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Inspection on 25/01/07 for Hyne Town House

Also see our care home review for Hyne Town House for more information

This inspection was carried out on 25th January 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

For older people who require twenty-four hour care Hyne Town House provides a home where each person is treated with respect and dignity, choice is positively encouraged and self-esteem is promoted through "person-centred care" - every day routines and practices are adapted to suit individual residents and improve their daily life so it is meaningful to her/him. The management of the home is open and transparent. There is a commitment to provide ongoing accredited training and personal development for each staff member to ensure that they are competent to recognise and meet the needs of the residents.

What has improved since the last inspection?

Since the last inspection all the requirements from that inspection have been met.

What the care home could do better:

The Registered Provider should progress with the proposed computerisation of all care files so that staff and residents will benefit from a less cumbersome method of holding information. Staffing levels should be reviewed to ensure that this is not the root cause of staff sickness and absence from work.

CARE HOMES FOR OLDER PEOPLE Hyne Town House Strete Dartmouth Devon TQ6 0RU Lead Inspector Megan Walker Unannounced Inspection 25th January 2007 11:15 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 Hyne Town House DS0000003725.V300675.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. Hyne Town House DS0000003725.V300675.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hyne Town House Address Strete Dartmouth Devon TQ6 0RU 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) 01803 770011 01803 770307 Mr Stephen Anthony Mould Mrs Yvonne Margaret Mould Mrs Jean Gloria White Care Home 33 Category(ies) of Dementia - over 65 years of age (33), Old age, registration, with number not falling within any other category (33), of places Physical disability over 65 years of age (33) Hyne Town House DS0000003725.V300675.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd January 2006 Brief Description of the Service: Hyne Town House is a privately owned care home registered for up to thirtythree residents within the categories of Dementia - over 65 years of age (33), Old age, not falling within any other category (33), Physical disability over 65 years of age (33). It does not provide intermediate care and it is not registered to provide nursing care. Hyne Town house is a Georgian period-detached building with a purpose-built wing. It is situated in the small coastal village of Strete, approximately 15 minutes drive from the town of Dartmouth. It is on a bus route (Kingsbridge/Dartmouth), and local amenities including a post office/small shop are situated nearby in the village. Car parking is available within the grounds of the home or opposite in the village car park. The home provides accommodation for residents over three floors, with a passenger lift to access the upper floors. Following an extensive refurbishment programme the home has been upgraded to a high standard. This includes a quiet lounge, assisted bathing facilities, a commercial kitchen, and a large garden room with patio doors allowing access to the garden and terraced areas. There are 27 single rooms and 3 double rooms, with the majority being en-suite and many with far reaching views of the surrounding countryside and out to sea. The home has two Love Birds housed in a cage in the garden room however there is a “no pet” policy. The fees at Hyne Town House range from £500 to £640. Additional extras are hairdressing, chiropody, newspapers, special interest journals and magazines, and any sundry items, all at commercial rates. There is also a charge of £10 per hour for accompanied visits away from the home (e.g. hospital visits). This information was given to the Commission by the Registered Provider in January 2007. Hyne Town House DS0000003725.V300675.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The fieldwork part of this inspection was unannounced and took place on Thursday 25th January 2007 between 11h15 and 19h45. It included talking to residents, staff and visitors to the home, observation of interactions between staff and residents, and residents with residents, a tour of the premises, and inspection of care plans, staff files, medication and other records and documentation. The Registered Provider, Mr Stephen Mould, was present at the time of this visit. Part of the time was spent talking with him and also the home’s Registered Manager, Mrs Jean White, about the day-to-day routines, as well as the management of the home. In addition other information used to inform this inspection: • The Pre-inspection Questionnaire completed by the Registered Manager. • The previous two inspection reports • All other information relating to Hyne Town House received by the Commission since the last inspection. Of approximately 75 Comments’ Cards and Surveys sent out, the Commission received back – • 8 Residents “Have Your Say About Hyne Town House” Care Homes Surveys • 12 “Relatives/Visitors” Comment Cards • 18 Care Workers