Care Home: Hawthorne Manor

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What the care home does well This service offers a good level of care in an excellent environment. Assessments are carried out prior to admission to ensure assessed needs can be met. The home offers care for low to medium dependency service users. Service users that were spoken with were very happy with the care they received and all said the staff were very kind to them and looked after them well. The home was very clean and very well maintained with very good quality furniture and fittings. Service users all said the food was very nice and homely and that they always had a choice over the menu. Drinks were seen to be freely available. What has improved since the last inspection? The owners have now introduced an effective quality assurance and quality monitoring system based on the views of the service users and they now need to compile a report to fully comply with regulation. Staff recruitment procedures have improved since the last inspection. Care planning has improved since the last inspection. What the care home could do better: The owners need to evidence that staff supervision is happening on a regular basis as required by NMS 36. Evidence was seen that yearly appraisals are undertaken. The hot water needs to be monitored and a full risk assessment undertaken to protect service users from the risk of scalding. All pipework and radiators need to be guarded. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Hawthorne Manor 369 Maidstone Road Gillingham Kent ME8 0HX     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sue McGrath     Date: 2 7 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Hawthorne Manor 369 Maidstone Road Gillingham Kent ME8 0HX 01634263803 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): rmsjradzik@aol.com Mrs Stephaneie Jane Radzik,Mr Richard Michael Radzik Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 37 Number of places (if applicable): Under 65 Over 65 37 old age, not falling within any other category Additional conditions: 0 The maximum number of service users who can be accommodated is: 37 The registered person may provide the following category/ies of service only: Care home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - OP Date of last inspection Brief description of the care home Hawthorn Manor offers accommodation in a detached property, situated in a residential area close to local shops and on a bus route. Rainham town centre is approximately two miles away. Mr and Mrs Radzik (Proprietors) oversee the daily management and running of the home. The home is registered for 37 older people; there are 33 single bedrooms and 2 double rooms within the home. The home caters for low to medium dependency residents. The home has ample off road parking and a large pleasant rear Care Homes for Older People Page 4 of 27 Brief description of the care home garden and patio area. Fees are from 442 pounds to 490 pounds. Care Homes for Older People Page 5 of 27 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: two star good 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: This was a Key Unannounced inspection that took place in accordance with the Inspecting for Better Lives (IBL) process. Key inspections are aimed at making sure that the individual services are meeting the standards and that the outcomes are promoting the best interests of the people living in the home. The IBL process for a Key inspection involves a pre-inspection assessment of service information obtained from a variety of sources including an annual self-assessment and surveys. It is now a legal requirement for services to complete and return an Annual Quality Assurance Assessment (AQAA). This assessment is aimed at looking at how services are performing and achieving outcomes for people. Care Homes for Older People Page 6 of 27 Judgements have been made with regards to each outcome area in this report, based on records viewed, observations and verbal responses given by those people who were spoken with. These judgements have been made using the Key Lines of Regulatory Assessment (KLORA), which are guidelines that enable The Commission for Social Care Inspection (CSCI) to be able to make an informed decision about each outcome area. Further information can be found on the CSCI website with regards to the IBL process including information on KLORAs and AQAAs. The actual site visit to the service was carried out over one day by one inspector, who was in the home approximately six hours. The main focus of the visit was to review any improvements made since the last visit and the well-being of the service users. Time was spent touring the building, talking to people living in the home, talking to staff and reviewing a selection of assessments, service user plans, medication records, menus, staff files and other relevant documents. The requirements made at the last inspection had been complied with. Overall this was a positive inspection with generally good outcomes for service users. The inspector on leaving the home was satisfied that residents were both safe and well cared for and wishes to thank the manager and her staff for their assistance and hospitality. 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 27 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 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents are provided with the information they need to make an informed choice about moving into the home. People who live in the home can be confident that their assessed needs can be met by the home. Evidence: The home had a comprehensive statement of purpose which provided prospective residents and their families with sufficient evidence about the home and what facilities it offered. Mr Radzik confirmed that all service users were provided with a contract/statement of terms and conditions with the home. Where possible these are signed by the resident Care Homes for Older People Page 10 of 27 Evidence: or their next of kin. Evidence was seen in their files that all residents had an assessment of their needs prior to admission. The owners confirmed that all residents were visited in their homes or current accommodation and that if residents were to be funded by Social Services, a Care Managers assessment would also be also taken into account. The owners