Inspection on 20/07/06 for The Hawthorns

This inspection was carried out on 20th July 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 found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Hawthorns 18/07/07

The Hawthorns 27/02/06

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 The Hawthorns 53 Station Road Bardney Lincs LN3 5UD Lead Inspector Mick Walklin Unannounced Inspection 20th July 2006 11:00 The Hawthorns DS0000063646.V304562.R01.S.doc Version 5.2 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 The Hawthorns DS0000063646.V304562.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 Adults 18-65. 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. The Hawthorns DS0000063646.V304562.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Hawthorns Address 53 Station Road Bardney Lincs LN3 5UD 01526 399868 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) Home From Home Care Ltd George Michael Bell Care Home 6 Category(ies) of Learning disability (6) registration, with number of places The Hawthorns DS0000063646.V304562.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered to provide personal care for service users aged 18-65 years of age of both sexes whose primary needs fall within the following categories:- Learning disability (LD) - 6 The maximum number of service users to be accommodated is 6. 2. Date of last inspection 27th February 2006 Brief Description of the Service: The Hawthorns opened in December and is a large redeveloped residential house in the village of Bardney. The home is owned by Home from Home Care, who operate another care home in the area, and are planning further developments. The home is a large detached building set in large grounds. There is car parking to either side of the building. The home has been refurbished to a high standard, with a good range of communal space, and large en-suite bedrooms. The home is registered for 6 adults with learning disabilities who require support with daily living. 5 of the residents require 1 to 1 staff ratio throughout the day. The Company’s stated philosophy is ‘Recognising and celebrating the uniqueness of every individual’. The Hawthorns DS0000063646.V304562.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was undertaken using a review of all the information available to the inspector regarding the service history of The Hawthorns, and through undertaking a visit to the home. The fieldwork visit took place over 7 hours. The main method of inspection used was called case tracking which involved selecting three people who live at the home, and tracking the care they receive through the checking of their records, discussion with them, the care staff and observation of care practices. A tour of the premises was conducted with the manager and one of the residents. Other documents connected with the running of the care home were also inspected. Three residents competed feedback forms, which provided positive comments about the home, and the manager completed a pre-inspection questionnaire. What the service does well: What has improved since the last inspection? There were only two requirements from the last inspection. A copy of a resident’s assessment was sent to the Commission, and staff have had training to prepare food safely. The Hawthorns DS0000063646.V304562.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Hawthorns DS0000063646.V304562.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Hawthorns DS0000063646.V304562.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents are introduced to the home in a sensitive manner, and a good range of assessment information is collected, to ensure that their support needs can be met. EVIDENCE: One person is in the process of being assessed for the home, and plans to move in August. A very detailed assessment is used by the home to assess prospective residents, and this had been partially completed by the person’s mother. The manager and a team leader had visited him both at his home, and at his residential school on a number of occasions. The person has visited the Hawthorns on a number of occasions with his mother and a key worker from the school, and it is planned that staff from the Hawthorns will work with him for two weeks at his mother’s home, prior to him moving to the Hawthorns. Staff from the Hawthorns had also attended transition reviews at the school. All prospective residents have an individual transition plan, which considers the least stressful way of introducing them to the home. A range of assessment information was seen on other residents files, which provides staff with an accurate picture of the persons support needs. The Hawthorns DS0000063646.V304562.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans reflect residents individual support needs, but daily records lack detail. Residents are supported to live as independently as possible, and to make decisions which affect their lives. EVIDENCE: Those care plans inspected appeared to accurately reflect the identified support needs of residents. They contain good pen pictures which provide a concise description of the person, and a good range of risk assessments, which enable residents to live as independently as possible whilst minimising risks. Staff were also clear about their role in promoting independence, whilst ensuring that residents are safe. One resident had two care plans that appeared to contradict each other about the number of staff required to escort him when going out. Another resident had a care plan from her previous home, although this seemed to accurately reflect her current needs. There is little evidence that residents are involved and consulted about their care plans. A resident confirmed that he does talk to his key worker about issues, but he had only signed parts of his care plan. The Hawthorns DS0000063646.V304562.R01.S.doc Version 5.2 Page 10 Daily records reflect how care plans are implemented, but there is inadequate detail to effectively track care. For example, one resident had recently been prescribed ointment, but there was no mention in the daily record that he had seen the doctor, or why. The same resident had been given ‘as required’ medication because of the behaviours that he was exhibiting, but the daily record only referred to him being agitated, and no incident form could be found. There was also no record of how effective the ‘as required’ medication had been. One relative commented, “They (the staff) see behaviour as a form of communication – not just being bad”. The Hawthorns DS0000063646.V304562.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the 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, 15, 16 & 17. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There are a wide range of activities, but residents would benefit from more structured educational and occupational timetable to further develop their skills. EVIDENCE: All residents have 1-1 support clearly identified for each shift, and a whiteboard in the office outlines the activities planned for each individual. Residents said that they are consulted about what activities they want to do, at a weekly meeting. On the day of the visit, all residents had home based activities or outings planned. The manager acknowledged that a more structured educational and occupational timetable would benefit residents, and said that some residents have attended an open day at Lincoln College. A resident has expressed an interest in working as a volunteer in a home for older people, and further enquiries are being made. Residents completed a questionnaire earlier in the year to identify where they wanted to go on holiday, and who with, and their wishes have been reflected. The Hawthorns DS0000063646.V304562.R01.S.doc Version 5.2 Page 12 Residents confirmed that they have good contact with friends and relatives. In a recent survey, parents commented “Staff are always very welcoming when we visit. Portable phones are available if residents wish to talk in privacy. One resident has a husband who lives a considerable distance away, and she said that staff support her well in maintaining contact. Catering arrangements enable individual choices to be catered for, and residents said that they enjoy the food served. They are encouraged to be involved in food preparation, and mealtimes can be flexible to accommodate outings and activities. Menus are discussed at the weekly residents meeting, and healthy options are encouraged. Records of meals served were up to date. The Hawthorns DS0000063646.V304562.