Care Home: Godwyne Hurst

What the care home does well The two people who live at Godwyne Hurst have been supported by Mrs Hodgson for over 20 years. They said they feel at home and they feel well cared for. They agreed that if they had any problems they could speak to Mrs Hodgson. One person said "...everything is fine, just what I want...". What has improved since the last inspection? Some redecoration has taken place and new curtains put up. What the care home could do better: More information and guidance in the care plans about specific things for some people would make sure all the staff know how to support someone. Written information about one person wishing to manage their own medication should be in place. Training or up to date instruction regarding safeguarding people needs to be provided to all staff. No one must be employed without all the necessary checks taking place to make sure residents aren`t put at risk. There should be a rota in place showing who has worked and the plan for covering upcoming days. Training must be reviewed to make sure that everyone has up to date information relating to meeting peoples` needs and maintaining health and safety. The next AQAA should be completed in a more relevant way, reflecting what the home does and is planning to do, including the views of the residents. Within the AQAA Mrs Hodgson noted that she intends to provide more opportunities for residents to go out this summer. She also has plans to have more flowers and shrubs in the garden. One more person is to be supported to carry out their national vocational qualification in care at level 2. Key inspection report Care homes for older people Name: Address: Godwyne Hurst 2 Leyburne Road Dover Kent CT16 1SN The quality rating for this care home is: one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Christine Lawrence Date: 0 6 0 5 2 0 0 9 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should:  Be safe  Have the right outcomes, including clinical outcomes  Be a good experience for the people that use it  Help prevent illness, and promote healthy, independent living  Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home:  3 stars – excellent  2 stars – good  1 star – adequate  0 star – poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. things that people have said are important to them: 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 They reflect the Care Homes for Older People Page 2 of 23 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by:  Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice  Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983  Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services.  Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Page 3 of 23 Internet address Care Homes for Older People Information about the care home Name of care home: Address: Godwyne Hurst 2 Leyburne Road Dover Kent CT16 1SN Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable): Type of registration: Number of places registered: Conditions of registration Category(ies): old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 4 The registered person may provide the following category/ies of service only: Care home only - PC to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - OP Date of last inspection: Brief description of the care home: Godwyne Hurst is registered to provide residential care for four older people. The property is a large building, which also contains rooms for independent private tenants on the upper two floors separate from the residential home. There is a shaft lift to enable residents to access the two floors of the home. The home is located in Dover with amenities close by, including public transport. It is owned by Mrs Hodgson who also has day-to-day responsibility for running the home. There is a small parking are to the rear of the building and parking is not restricted in the roads outside the building. The current fees for the service at the time of the visit are £305 per week. Information Care Homes for Older People Page 4 of 23 01304206391 Mrs Doris Anne Hodgson Care Home 4 Number of places (if applicable): Under 65 0 Over 65 4 D D M M Y Y Y Y about the home will be provided on request, including access to a copy of the last inspection report from the commission for social care inspection (CSCI) undertaken in June 2008. Care Homes for Older People Page 5 of 23 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: One star adequate service Our judgement for each outcome: How we did our inspection: We, that is the Care Quality Commission (CQC), visited Godwyne Hurst without notice. We had previously sent out surveys for residents to complete. We received two surveys from residents. Prior to this visit the provider had completed an annual quality assurance assessment (AQAA). Information from the surveys and the AQAA is used in this report. We also used information from the previous inspection report (June 2008). During our visit to Godwyne Hurst we spoke to a member of staff and to Mrs Hodgson who owns and runs the home. Mrs Hodgson took us for a tour of the building and gave us an opportunity to chat with the people who live there. There are only two people living in the home. Comments from surveys, as well as talking to people on the day are included in this report. Some requirements relating to checks on new staff had not been followed through from the last inspection. We issued an immediate requirement and a Code B notice. Subsequently a management review meeting took place and a formal warning letter was sent to Mrs Hodgson. Care Homes for Older People Page 6 of 23 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Care Homes for Older People Page 7 of 23 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 8 of 23 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 the service experience Good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. No one will be admitted to the home unless their needs have been assessed and the home is confident that it can meet their needs. Evidence: There have been no new admissions to the home since the last inspection. Mrs Hodgson said that she would seek information about any