were very clear about their admission policy, as the home was mainly aimed at residents with low to medium dependencies. The admission procedure includes prospective residents and their families visiting the home prior to admission. All of the residents spoken with said they felt well cared for, their needs were met and they were very happy to remain in the home. The home does not offer recuperative care. Care Homes for Older People Page 11 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home benefit from having their health care needs well met and are protected by the homes policy and procedure for the safe handling and administration of medication. People who live in the home are treated with respect and their right to privacy is upheld Evidence: Each person who lived in the home had a written care plan. Three of these plans were viewed during the inspection. They were comprehensive and gave clear instructions to staff on how best to manage that persons care. At the last inspection it was reported that the daily notes were intermittent and did not evidence that good care was given. At this inspection daily notes were seen to be written twice a day and not at the end of each shift. Although this was an improvement on last time there is still room for more improvement. Comments like Spent the day in his room does not reflect the good care given and again it is advised that daily notes be more comprehensive. Some daily Care Homes for Older People Page 12 of 27 Evidence: notes were better than others and this may highlight a training issue for staff. Evidence was seen that care plans were regularly reviewed and updated as required. There was good evidence in the care plans that the residents health was monitored and that health care needs were well met. All residents were registered with a local doctor and had full access to specialist medical, dental, pharmaceutical, chiropody services according to need. The administration of medication follows the guidelines laid down by The Royal Pharmaceutical Society of Great Britain. All staff that administer medication had completed an accredited course. Currently the home did not have any residents who wished to self medicate but senior staff were aware that a full risk assessment would be required if this changed. Several of the people who live in the home were spoken with and all confirmed that the staff were kind and considerate and that they felt well cared for and were happy to remain in the home. Comments like I am very, very happy here and I have no problems and the staff are very nice and I feel well cared for were made. Staff were also seen to treat the residents with respect and some good examples of staff interaction was seen during the day. A senior member staff commented that it was just like a big happy family and that the staff worked very well as a team. Care Homes for Older People Page 13 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home are suppoted to maintain contact with families and friends, which ensures they continue to receive stimulation and emotional support. People who live in the home benefit from the appetising meals and balanced diet offered by the home and people requiring specialist diets are well catered for. Evidence: There was a range of activities provided by the home and several residents said they were happy with the level of activities offered and could think of nothing else they wished to do. All residents spoken with said they were happy in the home and felt well cared for. One resident said how much she was looking forward to the summer so that she could use the lovely gardens and watch the squirrels playing. Residents confirmed they felt free to make their own decisions about how they spent their days and that they could have visitors whenever they wanted. Staff were seen to offer choices on a wide range of issues and were supportive and responded well to the Care Homes for Older People Page 14 of 27 Evidence: residents requests. All of the residents spoken with said the food was of a high quality and that they were always offered a choice. They commented that there did not appear to be any restriction on what they could have to eat. Drinks were seen to be freely available and residents confirmed bedtime drinks were always offered. One resident said a supper could be provided on request. Care Homes for Older People Page 15 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a clear complaints procedure and people who live in the home are aware of how to complain. Peopkle who live in the home benefit from robust adult protection policies and procedures that ensure they are protected from abuse. Evidence: The home had a comprehensive complaints policy and procedure, which clearly identified timescales for responding to written complaints. The registered person stated that all issues were taken seriously and that problems were normally dealt with informally before it became necessary to use the formal complaints procedure. Residents confirmed they were aware of the procedure and were happy to talk to either the senior carer or the owners. There had been no formal complaints since the last inspection. No complaints have been made to the Commission. The home had adopted the revised Kent and Medway Multi Agency Adult Protection Policy, Protocols and Guidelines and staff had been trained in the protection of adults, but some had not received training for some time. This is a mandatory training and needs to be refreshed every year. Staff spoken with confirmed a good understanding Care Homes for Older People Page 16 of 27 Evidence: of adult abuse and protection. The provider was advised to seek training for himself and staff on the Mental Capacity Act and The Depravation of Liberty Act. All residents were offered the chance to be registered for postal voting. Care Homes for Older People Page 17 of 27 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. People who live in the home benefit from living in a clean, safe and well maintained environment and have safe access to comfortable indoor and outdoor communal areas. Evidence: The home continues to be very well maintained and decorated to a very high standard. The lounges provide safe and comfortable surroundings in which to relax and enjoy some company. Several bedrooms were viewed and were found to be clean, comfortable and well