Care Home: Hawthorns Residential Home

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What the care home does well People living in the home are happy with their care. Comments included," Fine bunch of staff could not be nicer, I am here for good and I am pleased", "Food is good and staff are good". Relatives spoken to said "Staff are caring and kind" another said "My mothers food likes and dislikes are being met by the staff". The home provides good detailed information about the homes services and facilities to anyone thinking of living there. This was confirmed by a recently admitted persons relative, who said "I had the opportunity to visit before the admission, staff provided me with good information before the decision to stay was made". No one is admitted to the home until the manager is sure they can meet their assessed needs. The home looks after the health care needs of the people living there and makes sure they get the treatment that they need. The systems for the storage, administration of medicines is carefully carried out. People living in the home are treated with respect by the staff at all times and their privacy and dignity are protected. The food in the home is very good the cook is aware of individual peoples food likes and dislikes and sees that these are met. Staff listen to people`s concerns and any complaints are taken seriously and acted upon. The building is safe and well maintained and is clean and hygienic. There is an experienced staff group all of whom are trained at NVQ level 2 and above. Staff receive regular supervision. Regular audits of peoples personal monies are now being carried out. What has improved since the last inspection? The home has a rolling programme of repairs, decoration and refurbishment which is on going and satisfactory. Accommodation has been provided for staff changing facilities in the top floor of the home. Office facilities are now provided. All of the requirements and recommendations from the last inspection report have been actioned satisfactorily. What the care home could do better: In house fire instructions for staff are not at present being carried out at the specified levels of frequency. Need to purchase a hard backed book for the logging of concerns/complaints. A lockable filing cabinet needs to be kept in the office for the safe storage of confidential files for staff and people living in the home. CARE HOMES FOR OLDER PEOPLE Hawthorns Residential Home High Street Loftus Saltburn-by-Sea TS13 4HW Lead Inspector Ian Armstrong Key Unannounced Inspection 13th January 2009 10:00 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 Hawthorns Residential Home DS0000064898.V373734.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. Hawthorns Residential Home DS0000064898.V373734.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hawthorns Residential Home Address High Street Loftus Saltburn-by-Sea TS13 4HW 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) 01287 641508 P/F 01287 641508 Mr Justin Ignatius Lawrence Russi manager post vacant Care Home 15 Category(ies) of Old age, not falling within any other category registration, with number (15) of places Hawthorns Residential Home DS0000064898.V373734.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th March 2008 Brief Description of the Service: The Hawthorns is a detached, two storey stone built house, set back from the road with a pleasant front garden with trees, lawns and borders containing shrubs and flowers. The home is situated close to community facilities. Accommodation for the 15 service users is provided in 11 single bedrooms and two double bedrooms. There are no en-suite facilities in this home. The home has two lounge/dining areas, which overlook the garden. A stair lift is available for those service users requiring assistance to access first floor facilities. The resident’s fees currently are £403.42p per week. Hawthorns Residential Home DS0000064898.V373734.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is two star – good service. This means that people using this service experience good quality outcomes. What the service does well: People living in the home are happy with their care. Comments included,” Fine bunch of staff could not be nicer, I am here for good and I am pleased”, “Food is good and staff are good”. Relatives spoken to said “Staff are caring and kind” another said “My mothers food likes and dislikes are being met by the staff”. The home provides good detailed information about the homes services and facilities to anyone thinking of living there. This was confirmed by a recently admitted persons relative, who said “I had the opportunity to visit before the admission, staff provided me with good information before the decision to stay was made”. No one is admitted to the home until the manager is sure they can meet their assessed needs. The home looks after the health care needs of the people living there and makes sure they get the treatment that they need. The systems for the storage, administration of medicines is carefully carried out. People living in the home are treated with respect by the staff at all times and their privacy and dignity are protected. The food in the home is very good the cook is aware of individual peoples food likes and dislikes and sees that these are met. Staff listen to people’s concerns and any complaints are taken seriously and acted upon. The building is safe and well maintained and is clean and hygienic. There is an experienced staff group all of whom are trained at NVQ level 2 and above. Staff receive regular supervision. Regular audits of peoples personal monies are now being carried out. Hawthorns Residential Home DS0000064898.V373734.