Care Home: Hadleigh Court

What the care home does well Hadleigh Court is a welcoming and homely home. The service was described by a person as ‘marvellous’. The admission procedure is good. People tell us that the admission process is ‘made easier by the staff at the home. Staff really make you feel welcome’ People receive a very good standard of personal care, and communication with healthcare professionals in the community is very good. One person said `you only have to ask and staff will contact the doctor for you.` The care people receive is provided in a safe way and medicines are wellmanaged by the staff. Staff at the home make sure people see healthcare professionals when they need to. Care of the dying is also performed very well with the help of community and hospice staff. Relatives have written ‘Special thanks to the staff at Hadleigh Court who have lovingly cared for our mother’ Hadleigh Court DS0000018364.V376824.R01.S.doc Version 5.2 The care planning and documentation at home are good and mean that staff know how to care for somebody in a safe and consistent way that meet their individual needs and preferences. People have access to a range of activities and are able to maintain contact with their family and friends. People are grateful for the activities provided by the home particularly the opportunities for the 1:1 time with staff and trips out. People tell us that the food is `excellent` and `smashing`. Any issues regarding dietary requirements, preferences or weight issues are sensitively managed. People say there is plenty of food and staff know what they like and don`t like. People who use the service and their relatives can be confident that if they complain, their concerns will be listened to and acted on. People feel able to complain and know how to do this, although people said they have never needed to complain. The staff group are popular with people who live in the home who describe the staff as `caring and patient` `very kind` and `wonderful`. Thank you cards described the care as `loving` and `devoted`. Hadleigh Court is a safe and clean place to live and work. Maintenance systems are very well managed and a good level of decor and furnishings is provided at the home. The manager and staff group have suitable qualifications and experience to care for people who require personal care. The home is well-managed by the manager and supporting team. What has improved since the last inspection? The activities record is now formal and captures events that have taken place. This now means that people can remember and share with their visitors what they have been involved in. Staff training has begun to improve with the introduction of more specialised training such as dementia, and post death care to help provide a better service to people and their relatives. Staffing arrangements also continue to be reviewed to ensure there are enough staff on duty at peak times of the day.Hadleigh CourtDS0000018364.V376824.R01.S.docVersion 5.2Environmental improvements have also taken place since the last inspection. New lounge chairs have been purchased. The separate dining area has been re decorated and furnished with new chairs which are easier to manoeuvre. New garden umbrellas have been purchased and the pond has been filled in for safety. Routine maintenance work has continued since the last inspection. A new drive way has been provided and new security lights fitted for safety at night. A new roof has been fitted to part of the building and sky light fitted to improve lighting in part of the home. Nine bedrooms have been decorated as part of the rolling re decoration programme. A new wet room has been installed in the home and has proved very popular with people. One person said it had made them more confident when having a shower. A fire audit has been performed which resulted in many smoke detectors being installed, fire alarms being replaced and new fire doors being fitted to meet new fire legislation. New equipment has also been purchased inside the home. New TV’s and digital boxes have been purchased to meet the new ‘digital switchover’. A new hoist has been purchased and new fridges, freezers and hotplates have been purchased for the kitchen areas. The staff continue to improve their service and continue to monitor accidents, incidents and feedback from people who live in the home. As a result of a recent incident at the home a care manager checklist has been introduced to monitor safety equipment, such as window restrictors, at the home. The laundry facilities have improved at the home. A new industrial washing machine has been installed meaning foul laundry can be washed at temperatures high enough to kill bacteria. New systems have also been introduced to reduce the spread of infection. What the care home could do better: The pre admission process should be improved by ensuring more information is obtained before staff agree to accept a person into the home. This process should include more detail about history of mental state and cognition and other information listed in the national minimum standards. This will show that staff know whether they can meet a persons needs and know what care a person may need before they are admitted. Information given to people before they move into the home should also be updated to include up to date contact details for the Care Quality commission, this is particularly important for the complaints procedure.Hadleigh CourtDS0000018364.V376824.R01.S.docVersion 5.2Information for staff could also be improved by ensuring they know and have access to contact details if they need to report any allegations of abuse in the absence of the manager. Records can also be improved at the home. Risk assessments should be dated to clearly show when assessments have been performed and reviewed. This can show any improvements or declines in a persons