possible new person from the placing authority and relatives if appropriate. She has a suitable tool to assess someones needs if she did decide to admit a new resident. The care plan format currently in use is suitable for identifying residents needs. Existing care plans contain information from social services. Care Homes for Older People Page 9 of 23 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 the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents would benefit from having a plan of care which has more detailed information about how their health needs are to be met. They would also benefit from a risk management framework supporting their wish to be responsible for their own medication. Residents can be confident that they will be treated with respect. Evidence: The care plans for both the residents living in the home were looked at for this inspection. They are written using a person centred format and cover a range of things including personal care, health, communication, moving and handling, finances, activities and any other information pertinent to that person. The care plans reflected that residents health care needs are identified and responded to and there were examples of health care professionals being involved with residents. Both residents confirmed this and the surveys they completed prior to the inspection were ticked always in response to the question Do you receive the medical support you need?. The home has decided that a monthly summary would be used instead of daily records and these were seen to be up to date. There was no guidance relating to how staff should support one resident with diabetes and we discussed this with Mrs Hodgson. She has some general information but we advised that something more specific should be in place. There was no risk assessment in place for one resident who manages their own medication. Care Homes for Older People Page 10 of 23 Residents confirmed that they are treated with respect and good manners and their privacy is maintained. They said ...everything is fine here, the staff are good people... and one person said yes in answer to the question about staff being polite and respectful. Care Homes for Older People Page 11 of 23 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 the service good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a family like atmosphere. They are supported in activities which suit their individual needs. They have choices in all aspects of daily life and have nutritious and appealing meals. Evidence: The two people living in the home have lived there for some time and have been cared for and supported by Mrs Hodgson for many years. Mrs Hodgsons family are involved both as staff and regular visitors and this has led to the home being very much a family atmosphere for the two residents. They have individual things that they like to do throughout the day and this is supported by the home. The records showed (and this was confirmed by the residents) that they make choices about their routines and what they wish to do. One person recently chose to move to a different bedroom. It was also clear that where a resident chooses to do so they are supported to manage their own finances. There are two lounges so privacy is available for meeting with visitors if required. Examples were noted of the home supporting residents to keep in contact with family. Mrs Hodgson noted in the AQAA that she wants to support people to out and about more this summer and she confirmed this in our discussions with her during the inspection visit. The residents confirmed that they enjoy the food provided and there is always plenty of it. This was also confirmed in the surveys they completed before the inspection both of which had ticked always in answer to the question Do you like the meals at the home?. The meal served at the time of the inspection looked and smelt good. There is a large table in the kitchen/diner area but both residents confirmed they prefer to take Care Homes for Older People Page 12 of 23 their meals in the lounge. Care Homes for Older People Page 13 of 23 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 the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints would be handled in keeping with the homes procedures and residents can be confident that any concerns will be listened to, taken seriously and responded to. Residents are protected from abuse. Evidence: A copy of the complaints procedure is on display at the home. Mrs Hodgson said she would give a copy if she did admit a new resident. The residents both confirmed that they would talk to Mrs Hodgson, or anyone who worked at the home, if the had any concerns. This was confirmed in the surveys that they completed prior to the inspection. Mrs Hodgson said that there had been no complaints since the last inspection. One member of staff has a national vocational qualification, level 2. Although no members of staff have received any training regarding adult protection, Mrs Hodgson said she is confident that all the people who work at the home are fully aware of their responsibilities. The home has a copy of the Medway and Kent policies and procedures. There is a whistle blowing procedure at the home. We advised Mrs Hodgson about the e-learning course on safeguarding provided by Kent County Council and she agreed to look into this or ensure that staff have up to date instruction and guidance regarding adult abuse to underpin the policy and procedures in the home. Care Homes for Older People Page 14 of 23 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 the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in an environment which is safe, well maintained, clean and hygienic. Evidence: The location and layout of the home is suitable for its stated purpose. The rear entrance is the one most used as it leads from the car parking area. There is a small area within the garden with tables and chairs which residents can use to access sunlight. There are no requirements from the local fire safety officer or the environmental health officer. The laundry is small but appears satisfactory to meet the needs of the current residents. The home was clean and there