Inspection on 07/01/09 for The Hermitage

This inspection was carried out on 7th January 2009.

CSCI found this care home to be providing an Good service.

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 Hermitage 26/02/08

The Hermitage 24/05/06

The Hermitage 17/10/05

The Hermitage 20/04/05

The Hermitage 16/11/04

The Hermitage 01/06/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 27/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Hermitage 66 Holly Road Uttoxeter Staffordshire ST14 7DU     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Wendy Grainger     Date: 0 7 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: The Hermitage 66 Holly Road Uttoxeter Staffordshire ST14 7DU 01889562040 01889565299 manager@uttoxeterhermitage.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Doctor Charles Bamford Convalescent Home Trust care home 11 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home The Hermitage is a large detached Victorian house that has been extended to provide accommodation for fifteen ladies, six of who may have a physical disability and three of whom may have dementia care needs. The home is provided by the trustees of the Charles Bamford Memorial Trust and managed by Louise Hurst. The home is situated close to the centre of the market town of Uttoxeter and within easy walking distance of local shops and a public house. A bus route passes the end of the drive. Access to the first floor is by staircase that has been fitted with a stair, chair lift. Communal facilities consist of a large lounge and a dining room. The lounges, dining areas and all other 0 0 0 0 Over 65 3 11 15 6 Care Homes for Older People Page 4 of 25 Brief description of the care home indoor and outdoor facilities are adequate. Fees charged range from £393-£402 per week.Information for the current up to date fees can be obtained from the service. Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The overall quality rating for this service is 2 star. This means that people who use the service experience good quality outcomes. One inspector carried out this unannounced key inspection on one day between 08:00 and 16:30 hours. The service completed an Annual Quality Assurance Assessment (AQAA). This is a selfassessment tool, which was used as part of the key inspection. The completion of the AQAA is a legal requirement and it enables us to see how well the services focuses on the outcomes for the people who use the service to make sure that their needs are being met. The AQAA gives us numerical information about the service. The information contained in the AQAA was comprehensive. We received completed Have your say surveys from people who use the service, two Care Homes for Older People Page 6 of 25 members of the staff also completed surveys. We spoke to the majority of the people to find out their views about what it is like to live at the service. We also observed the staff and their working practices. We looked around the premises to see the standard of comfort and safety. We looked at the daily and weekly menus to assess their standard in terms of meeting peoples needs. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The needs of people who may choose to use the service are assessed so that they can be assured that these will be met. Information provided by people is current and up to date helping people decide if the service will be suitable for them. Evidence: We were given the Statement of Purpose and service users guide. Each of the people who use the service have been provided with these documents. This was evidenced in the bedrooms seen during the inspection. The service users guide contained the relevant information including the current fees. Evidence seen in two care plans identified that each person had had their needs assessed. The service had recently commenced a key worker system. It was suggested that the person who was going to be responsible for a prospective new person could be part of the assessment process. This will give them experience while the person would Care Homes for Older People Page 10 of 25 Evidence: meet the person who would be looking after them. We found the pre-assessment document in general satisfactory. We were told that the form is under review to make it more person centred. From the initial assessment the manager commenced with the care plan to ensure that the staff were aware of individuals needs. We discussed with the manager the need to ensure information on the file was current and not to leave it on the computer. The system we were told was backed up daily. Care Homes for Older People Page 11 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Processes in place ensure that the personal and health care needs of people who use the service are met. Medication management was satisfactory, safeguarding the people who use the service. People were seen to be treated with respect. Evidence: Arrangements were in place for the continued health care of the people who use the service. One person was visited daily for her medical needs by the district nurse. Care plans seen were very detailed; the information was readily available to all the staff. Daily reports were exceptional in detail and had follow up references to monitor/observe individuals. There was a need to transfer daily reports and care assessments more often to ensure that all the information is current live and active.Staff were observed to be knowledgable and aware at all times of individuals daily and current needs. Medication was seen to be administered satisfactorily; the records were current and signed at the time of administration. There was a need to monitor the temperature of the room the medication trolley is stored. Staff responsible for the administration Care Homes for Older People Page 12 of 25 Evidence: confirmed that they had received the appropriate training for the safe handling of medication. This was also confirmed from the staff training records we saw and within the AQAA information provided. We identified that from choice no one person selfadministered their medication. Staff on the day of the inspection were seen to be responsive to the peoples needs, demonstrating their knowledge of the person. They were polite, friendly and shared banter with the people. We were told by individual people the staff are good, they look after us, I am glad to be back home with the girls. Care Homes for Older People Page 13 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are given choices in respect of their daily routines. Generally peoples dietary needs are met by the range of food offered. Evidence: When we arrived at the service, five of the people were in the lounge, one was being assisted to rise and one person recently returned for hospital remained in bed, as did others by choice. People told us Its good to be back home I like to be up and see others. We were told that people had the choice when rising. The AQAA told us that there were no restrictions for families and friends visiting. We did not have the opportunity to speak to any visitors. People are encouraged to deal with their own finances; this was evidenced from the very limited finances held by the management. Two finances were checked at random and found accurate. Menus were based on the likes and dislikes of the people. The AQAA told us that the service provides a varied and a choice of meals, we discussed with the manger to review some meals to ensure