condition which may need to result in further action being taken. The records kept alongside person money accounts should be retained to show the balance a person has and when transactions have taken place to help show the process is robust and well maintained. Mandatory training systems must improve at the home to show the manager and provider proactively ensure all staff have received up to date training in order to perform their roles in a safe way. This will show that the manager and provider take their health and safety responsibilities seriously and do not rely solely on previous employers and care trusts to provide training. The manager should also ensure systems are introduced to make sure the supervision programme is kept up to date. Key inspection report CARE HOMES FOR OLDER PEOPLE Hadleigh Court Stanley Road Torquay Devon TQ1 3JZ Lead Inspector Clare Medlock Key Unannounced Inspection 20th July 2009 10:00 DS0000018364.V376824.R01.S.do c Version 5.2 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. Hadleigh Court DS0000018364.V376824.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 Hadleigh Court DS0000018364.V376824.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hadleigh Court Address Stanley Road Torquay Devon TQ1 3JZ 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) 01803 327694 01803 311833 hadleighcourt@hotmail.com Babbacombe Care Limited Mrs Delia Jane Chalk Care Home 31 Category(ies) of Dementia (31), Mental Disorder, excluding registration, with number learning disability or dementia - over 65 years of of places age (31), Old age, not falling within any other category (31) Hadleigh Court DS0000018364.V376824.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st August 2007 Brief Description of the Service: Hadleigh Court is a care home registered to provide accommodation with personal care for up to 31 people who may have a level of dementia, other mental disorder or physical disability. The home is on two floors and has a shaft passenger lift connecting the ground and first floors. It is also fitted with a stair lift to the main stairway, grab rails and ramps to help people mobilise independently. Most bedrooms are for single occupancy, the majority of which are en suite. There are three double bedrooms all of which have en suite facilities. One single room is kept as a respite room so that bookings can be made in advance. There is a large lounge and adjoining sun lounge, and a recently refurbished dining area. There is an attractive and enclosed level garden with ramped access, and a car parking area. This detached house is in a level residential area of Torquay, adjacent to a local park and near to shops and other amenities in St Marychurch and Babbacombe. The home has a minibus to offer transport to appointments and social outings. The fees range from £350 to £600 - dependent on the level of need. The fee does not include hairdressing and chiropody, although recreational trips are included in the price. The home’s Statement of Purpose is given to all prospective residents and in addition can be obtained from the home’s office. A copy of the latest CSCI inspection report was available in the entrance hall. Hadleigh Court DS0000018364.V376824.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This key inspection included a visit to the home on Monday 20th July 2009. During this time we spoke to the registered manager, the provider, at length with three people who live in the home, to two relatives and to four members of staff. We case tracked two people who use the service. This means we looked in detail at the care these people receive. We spoke to staff about their care, we looked records that related to them, and made observations if they were unable to speak to us or provide feedback. We looked at care plans, maintenance records, three staff recruitment records, training records, policies and procedures. We did this because we wanted to understand how well the recruitment and safeguarding systems work and what this means the people who use the service. During inspection we also watched interactions between staff and people living at the home. All this information helps us to develop a picture of how the home is managed and what it is like to live at Hadleigh Court. What the service does well: Hadleigh Court is a welcoming and homely home. The service was described by a person as ‘marvellous’. The admission procedure is good. People tell us that the admission process is ‘made easier by the staff at the home. Staff really make you feel welcome’ People receive a very good standard of personal care, and communication with healthcare professionals in the community is very good. One person said you only have to ask and staff will contact the doctor for you. The care people receive is provided in a safe way and medicines are wellmanaged by the staff. Staff at the home make sure people see healthcare professionals when they need to. Care of the dying is also performed very well with the help of community and hospice staff. Relatives have written ‘Special thanks to the staff at Hadleigh Court who have lovingly cared for our mother’ Hadleigh Court DS0000018364.V376824.R01.S.doc Version 5.2 Page 6 The care planning and documentation at home are good and mean that staff know how to care for somebody in a safe and consistent way that meet their individual needs and preferences. People have access to a range of activities and are able to maintain contact with their family and friends. People are grateful for the activities provided by the home particularly the opportunities for the 1:1 time with staff and trips out. People tell us that the food is excellent and smashing. Any issues regarding dietary requirements, preferences or weight issues are sensitively managed. People say there is plenty of food and staff know what they like and dont like. People who