Care Home: Hamilton Court

What the care home does well What has improved since the last inspection? Plans that explain how to care for people and help them stay safe are being reviewed so that people`s needs are more likely to be understood and met. There are good procedures to listen to people and keep them safe from possible harm. Effort is being made to present information to people in a way they understand so that they experience a more meaningful lifestyle. The home has been redecorated and has new furniture and equipment, which creates a more pleasant place for people to live. There is a new manager who people said is fair, friendly, a good listener and someone who gets things done.Staff receive support and training to do their job so that they can meet the needs of the people who live there. What the care home could do better: The way that medicines are recorded does not always show that the home has accurate evidence of the amount of medication in stock. Although health and safety is generally well managed, one person living in the home does not have access to equipment to alert them to the fire alarm sounding so that they can leave the building safely. CARE HOME ADULTS 18-65 Hamilton Court 2 Hinstock Road Handsworth Birmingham B20 2EU Lead Inspector Julie Preston Key Unannounced Inspection 21st May 2008 10:30 21/05/08 Hamilton Court DS0000054608.V364249.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Hamilton Court DS0000054608.V364249.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Hamilton Court DS0000054608.V364249.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hamilton Court Address 2 Hinstock Road Handsworth Birmingham B20 2EU 0121 5154955 0121 5154680 faisal@croner-management.co.uk 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) Tudor Views Ltd Manager post vacant Care Home 13 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (13) of places Hamilton Court DS0000054608.V364249.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. That the home provides personal care only for thirteen people for reasons of mental disorder, excluding learning disability or dementia. (13MD) Service users must be aged under 65 years. That a minimum of two staff are on duty at all times, one of whom should be designated senior. That the manager completes the Registered Managers Award or equivalent by April 2005. That additional garden space is created for the service users to the side of the home which affords a degree of privacy for service users, within 4 months of registration. That the home may provide care and accommodation for one named service user in need of respite care for reasons of learning disability. 2nd May 2007 6. Date of last inspection Brief Description of the Service: Hamilton Court is a large detached house situated opposite a park in the Handsworth area of Birmingham. The home provides care and accommodation to people with mental health problems and currently has an all male service user group, employing a predominantly male staff team. Shopping, leisure and public transport facilities are within walking distance of the home. This is important to people who live there as they enjoy making use of these facilities. Bedrooms are available on all floors and there are two lounges on the ground floor, one of which incorporates the dining room. There is a shared kitchen, which is used by people according to their skills and needs. Information is shared with people who live in the home at regular house meetings. People contribute to the cost of living in the home from their welfare benefit. The current charges range from £800 to £2,100 per week. Hamilton Court DS0000054608.V364249.R01.S.doc Version 5.2 Page 5 Hamilton Court DS0000054608.V364249.R01.S.doc Version 5.2 Page 6 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. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for people who live in the home and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provision that need further development. Prior to the fieldwork visit taking place a range of information was gathered to include notifications received from the home and a questionnaire about the home. The questionnaire is called the Annual Quality Assurance Assessment (AQAA). The visit took place over one day and staff and people who live at the home did not know that we were coming. The new manager and representatives of the registered provider were present during this visit and answered questions about the management and running of the home. Three service users were “case tracked” and this involves discovering individual experiences of living at the home by meeting or observing them, discussing their care with staff, looking at medication and care files and reviewing areas of the home relevant to these people, in order to focus on outcomes. Case tracking helps us to understand the experiences of people who use the service. Staff files and health and safety records were reviewed. We looked around the building to make sure that it was warm, clean and comfortable. There were no immediate requirements after this visit. This means that there was nothing urgent that needed to be done to make sure people stayed safe and well. What the service does well: Information is made available to people before they visit the home so that they can make an informed choice about whether or not to move in. People’s needs are assessed before they move into the home so they can be confident their needs will be met there. Hamilton Court DS0000054608.V364249.R01.S.doc Version 5.2 Page 7 People that live in the home receive good support to make choices and decisions about their lifestyles. People said – “I go through my care plan with the manager, I like to do this so that I remember what’s in it”. “I get the chance to cook for myself and go out for walks when I like”. People are supported to keep in touch with their families and friends so that they do not lose relationships that are important to them. There are lots of opportunities for people to make decisions about their lives so that they