Care Home: Hawkesgarth Lodge Nursing & Residential Home

What the care home does well The people who live in the home are well cared for and respected by staff. They are able to choose their own routines within the limitations of their health care needs. All the relatives spoken with said that the manager and staff respected their dignity at all times. One person did praise the staff to the ‘expert by experience’ especially the manager and one other member of staff saying "they were his kind" Comments received from relatives include: "Here you are not an ornament, here you have a life, the candle is lit and there is light at the end of the tunnel" "Daddy is treated with respect and he retains his dignity" "They genuinely care" and "Gets a good quality of care" "She always looks good her clothes are properly looked after" Throughout the day it was clear that the welfare of the people in the home was at the core of the philosophy of the manager and staff. Staff are properly checked to ensure they are suitable to work with vulnerable people before they commence their employment. The staff are encouraged to undertake training that will enable them to undertake their job with confidence. They have supervision and team meetings that keep them informed and up to date with policies and procedures. The `expert by experience` noted "I feel good practice was shown by the care workers who were feeding residents who were unable to feed themselves" A relative commented "All staff from domestics, cooks and care staff seem to care about the residents" Another professional noted "There is an excellent care and commitment to each individual, using the holistic approach. Staff also have excellent communication and listening skills. Each client has individualised care plans and care packages adapted to their needs" The food is of a good quality and people said that they had enough to eat. There are three meals a day and drinks and snacks available at all times. Hawkesgarth Lodge Nursing & Residential Home DS0000028005.V377296.R01.S.doc Version 5.2 What has improved since the last inspection? Since the last inspection there has been a big change in the staff team and this has led to an improved working atmosphere. Staff working in the home said they felt more supported by the management and this had led to an increased enjoyment of their roles. "There seems to be an improvement over the last twelve months and the staff team seems to be working together better" "Within the last year I have seen some really positive changes and improvements in the home making the work we do more rewarding and fulfilling" "I have been employed at Hawkesgarth Lodge for 6 months as a staff nurse and I really enjoy my job, I have the support from carers and management to fulfil my role and find everyone I work with to be fully committed to their job" Staff are also accessing more training and newer staff undergo a proper induction to ensure they have the basic skills needed to do their job. There has been an improvement in how medicines are disposed of and this is now done in line with advice provided by The Royal Pharmaceutical Society. What the care home could do better: During the inspection the `expert by experience` observed that the building is a tired building very much in need of refurbishment. The management also need to look at the fixtures and fittings as some of these were looking worn and shabby. A fire exit was found to be impeded by overgrown shrub branches and weeds, and whilst this was cleared immediately the `expert by experience` pointed it out, it reflects the almost neglected state of the building. At the last inspection a plan of works was requested as part of the response to the report, this was not provided. Whilst there is some reference to some of the diverse strands of the community not all are identified in the Statement of Purpose and Service User Guide. These documents should be expanded to include all the diverse strands of the community and that they would be welcome at Hawkesgarth Lodge.Hawkesgarth Lodge Nursing & Residential HomeDS0000028005.V377296.R01.S.docVersion 5.2 Key inspection report CARE HOMES FOR OLDER PEOPLE Hawkesgarth Lodge Nursing & Residential Home Station Road Hawsker Whitby North Yorkshire YO22 4LB Lead Inspector Pauline O’Rourke Key Unannounced Inspection 21st August 2009 09:00 DS0000028005.V377296.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Hawkesgarth Lodge Nursing & Residential Home DS0000028005.V377296.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Hawkesgarth Lodge Nursing & Residential Home DS0000028005.V377296.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hawkesgarth Lodge Nursing & Residential Home Address Station Road Hawsker Whitby North Yorkshire YO22 4LB 01947 605628 01947 605772 hawksgarth@tiscali.co.uk www.europeancare.net European Care (UK) Limited 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) Angela Champness-Smith Care Home 40 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (0), Mental Disorder, excluding learning of places disability or dementia - over 65 years of age (40) Hawkesgarth Lodge Nursing & Residential Home DS0000028005.V377296.