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Care Home: Hawthorns (EVESHAM), The

  • Church Street Evesham Worcestershire WR11 1EP
  • Tel: 01386444330
  • Fax: 01386444331
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The Hawthorns is a purpose built care home which provides nursing care for up to 47 people. Forty of the places are for older people who need nursing care due to physical difficulties or because they have a dementia type illness. The other seven places are in the aquired brain injury unit on the second floor which caters for younger adults. The home is a short distance from the centre of Evesham, convenient for local facilities and for people wanting to visit the home. There are car parking spaces for visitors and 102008 staff. The home is spacious with accommodation provided on three floors. The home is arranged in five self contained units, four have ten rooms and the aquired brain injury unit on the second floor has seven. This means that people live in relatively small groups with staff that usually work in the same unit when they are on duty. Each unit has a sitting room and a kitchen/diner; the size and layout of these has a domestic feel and means that visitors can make a drink when they come to visit. All of the bedrooms are singles and have an en-suite toilet and shower. In addition the home provides lounges, dining rooms and bathrooms with specialist equipment for people who need assistance with bathing. There is a garden for people to use when the weather is fine.

  • Latitude: 52.088001251221
    Longitude: -1.9390000104904
  • Manager: Mrs Mary Elizabeth Tasker
  • Price p/w: -
  • UK
  • Total Capacity: 47
  • Type: Care home with nursing
  • Provider: Shaw healthcare (Homes) Ltd
  • Ownership: Private
  • Care Home ID: 7752
Residents Needs:
Dementia, Physical disability

Latest Inspection

This is the latest available inspection report for this service, carried out on 26th August 2009. CQC found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

For extracts, read the latest CQC inspection for Hawthorns (EVESHAM), The.

What the care home does well People are seen as individuals and in the ABI unit the care is very individualised and supported by well organised and comprehensive care records. People are treated with respect and staff are aware of the importance of dignity and choice. In the ABI unit in particular staff have achieved considerable success in improving the health and quality of life of some people staying there. Medication is managed safely. People in the ABI unit are provided with a wide range of opportunities to become more independent. The staff working in both services are friendly and some have excellent skills in supporting and caring for people who have problems with memory and communication. Staff recruitment is robust so that new staff are fully checked before they start work. The building is safe and well maintained with important tests and checks recorded and scheduled so they aren`t missed. In 2009 the service achieved a 5 star rating from local environmental health officers for food safety and a full test of electrical safety was carried out. The service is being managed by a new manager who has identified areas where the service needs to improve and develop. What has improved since the last inspection? When the service last had a full inspection it was rated by our predecessor, the Comission for Social Care Inspection (CSCI) as a 3 star `excellent` service. Last year CSCI did an Annual Service Review followed by a random unannounced inspection because they were unsure that the service was operating at that level of quality. During this inspection we found that the requirements made by CSCI at the random inspection had been met. What the care home could do better: The Hawthorns has a number of areas where improvements are needed and is therefore not at present an `excellent` service. The appointment of a new manager is a positive step in dealing with the things that need to be improved. The new manager had identified a range of issues where she knows the home needs to do better. She made us aware of these during the inspection and acknowledged issues we highlighted. The care records in the care home lack the clarity and depth of those in the ABI unit, do not focus enough on the individual needs and wishes of people and in some cases do not provide enough guidance to staff. Work on dealing with the shortcomings in the care records was already planned and underway when we did this inspection. Some staff need support to develop their skill in dealing with people with complex communication needs and other dementia related difficulties. Work being done by the manager to stabilise staffing levels needs to be consolidated so that there are consistently enough staff on duty to meet people`s needs.Communal and personal rooms in the care home need to be improved to make them more comfortable and homely. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Hawthorns (EVESHAM), The Church Street Evesham Worcestershire WR11 1EP     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: Denise Reynolds     Date: 2 7 0 8 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 30 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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: Hawthorns (EVESHAM), The Church Street Evesham Worcestershire WR11 1EP 01386444330 01386444331 The-Hawthorns@shaw-homes.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Shaw healthcare Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 47 Number of places (if applicable): Under 65 Over 65 0 0 dementia physical disability Additional conditions: 47 7 The maximum number of service users to be ccommodated is 47. The registered person may provide the following category of service only: Care Home Only (Code PC) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) 40 Physical Disability (PD) 7 Date of last inspection Brief description of the care home The Hawthorns is a purpose built care home which provides nursing care for up to 47 people. Forty of the places are for older people who need nursing care due to physical difficulties or because they have a dementia type illness. The other seven places are in the aquired brain injury unit on the second floor which caters for younger adults. The home is a short distance from the centre of Evesham, convenient for local facilities and for people wanting to visit the home. There are car parking spaces for visitors and Care Homes for Older People Page 4 of 30 1 0 1 0 2 0 0 8 Brief description of the care home staff. The home is spacious with accommodation provided on three floors. The home is