the east of the city of Newcastle upon Tyne close to local shops and good public transport links. The building is over two floors with 46 single resident bedrooms all with en-suite facilities. Each floor has separate lounge and dining rooms with a number of toilets and bathrooms. The home shares a kitchen and laundry facility with an adjacent home. To the rear of the home there is a garden and patio area. The philosophy of care is to support the residents in their activities of daily living and to provide for their physical and mental health needs. Fees range from:£365 - £530 But do not include the following: hairdressing, chiropody or toiletires. Residents pay for these in addition to the basic fee. Hunter Hall DS0000028817.V335153.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This site visit was carried out over 11 hours on separate two days. The manager of the home was on duty during the visit and helped the Inspector with the process. Six residents and three relatives were spoken with individually during the visit. Eight members of staff were spoken to separately and others spoken to briefly. Records examined included four care plans, records for complaints, training records, staff recruitment files, fire records, health and safety, accident and maintenance records. As a result of the last inspection two requirements had been made one of which has been achieved the other has not. This means that the shower and bathroom on the ground floor of the home is still out of use, due to water damage, and work is still waiting to be carried out. Seven requirements were made recommendations were also made. as a result of this inspection. Two What the service does well: What has improved since the last inspection? The purchase of new dining chairs and tables has improved the facilities at residents mealtimes. Quality assurance systems have been improved in certain areas seeking the views of people who use the service. Hunter Hall DS0000028817.V335153.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Hunter Hall DS0000028817.V335153.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 Hunter Hall DS0000028817.V335153.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): Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Residents and their representatives receive good information on which to base the decision to move into the home. Pre-admission assessments are not currently being completed by senior staff to a standard good enough to form the development of a good care plan. This may affect the quality of the care residents receive. The home does not provide intermediate care. Hunter Hall DS0000028817.V335153.R01.S.doc Version 5.2 Page 9 EVIDENCE: Relatives spoken with said that they had the opportunity to visit the home prior to admission. They had been given copies of the homes brochure, service user guide and the complaints policy. These documents were read and provide good information about the homes services and facilities. Relatives said they were able to make a decision about the home from the information provided. Some of the residents had no pre-admission assessments completed, others did not have enough information recorded to form the basis for good care planning. Examples of this were little or no social information recorded, continence needs not assessed,mental health needs not assessed, in one file nutritional needs not assessed. Pre-admission assessments are of a poor standard. In some files these had not been completed in others they had not been dated or signed and were only partially completed. The home does not provide intermediate care. Hunter Hall DS0000028817.V335153.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): Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Overall, the standard of care planning is poor and is not centred around the individual’s needs. This means that residents may not receive the care they need. Residents healthcare needs are not being fully addressed within care plans but access to healthcare professionals is good. This may impact on residents health if healthcare needs are not effectively communicated within the care planning process. Language used by staff towards residents is generally respectful but occasionally use words which could compromise their dignity. Medications are well managed and the systems for receipt, storage and disposal of these is good. Hunter Hall DS0000028817.V335153.R01.S.doc Version 5.2 Page 11 EVIDENCE: The care plans contain assessments for mental health, nutrition, moving and assisting, continence promotion, wound care, social care, and risk assessments These assessments were poorly completed many were not dated and signed some had not been written, others were only partially completed. Care plans written due to poor assessments do not fully meet each individual residents needs. Two relatives spoken with said they had not been consulted or had discussed their relatives care plans. Forms to be signed by relatives about care plans in those records seen were not signed. There was also no evidence in the care records of reviews of care taking place with residents and their representatives. Residents have good access to other health care professionals, records of their visits are well recorded. Services for Dental, Optical and Chiropody are all satisfactory. Staff in the home described how they maintain residents privacy and dignity and were seen carrying this out when working with the residents. One member of staff however spoken to referred to a group of residents as “ the wanderers”. This matter was referred to the homes manager to pursue. Relatives spoken to said staff did respect residents as individuals. The systems for managing medicines in the home were checked and are in line with safe working practise guidelines. Hunter Hall DS0000028817.V335153.