Surveys 2 telephone calls from staff • 0 General Practitioner (G.P.) • 1 Health/Social Care Professional in contact with the home There are two requirements and one “Good Practice” recommendation made as a consequence of this inspection. What the service does well: For older people who require twenty-four hour care Hyne Town House provides a home where each person is treated with respect and dignity, choice is positively encouraged and self-esteem is promoted through “person-centred care” - every day routines and practices are adapted to suit individual residents and improve their daily life so it is meaningful to her/him. The management of the home is open and transparent. There is a commitment to provide ongoing accredited training and personal development for each staff member to ensure that they are competent to recognise and meet the needs of the residents. Hyne Town House DS0000003725.V300675.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Hyne Town House DS0000003725.V300675.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 Hyne Town House DS0000003725.V300675.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 5 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Prospective residents and their families can feel confident that their needs will be assessed before moving into the home and that they can have the information they need to make an informed choice about where to live. EVIDENCE: Hyne Town House has a comprehensive website, www.hynetownhouse.co.uk, via which it is possible to email the home. The home also has a brochure available to prospective residents and their families/representatives. On moving into the home each new resident has in her/his bedroom a book with the “Statement of Purpose” (the home’s aims and objectives), the “Service User’s Guide” (residents’ information about the home including terms and conditions of occupancy), the Complaints Procedure and a list of activities and times of the hairdresser’s visits. A copy is also given to the resident’s family. Hyne Town House DS0000003725.V300675.R01.S.doc Version 5.2 Page 9 Each resident has a written contract with terms and conditions of occupancy. A relative confirmed that as someone with Power of Attorney for a resident this was something with which they dealt. The Registered Manager explained that if a resident were unable to handle her/his own affairs for any reason then the next of kin or representative of the resident would be asked to sign the contract on behalf of the resident. Prospective residents are assessed before they move into the home to make sure that the care needs identified can be met by the staff team and within the environment of the home. Evidence of this was noted during this visit as the Registered Manager went to meet and assess a prospective resident having already gathered information from the person’s family and requesting a medical history from the medical practice. The Registered Manager expressed appreciation that the local medical practice had agreed to inform her of any relevant medical history that was important for the proposed plan of care for new residents known to it. Prospective residents are encouraged to visit the home before deciding if they wish to move in. This also helps the staff to get a better idea of the person within the environment of the care home, and how the care would be best managed. Hyne Town House DS0000003725.V300675.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents can feel confident that a staff team that is respectful and sensitive will ensure that all their health, personal and social care needs are met. EVIDENCE: Inspection of a random selection of care plans found that each one had a detailed assessment of care needs. There was also a care plan describing specific help and assistance to be given to each individual. Other records on the file included Resident Risk Assessment, Falls Risk Assessment, Behaviour Assessment and Mental Health Assessment. The District Nurses and Occupational Therapists at Dartmouth Hospital are sent the information about falls of residents for assessment, and individuals’ histories of falls are monitored. The Registered Manager confirmed that staff would accompany a Hyne Town House DS0000003725.V300675.R01.S.doc Version 5.2 Page 11 resident to any medical appointment should they wish or families would make arrangements. Some relatives said that this was a more practical option. General Practitioner (G.P.), District Nurses, Community Psychiatric Nurses (C.P.N.) visits are recorded and a G.P. Request book and Communication book were also seen during this visit. For agency staff the Registered Manager had devised a summary of each resident’s care file and this included any pertinent details for each shift. Care plans inspected had been reviewed monthly. It was noted on care plans when a resident had chosen not to sign it or if a resident preferred not give information about her/himself. Also included on each care plan seen was a “Personal Story”. Those seen varied in the amount of detail however it was evident from reading these that the information had been gathered by consulting with the individual resident. This background information is considered important by the home’s staff because it helps to build the bigger picture of the resident as a