use the service and their relatives can be confident that if they complain, their concerns will be listened to and acted on. People feel able to complain and know how to do this, although people said they have never needed to complain. The staff group are popular with people who live in the home who describe the staff as caring and patient very kind and wonderful. Thank you cards described the care as loving and devoted. Hadleigh Court is a safe and clean place to live and work. Maintenance systems are very well managed and a good level of decor and furnishings is provided at the home. The manager and staff group have suitable qualifications and experience to care for people who require personal care. The home is well-managed by the manager and supporting team. What has improved since the last inspection? The activities record is now formal and captures events that have taken place. This now means that people can remember and share with their visitors what they have been involved in. Staff training has begun to improve with the introduction of more specialised training such as dementia, and post death care to help provide a better service to people and their relatives. Staffing arrangements also continue to be reviewed to ensure there are enough staff on duty at peak times of the day. Hadleigh Court DS0000018364.V376824.R01.S.doc Version 5.2 Page 7 Environmental improvements have also taken place since the last inspection. New lounge chairs have been purchased. The separate dining area has been re decorated and furnished with new chairs which are easier to manoeuvre. New garden umbrellas have been purchased and the pond has been filled in for safety. Routine maintenance work has continued since the last inspection. A new drive way has been provided and new security lights fitted for safety at night. A new roof has been fitted to part of the building and sky light fitted to improve lighting in part of the home. Nine bedrooms have been decorated as part of the rolling re decoration programme. A new wet room has been installed in the home and has proved very popular with people. One person said it had made them more confident when having a shower. A fire audit has been performed which resulted in many smoke detectors being installed, fire alarms being replaced and new fire doors being fitted to meet new fire legislation. New equipment has also been purchased inside the home. New TV’s and digital boxes have been purchased to meet the new ‘digital switchover’. A new hoist has been purchased and new fridges, freezers and hotplates have been purchased for the kitchen areas. The staff continue to improve their service and continue to monitor accidents, incidents and feedback from people who live in the home. As a result of a recent incident at the home a care manager checklist has been introduced to monitor safety equipment, such as window restrictors, at the home. The laundry facilities have improved at the home. A new industrial washing machine has been installed meaning foul laundry can be washed at temperatures high enough to kill bacteria. New systems have also been introduced to reduce the spread of infection. What they could do better: The pre admission process should be improved by ensuring more information is obtained before staff agree to accept a person into the home. This process should include more detail about history of mental state and cognition and other information listed in the national minimum standards. This will show that staff know whether they can meet a persons needs and know what care a person may need before they are admitted. Information given to people before they move into the home should also be updated to include up to date contact details for the Care Quality commission, this is particularly important for the complaints procedure. Hadleigh Court DS0000018364.V376824.R01.S.doc Version 5.2 Page 8 Information for staff could also be improved by ensuring they know and have access to contact details if they need to report any allegations of abuse in the absence of the manager. Records can also be improved at the home. Risk assessments should be dated to clearly show when assessments have been performed and reviewed. This can show any improvements or declines in a persons condition which may need to result in further action being taken. The records kept alongside person money accounts should be retained to show the balance a person has and when transactions have taken place to help show the process is robust and well maintained. Mandatory training systems must improve at the home to show the manager and provider proactively ensure all staff have received up to date training in order to perform their roles in a safe way. This will show that the manager and provider take their health and safety responsibilities seriously and do not rely solely on previous employers and care trusts to provide training. The manager should also ensure systems are introduced to make sure the supervision programme is kept up to date. 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. Hadleigh Court DS0000018364.V376824.