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home with nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Dementia - Code DE, maximum number of places: 1 Dementia, over 65 years of age - Code DE(E), maximum number of places: 40 Mental Disorder, excluding learning disability or dementia, over 65 years of age - Code MD(E), maximum number of places: 40 The maximum number of service users who can be accommodated is: 40 We will under Section 17 (4) (C) of the Care Standards Act 2000 impose the following condition on your registration There shall be no further admissions of service users to Hawkesgarth Lodge Nursing & Residential Home without prior written agreement of the Commission for Social Care Inspection. 15th October 2007 2. 3. Date of last inspection Brief Description of the Service: Hawkesgarth Lodge provides nursing care and accommodation for up to 40 people who have mental health needs and/or a dementia type condition. The home, set in its own grounds, consists of a two storey older building and a more recently built single story unit. The premises are located in the village of Hawsker approximately 3 miles south of Whitby and can be reached by a limited bus service or private transport. The service provides 32 single and 4-shared bedrooms. 10 of the single rooms have en suite facilities. There is a passenger lift within the older part of the building where the accommodation is situated over 2 floors. The rest of the building is single storey. Hawkesgarth Lodge Nursing & Residential Home DS0000028005.V377296.R01.S.doc Version 5.2 Page 5 There are three distinct areas, though people are currently able to live in any one of the three areas Each ‘unit’ has separate sitting and dining areas. Care staff are usually delegated to work in specific units. Qualified nurses work across all units. The property has an enclosed garden area and ample car parking for visitors and staff. Current fees are £496.22 to £751.10 a week. This was correct as of 3rd September 2009 Additional charges are made for hairdressing, chiropody, toiletries, papers, magazines and dry cleaning. Information about the services provided are made available in the home’s Statement of Purpose, Service Users Guide and through published inspection reports available from the home. Hawkesgarth Lodge Nursing & Residential Home DS0000028005.V377296.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 Care Quality Commission inspects homes at a frequency determined by how the home has been risk assessed. The inspection process has now become a cycle of activity rather than a series of one-off events. Information is gathered from a variety of sources, one being a site visit. More information about the inspection process can be found on our website www.cqc.org.uk We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The key inspection has used information from different sources to provide evidence for this report. These sources include: Reviewing information that has been received about the home since the last inspection. Information provided by the registered person in an Annual Quality Assurance Assessment form (AQAA) Comment cards returned from people living at Hawkesgarth Lodge and from other people with an interest in the service. A visit to the home by an inspector that lasted for seven hours. An ‘expert by experience’ accompanied the inspector for three hours of the visit. An ‘expert by experience’ is a person who, because of their shared experience of using services, and/or ways of communicating, visits a service with an inspector to help them get a picture of what it is like to live in or use the service. During the visit to the home twelve people who live there, four staff and two relatives were spoken with. Care records relating to four people who live at Hawkesgarth Lodge, four staff members and the management activities of the home were inspected. Care practices were observed, where appropriate, and time was also spent watching the general activity within the home. This Hawkesgarth Lodge Nursing & Residential Home DS0000028005.V377296.R01.S.doc Version 5.2 Page 7 enabled the inspector to gain an insight of what life is like at Hawkesgarth Lodge for the people living there. The Registered Manager was available for feedback at the close. What the service does well: The people who live in the home are well cared for and respected by staff. They are able to choose their own routines within the limitations of their health care needs. All the relatives spoken with said that the manager and staff respected their dignity at all times. One person did praise the staff to the ‘expert by experience’ especially the manager and one other member of staff saying they were his kind Comments received from relatives include: Here you are not an ornament, here you have a life, the candle is lit and there is light at the end of the tunnel Daddy is treated with respect and he retains his dignity They genuinely care and Gets a good quality of care She always looks good her clothes are properly looked after Throughout the day it was clear that the welfare of the people in the home was at the core of the philosophy of the manager and staff. Staff are properly checked to ensure they are suitable to work with vulnerable people before they commence their employment. The staff are encouraged to undertake training that will enable them to undertake their job with confidence. They have supervision and team meetings that