Care Home: Hampton Court Care Home

What the care home does well We found that Hampton Court offers a satisfactory commitment to care with an able, yet open and personable approach, which reflects the homeliness of a confident relationship between carers and those people using the service. Comments received from surveys and talking with people during the inspection: "This home suits my needs, is sited where I can have visitors. Obviously it can`t be perfect, but I feel, and my daughter feels, it`s the right place for me at the moment".From examination of care records we established that there was an effective assessment, care planning and review of individual needs, which are meaningful in formulating a good standard of care. When we discussed the quality of care with those people using the service and visitors, it was made clear that they appreciated this personable attitude and approach to care. "We like it here, it`s relaxed, friendly and a homely atmosphere. Very welcoming to us, and we see the manager often". The housekeeping, administrative and support services have all contribute to the team approach, and are recognised by the management for their efforts. We considered that the overall management style demonstrated a satisfactory approach in maintaining an environment fit for care of the elderly. There is a regular review process of facilities and services to maintain that environment by the senior care management and Providers. What has improved since the last inspection? We found an improvement in the care assessment and planning process, with relatives and those people who may be coming to the home, being more actively involved in the planning of care. They were found to ensure staff qualifications and competencies are considered when admitting clients. We examined and confirmed that care files have been re-organised to provide a more focused care planning approach. Activities have been enhanced to take in the views of people, and to include more opportunities to get involved in outings and social events. We have acknowledged that there have also been significant improvements in the furnishings and decor throughout the home. Information gathered from the AQAA, and discussed during our inspection, included improvements in regular staff supervision and an updated training plan, this was found to be true. What the care home could do better: We considered that more variety in indoor activities would be beneficial, especially for people with dementia and other cognitive impairments, with consideration given to an activity coordinator being recognised. Consideration should be given to present the Service User Guide in an audio, and large print version, to help those people challenged with poor eyesight to make an informed choice. The achievements have been recognised, attention to areas of further recommended detail will significantly enhance the provision of an able and homely service. CARE HOMES FOR OLDER PEOPLE Hampton Court Care Home Wrottesley Park Road Perton Nr Wolverhampton West Midlands WV8 2HE Lead Inspector Keith Jones Unannounced Inspection 3rd December 2008 09:00 X10015.doc Version 1.40 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 Hampton Court Care Home DS0000022329.V373371.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 Older People. 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. Hampton Court Care Home DS0000022329.V373371.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hampton Court Care Home Address Wrottesley Park Road Perton Nr Wolverhampton West Midlands WV8 2HE 01902 840242 01902 844200 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) Mrs Gurdip Kaur Sahota Mr Resham Singh Sahota Mrs Maria Guest Care Home 52 Category(ies) of Physical disability (22), Physical disability over registration, with number 65 years of age (32) of places Hampton Court Care Home DS0000022329.V373371.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection Brief Description of the Service: Hampton Court is a care home located in Perton near to Wolverhampton. The home was purpose built, with people accommodated on the ground floor level. The home is registered to accommodate up to 52 people with physical disabilities, requiring nursing care or personal care. There are 42 single rooms and 5 double rooms all with en suite facilities, some with their own shower area. The corridor areas are wide and allow easy access for mobility and moving/handling aids. There are two large communal dayrooms; each with a comfortable, newly furnished dining area. There is also a large reception area, and a peaceful garden lounge where visitors can be received in private. The home is directly accessed from the main road and there is ample car parking facilities at the front. The home was built in open countryside backing onto farmland and there are rural areas all around the home, which are accessible to people, including wheelchair users. Amenities can be reached easily by transport, but are not within walking distance. Living accommodation has been utilised on the first floor, for private use by the landlord, separated from the care areas. The fees chargeable at Hampton Court range from £420 to £650 per week. The fees information contained in this report are available in the Service User Guide, and are applied at the time of inspection. The reader may wish to obtain more up to date information from the care service direct. Hampton Court Care Home DS0000022329.V373371.