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): Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Residents routines and social activities are limited. Therefore, they do not fully meet their cultural, social, religious and recreational interests. Arrangements for residents to maintain contact with their families and friends and the local community is good . This ensures that relationships can continue. Residents have a well balanced nutritious diet, which offers choice and is generally of good quality, the food is well presented. EVIDENCE: The homes weekly activities programme was seen this is currently not being carried out due to their being no activity Coordinator in post. During both days of the inspection residents had little or nothing to do. No planned activities had been organised. Two relatives spoken with both said social activies for residents were poor. One said “they were long boring days for her husband”. Hunter Hall DS0000028817.V335153.R01.S.doc Version 5.2 Page 13 Both relatives said there was open visiting and could visit at any time and were made welcome by the staff. Home staff referred to the fact of their being no Activies Coordinator in post for their being little or no activities occurring. No evidence was seen in individual residents social care plans of their needs being met. Since the last inspection of the home in July 2006 there has been no trips out for residents apart from one or two individuals going out for pub lunches. The lunchtime meal was egg chips and beans or broccoli and cheese soup, with sandwiches of egg mayonnaise or corned beef a choice of sweets was available. Tables were set with table cloths and centre pieces and appropriate cutlery was being used however there was no tablemats for the residents. Hot drinks were provided with the meal the alternative of a cold drink was not provided. Staff were observed assisting those residents who could not eat by themselves. Interactions between staff and residents was generally good. Menus showed a good choice and variety of food being offered. However forms completed by staff in the home about individual residents food likes, dislikes, the homes cook when asked about these said he was not aware of them so information from these had not been used when deciding the menus. Hunter Hall DS0000028817.V335153.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaints policy is good and clearly available for residents and relatives to access. The system allows them to be investigated and for any action to be taken when issues are identified. Good systems of staff training are in place to ensure that the residents are protected from abuse. Staff are knowledgeable of the procedures to follow. EVIDENCE: The homes complaints procedure is in the service users guide. The manager records any complaints however no new complaints have been recorded since the last inspection. Two relatives said they were given copies of the complaints procedure and said they were confident the manager would address any concerns or complaints they might have. The majority of the homes staff have received training in the protection of vulnerable adults. Staff in the home could describe the procedures to follow and who to inform. There has been no protection of vulnerable adults matters reported since the last inspection. Hunter Hall DS0000028817.V335153.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): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The environment of the home is generally good and maintained to a satisfactory standard. It is safe and appropriate for the residents who live there. The home is clean and tidy with no obvious unpleasant odours. Staff are aware of the procedures to follow for the control of infection. EVIDENCE: The home has a good maintenance programme and records kept show that regular checks of the building are carried out and work carried out where needed. Hunter Hall DS0000028817.V335153.R01.S.doc Version 5.2 Page 16 However at the random inspection in February 07 the downstairs shower and bathroom was out of use due to water damage and a requirement was made for this work to be completed by the 31st of March 07 this work has still not been carried out. This means that residents have to go upstairs to use shower and bathing facilities. New dining tables and chairs for the downstairs dining room have enhanced the environment for the residents. Relatives spoken to were happy with the decoration and maintenance standards. A number of residents’ bedrooms were personalised with their own furniture and effects. One resident sitting in her bedroom showed me her bedspread of which she was very proud. Relatives said bedrooms were kept clean and tidy by the staff. The kitchen was very clean, cleaning schedules were checked and were being well maintained. All staff working in the kitchen are trained in Food Hygiene and are knowledgeable in procedures to follow. The laundry was clean and tidy and well equipped. The member of staff there followed infection control policies. Coshh policies and procedures were displayed and the staff member was knowledgeable of these. Hunter Hall DS0000028817.V335153.