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: 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. The summary of this inspection report can be made available in other formats on request. Hawthorns Residential Home DS0000064898.V373734.R01.S.doc Version 5.2 Page 7 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 Hawthorns Residential Home DS0000064898.V373734.R01.S.doc Version 5.2 Page 8 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 3. People living in the home experience good quality outcomes in this area. People thinking of coming into the home are given good information to make an informed choice. Each person living in the home has a written contract. People have had their individual needs fully assessed by the homes manager and are only accepted to stay if those needs can be met by the home. We have made this judgement using available evidence including a visit to this service. Hawthorns Residential Home DS0000064898.V373734.R01.S.doc Version 5.2 Page 9 EVIDENCE: The homes statement of purpose and the service users guide are detailed and cover the necessary areas of information, it includes the homes complaints policy. A relative spoken to said the The homes statement of purpose and the service users guide are detailed and cover the necessary areas of information, it includes the homes complaints policy. A relative spoken to said they were given all of these plus a copy of the homes brochure prior to making a decision whether to stay. Another relative said they had visited the home prior to the admission and the home had given them good information documents about the homes services and facilities. Records seen showed the home received good information from referring agencies before accepting new clients. The manager of the home carries out her own assessment of individuals referred, to make sure the home can meet their needs. Three peoples files were randomly sampled and showed that these assessments had been done to a good standard. Hawthorns Residential Home DS0000064898.V373734.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. People living in the home experience good quality outcomes in this area. Detailed care plans had been written to meet the health, personal and social care needs of each person. Peoples health needs are properly assessed and are met by the use of a range of health care services. People living in the home are protected by the homes policies and procedures for the safe management of their medicines. People are treated with respect by the homes care staff at all times, and have their privacy and dignity upheld. This judgement has been made using available evidence including a visit to this service. Hawthorns Residential Home DS0000064898.V373734.R01.S.doc Version 5.2 Page 11 EVIDENCE: Three peoples care records were read these had detailed care plans written for health, personal and social care needs. On going record sheets were linked to the care plans and monthly evaluations of care needs were being carried out to a satisfactory standard. Reviews of care needs are being done every six months with evidence of relatives in attendance. The on going record sheets and visiting professionals records show evidence of visits by doctors, nurses and other health care professionals and records show that staff know the procedures to follow if a person needs input for a health related matter. A relative spoken to said “ I am involved when care needs are reviewed” and attend meetings for these. The homes medication administration charts were seen and no errors, gaps or emissions were found and these records are generally being well maintained. Medicines are stored in a drugs trolley which is secured to the wall when not in use. Records showed that all care staff have received accredited medications training. Four of the people living in the home were spoken to all of these said that staff were kind and caring and treated them with respect. Staff were observed during the course of the inspection in their dealings with people to have a good rapport and to treat them with dignity. One person who returned from a hospital appointment accompanied by a member of staff said how helpful the staff member had been to them whilst away from the home. Three relatives spoken to said that staff treat people well at all times and that they are courteous and helpful. Hawthorns Residential Home DS0000064898.V373734.