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. We conducted this unannounced inspection with the Registered Provider, Care Manager and senior nursing and care staff on duty, whose input contributed to this report. Our inspection of the building allowed us free access to all areas and open discussion with people who use the service, relatives and staff. There were 44 people in residence on the day of our inspection. We looked at how care is being arranged and supported for a range of people with nursing and personal care needs. To do this we looked at (case tracked) three people’s files from admission referral to the present time, and three staff files were examined. We also looked at other information such as complaints, incidents, events and other professional reports. We took the opportunity to speak with a number of people who are using this service, relatives and members of staff, who took an active role in our inspection process, their input contributed to the subsequent report. We acknowledged receipt of the Annual Quality Assurance Assessment (AQAA), and a survey form returned. We inspected a sample review of administrative procedures, practices and records, confirming consistent good practice and effective management. There followed an inspection report feedback, involving the Registered Provider and Care Manager, in which we offered an evaluation of the inspection, indicating those recommendations resulting from the inspection. What the service does well: We found that Hampton Court offers a satisfactory commitment to care with an able, yet open and personable approach, which reflects the homeliness of a confident relationship between carers and those people using the service. Comments received from surveys and talking with people during the inspection: This home suits my needs, is sited where I can have visitors. Obviously it can’t be perfect, but I feel, and my daughter feels, it’s the right place for me at the moment. Hampton Court Care Home DS0000022329.V373371.R01.S.doc Version 5.2 Page 6 From examination of care records we established that there was an effective assessment, care planning and review of individual needs, which are meaningful in formulating a good standard of care. When we discussed the quality of care with those people using the service and visitors, it was made clear that they appreciated this personable attitude and approach to care. “We like it here, it’s relaxed, friendly and a homely atmosphere. Very welcoming to us, and we see the manager often”. The housekeeping, administrative and support services have all contribute to the team approach, and are recognised by the management for their efforts. We considered that the overall management style demonstrated a satisfactory approach in maintaining an environment fit for care of the elderly. There is a regular review process of facilities and services to maintain that environment by the senior care management and Providers. What has improved since the last inspection? What they could do better: We considered that more variety in indoor activities would be beneficial, especially for people with dementia and other cognitive impairments, with consideration given to an activity coordinator being recognised. Consideration should be given to present the Service User Guide in an audio, and large print version, to help those people challenged with poor eyesight to make an informed choice. The achievements have been recognised, attention to areas of further recommended detail will significantly enhance the provision of an able and homely service. Hampton Court Care Home DS0000022329.V373371.R01.S.doc Version 5.2 Page 7 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. Hampton Court Care Home DS0000022329.V373371.R01.S.doc Version 5.2 Page 8 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 Hampton Court Care Home DS0000022329.V373371.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,4, and 6. The quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The needs of people who may use the service are appropriately assessed before they are offered a place. They and their relatives can be confident that the service will be able to meet their needs. EVIDENCE: We examined the services Statement of Purpose and Service User Guide, and found them to provide an informative description of Hampton Court’s aims, objectives, and the way it operated, although needing a review in light of the process of change. We acknowledged that the documents were presented to all enquirers prior to admission, and a copy placed in each bedroom for people to read. We advised that the Service User Guide be produced in large print Hampton Court Care Home DS0000022329.V373371.R01.S.doc Version 5.2 Page 10 and an audio version, to help people make an informed decision. We noted that fees are presented to private applicants in the Service User’s Guide. Our examination of three peoples care records and plans identified the preadmission and admission assessments. We identified that the Care Manager or her deputy, on referral, conducts the pre-admission assessment. We found each record showed attention to individuality, with the assessment formulating a care support plan, based on individual needs, with focused aims and interventions. This assessment is produced with the involvement of those people admitted and their family, allowing them to have an influence in the direction of care. Comments received from surveys sent in showed to us a confidence that people had in the service: “My daughter looked at the home on my behalf as she knows my needs”, and “Information was made readily available, and I was welcomed to visit the home whenever I chose, before I made a decision. From our discussions it was evident that people are able to visit and assess the quality, facilities and suitability of the Home at any reasonable time, to meet with staff and management. No intermediate care took place in the home. Hampton Court Care Home DS0000022329.V373371.