Care Home: Hackworth House

What the care home does well Hackworth House is a well-established care home. People who live there said good things about the care they receive. Many of the agency’s strengths were expressed in the comments that people gave and they said that they are involved in the planning and delivery of their care. The home has a friendly atmosphere and the staff who work there are open and welcoming. The people who live their and their relatives or visitors feel comfortable supported and are put at ease. People who live at the home said they were happy with the staff who offer care. People’s independence is promoted and the care received is flexible and reliable. One person who lives at the home said, “It’s a lovely place, good company, good food and they care about you as well.” People who move to the home have their needs assessed by social or healthcare workers and the manager so that everyone is sure that this is the right place for them to live. This is very important as people often have complicated needs that require well managed and agreed ways of supporting them. Personal care and support is provided to people with a wide range of needs with varied expectations and backgrounds. This diversity is reflected in the staff team, giving the manager the opportunity to recruit staff from the same background as the people living in the home. Some staff have been recruited from the community around the home. This match helps staff to understand peoples needs and people who use the service are more reassured that they get support from staff who understand them. Both care practice and staff recruitment practices are governed by equal opportunity principles. There are always enough care staff employed at the home to make sure that peoples needs can be properly met and the way that staff are recruited makes sure that they are suitable for working with vulnerable people. And they have undertaken qualifications in care and are provided with some specific training to help them develop the knowledge, skills and confidence to support people. The staff have formed good relationships with the residents and make sure their rights to privacy and dignity are met. Hackworth House DS0000031222.V377805.R01.S.doc Version 5.2 Staff are well organised by the acting manager, with good communication and record keeping. This helps staff to organise their work routines, and know how to meet the needs of the people they are to support. The home is managed in a way that makes sure that staff know peoples routines and how the activities at the home can to help people to be involved, motivated and interested. There is a good atmosphere at this home and everyone is included in the dayto-day options and activities if they wish. There is a low turnover of staff so some of them have worked at the home for a long time and have formed a good team. The acting manager and the owners Durham County Council show that they are have the commitment to invest time skill and finances in the home to produce good outcomes for the people who live there. They have the confidence of the staff who work well with them. The acting manager talks to visitors relatives and people living at the home to make sure that they are happy with the service they receive and people are asked for their views so that changes and improvements can be made if these are required. The home is visited by senior managers who check that the manager and staff are working well and following the organisations way of working. People living at the home and their relatives said that they would be able to use the complaints procedure if they had a concern or grievance and there are effective joint working arrangements with other agencies to protect people from abuse. What has improved since the last inspection? The home has a new acting manager and although she has only been in post for a short while, she has looked at all areas of how the home works to see if these match the levels of quality that is expected and is taking action where these need improvement. She has established herself as an effective, diligent and talented manager in a very short space of time which should be commended. Since the last inspection the home has achieved a “Charter Mark” award for good practice in customer relations. This recognises the hard work of staff and present and previous managers at the home. There are now steps in place to help prevent fire doors from being propped open and the manager now sends notifications to the Care Quality Commission more regularly where incidents have affected the wellbeing of people in the home. All care plans have been reviewed and updated by the service managers to make sure that they are up to date and contain all the information they need to including when visits by the doctor or other health professional have taken Hackworth House DS0000031222.V377805.R01.S.doc Version 5.2 place. The manager is working with staff so that they will find the new care plans easier to use. What the care home could do better: The person responsible for the home should make sure that staff continue to be supported to use the new design of care plans and that their ease of use should continue to be monitored. The person responsible for the home should make sure that staff record the time that medication audits are carried out to make it easier to check if they are correct. The person responsible for the home should make sure that the person in charge has been assessed by the Care Quality Commission as being suitable to become the Registered Manager. There a small number of minor maintenance / replacement issues which were reported to the manager at the time of the inspection. Key inspection report CARE HOMES FOR OLDER PEOPLE Hackworth House Cheapside Shildon Co Durham DL4 2HP Lead Inspector Steve Tuck Key Unannounced Inspection 23rd September 2009 10:30 DS0000031222.V377805.R01.S.do c Version 5.3 Page 1 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. 