Care Home: Hayes Court

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What the care home does well Comments from residents were generally positive, with indication that staff are kind and helpful in meeting their care needs. Residents were observed to be treated with respect by staff and to have their privacy and dignity respected. Residents are actively encouraged to keep in contact with family and friends living in the community. Visitors are welcome at any time and facilities are available for them. The home has a medication policy which is accessible to staff, medication records are generally up to date for each resident and medicines received, administered and disposed of are recorded. The home has a settled staff group and has the numbers and skill mix of staff sufficient to meet residents` needs. What has improved since the last inspection? The standard with regards to medication has improved. All staff who are working within the home have received training in Safeguarding adults. There has also been progress made in relation to staff supervision. A new passenger lift has been installed. What the care home could do better: Staff files must contain all relevant documentation as per schedule 2 of the revised Care Homes Regulations 2001 for the delivery of good quality services and for the protection of residents. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Hayes Court Hayes Court Nursing Home 50 Hayes Lane Kenley Surrey CR8 5LA     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: Mohammad Peerbux     Date: 0 1 0 4 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 24 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 24 Information about the care home Name of care home: Address: Hayes Court 50 Hayes Lane Hayes Court Nursing Home Kenley Surrey CR8 5LA 02086603432 02086684522 sturgesshayes@aol.com www.hayescourt.com Dr Michael John Sturgess care home 56 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 56 old age, not falling within any other category Additional conditions: 0 A variation has been granted to allow one named service user (male) under the age of 65 to be accommodated for respite care. The CSCI must be advised when the service user no longer resides at the home. One (1) place for a service user under the age of 65, requiring general nursing care, can be accommodated. Date of last inspection Brief description of the care home Hayes Court is a 56-bedded care home. It provides both nursing and residential care. The home is set in its own quite substantial grounds about a mile from Kenley railway station. Access for wheelchair users is available. There are three floors with access by stairs or two passenger lifts. The home provides the possibility a double room on each floor, though only one can be occupied doubly at any one time to keep within the registered number. The remaining bedrooms are all single occupancy; all bedrooms have en-suite facilities. The majority of rooms are located on the ground floor, with a small number in the original main building on first and second floors. There are a number of communal areas located throughout the home, and a conservatory for the Care Homes for Older People Page 4 of 24 Brief description of the care home use of residents. Parts of the garden are also accessible to them. Visitors may be seen in private in residents rooms, or in one of the small lounges. The range of weekly fees is between £480 and £750. Care Homes for Older People Page 5 of 24 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 peterchart Environment Staffing Management and administration Poor Adequate Good Excellent How we did our inspection: This unannounced visit to the home was undertaken as a part of the inspection process for the year 2009/2010. In writing the report, consideration has also been given to information received throughout the year such as comments from people who use the service, reports of incidents and complaints. The acting manager facilitated this inspection. Some of the residents were spoken to and they commented positively on the care they are receiving. One resident stated I am happy here and the staff are good.They are all thanked for their time and all of those who provided feedback for their support in the inspection process. A tour of the building was also carried out. All registered adult services are now required to fill in an annual quality assurance assessment (AQAA).It is a self-assessment that the provider (owner) must complete Care Homes for Older People Page 6 of 24 every year. The completed assessment is used to show how well the service is delivering good outcomes for the people using it. Some information from this AQAA is included in the report. 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.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 8 of 24 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 24 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. People who may use the service and their representatives have the information needed to choose a home that will meet their needs.The home undertakes an assessment of the healthcare needs of residents prior to their admission to ensure that all their needs would be met. Evidence: The home provides a statement of purpose that is specific to the individual home and the resident group they care for. It clearly sets out the objectives and philosophy of the service.The document was recently updated as the home is now providing intermediate care for rehabilitation and return to the community. Admissions to the home only take place if the service is confident staff have the skills, ability and qualifications to meet the assessed needs of the prospective resident. Information is gathered from a range of sources including other relevant Care Homes for Older People Page 10 of 24 Evidence: professionals.The assessment focuses on achieving positive outcomes for people using the service. People assessed and referred solely for intermediate care are helped to maximise their independence and return home.Rehabilitation facilities are sited in dedicated space and include equipment for therapies and treatment. Care Homes for Older People Page 11 of 24 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. Generally, residents care plans include detailed information about their needs and personal goals. This helps staff to know the residents needs and how to meet them.Overall the arrangement for health care needs of the residents is good and they receive personal support in the way they prefer. Evidence: Four residents care plans were sampled at random and it was noted they generally included information necessary to deliver the residents care needs. The care plan is a working document reviewed regularly.Reviews focus on asking what has worked for the individual, where there are progress, achievements, concerns and identifies action points. It was positively noted that the home actively promotes the residents right of access to the health and remedial services that they need, both within the home and in the community. Care Homes for Older People Page 12 of 24 Evidence: The home has a medication policy which is accessible to staff, medication records are up to date for each resident and medicines received, administered and disposed of are recorded. The home works creatively and actively with other services and organisations to ensure that the persons whole life needs are met, and goals addressed. The service recognises its own limitations and when to seek support from others to meet the individual needs of people.Observation of the staff team interacting with the residents showed that the carers were mindful how they addressed residents, and they were seen to be polite and friendly.Residents who were spoken to stated that they