do things for themselves, go out often and have a chance to practice their skills and stay as independent as possible. There are staff available that can communicate with people in their first languages. A range of food is provided that meets people’s cultural needs. People said “The food is very good” and “I cook for myself or eat what the chef has cooked. It’s up to me”. People who live in the home made positive comments about the staff team “I feel very safe and very happy here”. “J (the manager) is the best one we’ve had”. “I like them, they’re all very friendly”. The home listens to the views of the people who live there and acts upon what they say. What has improved since the last inspection? Plans that explain how to care for people and help them stay safe are being reviewed so that people’s needs are more likely to be understood and met. There are good procedures to listen to people and keep them safe from possible harm. Effort is being made to present information to people in a way they understand so that they experience a more meaningful lifestyle. The home has been redecorated and has new furniture and equipment, which creates a more pleasant place for people to live. There is a new manager who people said is fair, friendly, a good listener and someone who gets things done. Hamilton Court DS0000054608.V364249.R01.S.doc Version 5.2 Page 8 Staff receive support and training to do their job so that they can meet the needs of the people who live there. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Hamilton Court DS0000054608.V364249.R01.S.doc Version 5.2 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hamilton Court DS0000054608.V364249.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information is made available to people before they visit the home so that they can make an informed choice about whether or not to move in. People’s needs are assessed before they move into the home so they can be confident their needs will be met there. EVIDENCE: There have been no new people admitted to the home since the last inspection in May 2007. There are systems in place to ensure that individuals’ needs are assessed before they move into the home and that people have an opportunity to visit and stay over prior to making any decisions about whether to move in. Copies of assessments were seen in the two files sampled. Each showed that staff at the home, the person and healthcare professionals had been involved in the assessment. Two people commented that they had visited the home on several occasions before moving in and confirmed that they had been included in their assessment. Hamilton Court DS0000054608.V364249.R01.S.doc Version 5.2 Page 11 The home has a statement of purpose and service user guide, which give information about the services and facilities available at Hamilton Court. The manager stated that both documents are being reviewed to make their content more easily understandable to people who may consider living in the home. The manager was able to show us that work had begun to review each document. Hamilton Court DS0000054608.V364249.R01.S.doc Version 5.2 Page 12 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans and risk assessments are not always completed in detail to describe people’s individual needs, however staff have a good understanding of how to offer care and support to each person, which people who live in the home are satisfied with. People that live in the home receive good support to make choices and decisions about their lifestyles. EVIDENCE: Care plans were sampled for three people who live at the home. Two of those sampled did not provide information about people’s individual needs in sufficient detail for anyone reading the plan to understand how to meet them. For example, a care plan about a person’s communication needs, which had been reviewed each month, had not been completed in full. The staff members reviewing the care plan had not identified that it was incomplete. Hamilton Court DS0000054608.V364249.R01.S.doc Version 5.2 Page 13 Care plans and risk assessments for road safety were seen to be the same for two people, despite them having differing needs. This could lead to people’s needs being unmet or place them in a position of unacceptable risk. However, in discussion with staff and people who live in the home it was evident that individual’s needs are understood despite the, sometimes lack of information in care plans. People who live at the home said, “The staff help me a lot” and “They know me well, I have no complaints about them.” It was however positive to note that the manager had begun to review care plans and risk assessments, one of which was looked at during this visit. The file gave detailed information about how staff should support the person in order to meet their individual needs in relation to health, personal care, communication, culture and social and leisure preferences. Each care plan was linked to a risk assessment so that the person could take responsible risks according to his individual needs. The manager commented that she aimed to review all care plans and risk assessments as a matter of priority. The manager also said that she was looking into offering staff training in record keeping and felt that this would assist in providing better care planning systems for the benefit of people who live in the home. From discussion with staff and people who live in the home it was evident that people are encouraged to maintain and develop their independence. One person said, “I go through my care plan with the manager, I like to do this so that I remember what’s in it”. Another person said, “I get the chance to cook for myself and go out for walks when I like”. People were seen making their own food and drink and planning what to do during the day. One person said, “It’s very relaxed, there’s no pressure so you can do what you need to each day”. Hamilton Court DS0000054608.V364249.R01.S.doc Version 5.2 Page 14 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live in the home experience a