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. Hackworth House DS0000031222.V377805.R01.S.doc Version 5.2 Page 2 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 Internet address Hackworth House DS0000031222.V377805.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hackworth House Address Cheapside Shildon Co Durham DL4 2HP 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) 01388 773247 P/F lyn.bregazzi@durham.gov.uk www.durham.gov.uk Durham County Council Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Hackworth House DS0000031222.V377805.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th April 2007 Brief Description of the Service: Hackworth House is a care home situated in the Shildon area of County Durham which provides accommodation and personal care for forty people. The home cannot provide nursing services but people can be supported by community nursing staff visiting the home. The building is in a well-established residential area amongst residential properties and near to the village centre. The service is operated and managed by Durham County Council who have owned the home since it was built in the 1970’s. The home has 40 single rooms and there are shared toilets, showers and bathrooms, situated throughout the building, which are fitted with adaptations to help people who are frail or have a physical disability. Each floor has several lounge and dining areas which have been set out to make best use of the daylight and views of the gardens and the surrounding village. On the ground floor the home has a separate day centre in a large lounge. There are car parking spaces at the front of the building including disabled parking bays. There is easy access into building through the main doors into the reception area. Hackworth House is a short walking distance from local shops, and a bus or car ride from Durham City Centre and Bishop Auckland. There is access to local transport directly outside the building. This inspection took place over one day and was a scheduled unannounced inspection. At the time of this inspection it costs £432.32 per week to live at this home. The costs of newspapers, hairdressing, private chiropody and toiletries are not included in the fees. The actual fees paid depend on personal circumstances, further details can be found in the homes service user guide. Hackworth House DS0000031222.V377805.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Before the visit We looked at, Information we have received since the last Key Inspection. How the service dealt with any complaints & concerns since then. Any changes to how the home is run. The provider’s view of how well they care for people. We asked them to examine their own service and write to us with the results. We sent surveys to people who use the home, people who arrange for people to live there, those who visit the home to support people like doctors and therapists and the staff who work in the home to ask what they think about services there. The Visit An unannounced visit was made on 23rd September 2009. During the visit we, Talked with the people who use the service the staff, the acting manager and visitors to the home. Observed life in the home. Looked at information about the people who use the service and how well their needs are met. Looked at other records which must be kept. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around parts of the building to make sure it was clean safe and comfortable. Checked on what improvements had been made since the last visit. We told the manager what we had found. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated it is likely that enforcement action will be taken. Hackworth House DS0000031222.V377805.R01.S.doc Version 5.2 Page 6 The quality rating for this service is 3 Stars. This means the people who use this service experience Excellent quality outcomes. What the service does well: Hackworth House is a well-established care home. People who live there said good things about the care they receive. Many of the agency’s strengths were expressed in the comments that people gave and they said that they are involved in the planning and delivery of their care. The home has a friendly atmosphere and the staff who work there are open and welcoming. The people who live their and their relatives or visitors feel comfortable supported and are put at ease. People who live at the home said they were happy with the staff who offer care. People’s independence is promoted and the care received is flexible and reliable. One person who lives at the home said, “It’s a lovely place, good company, good food and they care about you as well.” People who move to the home have their needs assessed by social or healthcare workers and the manager so that everyone is sure that this is the right place for them to live. This is very important as people often have complicated needs that require well managed and agreed ways of supporting them. Personal care and support is provided to people with a wide range of needs with varied expectations and backgrounds. This diversity is reflected in the staff team, giving the manager the opportunity to recruit staff from the same background as the people living in the home. Some staff have been recruited from the community around the home. This match helps staff to