arranged in five self contained units, four have ten rooms and the aquired brain injury unit on the second floor has seven. This means that people live in relatively small groups with staff that usually work in the same unit when they are on duty. Each unit has a sitting room and a kitchen/diner; the size and layout of these has a domestic feel and means that visitors can make a drink when they come to visit. All of the bedrooms are singles and have an en-suite toilet and shower. In addition the home provides lounges, dining rooms and bathrooms with specialist equipment for people who need assistance with bathing. There is a garden for people to use when the weather is fine. Care Homes for Older People Page 5 of 30 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: Please note that this report about an inspection by the Care Quality Commission. However, the template is on the predecesor organisation, CSCIs template. This is because some initial planning for the inspection took place before the changeover and the template had already been set up by the computer system. We arranged this inspection in advance because there had been a recent change of manager and we wanted to be sure that the new manager would be at the home when we went. One inspector spent two days at the service. One day was mainly spent in the aquired brain injury unit (ABI unit) and one day in the dementia care service. Because these two services are different we have tried to explain in this report when we are describing either one or the other. Some of the report applies to both services. Care Homes for Older People Page 6 of 30 During our inspection we spent time observing day to day life, speaking to people who live there, some visitors and some staff. We also looked at a range of essential records needed to support the care of people and the overall safety and management of the service. The focus of our inspection was to look at the outcomes for people in the ABI unit and the care home and to find out what they think about their care. To help us with this we looked in detail at the care of two people staying in the ABI unit and of two people who live in the care home. This included observing some aspects of their care, talking to staff about the care they need, looking at their care records and where possible, speaking with them. Because people with dementia are not always able to tell us about their experiences, we used a structured way of observing care in the dementia care service. This method is called the Short Observational Framework for Inspection (SOFI). This involved us spending two hours sitting in one of the sitting rooms paying close attention to what was happening to five people during that time. We made detailed notes about how they spent their time, how much contact there was with them from staff and other people and also how they seemed in themselves eg were they bright and awake or asleep or withdrawn. We then use this information to contribute to the picture we have about what life is like for people in the home. Some months previously the service had sent us their Annual Quality Assurance Assessment (AQAA). This is a self assessment tool which services use to describe what they do well, what they need to do better and what their plans are for improvement in the coming year. At this time we also sent surveys to people using the service, their relatives, staff and some professionals. We used all of this information to help us build a picture of the quality of the service people at The Hawthorns are receiving. In this report we refer to the aquired brain injury unit as the ABI unit and to the dementia care service as the care home. What the care home does well: What has improved since the last inspection? What they could do better: The Hawthorns has a number of areas where improvements are needed and is therefore not at present an excellent service. The appointment of a new manager is a positive step in dealing with the things that need to be improved. The new manager had identified a range of issues where she knows the home needs to do better. She made us aware of these during the inspection and acknowledged issues we highlighted. The care records in the care home lack the clarity and depth of those in the ABI unit, do not focus enough on the individual needs and wishes of people and in some cases do not provide enough guidance to staff. Work on dealing with the shortcomings in the care records was already planned and underway when we did this inspection. Some staff need support to develop their skill in dealing with people with complex communication needs and other dementia related difficulties. Work being done by the manager to stabilise staffing levels needs to be consolidated so that there are consistently enough staff on duty to meet peoples needs. Care Homes for Older People Page 8 of 30 Communal and personal rooms in the care home need to be improved to make them more comfortable and homely. 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 30 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 10 of 30 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The ABI unit and the dementia care service both provide information about the service they offer to help people decide if it will be the right place for them. People who are thinking of using either service have their needs discussed with them first by staff to make sure the service can provide the right care for them. Evidence: The service offered in the ABI unit and the care home is described in a statement of purpose and service user guide. It may be beneficial to separate the information into two separate documents to make them easier to refer to. This would mean that the formats they are produced in could also be tailored to peoples specific communication needs with more ease. We found that there was lots of information gathered about the people in the ABI unit before they use the service and that this has been used to develop very detailed Care Homes for Older People Page 11 of 30 Evidence: records about their health and social needs and their plans for regaining as much independence as possible in the future. We also heard about the preparations being made before a person moves in shortly. This will include visits for them to get to know the unit and the people there, as well as planning how they would like their room decorated. We met one person who told us how they have made progress since they arrived because of the work staff do with them to help them regain day to day abilities. One person who sent a survey back to us wrote - I am happy to live here because when I go home I cant wait to come back In the