keep them informed and up to date with policies and procedures. The expert by experience noted I feel good practice was shown by the care workers who were feeding residents who were unable to feed themselves A relative commented All staff from domestics, cooks and care staff seem to care about the residents Another professional noted There is an excellent care and commitment to each individual, using the holistic approach. Staff also have excellent communication and listening skills. Each client has individualised care plans and care packages adapted to their needs The food is of a good quality and people said that they had enough to eat. There are three meals a day and drinks and snacks available at all times. Hawkesgarth Lodge Nursing & Residential Home DS0000028005.V377296.R01.S.doc Version 5.2 Page 8 What has improved since the last inspection? What they could do better: During the inspection the expert by experience observed that the building is a tired building very much in need of refurbishment. The management also need to look at the fixtures and fittings as some of these were looking worn and shabby. A fire exit was found to be impeded by overgrown shrub branches and weeds, and whilst this was cleared immediately the expert by experience pointed it out, it reflects the almost neglected state of the building. At the last inspection a plan of works was requested as part of the response to the report, this was not provided. Whilst there is some reference to some of the diverse strands of the community not all are identified in the Statement of Purpose and Service User Guide. These documents should be expanded to include all the diverse strands of the community and that they would be welcome at Hawkesgarth Lodge. Hawkesgarth Lodge Nursing & Residential Home DS0000028005.V377296.R01.S.doc Version 5.2 Page 9 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. Hawkesgarth Lodge Nursing & Residential Home DS0000028005.V377296.R01.S.doc Version 5.2 Page 10 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 Hawkesgarth Lodge Nursing & Residential Home DS0000028005.V377296.R01.S.doc Version 5.2 Page 11 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 3, standard 6 does not apply People using the service experience good quality outcomes in this area. People are effectively assessed prior to admission, which helps to ensure individual needs can be met We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The files for four people who live at Hawkesgarth Lodge were seen and these all contained comprehensive assessments by someone from the management team prior to admission to the home. The assessments detail health, personal, nursing social and mental health needs. The information gathered at the assessment allows the manager to make an informed decision before admitting someone to the home. The process also reassures the individual and Hawkesgarth Lodge Nursing & Residential Home DS0000028005.V377296.R01.S.doc Version 5.2 Page 12 their family that they will receive the right support. Surveys received from people in the home indicated they had enough information about the service before they moved in. A review of the placement is held after the person has been in the home for a number of weeks. Several people spoken with during the visit said that the manager had visited them prior to their admission. People are given a named nurse and a key worker on the day they move in and these people help them to settle in. A relative said that they had visited the home prior to their relative coming in and had found the staff helpful and informative. The manager confirmed that they visit people before they are admitted to the home and she said that this had enabled her to ensure the balance of needs within the home was appropriate to the availability of the staff. The Statement of Purpose and Service User Guide contain reference to some of the diverse strands of the community not all are identified. These documents should be expanded to include all the diverse strands of the community and that they would be welcome at Hawkesgarth Lodge. Hawkesgarth Lodge Nursing & Residential Home DS0000028005.V377296.R01.S.doc Version 5.2 Page 13 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, and 10 People using the service experience good quality outcomes in this area. People receive the care and support they need. The staff provide support in a sensitive way that promotes the independence and dignity of the people who live at Hawkesgarth Lodge We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Four care plans were looked at during the visit. They contained detailed information pertinent to the person they were about. This included; social care, dependency, dietary, falls, risk assessment, a waterlow risk assessment, and a record of professional visits. One plan contained a Deprivation of Liberty assessment which identified that any assessment would be decision specific. Staff spoken with were aware of the care plans and there was evidence that the plans are reviewed each month. One person who spoke to the Expert by Experience said My relative is treated with respect and he retains his dignity Hawkesgarth Lodge Nursing & Residential Home DS0000028005.V377296.R01.S.doc Version 5.2 Page 14 another relative said my relative gets a good quality of