understand peoples needs and people who use the service are more reassured that they get support from staff who understand them. Both care practice and staff recruitment practices are governed by equal opportunity principles. There are always enough care staff employed at the home to make sure that peoples needs can be properly met and the way that staff are recruited makes sure that they are suitable for working with vulnerable people. And they have undertaken qualifications in care and are provided with some specific training to help them develop the knowledge, skills and confidence to support people. The staff have formed good relationships with the residents and make sure their rights to privacy and dignity are met. Hackworth House DS0000031222.V377805.R01.S.doc Version 5.2 Page 7 Staff are well organised by the acting manager, with good communication and record keeping. This helps staff to organise their work routines, and know how to meet the needs of the people they are to support. The home is managed in a way that makes sure that staff know peoples routines and how the activities at the home can to help people to be involved, motivated and interested. There is a good atmosphere at this home and everyone is included in the dayto-day options and activities if they wish. There is a low turnover of staff so some of them have worked at the home for a long time and have formed a good team. The acting manager and the owners Durham County Council show that they are have the commitment to invest time skill and finances in the home to produce good outcomes for the people who live there. They have the confidence of the staff who work well with them. The acting manager talks to visitors relatives and people living at the home to make sure that they are happy with the service they receive and people are asked for their views so that changes and improvements can be made if these are required. The home is visited by senior managers who check that the manager and staff are working well and following the organisations way of working. People living at the home and their relatives said that they would be able to use the complaints procedure if they had a concern or grievance and there are effective joint working arrangements with other agencies to protect people from abuse. What has improved since the last inspection? The home has a new acting manager and although she has only been in post for a short while, she has looked at all areas of how the home works to see if these match the levels of quality that is expected and is taking action where these need improvement. She has established herself as an effective, diligent and talented manager in a very short space of time which should be commended. Since the last inspection the home has achieved a “Charter Mark” award for good practice in customer relations. This recognises the hard work of staff and present and previous managers at the home. There are now steps in place to help prevent fire doors from being propped open and the manager now sends notifications to the Care Quality Commission more regularly where incidents have affected the wellbeing of people in the home. All care plans have been reviewed and updated by the service managers to make sure that they are up to date and contain all the information they need to including when visits by the doctor or other health professional have taken Hackworth House DS0000031222.V377805.R01.S.doc Version 5.2 Page 8 place. The manager is working with staff so that they will find the new care plans easier to use. 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. Hackworth House DS0000031222.V377805.R01.S.doc Version 5.2 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hackworth House DS0000031222.V377805.R01.S.doc Version 5.3 Page 10 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1,3 and 6 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. Trained staff from the home find out and understand the needs of people who wish to live there before they move in. This information helps to make sure that peoples needs can be met at the home and agree the ways in which staff are to support them. EVIDENCE: By looking at the record kept at the home we could see that each persons needs are assessed before they move to the home, either by health services staff local authority social workers and the acting manager. This is so that the acting manager has a good understanding of peoples health and social care needs and can be sure that the home is going to be suitable for people who are going to live there. Where possible the person themselves or their representative is involved in the assessment process. Hackworth House DS0000031222.V377805.R01.S.doc Version 5.3 Page 11 The acting manager said that she liked people to visit the home first before they decided to move there so that they had an understanding of what it was like, but accepted that this is not always possible because people may need to move there quickly if they are experiencing problems or are waiting to leave hospital. The acting manager also finds out what cultural and lifestyle needs people have to make sure that these can be met. The manager has also had training which has given them the skills to find out what peoples needs are. The manager says that she has the skills and flexibility to decide if peoples needs can be met at the home and where this is not the case, she can help people to find an alternative. As a result of these measures, all of the people living at the home at present have been properly placed and the home is able to meet their needs. One relative said, “My (relative) chose this home because it is in