Care Home: Hawkhurst Care Centre

What the care home does well Residents were assessed before admission. This meant that staff understood what care the person might need and whether it could be provided at the home. Staff made sure that residents` health care needs were met. Relatives said that staff looked after the residents very well and made sure they saw the right professionals if they were not well. One relative said, "the health care is excellent" another wrote that their relative`s "individual needs were met." The relatives who returned surveys all said they were satisfied with the overall care in the home. Staff helped residents to have some choice and make decisions about their daily lives. The home provided activities for residents. A relative said that staff tried to keep residents stimulated and motivated. Relatives appreciated the open visiting policy. One said, "You can come when you want and stay as long as you want." Another said "they know and welcome everyone by name." Families were invited to social events at the home, which one relative said, "Ensures a whole community feel." Residents received a nutritious diet and most comments about the meals were very positive. One resident said, "It`s always a good dinner here." Another said, "The food is marvellous."All residents had a copy of the complaints procedure and relatives said they felt confident that the management would deal with any complaints. One said, "I believe (the manager) would deal with it efficiently." Staff were clear about what they must do if they thought any resident was being subjected to abuse. There were enough staff on duty to meet the needs of the residents. The residents and relatives were complimentary about the staff. One resident said, "they look after the patients very well." A relative wrote that staff were, "extremely caring and hardworking," and another said, "they are always calm and pleasant." New staff received induction training to help them to understand their job roles and most of the care staff held a nationally recognised qualification in care. Staff also received training in health and safety which helped to protect residents and themselves. The service was managed by an experienced, qualified and competent manager. Residents, relatives and staff praised her skills. One relative said, "the manager leads by example and heads a very efficient team." The company carried out a survey earlier in the year to make sure the home was providing a good quality service. Residents and relatives were able to put their views forward and make suggestions for changes. What has improved since the last inspection? Any residents that have to attend hospital have a booklet explaining to hospital staff what their needs are and any special ways they need to be helped. This makes sure there are no misunderstandings if a resident is not able to speak for themselves. The manager had made some minor improvements to medicine records to make them clearer and reduce the risk of errors. There had been some improvements to the environment, including new furniture in the lounges. Some of the bedrooms had been decorated and had new carpets fitted. These improvements helped to make Hawkhurst more comfortable and homely. What the care home could do better: All the residents had care plans to address their needs but some would benefit from a little more detail about the individual`s needs. This would help staff to know exactly what residents were able to do for themselves and what they needed help with. It would also help to ensure that staff provided care in a way that suited residents. One of the two bathrooms downstairs was out of action, which reduced the choice for residents who preferred a bath to a shower. It also meant that residents might have to wait for a bathroom to come available.In order to protect residents all new staff must have thorough background checks before they start work at the home. Although many staff are experienced in providing care to residents with dementia, not many had training in this area. Training would help to give them a better understanding of residents` specialist needs. CARE HOMES FOR OLDER PEOPLE Hawkhurst Care Centre 16-18 Shear Bank Road Blackburn Lancs BB1 8AZ Lead Inspector Jane Craig Unannounced Inspection 6th December 2006 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Hawkhurst Care Centre DS0000005823.V314017.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Hawkhurst Care Centre DS0000005823.V314017.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hawkhurst Care Centre Address 16-18 Shear Bank Road Blackburn Lancs BB1 8AZ 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) 01254 698338 0116 2702318 info@prime-life.co.ukwww.prime-life.co.uk Prime Life Limited Mrs Sandra Hazel Scarr Care Home 24 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (23), Mental Disorder, excluding learning of places disability or dementia - over 65 years of age (23) Hawkhurst Care Centre DS0000005823.V314017.