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 The quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. A wide range of needs are addressed through the care planning process, meeting principles of respect, dignity and privacy towards people who use the service. Medicine administration systems are safe and secure. EVIDENCE: We found that the care records we examined showed that this standard is met, in maintaining a satisfactory process of assessment. The pre-admission assessment represented the foundation for a well considered, and clear care planning process. There was evidence to show us that a review of the care process by the care manager, has produced a good standard of meeting peoples care needs. We found that the profile of people’s social, physical and psychological status offered an individual plan of care, based upon dependency Hampton Court Care Home DS0000022329.V373371.R01.S.doc Version 5.2 Page 12 assessment and activities of daily living, regularly reviewed at least once a month. Three individuals care records were examined in depth (case tracked), each demonstrated clear information on the individual, their life style and needs, events, procedures and actions, monitored on a daily basis, and reviewed monthly. We confirmed, through our discussions with staff, an effective understanding of need, enabling staff to identify risk areas and put systems in place to reduce those risks. Case tracking confirmed to us that specialist support and advice are sought as needed, with access to a local Doctor, Dentist, audiologist, physiotherapist and Chiropodist. Comments received by survey from a person using the service: “A Doctor is always contacted if there is a medical problem, he came this morning when I had a bad chest”, and “Doctors are always called out when they are needed”. We spoke with a local Doctor and a visiting District Nurse on general issues of standards. Each was complimentary of the care quality, and the home in general. Carers were seen to interact with people who use the service with understanding and friendly compassion. In the progress of meeting people who use the service it was acknowledged that their general appearance indicated that their health and personal care was attentive and effective. Several relatives were visiting and we asked for their comments on the quality of the service and care given. There was a clear appreciation of the openness and opportunity to contribute. All comments were complimentary of standards, facilities and staff, and included: “We like it here, it’s relaxed, friendly and a homely atmosphere. Very welcoming to us, and we see the manager often”. We found the administration of medicines adhered to procedures to maximise protection to people who use the service. The storage was secure, with good environmental controls, including the medicines fridge. Our examination of the record of administration of medicines showed consistency, with no omissions observed. A controlled drug register was examined and we found to be up to date when checking drug stocks. Staff training continues to be pursued actively by the care manager. It is stated in the services Statement of Purpose and the Annual Quality Assurance Assessment (AQAA), that independence, privacy and dignity are encouraged, with the full involvement of family in all matters concerning the well being of people. This was confirmed in our discussions with people who use the service, visitors and staff, and that relatives have freedom of visiting, which emphasised the importance of maintaining social contact. Hampton Court Care Home DS0000022329.V373371.R01.S.doc Version 5.2 Page 13 Our discussions with people confirmed that individual spiritual persuasions, and individual diversity was seen to be respected. There are regular Church of England services held, and a Roman Catholic priest attends on request. A person on residential care, who is a registered lay preacher, offers a service every two weeks, which is well attended and enjoyed by other people. There were two people with diverse religious needs, which had been identified and accommodated satisfactorily, to their expectations. Hampton Court Care Home DS0000022329.V373371.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 The quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Peoples rights to live a meaningful life are central to the homes aims and objectives, and are offered opportunities to exercise choice and control over their lives. People are offered a healthy, well balanced diet. EVIDENCE: We found the daily routine to be flexible and non institutionalised, offering choices for meal times, personal and social activities, including recognition of varied religious needs. Our discussions with people who use the service and staff, clearly identified a relaxed and informal atmosphere, in which the peoples needs were respected, with the security that there are familiar events to the day they could relate to. We were informed that the Home is planning extended activities to add to those already in place included bingo, exercises, games, and hairdressing Hampton Court Care Home DS0000022329.V373371.R01.S.doc Version 5.2 Page 15 sessions, with occasional trips to the locality. We recognise the principle that activities are a key element in the socialisation approach to care, with visitors encouraged to be involved in a partnership style with care staff. I really like the quizzes the staff do with us, a good laugh, was one comment received by us from a person using the service. During the course of the inspection we saw staff interact with people in a positive and polite manner. It is stated in the Statement of Purpose that personal choice and relative selfdetermination are respected in policy and action. Throughout the inspection we found this to be true. Those individuals rooms inspected showed a significant influence of personalisation in the inclusion of belongings, some furniture and general decor. Relatives and friends are encouraged to maintain social links as part of the planning of care. We found that the standards of catering offered a good service, to which those people we spoke with were highly complimentary of all aspects of quality. A menu on a four weekly cycle offered a wholesome, varied and suitable choice. We observed a pleasant lunch served during inspection, with choices available. A menu for the day was inspected and seen to offer a good choice of meals throughout the day, and was observed to be of a good standard. One person we were case tracking said: I’ve been here for nearly a year and this is the best yet. Nice people serving good food. We saw that staff offered discreet assistance to those who required it. The choice of dining room, lounge or bedroom was at people’s discretion. We confirmed that the assistant cook knew each person using the service, and some of the relatives. We discussed diversity with her and her colleague, who indicated awareness in meeting individual needs. Individual preferences were recorded in assessment and conveyed to the catering staff, who met with, and discussed their requirements. Hampton Court Care Home DS0000022329.V373371.