maintained. The provider said he had decorated the lounges and all of the corridors since the last inspeciton. He also confirmed ten bedrooms had been decorated, including new carpets. The rear garden and patio areas were pleasant and contain a safe area for residents to enjoy. One resident said she liked watching the birds and squirrels in the patio area. The home complied with the requirements of the local fire service and the environmental health department. The furnishings throughout the home were of very good quality and domestic in Care Homes for Older People Page 18 of 27 Evidence: nature. At the last inspection is was seen that the majority of radiators in the home were guarded, however a few remained unguarded. The owner was advised to complete a written risk assessment to identify that the surface temperature does not present a risk to residents or to cover these radiators. Care Homes for Older People Page 19 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home benefit from being cared for by competent staff who have a good understanding of their needs. Evidence: Information gathered from the AQAA and discussions with the service users and staff confirmed the home had sufficient staff to meet the needs of the current service users. The AQAA confirmed the home employed nineteen care staff and five other staff. The AQAA also confirmed that fourteen of the care staff had completed a NVQ at level two or above. The owner confirmed that three staff were currently undertaking NVQ level three. It was difficult to confirm if all staff had completed all the mandatory training as the home did not have a training matrix in place. The owner will be required to provide evidence that staff are fully trained. Several staff files confirmed that not all Moving and Handling training was up to date. Of the three files viewed the last Moving and Handling training in all three was recorded as 2006. Three staff files were viewed and the recruitment process was now seen to be robust. Several staff members were spoken with and all confirmed they were very happy working in the home and that they felt well supported by the management team and felt confident in their own abilities and weer sure they all provided a good level of care. Care Homes for Older People Page 20 of 27 Evidence: All of the service users spoken with confirmed the staff were caring and looked after them well. Care Homes for Older People Page 21 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home benefit from having a manager who has a clear vision for the home, which she effectively communicates to the residents, staff and relatives. Evidence: Both Mr and Mrs Radzik were extremely open and honest at all times during the inspection and were able to display a sound knowledge of their home, residents and staff. They were reminded that AQAAs are a legal requirement and must in future be completed in the designated time, as the one for this year was late and a reminder letter had to be sent. Discussions took place about how best to organise and manage this. The owners have recently employed a administrative assistant and they were hopeful a lot of the required paper work could be improved. Quality assurance and a quality monitoring system was now in place and had recently been completed. As at the last inspection Mr and Mrs Radzik were advised to read Care Homes for Older People Page 22 of 27 Evidence: Standard 33 to be able to fully comply with regulation. Staff confirmed they had regular staff meetings and felt well supported by the management in the home. Evidence was seen that all staff undergo yearly appraisals and again staff confirmed these were happening. There was some concern over the recording of staff supervision and this was discussed on how best to record these event to provide good evidence of compliance. Mrs Radzik confirmed she had reviewed the homes Policies and procedures and had updated these if necessary. Information given in the AQAA and evidence seen on the day confirmed the owners maintain the health, safety and welfare of service users and staff. However, as at the last inspection, concerns were raised over the temperature of some of the hot water in the homes. Mr Radzik did confirm the taps in the bathrooms had Thermostatic Mixers Valves fitted, but not in the bedrooms sinks, also some toilet sinks were not fitted with TMVs. A requirement will be made regarding safe water temperatures. A risk assessment must be carried out to identify potential scalding risks from hot water temperatures and to assess the vulnerability of those who have access to bathing and washing facilities. The owners were advised to read the guidance notes on the CSCI website under Guidance logs for Older People. It was also noted that not all radiators are covered or guarded. A further risk assessment will be required to ensure the residents safety. The owners confirmed the home complied with requirements from the local fire service and stated they were aware of their responsibilities under the Fire Safety Legislation. Regular fire drill were undertaken with records kept. Care Homes for Older People Page 23 of 27 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 24 of 27 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 1 25 13 The registered person shall 30/04/2009 ensure that all parts of the home to which service users have access are so as far as reasonably practicle free from hazards to their safety. In that all pipework and radiators are guarded or have low temperature surfaces. 2 30 12 The registered person shall ensure there is a staff training programme that ensures staff fulfil the aims of the home and meet the changing needs of the service users. In that the home can evidence all of the training undertaken by staff and maintain good records of any completed and planned training. 30/04/2009 Care Homes for Older People Page 25 of 27 3 38 13 The registered person shall 30/04/2009 ensure that residents and staff are not at risk from hot water temperatures. In that a full risk assessment is undertaken to identify potential risks from hot water temperatures and to assess the vulnerability of those who have access to bathing and washing facilities. 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 26 of 27 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. 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