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 26 service users to include: Upto 25 service users in the category of DE(E) (dementia over 65 years of age) Upto 25 service users in the category of MD(E) (mental disorder over 65 years of age) 1 service user in the category of DE (dementia under 65 years of age) Date of last inspection Brief Description of the Service: Hawkhurst Care Centre is owned by Prime Life Limited. The home provides 24 hour personal care and accommodation for people who have mental health care needs or dementia. The home has recently registered two extra places and can now provide care for up to 26 service users. Hawkhurst is located in a residential area and overlooks Corporation Park. Blackburn town centre is easily accessible. The home stands in large, well maintained grounds. There is a small car at the front entrance and a secure garden area at the rear. Hawkhurst is a two storey, detached house. The top floor is accessed by a passenger lift. Bedroom accommodation is on both floors. There is a mix of single and shared rooms with wash basins. Three of the rooms have en-suite facilities. There are accessible toilets and a bath or shower room on each floor. The home has two lounge areas, connected by a conservatory, and two dining areas. All communal areas are furnished in a comfortable and homely way. There is a range of seating to meet the needs of the service users. Various adaptations to promote independence and assist mobility are located around the home. Information about Hawkhurst, including the latest CSCI inspection report, is sent out to prospective residents when they enquire about admission. At the 6th December 2006 the weekly fees ranged from £383 for residents funded by social services to £450 for residents who were self-funding and occupying a premier room. There were additional charges for some hairdressing. Residents also paid towards transport costs and staff escorts for hospital appointments. Hawkhurst Care Centre DS0000005823.V314017.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A key unannounced inspection, which included a visit to the home, was conducted at Hawkhurst on the 6th December 2006. At the time of the visit there were 26 residents living at Hawkhurst. The inspector met with most of them and spent time observing interactions between staff and residents. Due to memory, orientation and communication difficulties most residents were unable to discuss their views or make comment on their experience of living in the home. The families of nine residents had helped them to complete questionnaires about the home. Their responses were positive. Eleven surveys had also been received from relatives and friends giving their opinions of the home. Discussions were held with the registered manager and three members of staff. The inspector also spoke to two visitors. A tour of the premises took place and a number of records and documents were viewed. This report also includes information submitted by the home prior to the inspection visit. What the service does well: Residents were assessed before admission. This meant that staff understood what care the person might need and whether it could be provided at the home. Staff made sure that residents’ health care needs were met. Relatives said that staff looked after the residents very well and made sure they saw the right professionals if they were not well. One relative said, “the health care is excellent” another wrote that their relative’s “individual needs were met.” The relatives who returned surveys all said they were satisfied with the overall care in the home. Staff helped residents to have some choice and make decisions about their daily lives. The home provided activities for residents. A relative said that staff tried to keep residents stimulated and motivated. Relatives appreciated the open visiting policy. One said, “You can come when you want and stay as long as you want.” Another said “they know and welcome everyone by name.” Families were invited to social events at the home, which one relative said, “Ensures a whole community feel.” Residents received a nutritious diet and most comments about the meals were very positive. One resident said, “It’s always a good dinner here.” Another said, “The food is marvellous.” Hawkhurst Care Centre DS0000005823.V314017.R01.S.doc Version 5.2 Page 6 All residents had a copy of the complaints procedure and relatives said they felt confident that the management would deal with any complaints. One said, “I believe (the manager) would deal with it efficiently.” Staff were clear about what they must do if they thought any resident was being subjected to abuse. There were enough staff on duty to meet the needs of the residents. The residents and relatives were complimentary about the staff. One resident said, “they look after the patients very well.” A relative wrote that staff were, “extremely caring and hardworking,” and another said, “they are always calm and pleasant.” New staff received induction training to help them to understand their job roles and most of the care staff held a nationally recognised qualification in care. Staff also received training in health and safety which helped to protect residents and themselves. The service was managed by an experienced, qualified and competent manager. Residents, relatives and staff praised her skills. One relative said, “the manager leads by example and heads a very efficient team.” The company carried out a survey earlier in the year to make sure the home was providing a good quality service. Residents and relatives were able to put their views forward and make suggestions for changes. What has improved since the last inspection? What they could do better: All the residents had care plans to address their needs but some would benefit from a little more detail about the individual’s needs. This would help staff to know exactly what residents were able to do for themselves and what they needed help with. It would also help to ensure that staff provided care in a way that suited residents. One of the two bathrooms downstairs was out of action, which reduced the choice for residents who preferred a bath to a shower. It also meant that residents might have to wait for a bathroom to come available. Hawkhurst Care Centre DS0000005823.V314017.R01.S.doc Version 5.2 Page 7 In order to protect residents all new staff must have thorough background checks before they start work at the home. Although many staff are experienced in providing care to residents with dementia, not many had training in this area. Training would help to give them a better understanding of residents’ specialist needs. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Hawkhurst Care Centre DS0000005823.V314017.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hawkhurst Care Centre DS0000005823.V314017.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The structured admission process meant that residents had information to help them to make a decision about moving in and staff had enough information to understand the new resident’s care needs. EVIDENCE: Relatives confirmed that they were given an information pack when they enquired about an admission to the home. The pack provided information about the services and facilities offered in the home but did not include information about the fees charged by the home. There was no statement of terms and conditions for residents who were not self-funding. The manager said she discussed fees with relatives when they met before admission and they had usually already discussed it with their social worker. One relative said she received information about fees from head office and social services after the resident was admitted. Residents who funded their own care received contracts from Prime Life and those who were funded by social services received an Individual Service Hawkhurst Care Centre DS0000005823.V314017.R01.S.doc Version 5.2 Page 10 Agreements. The registered manager said that residents or relatives would be informed in writing of changes to fees or contracts. There was evidence of this on one of the resident’s files. Prospective residents were assessed before they were offered a place at the home. Residents’ files contained assessments carried out by health and/or social care professionals. All residents were seen and assessed by the registered manager before they were offered admission. She said this was, “to make sure we can meet their needs.” Relatives confirmed that they had opportunities for discussion with the manager before admission. Staff said they received essential info about new residents during a staff handover meeting and were then encouraged to read the care plans at the earliest opportunity. Hawkhurst did not provide intermediate care. Hawkhurst Care Centre DS0000005823.V314017.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ personal and healthcare needs were planned for and met. The way medication was handled provided safeguards for residents. Residents were treated with respect and their rights to privacy were upheld. EVIDENCE: The care plans for three residents were inspected and others were viewed in less detail. The care plans were generally satisfactory but did not always give sufficiently detailed directions to ensure individualised care, for example the use of phrases such as “needs some assistance.” Detailed care plans are particularly necessary to ensure that care is carried out in the way that residents’ prefer, especially when the resident is unable to communicate this information. There was evidence that relatives were invited to be involved in care planning and one relative said, “we are regularly shown the care files, they are freely available and we are encouraged to sit and talk through the care.” Care staff reviewed the plans every month. There was evidence that plans were usually updated when care needs changed. Hawkhurst Care Centre DS0000005823.V314017.R01.S.doc Version 5.2 Page 12 All care plans included risk assessments for mobility, nutrition and pressure sore risk. However, the mobility assessments and plan were not adequate to assist staff to meet the fluctuating needs of one resident. The standardised risk assessment for falls did not show how the judgement of the severity of risk was reached. There was evidence on files that residents were referred to other health care professionals where necessary. On the day of the visit a resident was overheard telling the manager that her foot hurt. The chiropodist arrived at the home to see her within a few hours. Another resident said that the staff had, “done everything they could to help.” Relatives who completed questionnaires on behalf of residents all said that their care needs were met. Relatives and friends indicated that they were satisfied with the overall care at the home. One relative wrote, “it was evident to me that (the resident) was receiving excellent care and all her individual needs were met”. Another relative said, “the health care is excellent, they work well with families – an outstanding service.” None of the residents were able to administer their own medication. There were complete records of medicines received and returned to pharmacy. The Medication Administration Record (MAR) charts were complete and up to date. Omissions were recorded and a reason given. Handwritten records were signed and witnessed. Criteria for ‘when required’ medicines were recorded. Controlled drugs were stored, recorded and administered correctly. Staff who handled medication had the appropriate training. Storage was safe and there was restricted access to keys. There was no excess stock. Temperatures of the storage facilities were monitored and maintained at the recommended levels. The home’s charter of rights referred to residents’ rights to retain their personal dignity and also to have their personal privacy