Inspection on 02/11/06 for James Hirons Home

This inspection was carried out on 2nd November 2006.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

James Hirons Home 20/01/06

James Hirons Home 28/09/05

James Hirons Home 22/02/05

James Hirons Home 18/05/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE James Hirons Home 53 Lillington Road Leamington Spa Warwickshire CV32 6LD Lead Inspector Justine Poulton Key Unannounced Inspection 2nd November 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 James Hirons Home DS0000004250.V315074.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. James Hirons Home DS0000004250.V315074.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service James Hirons Home Address 53 Lillington Road Leamington Spa Warwickshire CV32 6LD 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) 01926 422425 01926 883332 The Trustees of the James Hirons Home Ms Anthea Mary Phillips Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places James Hirons Home DS0000004250.V315074.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th January 2006 Brief Description of the Service: James Hirons is a care home providing personal care and accommodation for 24 older people aged 65 and over. It does not offer any specialist services. The home is located in Leamington Spa and is close to shops, pubs, the post office and other amenities. The home consists of a three-storey building with a ground floor extension and two conservatories. All of the home’s bedrooms are single, and twenty of the bedrooms have ensuite facilities. There are two passenger lifts, a platform lift and two chair lifts. The home has extensive gardens that are well maintained and easily accessible. James Hirons Home DS0000004250.V315074.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was the first key inspection in relation to Inspecting for Better Lives. Identified key standards were looked at, along with a review of the organisations progress towards meeting requirements made at the previous inspection of this service. The pre fieldwork documentation was completed, as well as a site visit to the home, during which time staff, residents and the manager were spoken with. Three residents were identified for close examination by reading their care plans, risk assessments, daily records and other relevant information. This is part of a process known as ‘case tracking’ where evidence is matched to outcomes for service users. Other records, policies and procedures were also examined and the environment was looked at. All of the residents were at home for the inspection. The inspector would like to thank the residents, manager and staff for their hospitality and co-operation during the inspection. What the service does well: Prospective residents undergo a comprehensive assessment and are encouraged to visit prior to making any decision about whether to move into the home. Residents have current careplans that are reviewed regularly and are based on information gleaned from the initial assessment and observations and conversations with the residents after they move into the home. Resident’s healthcare is a high priority, with both routine and specialised appointments being facilitated as necessary. Medication is managed safely, in line with the homes policy and procedure for medication administration. The home has an activities co ordinator who ensures that there are sufficient and suitable activities available on a daily basis for residents to participate in as they wish. A large, pleasant dining room, split over two levels, ensures that mealtimes are an enjoyable and relaxed experience for residents. The homes complaints procedure ensures that resident’s views are listened to, taken seriously and acted upon as appropriate. Similarly the homes adult protection procedure ensures that residents are safeguarded, and that staff are aware of their responsibilities should abuse be suspected or disclosed. The environment is spacious, pleasant and decorated and furnished to a very high standard. Sufficient staff are employed to be able to meet residents needs. Training is deemed to be an important investment in the staff team which staff said they value. James Hirons Home DS0000004250.V315074.R01.S.doc Version 5.2 Page 6 The homes recruitment procedures ensure that residents are safeguarded. Emphasis is placed on ensuring that resident’s views are at the forefront of service development via a number of means. These include residents meetings and the completion of annual residents questionnaires. Health and safety is maintained in the home with all of the necessary checks and records being in place. Staff were seen to be approachable, polite and courteous to residents. Residents and relatives spoken with were very complementary about the home, the staff and the manager. 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. James Hirons Home DS0000004250.V315074.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 James Hirons Home DS0000004250.V315074.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Assessments are undertaken to ensure that the home can meet the person’s identified care needs. Prospective residents and/or relatives have the opportunity to visit the home in order to assess the facilities and suitability. EVIDENCE: The home has a comprehensive assessment and admissions process for prospective residents, which is completed by senior staff upon receipt of a referal. The opportunity for prospective residents and/or their relatives to visit the home prior to making the decision to move in is encouraged. Relatives of a prospective resident were shown around the home during the inspection. Key standard 6 is not applicable to this home, as intermediate care is not provided. James Hirons Home DS0000004250.V315074.