person, why s/he may behave in a certain way, have expectations for the way in which s/he lives her/his daily life. This is then focused into planning an achievable plan of care for that individual. The early evening “medication round” was observed and the medication room was inspected. The senior carer responsible on the day of this visit explained that all the senior carers are trained to understand about handling and giving of medicines. The medication records seen were signed and dated appropriately. The Registered Manager is currently exploring ways in which those residents with advanced dementia are assured of making an informed choice about taking their medication in line with the Royal Pharmaceutical Society’s “Administration and Control of Medicines in Care Homes and Children’s Homes”. It was evident from observation of interactions between residents and staff, and from talking to residents that they felt well looked after and respected. Their dignity was promoted and staff spoke to individuals in a sensitive manner using their preferred name. There was an easy-going atmosphere around the home. When asked, more than one resident said that they would ask for something if they needed it and would let staff know if they didn’t like something. Family members spoken to during this visit also confirmed that they were pleased with the care their relative was receiving and felt that it was personalised to suit the person. A relative who returned a Relatives Survey summed up this individual attention: “It [the care home] is extremely flexible in its approach to each individual’s needs and foibles, and the staff are almost unfailingly kind and patient.” Hyne Town House DS0000003725.V300675.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents are satisfied with their lifestyle at Hyne Town House and are encouraged to exercise choice and control over their lives. EVIDENCE: A Residents’ Meeting has been set up to give residents a regular opportunity to talk about their likes and dislikes in the running of the home, including things they would like to do and prefer not to do. This apparently included a request to stop the reminiscence sessions and this was duly respected after residents asked the staff why they (the staff) thought that they (the residents) would be interested in this. One relative spoken to during this visit explained that an “Activities” Co-ordinator came in three times each week however also since a Residents’ Meeting there is no formal programme. Instead residents are invited to the garden room if they wish where the Co-ordinator gleans the majority preference of what people would like to do for the afternoon. Some Hyne Town House DS0000003725.V300675.R01.S.doc Version 5.2 Page 13 relatives who returned surveys expressed a preference to see more mentally stimulating activities introduced: “More stimulation…more time for staff to stop and talk on a one to one basis” A relative spoken to during this visit said that she tended to pop in when she was passing which could be any time morning, afternoon or evening. She said that she was always made welcome by staff. The home’s website states that visitors are welcome at any time and the Registered Manager confirmed that there are no restrictions unless a resident does not wish to have visitors and that visits are at reasonable times of the day/evening. Observation throughout this visit showed that residents were treated in a manner that was respectful. They were not patronised and their daily life was one that encouraged individuals to feel comfortable with making choices and decisions for themselves. In response to the Relatives Survey Question 11) “What do you feel the care home does well?, a relative wrote: [The care home]”treats them [the residents] as people … and doesn’t talk down to them. Run more as a hotel than a home.” The residents had all been consulted about food and a four weekly menu had been compiled to try and meet all the preferences. There was a choice of hot dish as well as an alternative, and dietary needs as well as preferences were seen being catered for. This was also confirmed in surveys returned by residents. Homemade cakes were seen and a relative said that all the meals were home cooked with fresh vegetables and good quality ingredients. The cook confirmed that this menu is reviewed and changed regularly. Menus of the day were seen set out on each dining table as a prompt for residents. A diary of all the meals served each day was seen and this, the cook explained, was also used as a handover book between cooks. There is a big emphasis on fresh vegetables and fruit, delivered daily to the home. Residents may choose where they eat their meals and at what time they prefer to eat. Some residents were seen having a glass of wine with their lunch and the Registered Manager said that this option was available at all meals. Apparently some residents liked to have a bottle of wine on the table to share between them and the staff respected that this was part of the “home from home” lifestyle promoted at Hyne Town House. Care plans inspected had risk assessments for some individuals regarding alcohol and its potential affect with medication. There were also risk assessments for anyone whose alcohol intake needed to be monitored for safety reasons. Residents spoken to about their food were pleased with its quality. They also said that they could have what ever they wished. One resident wasn’t too sure if “foie gras” could be introduced on the menu although it hadn’t been requested yet! The Registered Manager and the Registered Provider said that the kitchen was open twenty-four hours a day so that residents may have food and drinks at any time and a relative confirmed that this was so. Hyne Town House DS0000003725.V300675.