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 Hadleigh Court DS0000018364.V376824.R01.S.doc Version 5.2 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): 1,2,3,4,5 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. Minor improvements to the information requested and to the information provided would mean that people have accurate information about Hadleigh Court before they come to the home and would also mean that staff have full information about people before they are admitted. EVIDENCE: People told us either themselves or their family and friends had an input into deciding whether Hadleigh Court was the right home for them to move into. One relative said the home was an obvious choice the home had a good reputation in the local community and was the nicest one they looked at. Hadleigh Court DS0000018364.V376824.R01.S.doc Version 5.2 Page 11 We were told that most pre admission information is passed onto the person verbally and that written information is also given later in the process. Relatives said that they had been provided with enough information to help decide Hadleigh Court was the best place to be. One person said they had been at the home for respite and had really enjoyed their stay. The person said staff had been very kind and welcoming and said they would ‘definitely come back’. A thank you letter from a relative read ‘Thank you for your help and support in getting P settled. Your kindness has been appreciated’. Another relative said ‘it was hard for us as a family to accept that mum needed to come into a home, but the staff made it better for us’. The Statement of Purpose and Service User Guide contained the majority of information needed. Minor details regarding changes in Care Quality Commission office changes had been highlighted for update. The manager told us she performs the pre admission assessment at the place where the person is or at their. This assessment is recorded on a tailor made document. This was well completed and contained some information to decide whether the home would be able to care for the person. Information is also obtained from the person, their family, social services and healthcare professionals. A discussion was held about how to improve the pre admission assessment to get further information. Each person is provided with a contract from either the home or social services. Hadleigh Court DS0000018364.V376824.R01.S.doc Version 5.2 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): 7,8,9,10,11 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 care planning systems at the home are good and mean people have their health needs identified and met in a safe and consistent way. Minor improvements would provide staff with more accurate ways of assessing a person. The management of medicines is generally good and helps protect people from risk. Minor improvements to medication records would help minimise any risk. EVIDENCE: People living at Hadleigh Court have access to a range of health care services both at the home and in the community. Each person has a GP who attends when staff request. One person said you only have to ask and staff will contact the doctor for you. Relatives were also complimentary about the care Hadleigh Court DS0000018364.V376824.R01.S.doc Version 5.2 Page 13 provided. One comment in a thank you letter read ‘Knowing he was receiving good care and attention from you was a great comfort to us all’. During the inspection people looked cared with the finer details such as eye care, nail care and appropriate foot wear present. People told us they thought the standard of personal care was good at the home. One person said I really appreciate that they encourage but dont take over Another person who was in for respite said I have really enjoyed having showers since I have been here’ and later said they now felt confident to request showers when they attended the home for day care because ‘staff had been so kind’. Staff also stated that they thought the standard of care was good at the home. One staff member said we are a team and it works well, I have worked in many care homes and Hadleigh Court is the best. Health care needs are communicated both verbally between staff and within care plans. Each person has a plan, which sets out his or her needs. Each plan contains personal information, dependency charts, health care professional visits, bath and weight charts, accident reports and evidence of monthly reviews. Risk assessments are performed on issues which are considered relevant for that person. Examples included moving and handling, skin assessment and nutrition. The majority of assessments were well completed, although a small number had not been dated which makes comparing and reviewing assessments difficult. The manager informed us that any specialist equipment is obtained through the community equipment supplies. This has included specialist beds and mattresses. Other equipment such as sit on scales are provided at the home. Specialist health care professionals are sought for advice and guidance. This input is recorded in the person’s notes. Examples included chiropodist, community psychiatric nurses, social workers, physiotherapists, optician, district nurse, specialist nurses, and GP. The management of medications is performed well at the home. Medications are supplied in individual blister packs and stored in a locked cupboards. Controlled drugs are stored within locked boxes. Medicines needing to be stored within the fridge are kept in a designated fridge with temperature records being performed daily. There are well maintained medicine administration records. The records of administration were clear. A discussion was held about the benefit of obtaining two signatures to show that two staff have checked any hand written entries on the administration record. This will minimise any errors when copying a prescription. Hadleigh Court DS0000018364.V376824.R01.S.doc Version 5.2 Page 14 Staff told us people are able to end their life at the home where possible. The community nurses, hospice staff and GP’s support the home with specialist equipment, pain relief and support for staff. Staff at the home find out the wishes and preferences of people in respect of terminal illness when they are admitted to the home. Staff also informed us that that had attended training provided by local funeral directors to help with supporting families and how to handle a person once they have died. Thank you letters read ‘I would like to thank you and all the staff at Hadleigh Court for their efforts and kindness in caring for her over the past 11 years’. A newspaper obituary notice read ‘Special