protected. Care plans made mention of promoting privacy and dignity but not necessarily how this was to be achieved. Staff discussed their understanding and talked about making sure that personal care was provided in a way that protected residents’ privacy. New staff received training in care values during their induction. During the course of the inspection staff were seen to treat residents with respect and offer care in a sensitive manner. A relative commented that all the residents always looked tidy and smart. Hawkhurst Care Centre DS0000005823.V314017.R01.S.doc Version 5.2 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Wherever possible residents were enabled to have choice and control over their lives and had access to activities to meet their social needs. The visiting arrangements were good and meant that residents were able to maintain contact with their relatives and friends. Residents received a nutritious and varied diet. EVIDENCE: Information about residents’ personal history and past interests was recorded in different ways. One of the residents had a “getting to know you” booklet. This provided rich information about the resident’s interests and staff said they also provided topics for conversation and reminiscence. All residents had a social inclusion care plan but the directions were all the same and did not give staff any indication of the residents’ individual abilities or interest in participating in activities. Records showed that recently the range of activities had been limited. Half of the relatives who completed comment cards indicated that there were always enough activities and one relative said that staff tried to keep the residents stimulated and motivated. The manager said that the programme was in need of review since a few new residents with different needs and abilities had been admitted. Hawkhurst Care Centre DS0000005823.V314017.R01.S.doc Version 5.2 Page 14 Most of the residents needed help from staff to make decisions about their daily lives. Some of the care plans included information about preferences likes and dislikes. This gave staff some background information to help them make choices on behalf of residents. For example, some plans indicated residents preferred daily routines, what clothes they liked to wear and what they liked to eat. Staff said they looked at the care plans for this information and also spoke to relatives. This was confirmed by all the relatives who returned comment cards. The home had an open visiting policy. All the relatives who completed surveys indicated that they felt welcome. One wrote, “the atmosphere is welcoming and homelike.” Relatives spoken with during the inspection said, “they know and welcome everyone by name,” and another said, “you can come at any time and stay as long as you want.” The manager and staff actively encouraged relatives to be a part of the home. Two relatives made mention of a recent bonfire party and another wrote, “quite often social events are arranged inviting friends and relatives to attend. Ensures a whole community feel.” The staff had arranged a recent trip out to Blackpool but the manager said that many of the resident were reluctant to go out unless it was with their families. Records of meals showed that residents received a balanced diet of plain, homely food. Their nutritional needs were monitored and referrals made to the nutritionist or speech and language therapist as necessary. Residents had a choice at each mealtime. On the day of the visit residents who were able were asked others were shown the options. Chef said that he had a list of residents’ likes and dislikes and staff kept him informed of changes and new residents. He said he would be able to cater for most special medical or religious diets and had done so in the past. Records required to be kept in the kitchen were up to date and there were no recommendations from a recent Environmental Health visit. Residents comments about meals were generally positive. One resident said the food was, “marvellous”, another said that if anyone complained there was something wrong with them. A third said “It’s always a good dinner here.” A relative wrote that there was a good variety, and another commented, “there always seems to be a good choice offered.” Hawkhurst Care Centre DS0000005823.V314017.R01.S.doc Version 5.2 Page 15 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents or their relatives had enough information to help them make a complaint and were confident it would be dealt with. Staff understanding of adult protection procedures provided safeguards for residents. EVIDENCE: There was a clear complaints procedure that stated how complaints would be dealt with and by whom. It stated timescales for response and gave contact details for CSCI. All residents, or relatives, were given a copy on admission. There was a copy in every bedroom and one on display in the hall. One relative said, “I can’t remember whether the complaints procedure came from Sandra or Prime Life but we got one.” Relatives completing questionnaires on behalf of residents all indicated that they knew who to speak to if they were unhappy and how to make a complaint. On the day of the visit one relative said, I couldn’t fault it but I would if need be.” Another said, “I would see Sandra if I needed to complain but I can’t see that happening at the moment.” Staff, residents and visitors had access to information about the protection of vulnerable adults. The home’s policy dovetailed with the local authority policy, and ‘No Secrets’ which were available for reference. Most staff had attended a course run by the Blackburn