were no unpleasant odours. Both residents confirmed in their surveys that the home was always fresh and clean. Mrs Hodgson has a copy of the Department of Healths Essential Steps but has not yet used it to identify any infection control needs within the home. She informed us that two staff members had received infection control training. Care Homes for Older People Page 15 of 23 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 the service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents would benefit from improved training for all staff. Residents safety would not be put at risk if recruitment procedures were improved. Evidence: There was no rota available showing who worked when or any planned staff cover. Mrs Hodgson and one other member of staff have national vocational qualifications in care at level 2. The newest member of staff had not completed an application form or given details of appropriate references. Mrs Hodgson told us she had seen references provided for a previous employer. Mrs Hodgson had not completed the process of seeking a criminal record bureau check although she and the member of staff confirmed that there had been some problems with this. However this had been allowed to drift without any urgent follow up. There was no record of any information about the member of staff. Mrs Hodgson explained that the person was known to her. Mrs Hodgson informed us that no training has been provided since the last inspection. Mrs Hodgson uses a checklist for induction but nothing was recorded for the newest member of staff. The common induction standards are not used in the home. Mrs Hodgson told us that she provides instruction to staff about various things such as manual handling and fire safety but she herself has not kept up to date with this. First aid training for two people has been allowed to lapse. Both the residents ticked always in answer to the question Are the staff available to you when you need them? and the same in response to the question Do you receive the care and support you need?. Care Homes for Older People Page 16 of 23 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 the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents would benefit from improved training for all staff. Evidence: Mrs Hodgson has run her own residential home for many years. She has a national vocational qualification in care at level 2. She has not undertaken any training in the last year and cannot therefore demonstrate that she has updated her knowledge, skills and competence, whilst managing the home. She is also the main carer. The care plans and other records are not kept secure. Mrs Hodgson does not currently seek formal feedback from residents and others. The current two residents are able to speak up for themselves and they and Mrs Hodgson have known each other for many years. Mrs Hodgson is confident that she listens to the residents and runs the home in their best interests. The AQAA was submitted on time but did not reflect that Mrs Hodgson had taken the views of the residents into account and did not refer to any outstanding requirement from the previous inspection and how she had responded to them. If the AQAA is to be used as the method for evaluating the service provided as well as planning any improvements, it needs to more accurately reflect what the service does. The two residents both said that they could speak to Mrs Hodgson and they felt she listened. Mrs Hodgson is not involved with the finances of either resident. The records of maintenance and service contracts were appropriate and up to date. As noted Care Homes for Older People Page 17 of 23 previously staff training needs to be reviewed and updated where necessary and this includes health and safety. Care Homes for Older People Page 18 of 23 Are there any outstanding requirements from the last inspection? Yes √ No 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 1 29 19 Proper recruitment procedures are to be followed at all times 31/08/2008 Care Homes for Older People Page 19 of 23 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 1 29 19 No one to be employed until relevant information and documents are obtained in keeping with Regulation 19(1)(b) Schedule 2. See also Regulation 19(9)(10) To ensure that residents safety and well-being is not put at risk 30/05/2009 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 1 7 15 More detailed information 17/06/2009 and guidance to be available to staff regarding diabetes To ensure that all staff can meet the residents needs 2 9 13 To have a detailed, person centred risk assessment, around any medicine self administration. To ensure that the resident is able to safely self medicate 17/06/2009 3 27 17 A duty roster to be maintained and available in keeping with Regulation 17(2)Schedule 4(7) 17/06/2009 Care Homes for Older People Page 20 of 23 To ensure that staffing levels are accurately reflected 4 30 18 Training needs to be 31/07/2009 reviewed and a plan compiled for what is needed to be provided or updated, including a structured induction training in keeping with Regulation 18(1)(c) To ensure that staff can meet the needs of residents and to comply with legislation 5 31 10 The owner/manager review 31/07/2009 her training needs and plan what needs to be updated or undertaken To ensure that she has the skills and knowledge necessary for managing the home 6 33 24 The AQAA to be completed more accurately To ensure that it is a relevant tool for assessing quality 7 37 17 Records to be stored securely To ensure privacy and confidentiality 8 38 13 Health and safety training 31/07/2009 needs for all staff to be reviewed and a plan devised for meeting those needs To ensure that all relevant training has been updated or completed 31/07/2009 28/05/2010 Care Homes for Older People Page 21 of 23 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 Care Homes for Older People Page 22 of 23 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.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) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 23 of 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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