thanks to the staff at Hadleigh Court who have lovingly cared for our mother’ People were encouraged to move freely around areas of the home if they are able to do so. Walking aids were present for those that required them. Grab rails, ramps, lifts, and stair lifts were present throughout the home to reduce risk. People said response to call bells was very quick. People who use the service were treated with respect during the inspection. They were offered choice regarding activities and addressed using their chosen term of address. People were full of praise for the staff saying, Staff are wonderful, they are excellent, and you only have to ask. One person said they had been at the home for many years and thought the staff were ‘the best’ and appreciated that staff ‘know the little things, such as knowing I like a mug not cup and saucer’. Hadleigh Court DS0000018364.V376824.R01.S.doc Version 5.2 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): 12,13,14,15 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. The routines of daily living are provided in accordance with the wishes and feelings of people in the home. The satisfactory activities programme helps to provide people with social and recreational stimulation. The provision of religious and spiritual services would mean that people have an opportunity to have their spiritual needs met. EVIDENCE: People we spoke with said they were pleased with the activities provided. People we spoke with particularly enjoyed the 1:1 with staff, trips out with staff, hairdresser visits and the more formal trips out. An activities book records what activities people have been offered and records who has Hadleigh Court DS0000018364.V376824.R01.S.doc Version 5.2 Page 16 attended. Posters were advertising musicians, quizzes, clothes shows and bingo. People told us they were able to join in or opt out as they preferred. During the inspection staff were doing a quiz which prompted interactions from people and relatives. People said they thought the range of activities provided was very good. One person said they would like a communion or church service but had never seen this occur. Staff said if people had an active faith they would be supported to continue this, and had done so in the past by getting people to their church and arranging visits from a roman catholic nun. The interactions between staff and people in the home were positive, affectionate and very professional. The staff were seen to display a genuine caring attitude with suitable laughter and light banter. Staff providing care behind closed doors were heard to continue with positive interactions speaking to people in a respectful way. People told us they appreciated the fact that staff do not take over, but encourage them to do as much as they like to do. Feedback at the inspection regarding food was positive. Comments such as excellent marvellous and lovely were received. One person said they had put on weight since they had been at the home. On the day of inspection people were being offered home made Sheppard’s pie with mixed vegetables and quorn Sheppard’s pie for vegetarians. Desert included spiced pears, mouse, jelly and fresh fruit. Tables were set with table cloths napkins, condiments and drinks. People told us the portion sizes were good and extra food out of meal times was available but not needed. The kitchen, food cupboard and freezers were well stocked. The kitchen areas were well managed with the use of the recommended safer food better business. All areas of the kitchen appeared clean and well organised with the use of new cleaning schedules. New fridges, freezers, hot plate and chopping board have been purchased since the last inspection. Hadleigh Court DS0000018364.V376824.R01.S.doc Version 5.2 Page 17 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 & 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 can be confident that complaints will be well managed at the home. The training, and staff knowledge helps to protect people from abuse. Further information would mean staff are aware of which numbers to use if a report is needed in the absence of the manager. EVIDENCE: The manager told us they had not received any formal complaints since the last inspection but one minor concern had been received regarding laundry error. The manager confirmed that a refund had been offered in this situation. Staff said they thought that the fact that the Manager at the home speaks to the residents daily to ensure they are happy and acts on any issues quickly’ means that complaints are not received. The complaints process is clearly displayed within the home, on notice boards and within the resident information folder. Minor amendments are needed to reflect the contact details of the CQC. This is reported upon in the first section of the report. Hadleigh Court DS0000018364.V376824.R01.S.doc Version 5.2 Page 18 People at the home all said they knew how to complain with comments given such as I know how to, but why would I need to, everything is perfect. The CQC have not received any complaints about Hadleigh Court. Everyone we spoke with said they felt safe living at home. People told us the staff were very kind and very caring. Several people told us the staff felt more like family rather than carers. A relative said they would speak to the manager if they had any concerns but this has not yet been needed. All staff we spoke with knew how to report any allegations of abuse to the manager but also who to report outside of the home. However, staff were not aware of how to contact the outside agencies in the absence of the manager or Provider. The manager said she would put a poster up giving staff this information. Staff said they had received training in safeguarding adults. The manager has experience in the safeguarding process and knows how to correctly report or refer any