that the option is appropriate and not a duplicate in an alternative form. We were told by people and observed the staff taking lunch. The food is good here Care Homes for Older People Page 14 of 25 Evidence: The cook will do something I like I enjoyed the lunch there is always enough for me. The cook has an National Vocational Qualification (NVQ) for catering. There was a varied supply of dry goods; home cooking is a priority for the catering staff. We would suggest that although the details of the meals are recorded in the dining room the teatime meals need to be recorded in the paper records. Care Homes for Older People Page 15 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Systems were in place to make sure complaints are listened to and acted upon. Processes are in place to protect the people who use the service. Evidence: We saw the services complaints procedure displayed in the entrance hall at the front of the service. This document was also included in the Statement of Purpose and service users guide. We evidenced the complaints record provided by the manager, there had been two complaints since our last key inspection. The care manager had addressed the issues and maintained a record. Whilst the records were detailed, it was suggested to complete the entries the manager should sign and confirm the outcome. We have received no referrals to the safeguarding team. Surveys completed by the staff and the people who use the service, told us that they knew how to make a complaint and who to speak to. The AQAA and records provided told us that staff had received training in the safe guarding of the people this was also confirmed by the staff on duty. The administrator had been on the training programme about the Mental Capacity Act. This course was to be extended to other staff. Care Homes for Older People Page 16 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Appropriate heating , lighting, and equipment ensures that the environment is comfortable and safe for the people who use the service. Evidence: Located off the busy main road and down a short dead end lane, the service is suitable for its registered purpose to provide care to older people. We were told by the care manager and it is written in the services completed AQAA that refurbishment of the service is being undertaken. There were plans to extend the service in the future. People spoken with told us the its always clean the staff do a good job these comments confirmed the completed have your say surveys sent to us. People have access to the light communal lounge. We were provided with comments left in the suggestion box. The home could be more modern. We looked at the bedrooms and found that the privacy and dignity of individuals was respected;staff were seen to knock and wait before entering a room. Each person had been surveyed regarding locks on their bedroom doors. The present people had refused the option and signed to confirm their decision. Each bedroom was personalised to suit individuals taste. The services cleanliness was a credit to the housekeeper. The service provides equipment for people who use the service to increase their Care Homes for Older People Page 17 of 25 Evidence: independence. From the records the equipment was serviced, staff training had been provided. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use the service have their needs met by appropriate numbers of staff with varied experience and skills. The service had robust recruitment systems in place to protect the people who use the service Evidence: The members of staff on shift included the manager who had a supernumerary role, deputy manager and one carer. The housekeeping and catering staff supported them. We were told that there was a recognised senior person on each shift, including the nights. This was evidenced from the rota, and AQAA. From the information provided in the AQAA, discussions with the staff; staff training records, which included mandatory training were curent, further training was planned. The services AQAA told us and this was confirmed in the Have your say surveys and by the staff that they were aware of the need to protect individuals from any form of abuse. They were aware of the process and procedure to bring any concern to the management or trustees. From the information in the AQAA and from records the service has achieved over the required percentage of National Vocational Training levels two, three, and four for across the range of staff employed. Staff spoken with confirmed that the management conducted supervision with them on Care Homes for Older People Page 19 of 25 Evidence: a regular basis this was also confirmed in the AQAA and the staff Have your say surveys. Two of the staff files were evidenced as part of the inspection, evidenced in each of the files were the appropriate references, mandatory police checks, and training certificates/qualifications.These safe recruitment practices mean that the vulnerable people are better protected form unsuitable staff working at the home. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager has the required qualifications and experience to run the service. The service is run in the best interests of the peole who use the service. Evidence: The registered care manager has been in the caring profession for over 15 years she has acheived the registered managers award. Her knowledge, is based on continuous development and training. The completed AQAA tolds us that policies have been reviewed annually and updates where necessary. People are supported to manange their own money where possible. We checked a sample of the limited funds held on behalf of the people and found the records and finances satisfactory. Fire records evidenced that fire training had taken place in July 2008 and the fire risk assessment was due in February 2009. We discussed the contingency plan for the service, which the manager will address. There was a need to rectify the fault identified on one of the automatic release doors. The manager had put into operation Care Homes for Older People Page 21 of 25 Evidence: extra checks during the night and a risk assessment for the area. We suggested that a record of the extra checks could be recorded in the event of an emergency. We were provided with evidence of the surveys for relatives and people who use the service. Positive comments included: It is the best home I visit, the staff are always welcoming and work very hard. Two comments made in respect of the building told us that a ramp at the front of the home would be beneficial.We were told that these comments were being addressed by an external agency. We evidenced records that told us that equipment was serviced and or checked to ensure the safety of the people who use the service. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 The system for the transferring information from the computer to the care plans needs to be completed earlier. care plans should be active and current. To ensure that all the meals prepared are recorded on the paper copy of the menus. To consider completing the complaints records with a recorded outcome and signature. To extend and to incorporate in the contingency plans details for a possible evacuation of the service in the event of an emergency. 2 3 4 15 16 38 Care Homes for Older People Page 24 of 25 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 25 - 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!