Inspection on 17/07/06 for Hunter Hall

This inspection was carried out on 17th July 2006.

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

Hunter Hall 26/08/09

Hunter Hall 10/03/09

Hunter Hall 23/10/08

Hunter Hall 08/04/08

Hunter Hall 10/04/07

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 17th July 2006 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.V295466.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.V295466.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.V295466.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 26th September 2005 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. Hunter Hall DS0000028817.V295466.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over two days. All of the key standards have been assessed during this visit and from other information provided to the Commission. Six residents and ten staff (nurses carers and ancillary) were spoken to. Three relatives were also spoken to during the visit. Four care plans, training records and medication records were examined. Staff files and health and safety documentation were looked at. A tour of the premises was also carried out. What the service does well: What has improved since the last inspection? A rolling programme of redecoration and refurbishment to resident bedrooms has commenced. Blinds have been purchased for resident’s bedrooms to meet privacy and dignity needs. The appointment of an Activities co-ordinator should improve the quality of life for the residents. Hunter Hall DS0000028817.V295466.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. Hunter Hall DS0000028817.V295466.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.V295466.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 The home does not provide intermediate care. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Satisfactory pre-admission assessments are undertaken but this is not always reflected in the care plan. EVIDENCE: Pre admission assessments are obtained from other professionals such as social workers, psychiatrists and nurses. The home completes their own assessment. Care plans must reflect all of the assessed needs. A relative said they were able to visit the home prior to the admission. They were satisfied with the information provided and the support they were given. Hunter Hall DS0000028817.V295466.R01.S.doc Version 5.2 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 the following standard(s): 7,8,9&10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The health and social care needs of residents are being met but the records that support this care must be improved. Residents are protected by the homes policies and procedures for dealing with medicines. Residents are treated with respect and their right to privacy is upheld. EVIDENCE: Four care records were examined. A good range of care plans were written with the exception of social care plans, which are too generalised and not specific to each individual. Not all of the care records are dated and signed. Evidence of regular evaluations and reviews of care were recorded. Contact with social and health professionals is good. Records of their level of input are recorded and are good. Hunter Hall DS0000028817.V295466.R01.S.doc Version 5.2 Page 10 Medicines are well managed and safely disposed of. The treatment room was clean and tidy. The treatment door has a sign stating activities room, this needs to be removed. No controlled medications are being used. Relatives said residents are treated well and their privacy is respected. Hunter Hall DS0000028817.V295466.R01.S.doc Version 5.2 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 the following standard(s): 12,13,14 & 15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Resident’s social needs are not being fully met. Residents 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, but the surroundings must be improved. EVIDENCE: The home has a new activities co-ordinator who is very committed and has been in post two weeks. This person was engaged in ball games with some residents in the garden at the time of the visit. The manager of the home has agreed that the activities co-ordinator attends pre-admission assessments to assess individual social care needs and ensure these can be met. Hunter Hall DS0000028817.V295466.R01.S.doc Version 5.2 Page 12 Visitors were observed to come and go throughout the day. Staff have a good rapport with relatives. Relatives said they were made welcome when they visited. Records show that resident’s food likes and dislikes are identified and met. Residents or their relatives, identify the types of clothing residents like to wear. Menus provide a good range and choice of food. Dining tables need to be enhanced by the provision of tablecloths. Two relatives said the food in the home was good. Hunter Hall DS0000028817.V295466.R01.S.doc Version 5.2 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 the following standard(s): 16&18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users are protected from abuse. EVIDENCE: The home has a good complaints policy and staff are clear about the procedure to deal with complaints. Relatives said that they knew who to talk to if they were unhappy and had confidence that complaints would be dealt with. The Protection of Vulnerable Adults (POVA) procedure is of a good standard. Staff are aware of POVA and whistle blowing procedures. Hunter Hall DS0000028817.V295466.R01.S.doc Version 5.2 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 the following standard(s): 19,24 &26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents generally live in a safe well-maintained environment. Residents live in safe, comfortable bedrooms with their own possessions around them. The home is clean and hygienic. EVIDENCE: Overall the building is well maintained. A rolling programme of redecoration and refurbishment of bedrooms has commenced. Vertical blinds have been bought and placed to all windows on the side of the home that is overlooked from the road. This has enhanced issues about resident’s privacy and dignity identified in the past. Communal areas are also well decorated however a lounge area on the top floor needs decorating. The treatment room door has a sign stating activities room this needs to be removed. Clinical waste bins to the front of the home were found to be unlocked and this has been the case on previous visits to the home. Hunter Hall DS0000028817.V295466.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Resident’s needs are met by the number and skill mix of staff. Residents are protected by the homes recruitment policy and practises. The staff team are trained and appear competent, but full records were not available to support this. EVIDENCE: The staffing rota showed the following levels of staff employed in the home on an average day. Am 2 Qualified and 5 care staff, Pm 2 Qualified and 4 care staff, Nights1 Qualified and 3 care staff. This level of staffing is in line with the needs of a reduced number of residents in the home. Three staff recruitment files were inspected and were satisfactory. Staff training files were examined and did not clearly detail what training staff had completed in all cases. Hunter Hall DS0000028817.V295466.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36 & 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is run in the best interests of residents. Resident’s financial interests are safeguarded. Staff supervision is currently not being carried out correctly. The health, safety and welfare of residents and staff are generally well protected. Hunter Hall DS0000028817.V295466.R01.S.doc Version 5.2 Page 17 EVIDENCE: The home’s manager is an experienced Registered Mental Nurse who has managed the home for over three years. The manager hopes to complete her Regional manager award training by December of this year. Good quality assurance arrangements are in place. The Regional manager completes monthly visits and reports. However, it is almost two years since Relative questionnaires have been sent out to seek feedback about the service. Relatives and staff meetings are occurring on a regular basis. Minutes show appropriate agendas being discussed. Resident’s financial records were checked. There was evidence of regular personal expenditures, with two staff signatures for all transactions. Staff supervision sessions, are not being carried out on a regular basis. The frequency of in-house fire instruction to staff was unsatisfactory. Hunter Hall DS0000028817.V295466.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X 3 x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 2 X 2 Hunter Hall DS0000028817.V295466.R01.S.doc Version 5.2 Page 19 Are there any outstanding requirements from the last inspection? Yes 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 OP7 Regulation 15 Requirement Individual social care plans are needed for all residents in the home. All care records must be dated and signed. Tablecloths must be provided for all residents’ dining tables. The lounge area on the top floor must be decorated. Clinical waste bins in the home must be kept locked at all times. Staff training records must be adequately maintained, and include induction, foundation, mandatory, NVQ and other training with dates completed. Staff supervision must take place for all staff at least six times each year. All staff must have in-house fire training at the frequency specified in the fire log book. Timescale for action 31/10/06 2. 3. 4. 5. OP15 OP19 OP19 OP30 23.2(g) 23.2(g) 16.2(j) 18(c)(i) 31/08/06 31/10/06 18/07/06 31/08/06 6. 7. OP36 OP38 18(2) 23.4(d) 31/10/06 31/10/06 Hunter Hall DS0000028817.V295466.R01.S.doc Version 5.2 Page 20 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 OP19 OP33 Good Practice Recommendations The sign stating activities room should be removed. Relative questionnaires need to be sent out more frequently to seek feedback about the service provided. Hunter Hall DS0000028817.V295466.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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