Care Home: Hatch Mill

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What the care home does well We were told by the service users that their right to privacy is maintained at all times and the support they receive from care workers is given in a way that maintains their dignity. They told us the home is responsive to their culture, religion, race, age, disability, gender and sexual orientation. They informed us management and staff are competent and knowledgeable about health care needs of older people including health and safety and that their practise routinely protects and promotes the safety of all who uses the home. There are policies and procedures in language staff and service users can understand to ensure excellent standards of care is achieved in all areas of practise. The home values the opinions of service users and staff and meetings are held regularly, minuted and outcomes actioned in a timely fashion to ensure the health and safety and seamless care are experienced by service users. Service Users meet together monthly to discuss and debate life at Hatch Mill and meet formally with the Committee Members (who are responsible for the smooth running of the home) quarterly to express their wishes and opinions about the service. Bi-annual questionnaires are also sent out and results collated and circulated. The Society has issued their Complaints procedure, Safeguarding adults leaflet and Mental Capacity leaflets to their local Citizen Advice Bureau and GP practise and local hospitals. No requirement or recommendations of good practice was made on this visit. What has improved since the last inspection? The Home has ensured that they complied with the requirements and recommendations of good practise made on the last key inspection visit. The home continues to be proactive in meeting the needs of the service users, ensuring suitable and up to date training is available and undertaken by care staff to ensure seamless care is provided and delivered to the people living at this home. The home has recently achieved the Investors in People Award, who identified staff training as exemplary including the culture fostered by the home regarding training. A local radio station in conjunction with an insurance company has awarded the home `Best Employer` as directed by the staff of the home who had put the home forward to be considered for this award. What the care home could do better: The home continues to provide excellent service to the people using the service. They are continually exploring ways in which they can improve their service, and listen and act on suggestions from service users and staff. Key inspection report Care homes for older people Name: Address: Hatch Mill Hatch Mill Mike Hawthorn Drive Farnham Surrey GU9 7UH     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Mavis Clahar     Date: 2 8 0 5 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Hatch Mill Hatch Mill Mike Hawthorn Drive Farnham Surrey GU9 7UH 01252899000 01252899042 hatchmill@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Abbeyfield Wey Valley Society Limited care home 36 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users to be accommodated is 36 The registered person may provide the following category/ies of service only: Care home with nursing - (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Mental disorder, excluding learning disability or dementia (MD) Physical disability (PD) Old age, not falling within any other category (OP) Dementia (DE) Date of last inspection 5 5 0 3 Over 65 0 0 36 0 Care Homes for Older People Page 4 of 28 Brief description of the care home Hatch mill is owned and managed by the Abbeyfield Way Valley Society Ltd. The service is registered to provide personal and nursing care for up to 36 older people over the age of 65 years including 5 with Dementia. The home is set over two floors and stairs or lift allows access to the first floor. The home is accessible to people who use a wheelchair. The thirty six bedrooms all have en-suite toilets. Bathrooms are shared and have been fitted with specialist bathing equipment as necessary. A number of communal and dining areas are provided to allow for small groups of people to be together or to allow for private meetings with relatives and friends. The building was completed in 2001 and incorporates the remains of the old mill that had been built on the river Way and is easily accessible close to the town centre of Farnham and major road links to the motorway and adjoining towns. The town centre offers many high street shops, cafe, restaurants, churches and theatres. There is ample car parking space available. Fee levels at the time of the visit were as follows: Residential care fee six hundred and twenty pounds per week Nursing care fee eight hundred and fifteen pounds per week Respite care nursing 740 pounds per week inclusive of hairdressing, chiropody and newspapers. Respite residential 600 pounds per week inclusive of hair, chiropody and newspapers Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The last Key Inspection for this service was completed on 18th June 2007. The quality rating for this home is Three Stars. this means the people wh use this service experience excellent quality outcomes. Fees charged at this home are in the range of six hundred and seventy pounds to eight hundred and fifteen pounds per week and does not always include costs for hairdressing, chiropody and personal toiletries. This unannounced site visit, which forms part of the first key inspection to be undertaken by the Care Quality Commission, (CQC) was undertaken on the 28th May 2009 and lasted for six hours and thirty minutes; commencing at 09:00 hours and concluding at 15:30 hours. The CQC Annual Quality Assurance Assessment (AQAA) to be completed by the service, which includes information from a variety