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area good. This judgement has been made using available evidence including a visit to this service. The service has a meaningful complaints policy. People are given opportunities to freely express any concerns, and these are quickly responded to. People are protected from abuse, and their human rights are promoted. EVIDENCE: We found that peoples legal rights are protected by the systems in place in the service to safeguard them, including their contract, the continual assessment of care planning and policies in place, for example, the complaints procedure. There were a few minor concerns, which we feel would be better dealt with through a record of concerns, complaints and safeguarding, to record peoples concerns in a meaningful and effective manner. From our talks with people who use the service, and staff, it was evident that any small matters were handled immediately, discretely and to the satisfaction of all concerned. All people had received information on the procedure to complain, including reference to us. This process was evidenced through the Service User Guide, examination of records, case tracking and discussion. Hampton Court Care Home DS0000022329.V373371.R01.S.doc Version 5.2 Page 17 A comment we received from a person who uses the service through the survey returned: My daughter and the manager deal with any comments that are made. Two anonymous complaints had been received during the past 12 months, and found to be unsupported. One complaint involving a respite care case is presently being dealt with. No allegations have been received. Our discussion with the care manager confirmed that there is satisfactory evidence of a way of dealing with, and response to anyone reporting any form of abuse, to ensure effective handling of such an incident. The policy and procedure for handling issues of abuse was examined, and found to be appropriate. We examined three staff records to confirm that staff were suitably checked through Criminal Records Bureau (CRB), and Protection of Vulnerable Adult (POVA) disclosure. We found staff received training on abuse at induction, this includes the right to whistle blowing, consistent with the Public Disclosure Act, 1998. Hampton Court Care Home DS0000022329.V373371.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,24,and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Hampton Court provides a safe, well-maintained, clean and comfortable environment for the people who use the service. EVIDENCE: Our inspection of the Home confirmed that the premises were fit for purpose, clean warm and tidy, and being well maintained. The grounds surrounding the home were maintained to a basic standard, with evidence of social activities having taken place. However, a small area is still used for dumping certain items no longer of any use, or awaiting disposal. The surrounding countryside provided a pleasant vista for relaxation throughout the year. Hampton Court Care Home DS0000022329.V373371.R01.S.doc Version 5.2 Page 19 Internal access was facilitated with suitable fittings of hand and grab rails, in adequate, well-lit and airy corridors. Wheelchair access was satisfactory throughout all areas of the home. On admission the Provider or Care Manager assesses each individual people’s needs for equipment and necessary adaptations. Positive efforts had been made to provide a homely atmosphere, and the décor in most areas of home was found to be of a high standard. The Home provided two large lounge areas that were pleasantly decorated for the Christmas festivities. A central ‘fireplace’ and large screen televisions complement essential furnishings and items, to offer comfortable areas where people meet. It was noted that few people took advantage of the lounge areas during the morning, preferring their own rooms. The central conservatory provided a tranquil area where people could experience the views of the surrounding grounds. There were spacious, recently renovated dining areas at each wing where people were able to dine in comfort. Toilets and bathrooms were located on both floors and were in close proximity to bedrooms and communal areas. All bathrooms and toilet areas have been refitted and decorated to a good standard. Several storerooms were found to be insecure. People we spoke to during the course of the Inspection expressed their general approval of their accommodation standards, which was complemented with the large number of personal items brought in to enhance the homeliness of their rooms. It is the policy that on bedrooms becoming vacant that each room is reappraised for redecoration, as confirmed during the inspection. There was evidence of a major refurbishment programme nearing completion, bringing throughout a good environmental standard. The care manager expressed a willingness to meet any reasonable demand for special needs. We found standards in the kitchen area much improved, with presentation showed good standards of cleanliness, and evidence of sound food hygiene practices. We also found the laundry to be well organised and equipped to a good standard. The home presented a clean and pleasant, odour-free atmosphere, much to the credit of staff. Hampton Court Care Home DS0000022329.V373371.