care home we saw that information has been gathered about the care people need when they move in. The information isnt as full as we saw in the ABI unit and the manager agreed that this was the case. We saw examples where useful things for staff to know (such as how a person liked to spend their time) had been buried in old paperwork rather than being used to help staff make life more enjoyable for people. We saw forms filled in by relatives about peoples lives which didnt tell staff very much beyond basic things like date of birth and maiden name. This may be because relatives had been given the forms to fill in rather than having staff sit and talk to them about how knowing about a person can help the home provide better care. The manager told us that she is already working with staff to make sure the information about people moving to the care home is as thorough as it is in the ABI unit. Care Homes for Older People Page 12 of 30 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 use the ABI unit and the care home receive care which is planned to meet their individual needs. Medication is managed safely. Staff treat people as individuals and with respect for their privacy and dignity. Evidence: The two services provided at The Hawthorns are different in many respects but we observed that staff in both units treated people respectfully. In the ABI unit we saw that staff are good at working with people to help them do as much as possible for themselves. One person we spoke to told us how they have regained the ability to do lots of day to day things themselves like simple cooking, keeping their room clean, shopping and looking after their money. Another person told us that they like the unit and the staff there. We saw care records that showed us the progress some people had made with support from staff. This included a person who had been able to move from having all food and fluids via a peg feed to being able to have most things by mouth. We spoke to a health professional involved in this persons care and they told us that staff at the unit had done a very good job in achieving this success. During the Care Homes for Older People Page 13 of 30 Evidence: inspection we saw staff helping the person and noted the time and patience that was taken. The care records are very detailed and those we looked at were up to date and gave a good picture of the care we observed during our visit. The records were well organised and easy to find things in. In the care home the records were not so well developed although they also contained a lot of information. However, these were not all so easy to refer to or find specific details in. We found some examples where there were gaps in information about the right care to give (for example, there was no guidance for staff about what to do when one person is reluctant to eat). During a meal we saw this person tell staff that they did not want to eat the meal they were given and observed that staff seemed unsure of how to respond when the person began to get cross about it. We noted that staff approached the person suddenly and felt that this may have been part of the problem. In other records we saw that information about things like the help people needed with moving or to reduce the risk of falls was recorded and information about wound care was detailed. In one example we saw that the records of dressings being changed did not match the frequency decribed in the care plan but the notes showed that the wound had steadily improved and had now completely healed. This shows that the outcome for the person was good but, if the wound had not improved, the discrepancy in the records could have been viewed as a contributory factor. We also saw in some records that staff described peoples behaviour in a negative way but this was not reflected in how we saw staff speak to them. We felt that this indicated a training need in respect of person centred care planning and recording rather than a problem about staff attitudes. Other areas we highlighted for checking in the care records were details such as the correct settings for pressure relieving air mattresses and the range of information recorded in bed rail assessments. We also saw some good recording including detailed weight records which were supplemented with bar charts which gave a very good at a glance picture of whether people at nutritional risk were maintaining their weight. During our SOFI observation we saw examples of good dementia care practice by staff working there. During the two hours we found that the people who live in that unit were awake and interested in what was happening around them. Staff were very attentive and spent a lot of time in the room with people or walking around with those who became restless. They showed patience and skill in communicating with people and a genuine interest in their well being. Activities were introduced for individual people, for example one member of staff asked a person to help her make a cup of tea and another sat and talked about the contents of a memory box with a lady. Care Homes for Older People Page 14 of 30 Evidence: The manager is aware of the need to improve the written records in the care home and is being supported by the manager of another home in dealing with this. When we were at the home the other manager showed us the work she has started in improving the care records about nutrition for each person. They explained that they have decided to work on the high risk topics first (such as nutrition, moving and handling, bed rails and falls) so that they can assure themselves that each person is getting the right care in these crucial areas. Medication in the ABI unit and the care home is safely stored. We looked in detail at all aspects of medication in the ABI unit and found that records and arrangements for administration reflected good practice. The manager confirmed that the same standard of medication safety is adhered to in the care home. In both units staff showed that they understand the importance of respecting peoples privacy for example by knocking on doors before going into rooms and, in the ABI unit by checking with a person first if they wanted to meet us or not. Care Homes for Older People Page 15 of 30 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the ABI unit are supported to have full and active lives and regain as much independence as possible. Although there are things to do, people in the care home would benefit from this aspect of daily life being developed more. The meals at the home are nutritious but more could be done to make mealtimes enjoyable in the care home. Evidence: People who live in the