meaningful lifestyle that promotes their independence and is reflective of their individual needs. EVIDENCE: Each person has a record of the things they enjoy doing in their personal file. Some people have activity planners that use photographs to help the person plan and understand what they are doing each day. We talked to people and looked at daily records to make sure that these things are offered on a regular basis as part of a meaningful lifestyle. People who spoke to us said that they go shopping, visit family, go for walks and to places of interest as well as take part in tasks around the home such as doing their laundry and cooking. Hamilton Court DS0000054608.V364249.R01.S.doc Version 5.2 Page 15 Staff members told us that people go out to the local Mosque each Friday, although this had not been recorded in individual daily records. The three daily records sampled over a period of three weeks provided little evidence that people are taking part in activities they have chosen and enjoy. The manager said that she felt this did not reflect what actually occurred within the home, but was due to unsatisfactory record keeping, which would be addressed with the staff team at future training sessions. Some people who live at the home have first languages which are not spoken English. There are staff on duty each day who are able to communicate with people so that their needs are understood and met. One member of staff who is a British Sign Language (BSL) trainer is due to begin sessions with the staff team to help them communicate more effectively with those people whose first language is BSL. People said that they visit friends and relatives and that their visitors are made welcome at Hamilton Court. The home has a visitor’s policy and the manager commented that relatives have regular contact either by telephone or in person. Menus and records of food consumed by individuals were sampled to establish that a balanced and varied diet is provided that meets peoples’ needs and preferences. A range of food had been offered including Caribbean meals, Sunday roasts and Asian meals, which is reflective of people’s cultural needs. People told us, “The food is very good” and “I cook for myself or eat what the chef has cooked. It’s up to me”. Hamilton Court DS0000054608.V364249.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are effective systems in place to meet peoples’ personal and health care needs. Medicines are generally well managed for the ongoing protection of people who live in the home. EVIDENCE: Three personal and health care plans were sampled. One plan contained comprehensive information about the person’s needs and preferences, the other two were in need of review as they did not describe the individuals needs in sufficient detail to enable anyone reading the plan to fully understand how to meet them. This has already been referred to in Standards 6-10 of this report. The personal and health care plan sampled that had been reviewed by the manager placed much emphasis on supporting the person to maintain and develop their independence. Cultural needs were clearly described and records Hamilton Court DS0000054608.V364249.R01.S.doc Version 5.2 Page 17 showed that monitoring systems were in place with regard to identified health care needs. The outcome of health care appointments had been recorded so that staff had accurate information about individuals’ state of health. It was evident that staff at the home had acted upon guidance from healthcare professionals. Well Man appointments had been attended so that people could be weighed as part of a healthy lifestyle plan and photographic activity charts had been implemented following advice from Speech and Language Therapists. The manager commented that all personal and healthcare plans would be reviewed as a matter of priority. It was clear from the one plan sampled that this process had begun. Staff spoken to during this visit demonstrated awareness of people’s health and personal care needs. A person who lives at the home said, “The staff respect you and help you if you’re ill”. The system of storing, administering and recording medicines kept in the home was looked at to establish that people are protected by robust procedures. Medicines were securely stored in a locked cabinet. Staff at the home have completed or are in the process of completing training in the safe handling of medicines, which should reduce the risk of potential errors so that people receive their medication safely. The sampled records did not show that any errors had occurred, which indicates that medicines are being given as prescribed. There have been no notifications to the Commission that any medication errors have occurred in the last twelve months. Two minor issues were discussed with the manager. In one case a quantity of medication carried over from one dispensing period to the next had not been added to the medication record. This means that the number of tablets in stock did not match the amount entered onto the medication record. In another case there was no protocol for staff to follow in the event that a person refused medication, which was identified as sometimes likely in his records. It is recommended that these matters be addressed so that there are adequate systems of auditing medicines and responding to the refusal of medicines for the well being of people who live in the home. Hamilton Court DS0000054608.V364249.