Inspection on 20/01/06 for James Hirons Home

This inspection was carried out on 20th January 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 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 02/11/06

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 Patricia Flanaghan Unannounced Inspection 20th January 2006 09:45 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.V280021.R01.S.doc Version 5.1 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.V280021.R01.S.doc Version 5.1 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.V280021.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th September 2005 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 two-storey building with a newer ground floor extension and conservatory. All of the home’s bedrooms are single, and twenty of the bedrooms have ensuite facilities. There are two passenger lifts as well as a chair lift. The home has extensive gardens that are well maintained and easily accessible. James Hirons Home DS0000004250.V280021.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This routine unannounced inspection took place between 9.45am and 2.00pm. This was the second visit of this inspection year. Discussions took place with residents, staff and managers. The inspection focused on the standards relating to medication, health and safety, staffing and management. A service questionnaire was completed by the home and returned to the Commission for Social Care Inspection (CSCI). The manager was asked to distribute other questionnaires regarding the service to residents, relatives and health care professionals. The completion of these is voluntary but proves useful in assessing the various views that are held. Five responses from relatives and one response from a resident had been received by the CSCI at the time of writing this report. Comments were all positive, one relative said that the care received by their relative is “exemplary. ” Another relative said that they had visited many care homes in a professional capacity and “ …can say emphatically James Hirons tops them all.” The comment card from the resident welcomed the appointment of a new activities co-ordinator and said they were looking forward to new activities such as scrabble and a bridge club. What the service does well: The home provides a spacious, pleasant and personalised environment for people to live with a variety of social and recreational activities are provided. The manager ensures that sufficient staff are on duty at all times to respond to the needs of the residents. Staff have good access to training and this is encouraged and supported by the manager. The training provides them with the knowledge and skills to deliver the care service that is needed. The residents spoken with were happy with the care provided and felt able to talk to the manager and staff if they had any concerns. Observations during the inspection showed that staff were interacting appropriately and engaging the residents in activities and conversations. Discussions with staff evidenced that they were aware of residents individual needs and their likes and dislikes. James Hirons Home DS0000004250.V280021.R01.S.doc Version 5.1 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. James Hirons Home DS0000004250.V280021.R01.S.doc Version 5.1 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.V280021.R01.S.doc Version 5.1 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): None of these standards were assessed at this inspection. Standards 3 and 5 were assessed as met at the inspection visit on 29/09/05. EVIDENCE: James Hirons Home DS0000004250.V280021.R01.S.doc Version 5.1 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): 9 The medicine management within the home was satisfactory but further improvements must be made to demonstrate that the residents needs are fully met. EVIDENCE: Audits demonstrated that the medicines administered from the Monitored Dosage System (MDS) supplied by the community pharmacist are administered and recorded correctly. Audits demonstrated that the medicines administered from the Monitored Dosage System (MDS) supplied by the community pharmacist are administered and recorded correctly. There was evidence of good stock control. All unused or unwanted medication is returned promptly to the supplying pharmacist and the returns books had been completed and receipted appropriately. The following issues were identified and discussed with the manager. The home’s medication policy requires updating to reflect current good practice. For example, it didn’t address medication for residents who are out of the home for holidays/visits, drug errors, or PRN medication. James Hirons Home DS0000004250.V280021.R01.S.doc Version 5.1 Page 10 The home did not routinely record the quantities of medicines dispensed in boxes and carried over from previous cycles so it could not be demonstrated that these medicines had been administered as prescribed. Medications transcribed by hand had not been initialled by staff. PRN medications did not consistently record the number of tablets given, for example, when the amount of medications can be one or two it should be recorded how many tablets were administered to the resident. Appropriate procedures and facilities were in place to facilitate those residents who wish to continue to administer their own medication. James Hirons Home DS0000004250.V280021.R01.S.doc Version 5.1 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 and 15 Residents were satisfied with their lifestyle in the home and they had been able to exercise choice and influence decisions affecting them. Residents receive suitable meals in pleasant surroundings, which promotes social interaction and wellbeing. EVIDENCE: There is a planned programme of activities and entertainment in the home. An activities leader, recently appointed by the home, undertakes most activities with residents. Trips out to local places of interest are arranged, for example residents had recently enjoyed visits to Stratford upon Avon and a Garden Centre. Entertainers also visit the home and church services are held there. Residents said that they could choose how they spend their day and could take part in the social activities if they wished to. The activities leader meets with the residents monthly where suggestions are made on what they would like to see happen or do for the following month. One to one meetings are also regularly held. It was evident that residents have a say in the running of the home with several suggestions on activities they would like to see delivered. Regular newsletters giving up to date information about happenings in the home are also produced for residents and relatives. Two residents spoken with felt there were sufficient activities offered by the home. James Hirons Home DS0000004250.V280021.R01.S.doc Version 5.1 Page 12 Meals are served by care staff in the pleasant split level dining room. Meals can also be served in residents own rooms if preferred. Choices are available at mealtimes. The lunch menu is displayed outside the dining area, however, residents can choose an alternative meal at the point of serving if they wish. Meals were served by care staff and looked well presented. A number of residents spoken with on the day of the inspection commented positively on the quality of the food served in the home. A brief inspection of the kitchen found it to be clean and in good order James Hirons Home DS0000004250.V280021.R01.S.doc Version 5.1 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, 17 and 18 Systems for the management of complaints are satisfactory. Residents can be confident that their concerns are listened to, taken seriously and acted up on. Residents legal rights are protected. There