ABI unit have full programmes of activity aimed at helping them develop their daily living skills and physical health as well as having enjoyable things to do. Support from occupational therapists, physiotherapists and speech therapists is obtained to meet the individual needs of people. Staff go out with people individually and in groups, for example on the day we inspected people went to town shopping or for coffee and in the afternoon went to a hydrotherapy session. This was well organised and co-ordinated around mealtimes, rest times and peoples individual activities. In a survey one person wrote - I am asked each day what I would like to do and Things I do are there for my enjoyment. People we met during the inspection told us they enjoy the things they do. At lunchtime we saw that people had individual support according to the level of help they needed and that where people Care Homes for Older People Page 16 of 30 Evidence: needed to be fed this was done in an unhurried and companionable way. In the care home we saw varied levels of activity. The day we were there the activity organiser was not at work. This meant we did not have chance to discuss with them what they do. However, in surveys, several people commented on staffing levels making it hard for staff to have time to arrange many activities. For example, one person wrote, I feel more activities are needed and more interaction but due to the shortage of staff who do their best it isnt possible The new manager showed us changes she has made in a shared communal room on the ground floor. This has mainly been used as a training and/or meeting room but she has begun to make one end of it into a comfortable area for people. She wants to make it a homely and familiar feeling area with decor and furnishings more like someones front room. She has already equipped it with a piano and a radio in a traditional older style. Alongside this she has plans to make the kitchenette next to this room available for visitors and to develop the whole room as a coffee shop environment. She hopes that this will give people an alternative place to see their visitors where families and friends can make themselves a drink and relax. During our SOFI observation one person had a member of their family with them for part of the time and another visitor also arrived. We saw that they were made welcome by staff and that they knew everyone. The atmosphere was very friendly and relaxed. We spoke to one of the relatives who told us they are always made to feel at home. We were in one of the care home units at lunchtime. People in this unit had lots of physical care needs and it was positive that they were up and dressed and not isolated in their rooms. We saw that people remained in their armchairs for their meal and ate from a small table placed in front of them or were fed by staff. It was positive to see that people were having one to one help where this was needed but some aspects of the meal could have been improved. For example, we have already described the uncertainty about the help staff should give one person when she didnt wish to eat. Another concern was that one of the staff had to stop feeding a person twice because her phone rang in her pocket. We also felt that although some did, all staff needed to be speaking to people more about what the meal was to help them gain more enjoyment from it. However, we were pleased to see that staff took their time and no one was rushed through eating their meal. In the surveys, some people commented that the food varied in quality. This was also raised by a relative in a complaint to the home. During the inspection, the meal we saw was well presented and nutritious and people able to do so said they enjoyed what they had had. Care Homes for Older People Page 17 of 30 Care Homes for Older People Page 18 of 30 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. People can be confident that staff will take notice if they have concerns and do what they can to put things right. Staff know what to do to protect people from the risk of abuse or neglect. Evidence: In the last year the care home had received complaints from a small number of relatives and we were shown correspondence about these matters. While the correspondence covered all the concerns raised we considered that the tone could have been more conciliatory. The new manager had identified that in some past situations more could have been done to deal with peoples concerns quickly and that records did not give enough information about the action taken. Since starting work at the home she had made contact with one family with the aim of assuring them that their concerns will be dealt robustly in future. The new manager is very experienced in dealing with safeguarding matters having had a lead role both operationally and as a trainer in her previous employment. She had identified a need for incidents relating to safeguarding to be dealt with in a more organised way and for records to be more detailed. Staff working at the home receive regular training so that they know what they should do if they are concerned that a person may have been neglected or abused. The appointment of a manager with expertise in this aspect of care is a positive Care Homes for Older People Page 19 of 30 Evidence: development which should ensure this aspect of care is dealt with robustly. Care Homes for Older People Page 20 of 30 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the ABI unit have the benefit of surroundings adapted for their specific needs which reflect their individual taste. In the care home, more needs to be done to make the environment welcoming and comfortable. The building is safe and basic maintenance is well organised. Evidence: The accommodation in the ABI unit is light and airy and peoples rooms have been decorated according to their individual taste. The rooms are spacious and have a small sitting and kitchenette area as well as a bedroom with ensuite facilities. Some of the bedrooms we saw in the care home have not been personalised to the same extent. We felt that more needed to be done to support people who live there and their families to make their personal rooms more homely. The communal rooms in the care home also need refurbishment to make them more homely and comfortable. For example, one of the sitting rooms was very bare apart from the chairs and a TV. The maintenance records showed that there is an organised programme of tests and checks to make sure that the environment is safe; for example a full check of the electrical systems had been carried out in 2009. Care Homes for Older People Page 21 of 30 Evidence: The new manager