care Staff spoken with were knowledgeable about the people living in the homes and the support they provided was reflected in the care plan. The care plans contained information about visits from other health professionals. The manager has organised a monthly visit to the home by one of the local doctors, this allows people to access the doctor in their own home on a regular basis. It also allows the doctors to keep informed about their patients. People also access other health services as necessary. Information provided in the AQAA stated that peoples weight is monitored on a monthly basis and when necessary a referral is made to the doctor or dietician. One person commented There is an excellent care and commitment to each individual, using the holistic approach. Staff also have excellent communication and listening skills. Each client has individualised care plans and care packages adapted to their needs Medication is provided through a monitored dosage system and a member of staff was observed administering medication. The records are well maintained and a running stock level is kept each time medication is dispensed. The medication is properly stored and there was separate storage for controlled medicines. Daily fridge temperatures are maintained to ensure that the medication stored in the fridge is done so at the correct temperature. All unused medication is disposed of in a de-nuturing unit and disposed of in the clinical waste by a company licensed to do so. Throughout the inspection people were seen to be treated with respect and dignity at all times. The expert by Experience said Residents I spoke with all said that they felt that they were treated with respect and that when they were bathing their privacy and dignity was respected People also told her that they are called by their chrisitan names, and this was their personal choice People told her that staff always knock on their bedroom door before entering. These observations were confirmed by visiting families. Feedback received in one survey said They look after my husband very well and he has been more settled and happy since he moved to the home Hawkesgarth Lodge Nursing & Residential Home DS0000028005.V377296.R01.S.doc Version 5.2 Page 15 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, and 15 People using the service experience good quality outcomes in this area. People are able to make choices on a daily basis and are supported to do this by the staff. They enjoy a good and varied diet and a social and recreational programme helps them to maintain their interests and hobbies. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: A dedicated activities organiser is employed by the home. They set out a programme of activities for both groups and on a one-to-one basis. The programme is varied and reflects the diversity and needs of people living at Hawkesgarth Lodge. An individual social activities log is completed for everyone in the home this allows staff to monitor their interactions. The activities provided are based on the care needs identified in an individuals care plan and where necessary risk assessments are in place to support this. One person is encouraged to assist the handyman with his tasks as he enjoys DIY and wants to keep his skills up to date. Regular entertainers visit the Hawkesgarth Lodge Nursing & Residential Home DS0000028005.V377296.R01.S.doc Version 5.2 Page 16 home and people are encouraged to go out in to the community to attend social functions. A planned event is a meal at an Indian restaurant at the request of one person in the home. A group of people from the home have already identified that they want to be included. People are encouraged to follow their own routines in the home and so there are no set rising and retiring times. Peoples preferences as to how they like to spend their time and the day is listed in their care plan. During the visit people were encouraged to play coordination games, staff with people reading them the local newspaper and just talking to them. People told the expert by experience that they enjoyed a ride out in the homes bus, they also said they had enjoyed barbeques, TV and music whilst quizzes were alright if you like that kind of thing They also said they enjoy coffee mornings and a special fuss is made on their birthday with a cake provided and the other people in the home send a home-made card. Visitors spoken with said that they are welcomed every time they visit. They are kept informed of any concerns the staff might have about their relative. Several visitors spoken with said staff are approachable and always friendly One relative said she had initially visited at different times of the day but had always found the staff to be friendly and knowledgeable about the people they were looking after. When she had visited at 11:20pm there had been no hesitation about letting her in to see her relative. She told the expert by experience my relative is well cared for and the staff are doing their job properly The meals are planned in advance and suggestions are taken from people in the home as to what should be on the menu. Information about dietary restrictions are also highlighted in the care plans. During the visit the lunch meal was observed and this was relaxed and staff assisted people as they needed. The expert by experience said I observed care workers feeding people who were unable to feed themselves. People were being fed at their own pace and not hurried in any way. Staff showed great sensitivity towards the people in the home when performing this duty People spoken with said that they enjoyed their meals and there is always an alternative to the main choice of a salad, soup and sandwiches. A cooked breakfast is provided along with cereals and toast. The evening meal tends to be sandwiches with fruit, scones and cakes. Drinks are offered throughout the day at regular intervals and on request. Hawkesgarth Lodge Nursing & Residential Home DS0000028005.V377296.