of sources Care Homes for Older People Page 6 of 28 which initially helps us to priorities the order of the inspection and identify areas that require more attention during the inspection process was sent to CQC (us) in good time. The AQAA is referred to throughout the report. We spoke with six service users and four staff and their responses and views of the home are also incorporated into the report. The registered manager Mrs Tracey Scurr assisted on this inspection visit. The majority of the service users spoken to were able to express their thoughts and feelings about their home and the care they receive. The information contained in this report is gathered mainly from speaking with a number of service users, observations by the inspector, discussion with the Chef, caring staff and the Registered manager and the General manager. Further information was gathered from records kept at the home. The first part of the inspection was spent discussing and agreeing the inspection process with the registered manager and general manager, followed by a partial tour of the home and garden which included time spent in discussions with service users and staff. Random sample of service users files and staff files were reviewed in order to verified information gathered from service users and staff. Random policies were reviewed to verify observations made by us (CQC). The registered manager and care staff are aware of the laws regarding equality and diversity and this was reflected in the staff mix. All service users in this home are British Caucasians and reflect the population of the area in which the home is situated. The final part of the inspection was spent giving feedback to the registered manager and general manager about the inspection. No requirement or recommendation of good practice was made on this visit. We would like to thank the service users and staff for taking time out of their busy schedule to speak with us and for making the visit such a pleasant and enjoyable one. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. All new service users receive a comprehensive needs assessment before admission. This is carried out by staff with skill and sensitivity. The service is highly efficient in obtaining a summary of any assessment undertaken through care management arrangements, and insists on receiving a copy of the care plan before admission. Individuals are encouraged and supported to be involved in the assessment process and information is gathered from a range of sources including other relevant professionals. Evidence: The AQAA informs initial assessments are carried out, in accordance with Standard 3 of the National Minimum Standards, by the Manager or Deputy Manager. Further assessments are carried out by a Senior Care Assistant if the placement is in the residential wing and by a Registered Nurse if the placement is in the nursing wing. Prospective service users are invited to come to Hatch Mill for visits. In discussion with service users on the day of the site visit they confirmed they had visited the home Care Homes for Older People Page 10 of 28 Evidence: prior to making a decision to live there, or their relative had viewed the home on their behalf. The assessment is obtained by observation, sometimes a joint discussion between other members of the multi disciplinary team and most importantly through the discussion with the prospective service user about the type of care and support they feel they need. The assessment covers the following needs: washing, including oral hygiene, dressing, continence, dietary-including enteral feeding, mobility, including falls, sleeping pattern, communication, hearing, eyesight, medication, skin integrity, clinical, pressure sores, including waterlow score, social, mental state, orientation, memory. The assessment defines how funding will be arranged. The form also requires a signature and date of when the assessment was carried out and by whom and also the signature of the service user or their relative if the service user is unable to sign. All potential service users to the nursing wing have a health needs assessment completed. We were told the home finds this an excellent framework to assist the assessment process ensuring they are able to meet the potential service users individual needs before moving in. Service users, whose residential placement is arranged by social services also have a health needs assessment carried out. The home encourages prospective service users to come and stay for meals or for the day so that they can meet with staff and other service users and have first hand experiences of what it is like to live at Hatch Mill. Prior to any admission to Hatch Mill, the home ensures that Service Users individual needs can be met and any specific equipment or aids are in place. Respite care can be offered for a minimum of one week and a maximum of six. The home has 3 respite rooms, one of which is a double room, which can be booked for couples or any two people wishing to share. Care Homes for Older People Page 11 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff ensure care is person led; personal support is flexible, consistent, and is able to meet the changing needs of the service users. Staff respects peoples preferences and have expert knowledge about individual personal needs when providing support, including intimate care. The staff response appropriately and sensitively in all situations involving personal care, ensuring that it is conducted in private and at a time and place directed by the person receiving the care. Evidence: The AQAA informs the home involve service users and their relatives or sponsors as appropriate in devising their individual care plans which are then updated and reviewed at least monthly or as individual needs change. Review of the care plans on the day of the site visit