his community. We hoped he would be able to move here because he’s lived in Shildon all his life.” Another said, “You won’t find care better than this. It doesn’t look like a Hotel like some of the homes do but it is comfortable, the staff are fabulous and the care here is top class.” There is good information about the home in the Statement of Purpose and a Service User Guide is available for people and their relatives who live or are interested in moving there. The Service User Guide has information in it about what it is like to live at the home, how people can be supported, what the accommodation is like, how to make a complaint and a copy of the recent inspection report. This is available in the home and relatives said that they were given information which told them all about the home before their relative moved in. The Guide also includes information about how residents’ rights will be respected regardless of age, gender, sexual orientation, race and religion. The information can be produced in large print, in different languages and in easy read style to make it easier for people to understand. There is information about the terms and conditions and range of fees charged. Hackworth House DS0000031222.V377805.R01.S.doc Version 5.3 Page 12 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples care and health needs are well supported at this home and the way that staff give out medication makes sure that they get the treatment that has been prescribed. And every person has a plan of their care which shows in detail how their care needs will be met and gives the practice guidance that staff need. EVIDENCE: All people living at the home have a plan of care, which gives a description of how their physical, emotional and lifestyle needs are to be met. Care plans have recently been changed so that they contain better information about how people are supported. The acting manager has reviewed each care plan to make sure that this information is up to date and there is evidence that she is monitoring how staff use these documents to co-ordinate peoples care. Hackworth House DS0000031222.V377805.R01.S.doc Version 5.3 Page 13 The way that care plans are written down shows that how they are to be supported and there are examples of where a great deal of thought consideration and care has gone into this planning. For example how peoples increasing frailty is supported. Care plans are regularly reviewed and updated according to changes in social, personal and health care needs. For example those people who have reduced appetite or low weights are regularly weighed and treatment advice sought from dieticians. Their recommendations are acted upon and care plans are updated. Care plans at this home have a thorough assessment and review section where peoples needs and any changes are described in detail. Staff commented that care plans were sometimes difficult to follow because of how the information was ordered. For example, the parts of the plan which described peoples history and background were not always easy to find. The manager confirmed that the new style of plans had only been used for a few weeks and that further training is taking place. Staff are very knowledgeable about the people that they support. They can describe in detail how each person is to be supported and how they prefer their care to be given. Staff have an excellent understanding of peoples histories, needs and preferences and these can be seen in the way that they respond and support people. Staff work closely with other community-based health and social support staff to make sure that peoples wider needs are supported by fully co-ordinated care. For example there are regular visits from GP’s and other health professionals including, dentists, opticians and chiropody services. There are records which show the measures in place which help prevent pressure damage, wound care, moving and assisting, continence promotion, nutrition and mental health condition which are completed, reviewed and updated. Up to date information is documented on a regular basis and regular reviews take place with residents’, their relatives and care managers to make sure the home is still meeting their needs. There are appropriate pressure relieving equipment available to support people who may be at risk of developing damage. Due to their levels of need, most people living at the home need support to administer their own medicines, and designated staff therefore help in this area. The home has detailed instructions which gives staff direction about how they are to administer medication. And all staff who administer medication have undertaken training to make sure they have the skills and knowledge to carry this out properly and accurately. Hackworth House DS0000031222.V377805.R01.S.doc Version 5.3 Page 14 Medicine is securely stored in a locked purpose made cupboard and records are in place for all medicines received, administered and disposed of. A check of medicines kept at the home showed no discrepancies although the times that staff count medication should be recorded to improve accuracy. There is a register of staff who are authorised to administer medication. People living at the home are treated with respect by staff who know them well. Examples include locking their bedroom doors, receiving their mail, being addressed by their preferred name and being able to go wherever they wish inside and where possible, outside of the home. Relationships between people and with staff are relaxed, friendly and informal which helps them to feel comfortable. People appeared to be relaxed and happy with the support they get from