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People using the service experience good quality outcomes in this area. People who live at Hawkesgarth Lodge and their representatives are able to express their concerns through the complaints procedure and are protected from abuse, so their rights are protected. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: There is a comprehensive complaints procedure in place, it is advertised on the information board as well as being in the Service User Guide. All of the people spoken with would take any concerns to the manager or their key worker. There have been no complaints received by the home in the last twelve months. The Commission received one complaint in January 2009 relating to a complaint made to the service in the previous year. This matter is still outstanding and is being dealt with by the senior management of European care. The expert by experience said Relatives felt that if they had any concerns or issues, they would feel comfortable in talking to the manager, and feel it would be dealt with appropriately Feedback received from surveys sent to people in the home indicated that they knew how to make a complaint if the needed to. Hawkesgarth Lodge Nursing & Residential Home DS0000028005.V377296.R01.S.doc Version 5.2 Page 18 A Safeguarding protocol is in place and staff were aware of their responsibilities under this procedure. This procedure has been implemented in the last twelve months and followed properly, as a result five staff were dismissed, and four of those were dismissed because they knew of the abuse but did not report it. Staff have received training through National Vocational Qualification and the manager also reinforces the training. The manager understands the procedures and attends meetings and provides information to external agencies when abuse or mistreatment of the residents. Staff are thoroughly checked prior to the commencement of their employment to ensure they are suitable to work with vulnerable adults. Staff also carry pocket size cards which, give examples of abuse, what to do and who to contact with telephone numbers if abuse is suspected or witnessed. Hawkesgarth Lodge Nursing & Residential Home DS0000028005.V377296.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People using the service experience poor quality outcomes in this area. People live in a building that is safe but is in dire need of a refurbishment. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The home is located outside Whitby and is set in its own grounds. The home is generally clean requires a full refurbishment. At the last inspection in September 2008 it was noted that the refurbishment was in the planning stage. However, nothing has been done at this point to improve the environment for the people living there. The expert by experience also toured the building and noted The building is a tired building, very much in need of refurbishment. I observed a number of bedrooms which were unoccupied with Hawkesgarth Lodge Nursing & Residential Home DS0000028005.V377296.R01.S.doc Version 5.2 Page 20 beds unmade and mattresses exposed which were stained and would certainly need replacing. There was old and stained carpets in these rooms, together with an unpleasant smell The manger did discuss the refurbishment and this will eliminate most of the problems. The quality of the furnishings were also questioned as it was washed up and in some cases almost see through. Staff have undertaken infection control training and people using the service have their washing and ironing done by staff. The issue of inappropriate taps was again raised, these are push down taps and do not allow for people to thoroughly wash their hands. These needs to be addressed in order to maintain hygiene prevent cross-contamination and make it easier for people using the service to obtain water. Hawkesgarth Lodge Nursing & Residential Home DS0000028005.V377296.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People using the service experience good quality outcomes in this area. People are cared for by staff that are competent, and recruited in sufficient numbers to meet individual needs. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The staffing levels at Hawkesgarth Lodge are currently sufficient to meet the needs of the people living in the home. There are usually 2 trained staff along with 5 care assistants, the ration of 7 staff to 29 people in the home is maintained even when at times only one trained member of staff is on duty. The staff are supported by ancillary staff. There are three waking night staff on duty. This level of staffing is adequate as the top floor is not used and should this situation change then extra staffing would need to be employed. Currently 46 of the are staff have a National Vocational Qualification level 2 in Care, the manager needs to ensure that over 50 of the staff have this qualification. Several staff also have a level 3 qualification. Along with the statutory training required staff have completed training in Deprivation of Liberty, the Mental Health Capacity Act, and Dementia Awareness. Staff also do in-house refresher training in Safeguarding procedures. All new staff do induction training and are Hawkesgarth Lodge Nursing & Residential Home DS0000028005.V377296.R01.S.doc Version 5.2 Page 22 supervised or mentored during the first few months of their employment. This ensure that all staff know how the work is to be done. The staff files for four people were seen and these contained all of the documentation as required by The Care Homes Regulations 2001. Staff spoken with confirmed they had not commenced their employment until the POVAFIRST check had been returned and then they worked under supervision until their full criminal records check had been returned. Evidence was also in their files that they had received a contract of employment. Staff spoken with said that since the last inspection the staff dynamics had changed and this meant the team work had improved and staff appeared much happier in their role. People spoken with during the inspection said the staff are nice here - not too cheeky and They are fine and take their time with me when I need help The Expert by Experience noted Staff showed great sensitivity towards the residents Throughout the day staff were seen spending time with people either assisting them with their care needs or just sat talking to them or encouraging them to interact in a physical activity. They were respectful at all times in their interactions. Hawkesgarth Lodge Nursing & Residential Home DS0000028005.V377296.R01.S.doc Version 5.2 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, and 38 People using the service experience good quality outcomes in this area. People live in a home that is well managed and systems are in place to protect their health and safety. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The registered manager is qualified and experienced. She has been the manager at Hawkesgarth Lodge for two years. People spoken with during the visit said that the manager and the deputy manager are always available if they want to speak to them and they have confidence in their ability to change Hawkesgarth Lodge Nursing & Residential Home DS0000028005.V377296.R01.S.doc Version 5.2 Page 24 things if they are not right. Staff also said that the manager was fair and operated an open door policy to all. There is a quality assurance system in place and includes information gathered from surveys completed by people living in the home, their relatives and other professionals. They also include information gained from their care plan, medication, and environmental audits. This means that improvements to the service can be easily identified and implemented. When it is necessary people can leave their personal monies in the office safe. The records and cash held were checked and all tallied. The health and safety records were checked and all were found to be up to date. Risk assessments for fire, the environment, COSHH and people who live in the home are in place. All accidents and incidents are recorded and when necessary they are reported to the Care Quality Commission. Whilst the accidents are reviewed on a regular basis it was suggested to the manager that the staff incorporate these in to the monthly reviews carried out. This might then show any patterns of incidents and allow staff to alter the care plan accordingly. Hawkesgarth Lodge Nursing & Residential Home DS0000028005.V377296.R01.S.doc Version 5.2 Page 25 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 X X 3 X 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 1 X X X X X X 1 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 3 X X 3 Hawkesgarth Lodge Nursing & Residential Home DS0000028005.V377296.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? YES 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 OP19 Regulation 23 Requirement A plan of refurbishment for the home must be forwarded to the CQC. This will help identify how the home can enhance the quality of life for people. This is outstanding from the previous inspection carried out on 09/09/2008 Timescale for action 31/10/09 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP1 Good Practice Recommendations Whilst there is some reference to some of the diverse strands of the community not all are identified in the Statement of Purpose and Service User Guide. These documents should be expanded to include all the diverse strands of the community and that they would be welcome at Hawkesgarth Lodge. Hawkesgarth Lodge Nursing & Residential Home DS0000028005.V377296.R01.S.doc Version 5.2 Page 27 Care Quality Commission Care Quality Commission Yorkshire & Humberside Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries.yorkshirehumberside@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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