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents and their families and friends can feel confident that any issues of concern or complaints raised by them will be dealt with appropriately and that they will be protected from abuse. EVIDENCE: Since the last inspection neither the Commission nor the Registered Providers has received any complaints about care provided at Hyne Town House or other matters relating to the home. The Complaints Procedure was seen displayed in the front entrance hall and residents also have a copy of it in a handbook kept in their rooms. Residents spoken to said that they would inform staff and/or the Registered Manager about things that they didn’t like or they prefer were done differently. Relatives who returned surveys wrote either that they had not had reason to complain or raise any concerns, or anything they had had to mention had been dealt with promptly. Hyne Town House DS0000003725.V300675.R01.S.doc Version 5.2 Page 15 As part of the home’s annual mandatory training programme the staff training plan showed that all staff were up to date with the “Safeguarding Vulnerable Adults” training so that they could recognise abuse and know what steps to take to report it. Contrary to this three staff members who returned Care Workers Surveys ticked “no” in response to Question 7: “Are you aware of adult protection procedures?. A fourth staff member wrote that this was “Not Applicable” yet this person’s job requires contact with residents. The Registered Provider and Registered Manager have since this visit written and spoken to all staff at the care home, and to the Commission, about this. From staff verbal responses it would seem that this question in the survey used a different title/name, and at Hyne Town House staff call this “Abuse Awareness”. The home has a Whistle-blowing Policy. Hyne Town House DS0000003725.V300675.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 23, 24, 26 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents at Hyne Town House live in a home that is comfortable and safe, clean, warm and well-lit, and set in attractive grounds. EVIDENCE: A tour of the premises found it to in good order and upkeep. Each bedroom seen was personalised and some residents had brought in pieces of their own furniture. Other residents had soft furnishings of their choice around their rooms. There is a choice of communal areas for residents to use and throughout this visit it was observed that each room was well used. There is access to the back garden through patio doors leading from the garden room on to a paved walkway guarded by a handrail. This was also seen being used by two residents during this visit, one of whom was using a wheel chair. They were able to make their way around the outside of the home and re-enter the Hyne Town House DS0000003725.V300675.R01.S.doc Version 5.2 Page 17 building through the front door. The garden itself was well kept and residents commented about the flowering shrubs and early Spring bulbs already growing. It was evident that certain areas would be sheltered and attractive for residents to sit outside if they wished to and enjoy good weather as well as watching the birds, (some of the residents had a keen interest in bird watching). The laundry is small however functional with individually named baskets for each residents’ washing. Next door is a room used for ironing and storing clean laundry before it is returned to individual residents. The kitchen is commercial in size yet the cook confirmed that it was a pleasant environment in which to work because it was light and airy with lots of natural ventilation. There is good storage space and industrial size fridges and freezers. During the tour of the premises a number of toiletry items such as bars of soap, talcum powder and shampoo were seen in the communal bathrooms. Concerns about the poor standard of cleanliness in an resident’s en-suite toilet was noted in a Relatives’ Survey and another relative wrote that “cleaning of rooms could be improved upon.” Other relatives and residents remarked that standards of cleanliness and hygiene generally were of a good/high standard, and this was found to be the case throughout the home on the day of this visit. Hyne Town House DS0000003725.V300675.