with Darwen adult protection team, others covered the subject during induction or NVQ training. Staff spoken with said that they would report any suspected abuse to the manager and would report Hawkhurst Care Centre DS0000005823.V314017.R01.S.doc Version 5.2 Page 16 outside the home if there was no response. The manager was clear about her responsibilities and how to handle an allegation of abuse. Relatives said that they had confidence in the staff and one said, “I feel OK about leaving him here.” Hawkhurst Care Centre DS0000005823.V314017.R01.S.doc Version 5.2 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 25 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was clean and well maintained. The standard of décor and furnishings provided residents with a safe, comfortable and homely place to live. EVIDENCE: A tour of the home showed that most areas were well maintained and the décor and furnishings were homely and comfortable. There had been an increase in the number of bedrooms since the last inspection, which had resulted in the loss of the ‘quiet lounge’. The manager said this had not been missed but on the day of the visit the lounges and conservatory were particularly noisy and residents had nowhere to go, should they have wanted quiet and relaxation, other than their bedrooms. The newly refurbished bedrooms were of a good standard and some other areas had been recarpeted and decorated. An audit of the premises had been carried out in September and the manager stated that all the work identified had been carried out. Hawkhurst Care Centre DS0000005823.V314017.R01.S.doc Version 5.2 Page 18 The two upstairs bathrooms had been replaced by shower rooms, which meant that residents who wanted a bath had to go downstairs. The manager said that none of them were concerned by this. However, one of the downstairs bathrooms had been out of action for a year because of a faulty hoist, which narrowed residents’ choice even further. To compound the difficulties the only bathroom in working order had a temperamental hot water supply. On the day of the inspection, the only way to get an adequate hot water supply was to run the tap in the wash basin at the same time. Environmental safeguards, such as window restrictors were in place. The manager stated that there were risk assessments in place to support the lack of guards on some of the radiators. Residents said they were happy with their rooms. One resident said she had chosen her own carpet and soft furnishings. Another resident said she liked her room very much. A relative said that staff had put themselves out to make her mother comfortable by handing pictures and putting up a shelf for her to display some items she collected. All the questionnaires indicated that the home was always clean and fresh smelling. One relative wrote, “ Hawkhurst is always exceptionally clean and pleasant smelling.” At the time of the visit a resident said, “It’s very clean, which is important in a place like this.” Most staff had received training in infection control and there were procedures for handling laundry and waste to protect residents and staff. Hawkhurst Care Centre DS0000005823.V314017.R01.S.doc Version 5.2 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels were sufficient to meet residents’ needs and staff had the minimum training needed to do their jobs. The absence of dementia care training meant that staff might lack the underpinning knowledge needed to understand residents’ specialist needs. Recruitment practices did not safeguard residents. EVIDENCE: The duty rosters provided an accurate reflection of which staff were on duty at any given time. The manager, staff and relatives all indicated that there were enough staff on duty during the day to meet the needs of the current residents. The manager said she had the flexibility to increase staffing levels at short notice should the needs and dependencies of the residents change. Evidence was seen that extra staff were rostered to cover escort duties and training. The manager said she was considering increasing the night staffing levels. One of the staff had also said that supervision at periods during the night could be difficult on occasions. Residents and relatives made a number of very positive comments about the staff team. One relative commented on the stability of the team which she said was very important and another said, “they are good with everyone, not just dad.” A resident said that staff, “look after the patients very well.” Written comments from relatives included, “dedicated to doing their best for the residents.” Hawkhurst Care Centre DS0000005823.V314017.R01.S.doc Version 5.2 Page 20 The file of one new member of staff was inspected. There was no evidence that they had had a new POVA check before starting work at the home. There was a note on the personnel file from Prime Life advising the manager that the member of staff could start work. Prime Life confirmed that they accepted the staff member’s previous CRB disclosure. The staff had written references on file but none had been requested from their previous employer. There was no written explanation of why this was so. New staff had first day induction training, which included an orientation to the home and instruction on essential procedures such as fire. They went on to an induction programme which covered all the common induction standards. The newest member of staff had completed some of the standards and been signed off as competent but there was no confirmation of how there competency had been assessed. New staff were supervised by experienced and senior staff. One member