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 good. This judgement has been made using available evidence including a visit to this service. Comprehensive care plans ensure that staff are able to meet residents assessed needs. Medication is managed safely. EVIDENCE: The files of three residents were looked at during the inspection. Information within these was clear, concise and informative, enabling staff to meet resident’s needs. Staff spoken with said that care plans are formally reviewed on a three monthly basis, but are informally reviewed and updated if necessary during the daily handovers between shifts. All of the care plans looked at stated three monthly reviews, and were dated to confirm that these took place. Records to confirm that residents are offered routine healthcare appointments with the dentist, chiropodist and optician at the recommended intervals were in place. Support to attend more specialised appointments such as outpatients is also provided as necessary. James Hirons Home DS0000004250.V315074.R01.S.doc Version 5.2 Page 10 Medication is supplied to the home by Boots, and is accompanied by medication administration record charts (MAR). The member of staff responsible for overseeing medication in the home talked through the procedure for checking medication when it arrives in the home, storage, administration, homely remedies administration and the process for returns. All medication was stored either in a locked medication trolley that was securely chained to a wall or in a locked cupboard within an office that remained locked unless a member of staff was in it. Three service users medication was looked at. The administration information on the blister packs or boxes corresponded with the information on the MAR charts, and the charts were signed appropriately. A medication round took place during lunch, which was completed efficiently and discreetly. A number of residents were spoken with during the inspection. All spoke very highly of the home and the staff. They were complimentary about the environment, their bedrooms, activities available, staff attitudes and the food provided. Positive comments made in the pre inspection comment cards received by residents include “…the home is run to a very good standard”, “everyone is looked after well”. James Hirons Home DS0000004250.V315074.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 good. This judgement has been made using available evidence including a visit to this service. Residents are offered opportunities to maintain the lifestyle they are used to within the home. The opportunity for residents to maintain relationships with families and friends is promoted. A nutritious and varied menu is available, with meals being served in pleasant homely surroundings. EVIDENCE: The home employs an activities coordinator who plans a programme of activities on a weekly basis. These include such things as seasonal cooking, art and craft activities, exercise sessions, manicures and knitting sessions. During the inspection residents were filling jars with mincemeat that they had made earlier in the week to sell at a coffee morning, and knitting squares to be made into blankets to send abroad. Residents spoken with during the inspection told of how they fill shoe boxes with gifts for Christmas for the relevant charity each year, and another two explained how they enjoy completing jigsaw puzzles to ensure that all of the pieces are there before they are sold in local charity shops. All of the residents spoken with said it was lovely to be able to do things that gave them a sense of satisfaction at having helped other people. James Hirons Home DS0000004250.V315074.R01.S.doc Version 5.2 Page 12 Activity records were in place in the three residents files looked at which included things such as outings, cookery, bowling and church services. One of the things residents said was important to them was being able to maintain contact with their family and friends. The home operates an open visiting policy, whereby resident’s visitors are welcomed at all reasonable hours. Throughout the inspection visitors were calling in to see their relatives. Those spoken with expressed satisfaction with the care their relatives receive. Relatives comment cards received prior to the inspection were all very positive and included comments such as “…the standard of care is excellent”, “a happy atmosphere for residents and visitors”. Residents were being supported by staff to retain as much independence over their lives within the home as they were able. In conversation residents said that they were “able to bring their own possessions into the home if they wished”, “a wide and varied choice of meals was available”, they were able to choose what times they got up and went to bed and whether to spend time in the lounges or in their own rooms. All of the residents have appointees external to the home. The homes administrator looks after the day to day spending money for the residents, ensuring that it is available to them at all times. Appropriate records and receipts were seen that confirmed that this is managed safely. The home has a large pleasant dining room split over 2 levels in which residents eat their meals. Tables were laid nicely with mats, cutlery and condiments with squash or water available to accompany the meals. Residents spoken with over lunch were very complementary about the food in the home saying that the meals were “an excellent standard”, “very good” and “plentiful and excellent”. A four weekly rolling menu is in place that is discussed with the residents at their residents meetings. The daily menu was displayed clearly throughout the home, and included a main choice and an alternative choice. Residents said that they have until 11.30 each morning the let the cook know what they would like for their meals. Any assistance required by residents during lunch was provided discreetly by staff. Inspection of the kitchen showed it to be very clean and tidy with appropriate cleaning schedules in place. Temperature records for delivered foods, frozen foods, cooked foods and fridges and freezers were in place. Plentiful stocks of fresh, frozen and tinned foods were available. James Hirons Home DS0000004250.V315074.