staff. There is a good, positive atmosphere at the home, staff and residents share jokes and are empowered to express their views. One relative who visits the home daily said, “The residents are in control at this home.” Hackworth House DS0000031222.V377805.R01.S.doc Version 5.3 Page 15 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,and 15 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. People who live at the home are encouraged and supported by the staff to lead fulfilling lives with their rights as individuals being respected and to eat healthily which supports their physical and emotional wellbeing. Contact with family members and friends are supported where possible so that people keep up links with those outside the home. EVIDENCE: People who live at this home are encouraged to be in control of their lives as far as possible. They are able to maintain links with their friends, relatives and the local community and groups from the nearby school visit the home which helps people to remain included. Several people had visitors throughout the inspection. Staff spent time with them and shared information about their relative if necessary. Hackworth House DS0000031222.V377805.R01.S.doc Version 5.3 Page 16 Information about advocacy is available for anyone who needs impartial support and people at the home and their relatives again said that they were confident that the manager would sort problems out if they had any. All of the people living at the home are encouraged to bring items and keepsakes with them to making their own bedrooms homely and personalised. Staff at the home organise events both inside and outside of the building. They also help people who live at the home with social and recreational activities. Activities from a ‘multi choice menu’ are displayed, and includes for example, regular live entertainment, a ‘create’ programme of artistic opportunities, visits to places of interest and recreational events. The hairdresser visits the home regularly and people are encouraged and supported to attend local church services. There is also a newsletter, which describes the monthly activities, events, and poems and has puzzles to keep everyone busy. Peoples care plans contain information about people so that staff can make sure their likes and dislikes are known. On the day of the inspection people enjoyed visits from relatives and watching films on television. People living at the home and their relatives said that there was always something going on to keep them entertained. There are photographs on display, which show events that have taken place throughout the year. Several people said they liked to be on their own and did not join in any events and they staff respected these wishes. There is a dining room which is pleasantly decorated and furnished. The dining tables were set with cutlery, crockery, napkins and condiments. Staff and the manager at the home have been working with Newcastle College to help make sure that the meals there meet nationally recognised food standards for older people. People who live at the home are encouraged to make choices about their diet and have been assisted to devise a healthier menu. People also have meal diaries which helps them to eat healthily whilst enjoying their meals. Everyone said that they like the meals at the home and that they are asked what they would like to eat. Staff were seen checking with people about their choice of meal, size of portion to make sure that they always had their choice of meal. The cook was able to make sure that everyone had the meal they wanted even where people changed their choices at the last moment. Comments from some of the people living at the home were, “The meals are excellent, today’s lunch was very nice, very tasty.” Hackworth House DS0000031222.V377805.R01.S.doc Version 5.3 Page 17 “The cook is always telling jokes and he sings - his food is always delicious and he helps to put people in a good mood.” Staff are available during meals to offer support and assistance where needed and this makes meal times a relaxed and unhurried experience for everyone. The cook has extensive knowledge of the meals which people living at the home prefer and make sure that the only good quality ingredients are used to prepare meals. Menus were available which confirmed that a range of meals are provided which give people a balanced diet and refreshments are available throughout the day and night. People living at the home and their families are involved in choosing the meals that are included in the menu. Where people need it food supplements are available to help people to maintain their health for example if people have diabetes or have difficulty maintaining their weight. Hackworth House DS0000031222.V377805.R01.S.doc Version 5.3 Page 18 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 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. People who live at this home and their families can make a complaint if they are unhappy, have a grievance or dispute which helps them to have control over their lives and there are measures in place which protect people from being harmed which helps to promote their safety and security. EVIDENCE: There is a clear complaints procedure in place at the home, which tells people how to complain, and the length of time a response will take. Observations of the staff’s day-to-day practices show that they ask for the views of service users all the time and help people to make real choices and decisions. People who live at this home assert their views and preferences and were clearly empowered to say what they thought. There is a record kept at the home