issues. We did not find any evidence where people were being restrained or deprived of their liberties. Hadleigh Court DS0000018364.V376824.R01.S.doc Version 5.2 Page 19 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): 19,20,22,23,24,25,26 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. The home is a pleasant, clean, and safe place to live and work. EVIDENCE: Hadleigh Court is situated within a quiet residential area of Torquay. The home was previously a hotel and had been adapted to meet the needs of people with mobility problems. The home is arranged over two floors and has a shaft passenger lift connecting the ground and first floors, as well as a stair lift to the main stairway, grab rails and ramps to assist people with mobility issues. Hadleigh Court DS0000018364.V376824.R01.S.doc Version 5.2 Page 20 Bedrooms are mostly single most of which have en suite facilities. There are a small number of double bedrooms all of which have en suite facilities. One person told us she had been offered a larger en suite bedroom but had decided to stay in her room because she was happy there. There is a large lounge and adjoining sun lounge overlooking the well maintained gardens. New lounge chairs have been purchased. The separate dining area has been re decorated and furnished with new chairs which are easier to manoeuvre. The attractive and enclosed level garden has ramped access and is popular for people to use during fine weather. New garden umbrellas have been purchased and the pond has been filled in for safety. This detached house is in a level residential area of Torquay, adjacent to a local park and near to shops and other amenities in St Marychurch and Babbacombe. The home has a minibus to offer transport to appointments and social outings. Maintenance work has continued since the last inspection. A new drive way has been provided and new security lights fitted for safety at night. A new roof has been fitted to part of the building and sky light fitted to improve lighting in part of the home. Nine bedrooms have been decorated as part of the rolling re decoration programme. A new wet room has been installed in the home and has proved very popular with people. One person said it had made them more confident when having a shower. A fire audit has been performed which resulted in many smoke detectors being installed, fire alarms being replaced and new fire doors being fitted to meet new fire legislation. New equipment has also been purchased inside the home. New TV’s and digital boxes have been purchased to meet the new ‘digital switchover’. A new hoist has been purchased and new fridges, freezers and hotplates have been purchased for the kitchen areas. Routine maintenance programmes continue at the home with the support of regular checks by the manager, maintenance man and outside contractors. An outside contractor was present in the home performing portable electrical checks on equipment in the home. Certificates and records were also available to show the home have systems in place to manage waste, gas services, lifts, hoists, electrical systems, pharmacy and water supply. The manager gave assurances that window restrictors have been fitted to all windows, including those on the ground floor. There are check lists in place to ensure these are in full working order. Hadleigh Court DS0000018364.V376824.R01.S.doc Version 5.2 Page 21 The management of the laundry systems ahs improved since the last inspection. Red bags are now used to safely transfer foul laundry to the machine. Washing machines are suitable to safely wash items of foul laundry to reduce the spread of infection. Hadleigh Court DS0000018364.V376824.R01.S.doc Version 5.2 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): 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. Staff are well-trained and motivated and employed in sufficient numbers to meet the needs of those currently living in the home. EVIDENCE: Everyone we spoke with were very complimentary about the staff at the home. People told us Staff are extremely patient and caring and make you feel safe’ Others described staff as wonderful excellent loving and caring. Relatives said the staff were always polite and welcoming. Interactions between staff and people in the home were positive. All members of staff were seen to interact with each other, people and relatives using appropriate conversations and light banter. People said there were always staff to meet needs. People said call bells were answered very quickly. Staff spoken to said they thought there were enough staff on duty. The manager informed us that generally there were five care staff on in the mornings, one cook, one cleaners, one laundry person, a driver and Hadleigh Court DS0000018364.V376824.R01.S.doc Version 5.2 Page 23 maintenance person/driver and the manager. In the afternoons care staff numbers are reduced to three plus the manager. At night there are two carers with an on call manager available. Staff duty records confirmed these levels. Staff recruitment records were consistent. All staff are asked to complete an application form which contains details of employment history, a photograph and health declaration. Two forms of identification are checked and two written references are sought. All staff files contained a CRB (police check) and POVA (protection of vulnerable adults pre employment check) All staff had either completed a recognised induction programme or were doing this. An example of this induction was seen, which showed a nationally recognised induction programme was used at the home. Staff explained that all staff receive basic information on their first couple of days which includes fire and emergency procedures. Staff had been issued with the General Social Care Council code of practice. Staff said they were supported to do NVQ training or additional training. Hadleigh