is a clear Adult Protection policy in place, to make staff aware of their responsibilities to provide a proper response to any suspicion or allegation of abuse. EVIDENCE: Residents and a relative spoken with were aware of the complaints procedure and how to make a complaint if they needed to. They were satisfied that any issues taken to the manager or a member of staff would be dealt with promptly. The home has a clear complaints procedure, which is explained in the homes statement of purpose and given to all prospective service users or their family/representative before moving into the home. The complaints procedure is also located on a notice board in the reception area. The Commission for Social Care Inspection (CSCI) has not received any complaints since the last inspection visit. Residents in the home are offered a post vote. The manager said most residents voted at the last local elections. Two residents were assisted by their families to vote at a local polling station. James Hirons Home DS0000004250.V280021.R01.S.doc Version 5.1 Page 14 The home have in place an Adult Protection Policy, which is in line with the Social Services Policy and the Department of Health document, “No Secrets”. Staff sign a declaration to state that they have read and understand the policy. All staff have taken part in Adult Protection Training. Staff spoken to during the inspection were aware of their responsibilities under the Protection of Vulnerable Adults Scheme. James Hirons Home DS0000004250.V280021.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 26 Facilities and equipment, supported by staff training, ensures that the risks of cross infection are kept as low as possible. EVIDENCE: On the day of the inspection the premises were clean, hygienic and free from offensive odours. The laundry facilities were in good order and residents confirmed they had no problems with laundering arrangements at the home. The home has provided policies for the control of infection and provides protective clothing and disposable gloves. A discussion with the laundry assistant demonstrated that sound infection control procedures operating in the home reduce the risks and control the spread of infection. James Hirons Home DS0000004250.V280021.R01.S.doc Version 5.1 Page 16 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): 28, 29 and 30 The recruitment procedure ensures that suitable people are employed to safely provide care for the residents. A strong commitment to training ensures staff have the knowledge and skills to undertake their duties. EVIDENCE: Training records examined show that staff have attended regular training on the conditions associated with old age. Six care staff have an NVQ Level 2 in Care, with two staff members currently undertaking this award. Recent training undertaken by staff include Catheter Care, Principles of Care, Protection of Vulnerable Adults, Palliative Care, and Tissue Viability. The staff files of two recently appointed staff were reviewed and indicated that the registered manager has completed all necessary recruitment checks to ensure the protection of service users. Evidence of new staff receiving a clear induction programme was available on the files. James Hirons Home DS0000004250.V280021.R01.S.doc Version 5.1 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, 32, 33, 35 and 38 The home has an experienced manager and is effectively and well managed. Systems are in place to monitor the quality of the service provided and identify areas in need of improvement. Residents financial interests are safeguarded. The health, safety and welfare of residents and staff are promoted and protected. EVIDENCE: The Registered Manager has many years experience in managing a care home for older people. There are clear lines of accountability within the home. Observations made and discussions with both residents and staff indicated that the manager is available and approachable should they wish to discuss any James Hirons Home DS0000004250.V280021.R01.S.doc Version 5.1 Page 18 issues. The manager continues to update her knowledge and skills and is familiar with the diseases and conditions associated with old age. Residents and relatives expressed positive comments about the manager and were happy with the way the home is run. An open door policy for residents and relatives is practised. Relatives spoken with stated that they found the managers, care staff and other staff in the home approachable. The quality of the service is continuously monitored through feedback received from the residents and their relatives. The manager said that every resident received a questionnaire at the end of their stay, that sought their opinion of the care and service they had received. An analysis of the results was then made available. The result of the survey undertaken in August 2005 was viewed. The home had a 61 uptake and comments received were very positive about the quality of care received by residents in the home. The staff, in particular, were praised for their kindness and friendliness to both residents and visitors. Feedback from relatives and others was also obtained in a less formal manner during reviews and one to one meetings. A large number of ‘thank you’ letters and cards were also seen during the inspection. Monies on behalf of residents are held in a central residents bank account by the home. Cash is pooled together in one amount at the home, therefore residents individual cash balances could not be checked. A separate record is maintained for each resident which details their individual balance. The total amount tallied with what had been recorded on the central account. When a resident’s balance is low or goes into ‘debit’ a request is sent to the resident or representative for further funds. In the future, if an individual without sufficient funds requires monies, this should be taken from the home’s petty cash and not the residents ‘cash pool’ as at present. This will ensure all residents financial interests are safeguarded. No health and safety hazards were observed. Evidence was seen to confirm that staff receive regular training in moving and handling, fire safety, first aid and food hygiene. Certificates were seen during the inspection for the maintenance and service of major systems. James Hirons Home DS0000004250.V280021.R01.S.doc Version 5.1 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 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 X X X X X X X 3 STAFFING Standard No Score 27 X 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 2 X X 3 James Hirons Home DS0000004250.V280021.R01.S.doc Version 5.1 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. 1 Standard OP9 Regulation 13(2) Requirement The quantities of all medicines carried over from previous MAR charts must be recorded to enable audits to take place to demonstrate medicines are administered as prescribed. All hand written MAR charts must accurately record all the medication the service user has been prescribed, the strength of the medicines and the correct dose. A competent person should countersign all entries. The medication policy must be reviewed to reflect good practice in medicine management. 2 OP35 20 The Registered Manager must ensure that appropriate records are maintained of all transactions involving residents monies. 31/03/06 Timescale for action 31/03/06 James Hirons Home DS0000004250.V280021.R01.S.doc Version 5.1 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.V280021.R01.S.doc Version 5.1 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. Extracts may not be used or reproduced without the express permission of CSCI James Hirons Home DS0000004250.V280021.R01.S.doc Version 5.1 Page 23 - 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!