Inspection on 03/08/05 for The Hawthorns

This inspection was carried out on 3rd August 2005.

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

The Hawthorns 02/10/08

The Hawthorns 03/10/06

The Hawthorns 30/01/06

The Hawthorns 20/10/04

The Hawthorns 26/04/04

The Hawthorns 30/01/04

Similar services:

Hillside

Applegarth

122 Scorer Street

St Marys Nursing Home

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

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

CARE HOME ADULTS 18-65 The Hawthorns 86 Wymington Road Rushden Northants NN10 9LA Lead Inspector Sarah Jenkins Unannounced 03 August 2005 @ 7.10am 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 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 Stationary 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 C51 C08 S12799 The Hawthorns V244172 030805 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Hawthorns Address 86 Wymington Road Rushden Northants NN10 9LA 01933 395533 01933 395511 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Marie Mather-Franks Vacant Care Home Only (PC) 6 Category(ies) of Learning Disability (LD) 6 registration, with number of places The Hawthorns C51 C08 S12799 The Hawthorns V244172 030805 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. To include up to 2 service users within the category of Learning Disability/Physical Disability. Date of last inspection 20/10/2004 Brief Description of the Service: The Hawthorns is one of three homes in Rushden owned by Mrs Mather-Franks. It is a six-bedded house in the residential area of Rushden with good access to local facilities and amenities. It is a spacious and modern home offering individual personalised bedrooms and a range of communal space including an enclosed garden area.It provides personal care for up to six Service Users within the category of Learning Disability. The Hawthorns C51 C08 S12799 The Hawthorns V244172 030805 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for Service Users and their views of the service provided. This process considers the home’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. The primary method of inspection used was ‘case tracking’ which involved selecting 2 service users and tracking the care they receive through meeting with the service users, a review of their records, discussions with the care staff and observation of care practices. The Inspector visited during the early morning period to observe practices by staff and to meet with service users. Service users have learning disabilities and some have additional physical disabilities. Communication for some is difficult. Establishing Service Users choices and informed decisions is dependant to some extent upon the consistency of staff, service users relationships with staff, and the quality of communication. Feedback obtained from Service Users in this report was in part through observations of their relationships with staff, and also through interpretations of their general levels of happiness with their routines. The Inspector spent an hour preparing for the inspection and three and a half hours in the home. Three comment cards were received from relatives and two cards were received from Service Users. All comment cards received were positive in their contents. The Registered Manager has left the employment of the home since the last inspection and management issues were therefore discussed with the Acting Manager. What the service does well: The inspector observed that the atmosphere was friendly and homely. There was a family style atmosphere conducive to Service Users happiness and wellbeing. Staff had good relationships with Service Users who were clearly relaxed and happy in their company. Staff take a pride in offering Service Users active and stimulating lifestyles with plenty of activities. There is good team work by the staff who feel that they have good relationships and communication. The Hawthorns C51 C08 S12799 The Hawthorns V244172 030805 Stage 4.doc Version 1.30 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 Hawthorns C51 C08 S12799 The Hawthorns V244172 030805 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection The Hawthorns C51 C08 S12799 The Hawthorns V244172 030805 Stage 4.doc Version 1.30 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 standard(s) None This area was not reviewed at this inspection. EVIDENCE: The Hawthorns C51 C08 S12799 The Hawthorns V244172 030805 Stage 4.doc Version 1.30 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 standard(s) 6 Service Users needs are not always met sufficiently promptly. EVIDENCE: Service Users were observed to have their general social and emotional needs well met by staff on duty during the early morning period. Generally their physical needs such as assistance with personal hygiene, dressing etc were also well met. The current means of ensuring safety for a Service User who is at risk of falling from his bed had not been properly approved by a relevant professional (District Nurse, Occupational Therapist or Physiotherapist). Care details on some care plans had not always been sufficiently promptly updated to guide new staff in the correct practice, for example details of the way in which a Service User was to be offered his medication were out of date. The Hawthorns C51 C08 S12799 The Hawthorns V244172 030805 Stage 4.doc Version 1.30 Page 10 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 standard(s) 12, 13, 14 and 17 Service Users lead active and stimulating lifestyles conducive to their happiness and wellbeing. EVIDENCE: Service Users are enabled to attend appropriate work placements during the day and told the Inspector that they enjoyed their day placements. Staff enable Service Users to access to the community facilities on a regular basis. For example Service Users go to the local shops, visit the local park and go to the swimming pool and youth club. Staff promote interest in leisure activities and support Service Users choices where possible. The kitchen was well maintained and stocked. Service Users are involved in choosing the menu with guidance towards healthy eating patterns. Alternatives are offered. Service Users were observed to be telling staff what they wanted for breakfast. The Hawthorns C51 C08 S12799 The Hawthorns V244172 030805 Stage 4.doc Version 1.30 Page 11 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 