of all complaints, which includes details of any investigation and the outcome. No one has approached the Care Quality Commission (CQC) because they have been unhappy with the way that the home has managed their complaint. One person living at the home said, “I know how to complain if I need to although I am not too demanding.” Hackworth House DS0000031222.V377805.R01.S.doc Version 5.3 Page 19 A relative said, “When my mother wanted to change rooms we just had to mention it - I don’t think you would have any problems if you needed to make a complaint.” The home has an adult protection procedure which is robust and complies with the Public Disclosure Act and the Department of Health Guidance. There is a staff guide, which gives clear instructions about the actions which they must take if abuse is disclosed or witnessed and all staff spoken to are knowledgeable and vigilant. Hackworth House DS0000031222.V377805.R01.S.doc Version 5.3 Page 20 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 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. People live in a homely, clean and comfortable environment, which promotes their privacy, independence and comfort during their stay at the home. The home is clean, pleasant and hygienic which supports the health and lifestyles of people living there. EVIDENCE: The home has been adapted so that all the people who live there can have safe access to the areas where they live. Everyone is able to lock their bedroom doors so that they can have privacy and there are areas where people can meet and talk in private. There are large gardens with views across the village which adds to the feeling of space. Hackworth House DS0000031222.V377805.R01.S.doc Version 5.3 Page 21 The bedrooms are pleasant areas, which have a useful range of comfortable furniture and fittings. Most people have decorated their rooms with their items, photographs and keepsake’s. There are enough toilet and bathrooms available, some of which have been changed to help people who have mobility needs to use them. The home is kept clean by staff who take effective steps make sure that there are no unpleasant smells. The home is over 30 years old and was built to meet previous standards of space and convenience. The manager has drawn up a programme of future developments and repairs are allocated on a priority system for this building. The manager and the council have done well to continue use their ingenuity with limited finances to continually adapt and maintain the building so that it remains fit for it’s purpose in meeting people’s needs. There are laundry facilities are in place to make sure that that peoples clothing and linen is hygienically cleaned and the risks of passing on any infections is reduced. Arrangements are in place to make sure that clean clothing is always returned to their owner and mistakes are avoided. The home is inspected by the Fire Prevention Authority and the Health and Safety Executive (HSE) to make sure that the building and safety systems are suitable for the protection of those who live and work there. Hackworth House DS0000031222.V377805.R01.S.doc Version 5.3 Page 22 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 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. There are sufficient staff working at the home to meet the needs of the number of people who presently live there. The ways that staff are employed makes sure that people are protected and most staff have been trained to make sure that their care practice is good. EVIDENCE: The manager has organised the home so that overall there are sufficient staff available to meet the needs of people who currently live there. Staff can describe the needs of people living at the home in detail. They get on well together and with people who live at the home and promote an inclusive and supportive structure. One person living at the home said, “Some of the staff who work here come are locals and I think that helps people to feel comfortable.” A relative said, “The staff are fantastic they have such patience and they really make it feel comfortable and happy.” Hackworth House DS0000031222.V377805.R01.S.doc Version 5.3 Page 23 Staff spend time with people who live at the home, listening to their opinions and experiences and taking part in discussions and laughing together which creates a happy atmosphere at the home. Staff turnover at the home is very low which gives people who live there and staff the opportunity to get to know each other. Almost all of the staff team have now attained NVQ awards in care at level 2, and some are working towards either Level 2 or 3. There is a plan in place which describes the training which staff are to undertake and is based on their personal training requirements and interests. Recently staff have had training about the care of people whom are dying and caring for people with dementia type illness. All of those staff who were asked said that they felt supported at work by the manager and their employer, particularly when they wanted to complete training. One visiting healthcare worker said, “I am very impressed with the quality of care provided and the skills that staff have achieved.” The manager makes deliberate attempts to recruit staff from similar cultural backgrounds as the people living at the home. In some cases they share the same community and social links which helps to make sure that people are confident with the way in which they are supported. Looking at staff records for people appointed in the home confirmed that rigorous checks are carried out before they are employed to work there. This includes receiving appropriate references