are happy with the way that the staff deliver their care. Care Homes for Older People Page 13 of 24 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. The home tries to be flexible and attempts to provide a service, which is as individual as possible. Dietary needs are well catered for and a well balanced diet is provided, to ensure health and enjoyment of food. Evidence: Generally staff are aware of the need to support residents to develop their skills, including social, emotional, communication, and independent living skills. People using the service are given the opportunity to take part in a variety of activities both within the home and in the community. People who use the service have the opportunity to develop and maintain important personal and family relationships.The home has open visiting arrangements and residents know they can entertain their family and friends in their own room. If they prefer they can use communal areas of the home to talk to visitors. The home tries to be flexible and attempts to provide a service that is as individual as possible, using its staff and resources effectively. The service actively supports people to be independent and involved in all areas of daily living in the home. Care Homes for Older People Page 14 of 24 Evidence: It was clear from the menus that a wide variety of different food options were available in the home with a lot of consideration given to the nutritional value of the meals provided. Staff are ready to offer assistance in eating where necessary, discreetly, sensitively and individually, while independent eating is encouraged for as long as possible. It is recommended that the menu is also made available in pictorial format to enable all residents to choose what they would like to eat. Care Homes for Older People Page 15 of 24 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 who use the service are able to express their concerns, and have access to an effective complaints procedure, and are protected from abuse, and have their rights protected. Evidence: The home has an open culture that allows residents to express their views and concerns in a safe and understanding environment.The service has a complaints procedure that is clearly written and easy to understand. Unless there are exceptional circumstances the service always responds within the agreed timescale. There are policies and procedures for safeguarding people who use the service. The acting manager stated that most of the staff working within the home are fully trained in Safeguarding Adults and know how to respond in the event of an alert.Staff working at the service know when incidents need external input and who to refer the incident to. Care Homes for Older People Page 16 of 24 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is generally hygienic and clean, homely and comfortable; this environment therefore facilitates the residents health and emotional well-being. Evidence: The home provides a physical environment that is appropriate to the specific needs of the people who live there. The well-maintained environment provides specialist aids and equipment to meet their needs. There is a selection of communal areas both inside and outside of the home, this means that people using the service have a choice of place to sit quietly, meet with family and friends or be actively engaged with other people who use the service. The home is kept clean and hygienic and free from offensive odours throughout. Systems are in place to control infection in accordance with relevant legislation and published professional guidance.The management has a proactive infection control policy and they work closely with their own staff and external specialists. Care Homes for Older People Page 17 of 24 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. The home has the numbers and skill mix of staff sufficient to meet residents needs however there has been shortfall in the recruitment procedure which could potentially place residents at risk. Evidence: People have confidence in the staff who care for them. Copies of staff rotas show well thought out and creative ways of making sure that the home is staffed efficiently, with particular attention given to busy times of the day and changing needs of the residents. The acting manager informed us that more than 50 of staff have an NVQ level 2 qualification. The service has a recruitment procedure that meets statutory requirements.However it was noted that not all relevant documents were on two staff personnel files.Staff files must contain all relevant documentation as per schedule 2 of the revised Care Homes Regulations 2001 for the delivery of good quality services and for the protection of residents. The service recognises the importance of training, and tries to delivers a programme Care Homes for Older People Page 18 of 24 Evidence: that meets any statutory requirements. All staff receive relevant training that is focussed on delivering improved outcomes for residents. Care Homes for Older People Page 19 of 24 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. The home generally provides guidance and direction to staff to ensure residents receive consistent quality care. There is a quality monitoring system and this ensures the home is run in a way that is in the best interests of the residents. Evidence: Since the last inspection the previous acting manager is no longer in post .The provider is presently considering appointing a lead nurse and have a non-nurse as the manager.The provider is reminded that they must follow the framework for appointment of a non-nurse as registered manager within care homes providing nursing care and the guidance in on our website.The named clinical lead must have clear lines of accountability for decision-making and clinical governance. They must also have a role as part of the management team of the home and in the provision of clinical leadership and advice to the registered manager.They must also have a role in the following:- Care Homes for Older People Page 20 of 24 Evidence: Individual assessment and reassessment of care needs. Management of Infection control. Management of Medication. Management of Moving and Handling. Tissue viability care and management. Nutritional and dietary management. Identifying the staffing requirements to meet residents needs. The registered manager must ensure that the clinical lead/lead nurse has a personal development plan, which identifies professional and leadership development needs. We will continue to monitor progress with regards to the management standard in the home. Effective quality assurance and quality monitoring systems, based on seeking the views of residents, are in place to measure success in meeting the aims, objectives and statement of purpose of the home. The AQAA was received on time and contains clear and relevant information. The AQAA lets us know about changes the home has made and where they still need to make improvements. It shows clearly how they are going to do this. The acting manager informed that the home does not look after residents money. Improvement has been made with regards to staff formal supervision sessions. Certificates relating to health and safety were up to date servicing certificates. These included gas safety, fire safety and lift maintenance. Care Homes for Older People Page 21 of 24 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 22 of 24 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 15 It is recommended that the menu is also made available in pictorial format to enable all residents to choose what they would like to eat. Care Homes for Older People Page 23 of 24 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. 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