standard(s) 18 and 19 Service Users personal and healthcare needs are generally well met. (See also under “Individual needs and choices”) EVIDENCE: Service Users were observed to be being assisted in their early morning routines and their rights to privacy and dignity were properly observed. A Service User told the inspector that he had full confidence in the staff to give him any necessary help, and that staff were kind. Healthcare is well supported and Service Users are enabled to access relevant professionals as needed. Records are properly maintained in this area. The Hawthorns C51 C08 S12799 The Hawthorns V244172 030805 Stage 4.doc Version 1.30 Page 12 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 standard(s) 22 and 23 The training and awareness of staff in this area should be improved. EVIDENCE: Protection of Vulnerable Adults is an area of development that has been recognised as necessary by the Registered person. The Acting Manager is shortly to attend a course that will enable her to give in house training to all staff in the area of Protection of Vulnerable Adults. The complaints procedure is accessible to staff, Service Users and their visitors. There have been no complaints made to the home, or to Commission for Social Care Inspection about the home, in the past year. The Hawthorns C51 C08 S12799 The Hawthorns V244172 030805 Stage 4.doc Version 1.30 Page 13 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 standard(s) 24 and 30 Service Users live in a homely and comfortable environment, with a pleasant garden area available. EVIDENCE: The home is well maintained, decorated and furnished. The home is spacious, with furnishings suitable for the Service Users and there is access to all communal areas, including the garden, for Service Users with a physical disability. Service Users have personalized their rooms with assistance from staff. The home was very clean and there was evidence of a commitment to safe and hygienic practices in the information to staff and the equipment available. It was unclear to the Inspector and the Acting Manager why there is no clinical waste collection from the home at the present time. The Hawthorns C51 C08 S12799 The Hawthorns V244172 030805 Stage 4.doc Version 1.30 Page 14 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 The training and experience of staff varies, and therefore not all shifts are adequately covered. EVIDENCE: Staff on duty at the time of the inspection were mainly sufficiently trained and experienced to provide competence. Interactions between staff and Service Users were observed to be warm and relaxed, and Service Users who spoke with the inspector demonstrated confidence and trust in staff. Staff had a good understanding of the communications of Service Users, but will benefit from the planned “Makaton” training. A review of the night care arrangements showed that although senior staff are on call, one recently appointed staff member has not yet undertaken sufficient training to be left in charge of the home. Some staff members do not have up to date training in Protection of Vulnerable Adults, Moving and Handling or in First Aid. Training in these areas has been arranged. The Hawthorns C51 C08 S12799 The Hawthorns V244172 030805 Stage 4.doc Version 1.30 Page 15 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 and 43 The temporary management arrangements in the absence of a Registered Manager are meeting the necessary Standards. EVIDENCE: Staff spoke confidently about the management of the home and the smooth transition since the resignation of the last Acting Manager. Overall there is a good level of organization, and several issues had already been identified, prior to the inspection, as being in need of review. COHSS (Control of Substances Hazardous to Health Regulations 1999) regulations were not being fully met at the time of the inspection. Hazardous cleaning substances were left in the laundry area, which was not locked at all times. The Acting Manager said that she had just locked the area and that she had recently spoken to staff about this. She was advised to formalize this instruction to staff. The Hawthorns C51 C08 S12799 The Hawthorns V244172 030805 Stage 4.doc Version 1.30 Page 16 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 x x 3 Standard No 31 32 33 34 35 36 Score x x x x 1 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Hawthorns Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x 3 x x x x 1 C51 C08 S12799 The Hawthorns V244172 030805 Stage 4.doc Version 1.30 Page 17 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 23, 35 Regulation 13,18 Requirement Each shift must have sufficient trained experienced staff to safeguard Service users. To this end staff training must be provided in the areas of First Aid, Moving and Handling and the Protection of Vulnerable Adults. There must be staff on each shift who are competent in all necessary procedures if these responsibilities have been taken on by the home. For example: the administration of non oral medications. To this end relevant training must be given. Sustances hazardous to health must be properly stored in accordance with the Control of Substances Hazardous to Health Regulations. Where service users safety needs to be protected through preventing them falling from bed, proper arrangements must be made in consultation with the relevant proffessionals. Timescale for action By November 30th 2005 2. 35 13,18 By September 30th 2005 3. 43 13 By August 3rd 2005 4. 43 13 By September 30th 2005 The Hawthorns C51 C08 S12799 The Hawthorns V244172 030805 Stage 4.doc Version 1.30 Page 18 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 6 43 Good Practice Recommendations Care should be taken to ensure service users care plans are under continuous review and updated whenever necessary. The clinical waste collection should be reinstated as necessary. The Hawthorns C51 C08 S12799 The Hawthorns V244172 030805 Stage 4.doc Version 1.30 Page 19 Commission for Social Care Inspection Northamptonshire Area Office Newland House, First Floor Campbell Square Northants, NN1 3EB 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 The Hawthorns C51 C08 S12799 The Hawthorns V244172 030805 Stage 4.doc Version 1.30 Page 20 - 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. 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