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. A satisfactory system for managing complaints is available that ensures that residents concerns are listened to, taken seriously and acted upon appropriately. A clear adult protection policy ensures that staff would be able to respond to any allegations or suspicions of abuse that may arise. EVIDENCE: The home has an easily accessible complaints procedure available for residents and/or their relatives and visitors. A copy of this procedure is located in the main entrance hall on the notice board. Residents spoken with said that they had been given a copy of the complaints procedure and were aware of how to complain if they were unhappy about anything. They also said that they were very happy with the home. The complaints log had two grumbles about the food recorded which had been referred to the cook for action. The Commission for Social Care Inspection has not received any complaints about the home. A policy on Adult Protection that is in line with the social services policy and the Department of Health document ‘No Secrets’ is available in the home. Staff have participated in training on adult protection, and were aware of their responsibilities should abuse be disclosed or suspected. James Hirons Home DS0000004250.V315074.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, 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is comfortable, clean and attractive, providing residents with a homely place to live. EVIDENCE: The home presents as well maintained, comfortable and homely. There are three lounges varying in size, two conservatories and a recently decorated split level dining room available for residents to use. The home had a very pleasant ‘fresh clean’ smell throughout. Residents were appreciative of the home and environment, making comments such as “the home is always clean”, “the lounges are very comfortable” and “the dining room is very pleasant”. The laundry room is separate from the kitchen and was very tidy and organised. Cleaning products were stored in a locked cupboard, and staff were wearing appropriate personal protective clothing. James Hirons Home DS0000004250.V315074.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 good. This judgement has been made using available evidence including a visit to this service. The home is staffed by skilled and knowledgeable staff who have been recruited appropriately. EVIDENCE: The home employs a variety of staff to ensure that it runs smoothly. Copies of rotas provided with the pre inspection questionnaire information received prior to the inspection indicate that on average there are three care staff on duty in the mornings and evenings with two over night. On the day of the inspection sufficient staff were on duty. Residents spoken with said that “they are able to find a member of staff if they need one” and that “staff are always available to assist them”. The staff files of three recently recruited staff were looked at during the inspection. All of the necessary checks were in place to confirm that the recruitment procedure ensures residents are safeguarded. Information recorded in the pre inspection questionnaire indicates that 8 staff have completed the NVQ II (or above) qualification. Staff spoken with said that the home places great emphasis on training, and tries where possible to accommodate specific requests, such as supporting staff who have requested to undertake the NVQ III qualification. James Hirons Home DS0000004250.V315074.R01.S.doc Version 5.2 Page 16 Training information looked at and provided confirmed that staff have undertaken training in all of the mandatory subjects at the required intervals over the previous 12 months. More specialised age related training such as dementia care, perception and reality, palliative care and Parkinsons disease training has also been provided. James Hirons Home DS0000004250.V315074.R01.S.doc Version 5.2 Page 17 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, 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is managed effectively, with systems in place to ensure that resident’s views are at the forefront of any service development. Health and safety is maintained. EVIDENCE: The home continues to be run by an experienced, suitably qualified manager who is supported by a competent deputy care manager and senior team. There are clear lines of accountability throughout the team with all staff appearing confident and competent in their roles. The quality of the service provided to residents is monitored through a variety of ways. Residents have regular meetings where they are encouraged to highlight any issues they wish to discuss. Regulation 26 visits are undertaken on a regular basis, with the reports from these visits being available within the home. James Hirons Home DS0000004250.V315074.R01.S.doc Version 5.2 Page 18 Resident’s surveys are undertaken on an annual basis via questionnaires, which the administrator said had recently been given out to residents for this year. The results of these are analysed, a report is written and any actions necessary are addressed. The health and safety of residents, staff and visitors is maintained. No health and safety issues were identified during the inspection. Current records and certificates were available to confirm that routine maintenance and servicing of equipment such as the lifts, baths, gas systems, and portable electrical appliances is undertaken as required. James Hirons Home DS0000004250.V315074.R01.S.doc Version 5.2 Page 19 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 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 James Hirons Home DS0000004250.V315074.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action James Hirons Home DS0000004250.V315074.R01.S.doc Version 5.2 Page 21 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations James Hirons Home DS0000004250.V315074.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Leamington Spa Office Imperial Court Holly Walk Leamington Spa CV32 4YB 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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