revealed the care plans consider all needs specific to the individual including the following, Communication, eyesight, hearing, personal care to include bathing and washing, dressing, choosing own clothing, oral hygiene, medication administration, memory and mental awareness, mobility, skin care , including waterlow score, elimination, hobbies, social, family and work histories, activities within the home, eating and drinking including likes, dislikes, special needs Care Homes for Older People Page 12 of 28 Evidence: and any adaptations necessary, and likes and needs of the service user during the day and at night. We observed that Death and dying is also discussed on admission and funeral preferences were also documented. The plan focuses on independence and strives to encourage service users to optimize their abilities to reach their full potential. The AQAA informs service users rights, responsibilities, dignity and privacy are respected in accordance with the homes philosophy of care and we observed that service users received care based on a positive approach to equality and diversity and human rights at the centre of service delivery. We observed from the randomly selected service users care plans reviewed that each service user has a Tree of Life within their care plan which details their life experiences including family, travel, work, childhood memories, dreams, school and hobbies. These are completed on admission if the service user agrees, and give the care staff an insight into the past life of a service user to better facilitate individualised care. We also observed there is also a best interests care plan which is completed by the service user on admission. We were told this type of care plan helps the staff to continue to offer seamless care to the service user, in the event of a service user becoming mentally incapable of making certain decisions such as specific clothes they like, hobbies, activities they like to do, places they like to visit. If the service user is incapable of completing this plan information is sourced from family and friends, to build up a comprehensive picture of what the service user would actually want. The care plans are kept in a personal file, which is locked in a trolley to ensure privacy. We were told Service users are able to access their plan at any time, and in discussion with service users they confirmed this and told us their sponsors are also able to have access based on the service user giving permission. Senior members of staff have received training in writing care plans. The Senior carers, all with NVQ level 3, write the care plans with the residential service users and the Registered Nurses write the care plans with the nursing service users. All care staff are encouraged to read the care plans to ensure the care they are giving is person centred.Staff are trained through induction on how to deliver individualised care and treat all service users with respect. Staff are able to extend their two weeks supernumerary period if they feel they need more training. Referrals are made wherever needed to members of the multidisciplinary team eg, speech and language therapist, dentist and hygienist, physiotherapist, dietitian, diabetic nurse, Parkinsons nurse, occupational therapist, wheelchair services. The AQAA informs the home has a retained GP who visits weekly. However service users can remain with their own doctor if they prefer. Within the Service users personal file there are risk assessments which cover the following, falls, nutrition, Care Homes for Older People Page 13 of 28 Evidence: mobility and manual handling, wandering, level of awareness, medication risk, hazards in rooms, use of side rails. Service users also have risk assessments that are specific to them. E.g use of wheat bag. All service users risk assessments are reviewed at least monthly or more often if required. Side rails are checked more often to ensure they are in full working order. The home has found the use of specific individual risk assessments an excellent way of empowering service users to live their life as they wish. There are also risk assessments for equipment, health and safety, general environment and first aid. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are able to enjoy a full and stimulating lifestyle with a variety of options to choose from. The home has sought the views of the service users and considered their varied interests when planning the routines of daily living and arranging activities both in the home and in the community. Routines are very flexible and service users can make choices in major areas of their lives. Evidence: The home employs an Activities Co-ordinator who is responsible for the planning and organisation of activities for people living at the home. We were told there is a variety of ctivities within Hatch Mill including scrabble, triangular and traditional dominoes, bingo, musical bingo, music and movement, listening to music. There is a designated Newspaper Corner, where service users like to discuss current affairs. We observed the activities menu placed in service users bedrooms and in the dinning and living rooms on the day of the visit. In discussion with service users they told us they are very involved in the planning of the activities and enjoys them very much. We were told service users have been on a number of outings at least one outing per week and we were told of some of the interesting places they have visited such as, Polsden Lacey and Denbies Winery. The home also have a Sensory Room with fibre optics, bubble lamp, project images or calming music for service users who may have Care Homes for Older People Page 15 of 28 Evidence: dementia or some agitation. Service users can use this facility for short sessions with the activity co-ordinator to help them feel calm. We were told by