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are appropriate procedures in place to listen to peoples’ concerns and complaints and safeguard them from the risk of harm. EVIDENCE: The AQAA and records seen during this visit showed that there had been no complaints made about the home since the last inspection in May 2007. The home has a complaints procedure that is referred to in the statement of purpose and service user guide. There has been some effort to produce the procedure in picture format for the benefit of people who may have difficulty reading. A log of complaints is maintained that records the nature of the complaint and the action taken in response, in the event that complaints are received. We spoke to people who live in the home about their understanding of the complaints procedure and were told, “J (the manager) listens. You can go to her with anything and she’ll sort it out” and “All the staff are very good, they’re easy to talk to”. Staff development records showed that all had received training in safeguarding vulnerable adults so that allegation or suspicion of abuse could be responded to in accordance with the home’s policies and procedures. Hamilton Court DS0000054608.V364249.R01.S.doc Version 5.2 Page 19 Staff spoken to during this visit were aware of the procedures to follow to protect the people who live in the home. Some people who live at Hamilton Court demonstrate behaviour that may challenge and therefore require a specific response from staff to reduce the risk of this happening and manage the behaviour in the event it occurs. We looked at written strategies that describe how to support individuals in the event that challenges take place, which had been devised by Community Nurses working within the Primary Healthcare Trust. During the visit staff were seen to support a person in a manner that was consistent with the guidance on file. This indicates that the staff team have read and understood guidance, which promotes the well being of the person. We were told that some people might need the support of two staff in the event that they become distressed or anxious. During the day, the rotas sampled showed that there would be sufficient numbers of staff available to meet this need. At night, two staff work within the home. The layout of the home is such that staff may be unable to hear each other call for assistance if needed. The manager stated that walkie talkie radios were being considered to reduce the risk of staff being unable to summon their colleague to assist them should the need arise. Some people who live in the home need assistance to manage their money. There are systems in place to record individuals’ income and expenditure, which are audited for their ongoing protection. Hamilton Court DS0000054608.V364249.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in a clean, safe and comfortable environment that meets their individual needs. EVIDENCE: Hamilton Court is a large detached house, situated in a residential area of Handsworth, Birmingham. There are shops, parks, cafes, public transport routes and places of worship nearby. This is important to the people who live there as they enjoy using these facilities. Shared space consists of two lounges on the ground floor; one of which incorporates the dining room, a kitchen, laundry room and garden. Entry to the kitchen is restricted by a keypad entry system to make sure that people who would be at risk in this area do not have unsupervised access. We were told that those people for whom this does not pose a risk are aware of Hamilton Court DS0000054608.V364249.R01.S.doc Version 5.2 Page 21 the code to enter the kitchen. This was confirmed by some of the people living in the home. The whole building has been redecorated since the inspection in May 2007; new laminate flooring has been fitted throughout and quotes have been received for the kitchen to be refurbished. People told us that they had a new cooker and plasma screen television, which they were pleased about. There are separate toilet facilities for staff so that they do not impose on the bathrooms used by people who live in the home. Information within the AQAA stated that a cleaner is due to be appointed to work three hours a day so that care staff can spend more time working with people who live in the home. The manager confirmed that this post was due to be advertised. The building was clean and there were no unpleasant odours, which indicates that effective cleaning routines are in place. The rear garden is small and currently has nowhere for people to sit during good weather. The AQAA stated that new garden furniture and a barbeque were due to be purchased. Hamilton Court DS0000054608.V364249.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are supported by a well-trained and competent team of staff who have good understanding of their individual needs. The home operates a robust system of recruiting staff for the protection of the people who live there. EVIDENCE: The recruitment records sampled for three staff members showed that appropriate checks had been made to make sure that staff were suitably experienced and qualified to work with vulnerable adults. Criminal Records Bureau checks had been made and written references received before the employee began work so that people were protected from the risk of having unsuitable staff work in the home with them. Staff take part in an induction to the home so that they have an opportunity to read policies and procedures, which contribute to the running of the home. A member of staff confirmed that they had read care plans, risk assessments, Hamilton Court DS0000054608.V364249.R01.S.doc Version 5.2 Page 23 adult protection and health and safety policies before beginning to work with people who live in the home. The staff member also said that they had shadowed more experienced staff for five days prior to working as part of the team’s rota. This person said that shadowing team members had been helpful and assisted them to learn the routines of each shift. The staff present during this visit took an active part in the inspection process and were able to answer our questions about people’s care and support needs with confidence. The interaction between staff and people who live in the home was relaxed and friendly, which indicates that positive relationships have been formed. People who live in the home made the following comments about the staff team:“I feel very safe and very happy here”. “J (the manager) is the best one we’ve had”. “I like them, they’re all very friendly”. From observation of the staff training matrix, discussion with staff and the sampling of certificates on staff files it was evident that the team have access to regular sessions and updates to assist them to care for the people who live at the home. We observed records, which showed that staff were due to receive training in Equalities and Diversity and Nutrition and Health, which should assist the staff team to meet the specific needs of people who live in the home more effectively. Eleven of the thirteen members of staff currently employed at the home have achieved or are working towards their National Vocational Qualification (NVQ) Level 2 in care. This should contribute to a well trained team of staff who have effective knowledge of social care. Hamilton Court DS0000054608.V364249.