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. People using this service experience good quality outcomes. People living in the home have a clearly planned weekly programme of social activities. Good support is received from relatives, families and friends and visitors are made welcome by the staff. People are helped to make choices and have control over their lives. People get a varied nutritious diet and individuals likes and dislikes are provided for and met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A weekly programme of activities is now written and displayed on the homes notice board, daily events include chairobics, memory lane, singalongs, nail care, dominoes, jigsaws, cake making and a variety of board games. Individual social care plans are written and include individual food likes and dislikes, evidence of the homes cook meeting some of these was observed and records Hawthorns Residential Home DS0000064898.V373734.R01.S.doc Version 5.2 Page 13 of these preferences are kept in the kitchen. A relative spoken to said “My mother likes her bacon sandwiches and the staff make sure she gets these”. The lunchtime meal was observed dining tables were set with table cloths, serviettes and condiments, the food offered was roast beef, mashed potato, carrots and Brussels sprouts with gravy an alternative meal was ham or cheese salad. Sweet was strawberry cheesecake or fresh fruit or ice cream. Drinks of fruit juice or a cup of tea were provided with the meal. Three staff were in attendance throughout the mealtime and assisted people who needed help when necessary. The meal was observed to be unhurried and people had time to enjoy their food. Two people spoken to said the food provided by the home is good. After the meal a person was heard to ask if they could lie down for an afternoon nap and staff assisted them to their room so that they could. Some of the people spoken to said they had been out on trips to the coast earlier in the year which they had enjoyed. Pets as Therapy had brought dogs to the home which people said they had enjoyed these visits. I visiting library service visits the home on a regular basis to exchange large print books. A local artist has been to the home and provided art classes. A number of clothes parties have been organised and people said they enjoyed these events. Earlier in the year a summer fayre had taken place in the homes garden which staff and people living their said had been a big success in raising funds. During the afternoon of the visit a hairdresser arrived to cut and set a number of peoples hair. A person spoken to said “Staff are very kind I can do what I want” Another person who was visiting said “I can come at any time and staff always make me feel welcome”. Anglican and catholic priests visit the home weekly and give communion to those who wish to do so. Hawthorns Residential Home DS0000064898.V373734.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. People using the service experience good quality outcomes in this area. People are confident that any concern or complaint they might have will be taken seriously and properly investigated. People are protected from abuse by the homes policies and procedures and the appropriate training of staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has an appropriate complaints policy and welcomes comments suggestions and complaints. Copies of the complaints policy is displayed in all peoples bedrooms. The policy gives the name of the local abuse co-ordinator and contact if the person wishes to contact them first without going through the home this is good practise. A recent complaint was discussed with the homes manager which had been handled sensitively and well. Discussions with staff members showed that they were aware of the procedures to follow and what to do if action was required. Hawthorns Residential Home DS0000064898.V373734.R01.S.doc Version 5.2 Page 15 Two relatives spoken to said they felt confident in approaching the manager and felt any concerns they might have would be addressed. People living in the home said they felt safe and were confident staff would look after them if they had any concerns. One person said “I know the manager will always look after me”. Training of staff in the protection of vulnerable adults, staff training files showed that “No Secrets” training had been carried out. Staff when questioned were aware of the procedures to follow. Hawthorns Residential Home DS0000064898.V373734.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, and 26. People using this service experience good quality outcomes in this area. The home provides people with a safe and very homely environment, including comfortable indoor communal facilities. People have safe and homely comfortable bedrooms. The home is clean and hygienic. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A good rolling programme of redecoration is now in place since the last inspection and the home is well maintained and decorated. A number of peoples bedrooms were seen all of these highly individual with lots of personal effects and possessions and were very comfortable and homely. New wardrobes and chairs have been purchased since the last Hawthorns Residential Home DS0000064898.V373734.R01.S.doc Version 5.2 Page 17 inspection. One person showed me their bedroom which had an en-suite facility he said “I am more than comfortable here and I am stopping”. New carpets have been fitted been fitted to the ground floor of the home in the last year and are wearing well. Since the last inspection the decision to provide office facilities in the adjacent home is satisfactory and staff changing facilities are now being provided. A number of bathrooms and toilets were seen these were homely and clean. The two lounge/dining areas are well furnished and decorated with views over the front lawn and garden. Three people sitting in these rooms said they were comfortable living in the home. The homes kitchen was visited and was clean and tidy, stocks of food were satisfactory, cleaning records were checked and were being followed correctly. The laundry service for the home is provided next door in the adjacent home this was seen, facilities are satisfactory and machines were in working order. COSHH information was displayed here. Hawthorns Residential Home DS0000064898.V373734.