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are well supported, and there are good arrangements to meet their health needs. EVIDENCE: All but one resident is funded on a 1-1 basis, and all those interviewed said that they are happy with the level of support provided. There were a number of occasions during the visit, when staff dealt with potentially difficult situations in a sensitive manner, and prevented potential incidents. They explained reasons for their requests, and explored options with residents, so as to defuse situations. All residents are registered with local GP’s, and other services such as psychology and psychiatry are available by referral. A resident outlined how she is getting help from a physiotherapist to help improve her mobility, and how staff are trying to get help from an occupational therapist to review the aids and adaptations in her bedroom. Medication storage and administration was satisfactory, but there had been two medication errors in June, which had been dealt with appropriately. There The Hawthorns DS0000063646.V304562.R01.S.doc Version 5.2 Page 14 are satisfactory arrangements in place for storage and stocktaking of medication requiring special storage. Medication for home leave is dispensed into non-sealed containers, and it is recommended that the pharmacist be contacted for advice on this matter. There is no policy relating to homely remedies, and the manager is writing to the GP to obtain authorisation for the administration of ‘over the counter’ medications. The Hawthorns DS0000063646.V304562.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have confidence that staff will take complaints and concerns seriously, and feel safe living at the home. EVIDENCE: All residents have a copy of the complaints procedure in their welcome pack, in written and symbols format, and those interviewed said that they would feel comfortable reporting any concerns to staff. There have been no complaints since the last inspection. All staff interviewed demonstrated a sound knowledge of the adult protection procedures, and their reporting responsibilities. They confirmed that they had received training, and were aware of the location of policies and procedures. Adult protection awareness is not listed on the initial staff induction record, and it is recommended that this be covered. The Hawthorns DS0000063646.V304562.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home provides a comfortable well-decorated and maintained environment of a very high standard for residents to enjoy. EVIDENCE: The home has been extensively refurbished, and has a good range of communal areas, large enclosed grounds and large en-suite bedrooms. Residents had personalised their rooms extensively, and all those interviewed were very happy with the accommodation. One resident talked about her plans to have her bedroom redecorated in Manchester United colours. There are plans to build an activity area, and install a hot tub in the garden. Residents help with household tasks, and take responsibility for the tidiness of their bedrooms, with room maintenance as part of their timetables. The Hawthorns DS0000063646.V304562.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staffing levels allow a good level of support to be provided for residents. EVIDENCE: The company aims to offer staff eight days training a year. Training is coordinated by an assistant manager, but there is no training plan for the forthcoming year, so it was not possible to identify when mandatory training updates will be held. Staff commented that training opportunities are “very good”. The previous inspection identified that some staff required food hygiene training, and this has now taken place. Four staff files were inspected, and all provided evidence of a thorough recruitment and selection procedure. Two did not contain copies of references, but these were faxed over from the company human resources department. Another did not appear to have a reference from the previous employer, which it would be good practice to expect. Staffing levels in the home are good, with all but one resident being funded on a 1-1 basis. The home has suffered from staffing shortages over the past few months, with some agency staff used for cover, but the manager explained that six staff are awaiting pre-employment checks before starting. The Hawthorns DS0000063646.V304562.R01.S.doc Version 5.2 Page 18 The Hawthorns DS0000063646.V304562.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed, and the views of residents are sought. EVIDENCE: Staff said that the home is well managed and organised, with good teamwork and morale. They said that they are well supported, and the manager is always approachable. There are good systems in place to monitor the quality of care provided. Questionnaires are sent every six months to residents and relatives. Feedback from recent questionnaires had all been positive. The manager conducts an audit every 1-2 weeks, and regular Regulation 26 visits are conducted on behalf of the provider. The Hawthorns DS0000063646.V304562.R01.S.doc Version 5.2 Page 20 There have been significant events which have not been reported to the Commission as required, including a medication error, and an injury to a resident. The home was registered under one year ago, so maintenance and servicing records were not inspected. Records of fire equipment testing and fire drills were up to date. During a tour of the building a cupboard containing COSHH materials was found unlocked, and the manager attended to this promptly. The Hawthorns DS0000063646.V304562.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 x 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 x 3 x LIFESTYLES Standard No Score 11 x 12 2 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x 2 3 x The Hawthorns DS0000063646.V304562.R01.S.doc Version 5.2 Page 22 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA6 Regulation 15 Requirement Timescale for action 30/09/06 2. YA12 12(1)(b) 3 YA41 37 The registered person must ensure that accurate and detailed daily records are kept to support care plans, and that there is evidence that service users or their representatives have been consulted about their plan. The registered manager must 30/09/06 ensure that residents educational and occupational needs are catered for. The registered person must 31/08/06 notify the Commission of any events outlined in this regulation. The Hawthorns DS0000063646.V304562.R01.S.doc Version 5.2 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard YA20 YA22 YA35 Good Practice Recommendations It is recommended that the pharmacist be contacted for advice about the packaging of medication which is sent with service users on leave. It is recommended that adult protection awareness is covered during staff’s initial induction. It is recommended that an annual staff training plan is prepared to identify when training updates are due. 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