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Staffing levels ensure that suitably trained staff are provided to meet the needs of people who use the service. Recruitment processes are consistent and robust, protecting the people who use the service from harm and abuse. EVIDENCE: There were 44 people using the service on the day of inspection, which includes 14 people requiring nursing care. Three weeks of duty rotas were examined, providing evidence that the home is suitably staffed in numbers, skills and qualifications to ensure the needs of people are met. We recognised that the care manager is supernumerary to the staffing rota. Flexible rostering, with agreed overtime are used to accommodate shortfalls due to sickness and absence; agency staff are infrequently employed. There are improved adequate levels of support staff for domestic duties, catering, administration and maintenance. We were informed through the AQAA that some 85 of care staff have the National Vocational Qualification (NVQ) level II or level III, with a further 15 Hampton Court Care Home DS0000022329.V373371.R01.S.doc Version 5.2 Page 21 undertaking training. This was confirmed on examination of training records and speaking with staff. It is recognised that staff received a meaningful training programme to compliment induction and to enhance supervision. The Provider and Care Manager have established, and continue to pursue a satisfactory procedure for interview, selection and appointment of staff. The thoroughness of improved staff selection has a significant effect upon the provision of care to ensure protection of people who use the service. Three staff were interviewed and confirmed that the policies were in place, and acted upon. All new staff goes through a detailed induction process, to ensure that they are going to be the right person for the home. Staff training was seen by us to be effective in meeting the essential requirements. We noted that the home has an allocation of a student nurse from Wolverhampton University attached. Some of the comments received from feedback from the students: “I had an amazing mentor support, got on well with all the staff and clients”. “I would recommend this Nursing Home to any other student”. All staff are given the General Social Care Council code of conduct to work to. Our discussion with staff demonstrated that an on-going process of supervision, six times a year is an established effective process. Hampton Court Care Home DS0000022329.V373371.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,37 and 38 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The care team promote the health, safety and welfare of people using the service, and working practices are safe. People who use the service can be assured that the home is run in their interests, based on openness and respect. EVIDENCE: The experienced care manager has over the past two years demonstrated effectiveness in establishing a solid management foundation, implemented to achieve a good standard of set aims, objectives and care. A qualified general Hampton Court Care Home DS0000022329.V373371.R01.S.doc Version 5.2 Page 23 nurse with a professional portfolio of practical and managerial experience, supported by senior nurses and experienced carers, who represent an effective care team. She has been actively engaged in quality reviews and audits with the Registered Provider, following our last inspection, meeting compliance to requirements and addressing recommendations we made. She has applied to undertake the Registered Managers Award qualifications. We observed an openness, professional, confidence in the interactions of staff, relatives and people who use the service, based on mutual trust and respect. Comments from those people we met and surveyed included: This home suits my needs, is sited where I can have visitors. Obviously it can’t be perfect, but I feel, and my daughter feels, it’s the right place for me at the moment. Hampton Court is a relaxed, friendly, homely atmosphere. Very welcoming to my visitors and keeps them informed of my progress”. Through the inspection process we found appropriate risk assessments in place for people using the service, through care planning and monitoring, staff selection and of the general environment, these are up to date and accurate. We found records to be generally well maintained in ensuring that the peoples rights and best interests are safeguarded. We were informed through the AQAA, and by the manager that financial arrangements are supervised and administered by the Registered Provider and care manager in respect of pocket money, comfort fund and petty cash management. The administration and management of the home is considered by us to be effective, uncomplicated, and sensitive to the needs of people. Hampton Court Care Home DS0000022329.V373371.R01.S.doc Version 5.2 Page 24 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 X 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X 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 3 3 3 X X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X 3 3 Hampton Court Care Home DS0000022329.V373371.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? None STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP12 Good Practice Recommendations That the Statement of Purpose and Service User Guide be updated to reflect change and that consideration be given to producing the documents in larger print and audio versions. A Concerns, Complaints and Allegation book be established to more effectively monitor incidents. The registered person shall ensure that the garden area of the home is kept in a good state of repair. That a full unit risk assessment programme be updated. That consideration be given to the provision of activity coordination. 2 3 4. 5 OP16 OP19 OP19 OP27 Hampton Court Care Home DS0000022329.V373371.R01.S.doc Version 5.2 Page 26 6 OP26 That COSHHE laminates be displayed in all areas involving the use of hazardous chemicals, to complement existing procedure sheets. Ensure access to all storage rooms be secure to casual entry by residents, to minimise risk of injury. 7 OP38 Hampton Court Care Home DS0000022329.V373371.R01.S.doc Version 5.2 Page 27 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. 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