and completing a criminal record check. Staff files contain employment history, records of training and any training certificates. Hackworth House DS0000031222.V377805.R01.S.doc Version 5.3 Page 24 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35 and 38 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. The acting manager at the home makes sure that people who live there are supported properly and gives leadership and direction to staff so that the quality of the service they give is improved. EVIDENCE: There is a new acting manager at the home who had been in post for around two months. Although she has not yet been assessed by the Care Quality Commission to see if she is fit to be the Registered Manager of the home, she does have over 14 years management and supervisory experience in a variety Hackworth House DS0000031222.V377805.R01.S.doc Version 5.3 Page 25 of care homes run by Durham County Council. She has been an acting manager in several homes since November 2008. As well as her experience in care services, she has a National Vocational Qualification at Level 4 in care and has achieved the Registered Managers Award (RMA). She is also a qualified NVQ assessor. The new manager has set about looking at and changing the way that the home operates. She has improved the way that care plans are written and put into practice to make them more complete and relevant to peoples’ lives: She has looked at the training that staff want and need to complete and taken steps to put these in place. She has made sure that repairs and redevelopment to the building have been carried out: She has looked at all areas of how the home works to see if these match the levels of quality that is expected and is taking action where these need improvement. The acting manager is described by staff as being “fair” and “knows what she is doing.” People living at the home and the staff working these said that she was approachable and always helpful. In all she has established herself as an effective, diligent and talented manager in a very short space of time which should be commended. The owners Durham County Council oversee the managers work and the running of the home. Senior managers visit the home at least once a month to check that the staff and the manager are working well and that the quality of care remains high. The owners have informed the Care Quality Commission that once they have finalised management arrangements they intend to make an application so that the acting manager can be assessed to see if they can become the Registered Manager of this home. The manager collects the views of service users, families and friends so that she can check to see if the service is meeting the needs of all parties. There are a number of meetings held at the home and other informal occasions where the manager is able to check that people are satisfied with the service. This helps the manager to monitor progress and develop the service. Since the last inspection the home has achieved a “Charter Mark” award for good practice in customer relations. This recognises the hard work of staff and present and previous managers at the home. There were no significant hazards at the home throughout the inspection and arrangements are in place to minimise risks for people living at the home and staff. For example, Staff have had training in safe working practices. Fire training is completed for day and night staff and there is an emergency plan in place to be used in the event of a fire at the home. Accidents are clearly recorded and the manager completes monthly accident analysis to examine and track any trends. In house health and safety checks are carried out weekly. Hackworth House DS0000031222.V377805.R01.S.doc Version 5.3 Page 26 Water temperatures are recorded to ensure temperatures of 44 C is not exceeded. External contract certificates are up to date. The home is also subject to inspections by the Fire Authority and local authority environmental health officers to make sure that the home is safe. People living at the home said, “I am confidence in the manager.” Another said, “Her door is never closed.” A visitor said, “She is approachable and I don’t hesitate if I need to talk to her.” The manager makes sure she is available if people living at the home or their families need to talk to her. Through out the inspection numerous people came for advice, direction, comfort and support. Hackworth House DS0000031222.V377805.R01.S.doc Version 5.3 Page 27 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X X 3 Hackworth House DS0000031222.V377805.R01.S.doc Version 5.3 Page 28 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 Refer to Standard OP7 Good Practice Recommendations The person responsible for the home should make sure that staff continue to be supported to use the new design of care plans and that their ease of use should continue to be monitored. The person responsible for the home should make sure that staff record the time that medication audits are carried out to make it easier to check if they are correct. The person responsible for the home should make sure that the person in charge has been assessed by the Care Quality Commission as being suitable to become the Registered Manager of the home. 2 3 OP9 OP31 Hackworth House DS0000031222.V377805.R01.S.doc Version 5.3 Page 29 Care Quality Commission Care Quality Commission North Eastern Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries.northeastern@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. Hackworth House DS0000031222.V377805.R01.S.doc Version 5.3 Page 30 - 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!