has started to think about ways to improve the care home environment including the reminiscence room and coffee shop we mentioned in the daily life section. Care Homes for Older People Page 22 of 30 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the ABI unit and the care home can be confident that staff who care for them have had the required employment checks before they start work. Staff training is arranged in an organised way to make sure staff can develop their knowledge and skills. Staff are caring and some have excellent skills in supporting people with impaired memory and communication. Staffing levels need stability to ensure people living in the care home always have enough staff to support them. Evidence: Shaw healthcare has well established recruitment procedures to make sure that new staff are properly checked before they begin work. We looked at the recruitment files for three staff and found that all the required checks on their suitability had been done before they started. There is a rolling programme of staff training and a colour coded matrix is used to help manage this. We were given an up to date copy which showed that mandatory training for 70 of staff was up to date. A range of care related training is also shown on the matrix showing that staff have opportunities to develop their knowledge and skills. The manager told us that there has been some slippage in training in the last year due to the change in managers and to high levels of staff sickness. One of her aims for the coming year is to stabilise this situation partly by working to reduce staff absence Care Homes for Older People Page 23 of 30 Evidence: levels. Staffing levels in the ABI unit and the care home appeared to enable staff to spend time with people. However, we know from complaints made to the home and to us that there have been periods in the last year when staffing levels have caused concerns to some relatives. The manager told us that she has begun to address this. She told us she has made a request for increased staffing due to the results of a falls audit which identified a need for additional staff in the care home. In addition, she is addressing the levels of staff sickness by implementing improved monitoring and counselling arrangements. The staff we met during the inspection of the ABI unit and the care home came across as welcoming and interested in their work. In the ABI unit and during our SOFI observation we witnessed some very good practice in terms of the level of skill and warmth in the way staff dealt with people. We did note that some staff working in the care home do not have such well developed skills; for example we saw some staff approach and speak to some residents not unkindly but too quickly and without taking enough care to explain what they were doing. Care Homes for Older People Page 24 of 30 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 can be confident that both the ABI unit and the care home are managed in the best interests of the people who are staying at The Hawthorns. Arrangements for health and safety are well organised. Evidence: We were assisted during the inspection by three senior staff - a team leader and the clinical lead in the ABI unit and by the new manager for the whole service. We found them to be knowledgeable about the people using the service, best practice in their fields of care and eager to develop and improve the services provided in both the ABI unit and the care home. We were shown the results of an in-house survey of people who live in the home and their relatives. These showed high levels of satisfaction with results in categories for care, staffing and environment mainly in the very good or good range with a small number of average responses. Care Homes for Older People Page 25 of 30 Evidence: We looked at the reports written by the area manager in respect of the monthly visits to check standards at the home and saw that these cover a wide range of issues. We also saw the maintenance and fire safety records which were well organised and provided evidence that the building is safe and well maintained. The service received a 5 star excellent food safety rating in 2009 from the local authority. Although the new manager had only been working at the service for three weeks she had identified areas for development and improvement and had written an action plan to help her manage these changes in an organised way. She was prioritising important areas that affect peoples health, safety and welfare so, for example she had started a structured audit of incidents and accidents and was looking at ways of reducing staff absence. The manager told us that she hoped to be able to strengthen the overall management of the service by appointing a deputy manager and was in discussion with Shaw healthcare about this. Care Homes for Older People Page 26 of 30 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 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 3 Consideration should be given to how information about a persons life history is gathered so that staff and relatives can together build a picture of the person to help staff understand them and provide good care. Care records for people living in the dementia care service need to be improved and developed to make them more person centred. Whilst working on the improvements to the care records you should check that accurate and up to date information is available in respect of specific aspects of peoples care so that clear information is available to staff. People living in the dementia unit would benefit from a more person centred approach to daily life and activities. Consideration needs to be given to making mealtimes in the dementia service more tailored to the individual needs of people. This should include staff not answering phone calls while assisting people to eat. More work needs to be done in the care home to make the bedrooms and communal areas more welcoming and homely. 2 7 3 7 4 5 12 15 6 19 Care Homes for Older People Page 28 of 30 7 27 Work to stabilise staffing levels needs to be consolidated to ensure that there are consistently sufficient staff on duty to meet peoples needs. Staff training should include input which helps staff develop their skills in communicating with people with memory and communication problems linked to their dementia illness. 8 30 Care Homes for Older People Page 29 of 30 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) 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. Care Homes for Older People Page 30 of 30 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!

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