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and peoples’ health and safety is promoted and protected. EVIDENCE: The home has a new manager who began work in January 2008. The manager has completed her NVQ Level 4 and Registered Managers Award as well as having several years’ mental health experience. This person was present during this visit and provided evidence that she had made progress in developing care plans, risk assessments and staff training opportunities as part of her stated commitment to improving outcomes for people who live at Hamilton Court. Hamilton Court DS0000054608.V364249.R01.S.doc Version 5.2 Page 25 Staff and people who live at the home spoke highly of the manager and said that she was fair, friendly, a good listener and someone who gets things done. Quality assurance systems are in place. A representative of the registered provider visits the home on a regular basis to report on the standard of care provided of which reports are made available to the home and the Commission. A Compliance Manager has been recently appointed and we were told that this person’s role is to ensure that service delivery is in accordance with National Minimum Standards. We observed questionnaires, which had been completed within the last two months by people who live in the home, their relatives and friends and visiting professionals that commented on the standard of care provided at Hamilton Court. The questionnaires were looked at and some of the responses are listed:From someone who lives in the home – “I am completely satisfied with the care provided”. From a relative – “Excellent. Friendly staff, meals, choice of food, overall impressions are excellent”. From a visiting healthcare professional – “A very friendly atmosphere. The décor is much improved”. For people who were not able to complete written questionnaires there was evidence that a picture version had been used as well as discussion in British Sign Language. In one case a questionnaire had identified most areas of service provision as “fair”. There was evidence that the manager had met with the person completing the questionnaire to discuss and resolve their concerns. This indicates that action is being taken to listen to the views and opinions of people who live in or visit the home. A number of checks are made by staff to make sure that peoples’ health and safety is maintained. Records showed that the fire alarm system had been regularly tested and serviced to make sure that it was working properly. Fire drills had been conducted on a regular basis to enable staff and people who live in the home to practice evacuation in the event of an emergency; each drill had been recorded. One issue was discussed with the manager with regard to fire safety. A person with a hearing impairment who requires a flashing light to alert them to the Hamilton Court DS0000054608.V364249.R01.S.doc Version 5.2 Page 26 fire alarm sounding had moved bedrooms, however the light had not been relocated. We were assured that this would take place, however this had not been done at the time of this visit. Staff have undertaken health and safety, fire safety, first aid and infection control training, which should ensure a safer environment for the people who live in the home. Hamilton Court DS0000054608.V364249.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 Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 4 X X 2 X Hamilton Court DS0000054608.V364249.R01.S.doc Version 5.2 Page 28 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA42 Regulation 23(4) Requirement There must be systems in place to alert people who live in the home to the fire alarm sounding so that they are not placed at risk of potential harm. Timescale for action 20/06/08 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 YA6 Good Practice Recommendations Care plans should be reviewed so that they remain relevant to people’s assessed needs in order to provide consistent care and support to people who live in the home. Risk assessments should be reviewed so that they remain relevant to peoples assessed needs in order to provide consistent care and support to people who live in the home. Daily records should be completed in sufficient detail to show that people who live in the home have access to activities that meet their personal needs and preferences. Personal care plans should be reviewed so that they remain relevant to people’s assessed needs in order to provide consistent care and support to people who live in DS0000054608.V364249.R01.S.doc Version 5.2 Page 29 2 YA9 3 4 YA12 YA18 Hamilton Court 5 YA19 6 7 YA20 YA20 the home. Health care plans should be reviewed so that they remain relevant to people’s assessed needs in order to provide consistent care and support to people who live in the home. Medicines that are carried over from one dispensing period to the next should be accounted for within the medication record so that medicines can be accurately audited. Protocols should be in place to guide staff how to respond to people who refuse medicines so that people maintain good health. Hamilton Court DS0000054608.V364249.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Hamilton Court DS0000054608.V364249.R01.S.doc Version 5.2 Page 31 - 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. 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