service users they enjoy Themed Lunches, tea parties and suppers, celebrating special days such as St Patricks, St Georges, Halloween, Easter parties with an Easter bonnet parade.The AQAA informs the home provides summer fetes, Christmas fairs, hog roasts, pantomimes, musical concerts, which are held in the Courtyard when the weather permits, or in the the Courtyard lounge for all service users together or for smaller groups in the wing lounges. The Hatch Mill residents group meets on a monthly basis to discuss what they want to do for the next month. At this meeting the manager is then able to keep everyone informed of news, the forthcoming events and to give feedback from the previous meeting. These meetings are minuted and every service user receives a copy. Service users, unable to attend, are consulted prior to the meeting to see if they have anything they wish to bring up. Following the meeting they are given verbal feedback until the minutes are ready. The Cook regularly attends these meetings. There is no restriction made by the home on visiting time. Service users can have visitors any time it is convenient to them. Visitors are always made welcome and offered refreshments or meals at no charge. There are areas around the home which are available for service users to meet their visitors in private, to play cards, games, sit quietly and read or rooms for private meetings and gatherings. Service Users are encouraged to maintain links with the local community. They have had guest speakers from Guide Dogs for the Blind, the local Womens Institute, and P.A.T. dogs visits the home on a regular basis. Some service users attend the local day centre and visits to the Societys other homes is also arranged. Newspapers are provided free of charge. Service users are encouraged to manage their finances independently in accordance with the homes policies. Service users who require contact with external agencies e.g. advocates are provided with this information in The Societys information leaflets. Safes are provided in all rooms. Service users continue to be involved in devising menus with the Cook based on their favourite choices. There is also an extensive off menu choice. At lunchtime this includes a fish option, salad, omlette, baked potato. These are in addition to their two main choices. Specialist diets are catered for when required and details are recorded in individual care plans. Hot and cold drinks and snacks are offered and available on request at all times. Risk assessments are put in place if service users wish to make their own drinks or snacks. Mealtimes are as flexible as practicable. Meals can be taken in service users rooms or in the dining rooms. Meals are promoted as social occasions and service users are encouraged to join each other for meals where they can chat and enquire after each other and staff Care Homes for Older People Page 16 of 28 Evidence: ensures that mealtimes are unhurried. Staff assists service users discreetly and sensitively with eating their meals and promote independence for as long as possible. Menu holders are available on all dining tables Care Homes for Older People Page 17 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has an open culture where individuals feel safe and supported to share any concerns in relation to their protection and safety. Policies and procedures regarding safeguarding adults are available to staff and give them clear guidance about what action should be taken. People using the service or their representatives are made aware of what abuse is and the safeguards that exists for their protection. Access to external agencies or advocacy services is actively promoted. Evidence: We observed information leaflets in Mental Capacity, Safeguarding Adults and Complaints procedure are available in the home to staff, service users and all visitors. We were told that recently an information pack has been distributed to all GP practices, local hospitals and Citizen Advice Bureaux which includes the Complaints Procedure. We saw evidence where Staff have undertaken an accredited level 2 course in the Control of Infection and Contamination with Guildford College to ensure service users are protected. The AQAA informs Key discussion sessions have been implemented in addition to care plan review meetings. These discussions enable topics covering all aspects of life at Hatch Mill to be discussed, which may not necessarily involve direct care delivery. They have found this provides an excellent forum for service users to discuss any issues or put forward ideas and suggestions on how the home can improve their service. Both key discussion and care plan review sessions enable service users to verbally comment on any issue they feel needs addressing. This statement was verified during discussion with a number of service users in an Care Homes for Older People Page 18 of 28 Evidence: individual situation. The Home continues to promote a transparent service and have a clear complaints procedure, which is contained in the Service users guide, contract of residency and statement of purpose. A complaints leaflet has also been formulated to give to service users, relatives and sponsors on admission and a copy is also displayed on all notice boards. We observed copies in reception available in large print. A record is kept of all complaints made, and the details of what has been done about it. We were told by service users the home has Complaints book for service users, relatives, sponsors and visitors to the home to write in if they wish. Details of how to complain to the CQC is also contained in the Complaints procedure. We were also told complaints procedure can be made available in audio and large print in house. Other formats such as different languages or Braille has been sourced and can be accessed when or if required. The AQAA informs