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents’ care needs are met by a staff team that is caring and appropriately skilled however this risks being compromised by high levels of sickness and loss of motivation. EVIDENCE: Verbal and written feedback from residents about staff was good, for example, “Even when busy the staff are available, helpful and cheerful.” A couple of residents commented about having to wait for staff: ““There is sometimes a little delay owing to pressure of work and shortage of staff. Everyone does their best.” “There are times when one waits for a long time to have the bell answered. I feel the home is understaffed especially with getting dressed in the morning and getting to bed at night.” Relatives’ written comments were all positive and praise the staff for their attitude and friendliness, for example, in response to the question” What do you feel the care home does well?” remarks such as: Hyne Town House DS0000003725.V300675.R01.S.doc Version 5.2 Page 19 “The staff are friendly and caring” “Above all the love and kindness shown, and always very friendly”. “I feel that generally there is a team of kind/sensitive staff at Hyne Town House.” However relatives also wrote about staff being” overstretched”, particularly at night and at weekends, and raised their concerns about the detrimental affects this was having on residents. For example: “I do feel at times that there are not enough staff on duty to deal with the level of care required by the residents.” “More staff especially at getting dressed am and bed pm times.” [This was a recurring comment about individuals having to wait for assistance apparently because of staff shortages.] A couple of relatives thought that routine matters such as finger nail cutting could be overlooked and that baths were limited because of staff time this takes. This was discussed with staff during this visit. They confirmed that they do try to enable residents to have a bath when they wish however sometimes it was not possible particularly if an individual resident needed two carers to assist them. A Senior Carer said that for practical reasons baths were encouraged to be taken either in the morning on getting up or before bedtime. At the time of this visit staff employed to work at the home in addition to the Registered Manager were thirty-one care staff including two “awake” night staff,(each care assistant on duty at night does not sleep during that shift) two full-time housekeepers responsible for cleaning and laundry Monday to Friday, two cooks who split the week between them and one of whom is also a parttime housekeeper, and a kitchen porter/assistant who works thirty-five hours a week. The Registered Provider has subsequently explained in writing to the Commission that the kitchen porter/assistant post was set up to reduce the work load on care staff. This person therefore now completes tasks previously done by care staff thereby “freeing up more time to spend with residents”. The majority of staff who returned Care Workers Surveys commented about the staffing levels and the amount of sickness due apparently to tiredness, stress and covering holiday absences. Inspection of the staff rota for the month of January 2007 showed that nine staff members were unable to work their shifts on twenty-two out of twenty-eight days due to sickness. On most of these days identified there was an average of two staff members absent, and two days in different weeks up to five staff were absent on the same day because of sickness. In addition during the same month six staff members were on annual leave. During this visit the Registered Manager commented on a recent need to employ agency workers to cover for high levels of sickness in addition to booked annual leave. The staff that returned surveys infer that this has been a rumbling issue at the home for a long time now. Analysis of their written comments showed that there is an underlying frustration harbouring on resentment. The overriding common factor was that the staff team felt that it is expected to achieve too much without sufficient human resources and that they would appreciate action being taken by the Registered Provider in the Hyne Town House DS0000003725.V300675.R01.S.doc Version 5.2 Page 20 near future to resolve it. It was evident from discussion with the Registered Provider during this visit that providing good levels of care staff on each shift is something that both he and the Registered Manager take very seriously. The Registered Provider has subsequently written to the Commission: “We take staffing levels very seriously and do everything in our power to ensure sufficient numbers are on duty. “If staff are sick we will endeavour, without exception, to fill the gap from our own workforce or employ agency staff. (We do not avoid this responsibility).” Residents are protected by robust staff recruitment procedures. Inspection of a random selection of staff files found that they all had evidence of the relevant required checks having been completed. All staff except one had had the legally required checks including Criminal Record Bureau (C.R.B) checks and “Protection of Vulnerable Adults” (P.O.V.A.) list checks (i.e. police checks). The staff member still awaiting the return of a C.R.B. check works supervised by a senior carer and does not do any personal care. There were job descriptions and a staff handbook for each staff member. There was evidence of accredited induction as well as in-house induction training for each staff member. Also each staff file had evidence of an ongoing training and development programme. Observation of staff working practices during this visit found that they were confident about their jobs and from conversations with staff it was evident that they enjoy working at Hyne Town House. Written feedback from staff has also been generally positive particularly about the provision of up to date training and National Vocational Qualification (N.V.Q.) training that is now mandatory for all staff working at Hyne Town House. Hyne Town House DS0000003725.V300675.