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Numbers of staff employed in the home are sufficient to ensure the needs of the current residents are met. Good recruitment and selection procedures are place. This ensures that staff have the skills and qualifications to care for the residents without placing them at risk. All staff receive a comprehensive induction training. This ensures that staff are equipped with the skills to meet people’s needs. EVIDENCE: Duty rosters for staff showed adequate numbers employed in the home each day. Staff on duty on the inspection days matched those on the roster. Relatives spoken to said they were satisfied with numbers of staff employed. Recently recruited staff files were checked two written references and application forms were present also proof of identity checks. CRB and POVA checks had also been carried out. The standard of recruitment procedure followed was good. Hunter Hall DS0000028817.V335153.R01.S.doc Version 5.2 Page 18 Staff training files were examined. Statutory and clinical training is given this includes, fire, moving and handling, and health & safety, all staff have been trained at necessary intervals. A number of staff have completed Dementia awareness training, a member of staff said this had helped them understand better the needs of the residents. Hunter Hall DS0000028817.V335153.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Tha manager is suitably qualified to manage the service and ensure that the service is run in the best interests of the people living there. Residents personal allowance management is good and the records are in place to allow audits to be effective. Residents and staff are protected by safe working procedures in the home in line with company policy. Hunter Hall DS0000028817.V335153.R01.S.doc Version 5.2 Page 20 EVIDENCE: The manager has successfully completed the RMA. She maintains her professional portfolio as required by the Nursing and Midwifery Council. Statutory records confirming safe practises in fire, first aid, food hygiene and moving and handling are being maintained and satisfactory. Staff supervision records were checked and are satisfactory, supervisions are carried out at specified intervals. The manager of the home has recently completed a quality assurance assessment of the home, Team Audit Process, this looks at systems and procedures in the home and monitors their effectiveness. An action plan will be developed for areas identified as needing improvement. Relatives and staff meeting minutes were read the agendas of these meetings are appropriate. Minutes from the meetings show that areas identified for improvement have been actioned by the manager. Relative questionnaires were sent out in February 07 seeking feedback about services provided by the home, the information from these is currently being collated and will be passed to CSCI when known. The residents personal financial records kept in the home are detailed. All transactions have two signatures, there is evidence of regular personal expenditures. Records allow the audit of individual residents monies. Hunter Hall DS0000028817.V335153.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 1 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 3 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 1 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 4 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 3 x 3 Hunter Hall DS0000028817.V335153.R01.S.doc Version 5.2 Page 22 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 OP3 Regulation 14.1(a) Requirement All new residents must be assessed in relation to their care needs prior to their admission to the home. Timescale for action 12/04/07 2. OP7 15.1 All residents in the home must 31/07/07 have well written care plans based on their assessed care needs. Plans must meet physical, mental and social care needs. Residents relatives or their representatives must be consulted about their care needs. Regular reviews of care must be structured with relatives or their representatives in attendance. All assessments for residents must be fully completed dated and signed. These records must be kept under regular review with the residents relative or their representative informed of any changes. A weekly activities programme for residents currently written must be carried out in the home. DS0000028817.V335153.R01.S.doc 3. OP7 15.2(a,b,c ,d) 31/07/07 4. OP8 14.2 (a) 31/07/07 5. OP12 16.2(n) 16/04/07 Hunter Hall Version 5.2 Page 23 6. OP19 23.2(j) 7. OP15 16.2(i) Insufficient shower and bathing 30/04/07 facilities being provided in the home. The home must ensure that work is carried out to the downstairs shower and bathroom to bring it back into use. Information about residents food 16/04/07 likes , dislikes must be passed to the homes cook so that the information can be used when deciding on the menus. 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 OP15 OP10 Good Practice Recommendations Placemats need to be purchased for residents use at mealtimes. Alternative cold drinks should be offered at mealtimes for the residents. Staff in the home should address residents by their preferred titles residents should not be referred to by the behaviours they might display. Hunter Hall DS0000028817.V335153.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 Hunter Hall DS0000028817.V335153.R01.S.doc Version 5.2 Page 25 - 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!