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. People using this service experience good quality outcomes in this area. There are adequate numbers of staff to meet the people living in the home needs. People are in safe hands as staff have relevant qualifications to meet their care needs. Recruitment of staff is well carried out and people are protected by the checks carried out. Staff are well trained and competent to do their jobs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The homes staff duty rotas were seen these showed the following levels of staff in the home each day; Am, 1 Seniors and 1 Carer, Pm, 1 Senior Carer and 1 Carer, Nights, 1 Carer awake and 1 Carer asleep but on call. The manager of the home is authorised to increase staffing levels if needed. Staffing levels are being maintained to the levels stated according to the rosters seen. Hawthorns Residential Home DS0000064898.V373734.R01.S.doc Version 5.2 Page 19 A relative spoken to said “There are adequate numbers of staff always available”. The home is fully established for all grades of staff and there are no vacancies. Two staff files were checked both of these showed that two written references had been obtained, and that all appropriate checks had been completed. Both staff members had received good induction training programmes. NVQ training, all staff employed in the home have NVQ level 2 an d above this is to be applauded an d is good practise. Two members of staff were spoken to both said they had received good levels of training both client centred and mandatory. They also confirmed that they had good regular supervisions and annual appraisals. Training records confirmed this to be so. Hawthorns Residential Home DS0000064898.V373734.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. People using this service experience good quality outcomes in this area. The homes manager is qualified and experienced to run the home. The Hawthorns is run in the best interests of the people living there. Peoples financial interests are safeguarded. Staff are appropriately supervised. The manager generally ensures the health, safety and welfare of people and staff. This judgement has been made using available evidence including a visit to this service. Hawthorns Residential Home DS0000064898.V373734.R01.S.doc Version 5.2 Page 21 EVIDENCE: The homes manager Mrs Judith Weed all has the necessary qualifications and experience to carry out her role, she has been the registered manager of other care homes. She is currently awaiting a fit person interview to be carried out by the Commission for Social Care Inspection. The manager carries out monthly quality audits of management issues for complaints, accidents, medicines, health and safety, risk assessments, staff sickness and training. Records for these were all satisfactory with one exception in-house fire instruction for staff is not being completed at specified levels. It was also identified that the home should purchase a hard backed book for the logging of complaints/concerns. People living in the home, minutes of meetings for these were read and were found to be satisfactory and examples of staff responding to peoples issues were recorded. Staff meeting minutes were also read and were being held on a regular basis and agendas were appropriate for the client group. Peoples personal monies records were checked three persons individual accounts were looked at, there was evidence of regular transactions and expenditures with receipts kept and money balances were correct. The manager audits these every month. Two members of staff were spoken to both said “The manager is always available for support, we get regular supervision and annual appraisals”. Supervision records were checked and are satisfactory and are carried out at specified frequencies. Some records at present in the home are not kept secure, a lockable filing cabinet needs to be purchased and stored in the office for the safe keeping of peoples and staff files. Hawthorns Residential Home DS0000064898.V373734.R01.S.doc Version 5.2 Page 22 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 3 3 3 x x X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 x X X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X 2 2 Hawthorns Residential Home DS0000064898.V373734.R01.S.doc Version 5.2 Page 23 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 OP38 Regulation 23(4) Requirement All staff employed in the home must have in-house fire instruction at the frequency specified by the Fire Brigade each year. Timescale for action 14/01/09 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP37 Good Practice Recommendations A locked filing cabinet should be purchased for the safe storage of peoples and staff files and kept in the office. A hard backed book should be purchased for the logging of all complaints/concerns. 2. OP16 Hawthorns Residential Home DS0000064898.V373734.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection North Eastern Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries.northeastern@cqc.org.uk Web: www.cqc.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 Hawthorns Residential Home DS0000064898.V373734.R01.S.doc Version 5.2 Page 25 - 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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