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 37, 38 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Health, safety and welfare is promoted and protected by competent and capable Registered Providers and the Registered Manager who are keen to achieve positive outcomes for residents and staff. EVIDENCE: Mr Stephen Mould, the Registered Provider, is actively involved in the day-today running of the home however Mrs Jean White, the Registered Manager, has overall responsibility for staffing and overseeing the provision of care. The Registered Provider stated that he has made clear to all staff the lines of accountability so that the management of the home was transparent and honest. Observation during this visit saw that the staff group respected both Hyne Town House DS0000003725.V300675.R01.S.doc Version 5.2 Page 22 the Registered Provider and the Registered Manager and those asked said that they were approachable and friendly. The last quality assurance survey conducted at Hyne Town House was in May 2006 when residents and/or their representatives, staff, families, district nurses and local doctors were asked their views about the home. The Registered Manager confirmed during this visit that when a new computer programme has been established (expected in the near future) another questionnaire would be sent out. During this visit evidence was seen of a collection made by the Registered Provider of written feedback from relatives and friends about the care given by staff at the home. The residents living at Hyne Town House are encouraged to either handle their own financial affairs or to make alternative arrangements. As mentioned above the Registered Providers are in the process of purchasing and setting up a new computer database for the home. This will enable all the residents’ care files to be kept in a more systematic way and should be easier for staff to refer to as well as to review and change care plans as needed. They have also recently joined the Small Businesses Association and plan to up date all the home’s policies and procedures into a booklet once they have all been reviewed with assistance from this support network. The Pre-Inspection Questionnaire confirms that all the required and necessary maintenance checks have been done including fire drill, fire training and fire alarm and emergency lighting tests. Hazardous cleaning materials were found in a non-lockable storage cupboard during the tour of the premises. The Registered Provider was made aware of this at the time and he agreed to fit a lock to the cupboard as well as remind staff about correct storage of hazardous materials. Hyne Town House DS0000003725.V300675.R01.S.doc Version 5.2 Page 23 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 4 4 4 X 4 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 4 4 X 4 4 3 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 3 3 X N/A X 3 2 Hyne Town House DS0000003725.V300675.R01.S.doc Version 5.2 Page 24 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 OP38 Regulation 13 (4c) Requirement “The registered person shall ensure that(c) unnecessary risks to the health or safety of service users are identified and so far as possible eliminated.” This refers to the toiletry items seen in the communal bathrooms. The Registered Provider/Manager must ensure that all staff, including agency staff and cleaners, do not leave unattended any potentially hazardous substances such as shampoo, liquid soap (unless its fixed to a wall in a pump dispenser), bars of soap and talcum powder. Residents, who may have a level of confusion, may be at risk if they mistake such toiletry items for food or drinks. “The registered person shall ensure that – (a) all parts of the home to which service users have access are so far DS0000003725.V300675.R01.S.doc Timescale for action 31/03/07 2 OP38 13(4) 25/01/07 Hyne Town House Version 5.2 Page 25 (a) as reasonably practicable free from hazards to their safety; unnecessary risks to the health or safety of service users are identified and so far as possible eliminated, “ This refers to the hazardous chemicals found stored in a non-lockable cupboard. The Registered Provider/ Manager must ensure that all staff understand the Control of Substances Hazardous to Health Regulations (COSHH) 1988. The Registered Provider has informed the Commission in writing since this visit that this requirement has been met and additionally as advised during the visit, a lock has been fitted to the cupboard. 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 OP27 Good Practice Recommendations This refers to the ongoing problem of high levels of staff absences due to sickness. The Registered Provider should continue to take appropriate and urgent measures to address this issue thereby continuing to ensure that residents’ health, welfare and safety is not compromised. Hyne Town House DS0000003725.V300675.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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. 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