of staff said they were supervised for the first month whilst working on night duty. Other training was organised by Prime Life. The manager’s training records showed that all staff were up to date with fire safety training, moving and handling and all other safe working practice topics. Prime Life decided how often the training should be updated, for example, moving and handling training was every three years. Although many of the staff had worked with residents with dementia for a number of years and were experienced, there were only a few staff members who had appropriate training in dementia care. Following the site visit the manager provided evidence that seven staff would be starting dementia care training later in December. Information submitted by the home indicated over 73 of staff were qualified to NVQ 2 and a number of these had gone on to do NVQ 3. Hawkhurst Care Centre DS0000005823.V314017.R01.S.doc Version 5.2 Page 21 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager was competent and qualified. She managed the home in the best interests of residents and in a way that protected the health and safety of residents and staff. EVIDENCE: The registered manager is qualified to NVQ level 4 in care and management. She has many years experience of managing the home. The manager demonstrated her commitment to providing good quality care and wherever possible improving the service. She ensures that she keeps her knowledge and skills up to date and takes action to meet any requirements or recommendations for good practice made during inspections to the home. It was apparent that residents, relatives and staff held the manager in high regard. One resident said the manager and senior had, “done everything they can to help.” A member of staff commented that they had good Hawkhurst Care Centre DS0000005823.V314017.R01.S.doc Version 5.2 Page 22 communication from the manager. One staff said, “it’s well managed, never chaotic and rushed.” A relative wrote that it was the relaxed atmosphere that was the deciding factor for choosing Hawkhurst and another relative wrote, “the manager leads by example and heads a very efficient team.” The home had retained the Blackburn with Darwen quality assurance award. Prime Life had conducted a quality audit of the service earlier in the year. Results submitted to Commission for Social Care Inspection showed positive outcomes in all areas. Residents and relatives had been asked for their views of the service and had opportunity to make suggestions. The audit included objectives for the future but there were no timescales or dates for review attached to these. The manager regularly audits procedures and care systems such as care plans and medication. There are regular staff meetings and meetings were held with relatives to discuss care issues. None of the residents’ finances were managed at the home. All finances were handled by relatives or representatives. Small amounts of money were handed to the home for safekeeping. There were records of all transactions. Residents’ monies had been audited by Prime Life last month and there had been no recommendations. There were health and safety policies and procedures which were accessible to staff. The fire officer had recently inspected the home and Prime Life was addressing the one recommendation. Maintenance and servicing of fire safety equipment in the home was up to date. Staff had recent training and were clear about what to do in the event of fire. Lifting equipment had been serviced but one of the bath hoists needed to be repaired. From information submitted by the home all other equipment and installations had been serviced. There were individual environmental and fire risk assessments on residents’ files. Hawkhurst Care Centre DS0000005823.V314017.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X 2 3 STAFFING Standard No Score 27 3 28 4 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 3 Hawkhurst Care Centre DS0000005823.V314017.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No 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 OP1 Regulation 5(1)(ba)(bd) Requirement The service user’s guide must include information about the terms and conditions and the fees payable for service users and the differences for those service users who are self funding. The hot water system must be attended to in order to ensure a there is an adequate flow of water in the downstairs bathroom. The water must be maintained at an appropriate temperature. All care staff must have a POVA check before starting work at the home. Wherever possible a reference must be obtained from the applicant’s last employer. Timescale for action 31/03/07 2. OP25 23(2)(j) 31/03/07 3. OP29 19 31/12/06 Hawkhurst Care Centre DS0000005823.V314017.R01.S.doc Version 5.2 Page 25 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. 2. Refer to Standard OP7 OP7 Good Practice Recommendations Care plans should provide sufficiently detailed directions to ensure that residents’ needs are met in a consistent way. Risk assessments for moving and handling and falls should be further developed to ensure that they assist staff to plan strategies to meet residents’ needs. The second downstairs bathroom should be in use in order to give residents a choice of bathing facilities. All staff should have training in caring for residents with dementia. 3. 4. OP25 OP30 Hawkhurst Care Centre DS0000005823.V314017.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Hawkhurst Care Centre DS0000005823.V314017.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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