prompt response to any complaints,concerns and issues and are the managers first priority. Any service user or sponsor who feels their complaint has not been dealt with effectively can appeal to the General manager and or Chairman of the Society. The manager told us she pro-actively deals with complaints when they are made and ensure any disciplinary action is taken if required after the appropriate investigations and discussions have taken place and she keep the complainant informed at each stage of the complaint investigation. All allegations or incidents of abuse are dealt with immediately in accordance with the Surrey Multi agency procedures. Safeguarding adult referrals are made appropriately. The AQAA informs the home received four complaints since the last Key inspection. CQC has not received any complaints about his home. Care Homes for Older People Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has single bedrooms available for all persons wishing to have one. There is one double bedroom for married people or two people wishing to share. Service users spoken to told us they had real choice in the room they use. The rooms are above average size, very well designed with all having en suite facilities. The fixtures and fittings are of a high quality, well maintained and adapted to meet the wishes of the current occupant. individuals personalise their bedrooms and can use their own furniture if they wish. Evidence: On approaching the building it appears shabby. This is due to the fact that the doors and window frames are made from solid wood and the Society have decided to allow the external wood to age and colour naturally. A partial tour of the home and garden was undertaken and the whole complex seen appears clean and tidy and extremely hygienic throughout. Sluices and bathrooms were particularly clean. This is a true testament to the staff who have undertaken the Infection and Hygiene control course. We were told the building has been inspected by the Environment Health Agency and Fire Brigade and the home has complied with suggestions made. There were no requirements made for these visits. We observed all bedroom doors had fire guards fitted and keys to doors are available for those service users who wish to have a key. . Each room is en-suite and complies with relevant guidance regarding door widths to Care Homes for Older People Page 20 of 28 Evidence: enable wheelchair use and floor space. The AQAA informs the Society employs a full time handyman and gardener, who is responsible for the grounds and for minor odd jobs within the house. The home has rolling programme for decorating. The Business and operational plans incorporate the maintenance programme and a schedule of planned maintenance has been developed for the next 5 years. The home encourage Service Users to bring in their own furniture and personal belongings e.g pictures, photos, ornaments, cushions etc. If a service user does not have any furniture the Society would be happy to supply what was requested. Beds are supplied and the height can be adjusted to aid care staff with bed making and delivery of care to service users in bed. Prospective service users can choose the bedroom wall colour and carpets before moving in. Handrails are fitted throughout the home and are regularly monitored for damage. Grab rails are fitted in service users en-suites and can be fitted in their rooms if they required them. There is call bell system in all rooms, toilets, bathrooms and shower rooms and service users can have a personal pendant if preferred. There is a software programme on the managers computer to enable response times to be monitored. We observed the staff adhered to their clinical waste policy. We observed several exits into the courtyard and gardens from the ground floor. The AQAA informs the raised planters in the courtyard have been maintained by one of the service users and their sponsor. Two beds have been cleared by the gardener and are awaiting new shrubs and plants which arrived on the day of the visit. The paths have been washed and are well maintained, the garden furniture has been varnished. There are umbrellas and cushions for the Courtyard and its seating. The AQAA informs all equipment and services are serviced regularly and this was verified during partial tour of the home and in discussions with the manager. There are two sling hoists and three stand aid hoists in the nursing wing and a small sling hoist available in the residential wing. There are four large rhapsody baths and two walk-in shower rooms with a shower chair in each. There are four alenti bath hoists, one in each bathroom. These are serviced twice yearly once including loler tests. Care Homes for Older People Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has a highly developed recruitment procedure that has the needs of the service users at its core. The recruitment of good quality carers is seen as integral to the delivery of an excellent service. The service is highly selective , with the recruitment of the right person for the job being more important than the filling of a vacancy. People who use the service are involved in the recruitment of staff and receive training and support to do this. Evidence: The staff rota demonstrated the number and grade of staff on duty to provide care and attention to service users for any twenty-four period was good to meet the assessed care needs of the service users. The home has a programme of planned training in place and all members of staff have an individual training record. Over 80 of care workers have attained the National Vocation Qualification at Level 2 (NVQ L2). Care workers are encouraged and enabled to undertake developmental training as well as the mandatory training. . All newly appointed staff undertakes an induction programme. The home ensures that staff undertakes