Court DS0000018364.V376824.R01.S.doc Version 5.2 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): 31,32,33,34,35,36,37,38 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 approachable manager ensures there is a positive working environment at the home. Improvements to the training and supervision programme would show staff are provided with sufficient support and information to perform their roles in a safe way. EVIDENCE: Staff, relatives and people at the home were extremely complimentary about the manager at the home. Staff commented that the Manager is the best that there has been and has provided ‘good morale’. Staff also said the manager is ‘very supportive, and ‘is firm but fair. Another member of staff said the Hadleigh Court DS0000018364.V376824.R01.S.doc Version 5.2 Page 25 manager and provider were ‘organised and did not discriminate’ One member of staff said she had moved to Hadleigh to follow the Provider after she had sold the other home’. Another member of staff said ‘they had worked at other homes but found Hadleigh better than anywhere else’. People at the home said the manager ‘kept staff in line’ and was the best. People appreciated being able to share a joke with her and said she really is good. The manager has been in post since January 2008. She has a registered manager’s award and NVQ 4 in care. She regularly attends mandatory training sessions and specialist training. Staff informed us that there are staff meetings held on a regular basis. The manager also confirmed there were senior staff meetings and resident meetings with minutes taken. Staff said there are clear lines of accountability, and contact details for the provider were available. Some staff had received supervision although not all. Some dates had lapsed and the manager said she was aware that this programme needed to be re introduced. Staff told us they know if they do anything wrong they are quietly pulled aside in a professional way and are always able to see the manager for support at any other time. All staff said they felt well supported by the manager. Quality assurance is performed in a variety of ways at the home. The manager tries to see everyone on a daily basis and relatives say she is available to speak to whenever she is needed. The manager looks at complaints as a way of improving the service and also monitors accidents to look for trends. As a result of a recent incident at the home a care manager checklist has been introduced to monitor safety equipment at the home. The Provider visits the home on a regular basis and takes the time to speak with staff and people at the home. The manager told us annual satisfaction surveys are also sent each May to residents, their families and health care professionals. There were no obvious signs where the health and safety of people was being placed at risk. However, the management of mandatory training was not clear. Two staff we spoke with were unclear of when they had received mandatory training and another member of staff said they had received mandatory training through their previous employer. Other staff confirmed that some training was out of date but knew future dates had been booked. The manager explained they are dependent on mandatory training being provided by the Hadleigh Court DS0000018364.V376824.R01.S.doc Version 5.2 Page 26 PCT but could only attend when spaces were available. Discussion was held about the importance of ensure all staff were up to date with training. People at the home told us they are able to manage their own finances where possible often with support from families. The manager confirmed that a small number of people have an amount of money for safekeeping which can be accessed for hairdressing and chiropody and some people have their finances managed by appointed solicitors. Inspection confirmed that receipts are kept for each transaction. However, the balance record for one person had been thrown away in error. Hadleigh Court DS0000018364.V376824.R01.S.doc Version 5.2 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 2 3 2 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 3 3 3 3 3 3 3 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 3 2 2 3 1 Hadleigh Court DS0000018364.V376824.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP38 Regulation 13 (4,5,6) Requirement Evidence must be provided to show that staff have received suitable mandatory training. This will show that staff have received the necessary training to be able to care for vulnerable people in a safe way. Timescale for action 01/02/10 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 OP1 Good Practice Recommendations The manager should ensure the statement of purpose and service user guide contain up to date contact details for the CQC. The pre admission assessment should be improved to ensure full information (listed in standard 3) is obtained prior to a person moving to the home Staff should be reminded to date any risk assessments DS0000018364.V376824.R01.S.doc Version 5.2 Page 29 2 OP3 3 OP7 Hadleigh Court 4 OP9 performed Two signatures on hand written entries on the MAR sheet would minimise errors being made when transcribing prescriptions. The manager should access services to enable people to have their spiritual needs met. Staff should have easy access to contact numbers and details for staff to use if they suspect abuse. Suitable systems must be in place to ensure records for people’s money balance are kept to protect both people and staff at the home. The programme of supervision should be maintained. 5 6 7 8 OP12 OP18 OP35 OP36 Hadleigh Court DS0000018364.V376824.R01.S.doc Version 5.2 Page 30 Care Quality Commission Care Quality Commission South West Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: 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. 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