the mandatory training with yearly updates as necessary to maintain their competency to fulfill their duties. This was evidenced through discussion with the manager and care workers and from review of care workers training records. Care Homes for Older People Page 22 of 28 Evidence: It was noted that staff turnover at the home is relatively low. All care workers are Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) checked prior to commencing employment, and they are in receipt of terms and conditions of employment as evidenced in their randomly selected files. The manager informed the inspector that supervision record were up to date and this was verified during random sampling of care workers files. The manager had shown the inspector her planned programme of improvements and supervision of staff was high on her agenda. In discussion with service users we were told they are involved in the formal interview process of all new staff and in internal interviews of staff applying for promotion within the home. All permanent staff receive a Contract of employment. They also receive the Policy and Procedures Manual and sign to say they will read it and seek help for anything they do not understand.This is monitored through support and supervision. Induction Period is six weeks, during this period all new staff receive two weeks of being supernumerary and work along side other members of staff. This supernumerary period can be extended dependent on the needs of the individual staff member. The induction process incorporates the six common induction standards. All Staff have a copy of the GSCC code of practices. The manager was knowledgeable about equality and diversity and equal opportunities and how this relates to employment and retention of staff. We evidenced staff have had Equality and diversity training. In discussion with staff we were told they have recommended Hatch Mill for Best Employer a competition run by a local insurance company with the local radio station and Hath Mill has won. The home is expecting the radio station to visit to hand over the certificate. Also the home was awarded the Investor In People Award and they are waiting for their plaque to be delivered. These statements were confirmed by the manager in discussion about the home. Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager is able to describe a clear vision of the home based on the Societys value and corporate priorities. She communicatess a clear sense of direction, is able to evidence a sound understanding and application of best practice operational syatems, particularly in relation to continous improvement, customer satisfaction and quality assurrance. Equality and Diversity, human rights and person centred thinking are given priority by the manager who is able to demonstrate a high level of understanding and demonstrate best practice in these areas. The way the home is run shows an understanding of peoples needs in respect of the six strands of diversity; gender, including gender identity, age, sexual orientation, race, religion or belief and disability. Evidence: The manager has demonstrated that she has kept herself updated on issues relating to care of the service users and staff in her charge. She has attained the Registered Managers Award and also the National Vocational Qualification Level 4 in care. She has also recently completed the falls assessment course, which she says she will share Care Homes for Older People Page 24 of 28 Evidence: with the care workers. In discussion with the manager it was evident she was knowledgeable about the care needs of the service users and the training needs of the care workers to meet these identified needs. She continues to strive to meet the aims and objectives of the Society and is committed to providing service users with an excellent quality of service which meets their needs. She ensures equality and diversity, human rights and person centred care are an every day occurrence within the home through various avenues such as, Staff meetings, support and supervision sessions, appraisals, staff questionnaires and her open door style of management, and by actively promoting and seeking the views of all staff. Service User meetings, care plan reviews, key discussion meetings, service user questionnaires, best interest records ensure the views of service users and their sponsors are actively sought and all these contributed to the development of the Society business and Hatch Mills operational plans. The AQAA informs the Society has undertaken the Investors in People award since the last key inspection and passed its assessment in March of this year. The manager informs us that this has benefited the home by ensuring that all quality assurance processes, business plans and staff policies and procedures have been audited and reviewed by an external agency. The home has developed an excellent tool to indicate traits for all senior staff to aspire to, which was based on staff views. This tool is LEADERS and is an acronym (Level headed, Equal to all, Approachable, Direct and open with giving feedback, Educator, Responsible for supervision, training, managing a shift, appraisal, Sense of humour) this has proved very beneficial in highlighting areas for development and areas in which they excel. Quality Assurance questionnaires are carried out to establish feedback from service users and their sponsors, which are evaluated and any areas are actioned by the manager as appropriate. The results of these questionnaires are collated, published, distributed and displayed in all areas of the home. There are clear lines of accountability within the home, each member of staff spoken to on the day of inspection aware of their role and responsibilities. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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