Care Home: Hazel Garth

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What the care home does well Staff at the home make sure that before people are admitted to the home they have been properly assessed, to make sure that the home will be able to meet their individual needs. They then develop care plans, bearing in mind individual`s personal preferences, needs, abilities and previous lifestyles to inform staff how to support those in their care. Staff develop good relationships with people`s relatives and friends and involve them in the care of the people who are living at the home.Good procedures are followed to make sure that people living at the home are safe and that their views and the views of their relatives and friends are taken into account in the ongoing development of the home. The home provides a nice homely environment where people have the space to walk around, spend time with others or have some more quiet time. What has improved since the last inspection? Standards of care planning and systems for making sure that people are safe have both been developed and improved. Training and assessments for moving and handling people safely have taken place and practice has improved in this area. What the care home could do better: Having better access to activities could enhance the lives of people living at the home. The provision of a dedicated activities organiser would assist this. CARE HOMES FOR OLDER PEOPLE Hazel Garth Hazel Road Warwick Estate Knottingley WF11 0LG Lead Inspector GILLIAN WALSH Key Unannounced Inspection 9th January 2008 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 Hazel Garth DS0000034421.V357549.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. Hazel Garth DS0000034421.V357549.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hazel Garth Address Hazel Road Warwick Estate Knottingley WF11 0LG 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) 01977 722405 01977 722408 jlinwood@wakefield.gov.uk www.wakefield.gov.uk Wakefield MDC Miss Janet Linwood Care Home 24 Category(ies) of Dementia - over 65 years of age (24) registration, with number of places Hazel Garth DS0000034421.V357549.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Can provide accommodation and care for four named service users in OP category. 29th August 2007 Date of last inspection Brief Description of the Service: Hazel Garth is a care home registered to provide care for 24 older people who are living with dementia. It is owned by Wakefield MDC (Metropolitan District Council) a Local Authority offering a wide range of services to vulnerable people. The home is situated on a residential estate on the outskirts of Knottingley, a small town adjacent to the A1 & M62 motorways and local buses stop very near the entrance to the home. The home was purpose built and was extensively refurbished in 2000 with a further programme of refurbishment taking place as part of the change of registration to dementia care in 2005/6. It is a two-storey building with both personal and communal accommodation based on four potentially selfcontained wings. All the bedrooms are single and there is a passenger lift. There are large gardens to the side and rear of the premises. The manager said in January 2008 that the current charges for living at the home are £86.52 - £494. 54 per week. Extra charges are made for hairdressing, newspapers/periodicals and private chiropody. Information about the home is available within the Statement of Purpose and the Service User Guide. Information about the Commission for Social Care Inspection is included in the Service User Guide. Hazel Garth DS0000034421.V357549.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 2 star. This means the people who use this service experience good quality outcomes. This was an unannounced visit to the home by one inspector from the Commission for Social Care Inspection, which took place from 10.15am to 2pm on 9 January 2008 and was made as part of a full inspection of the service. During the visit time was spent speaking with people who live at the home, the home manager, staff and a visitor to the home. Time was also spent looking around the home and looking at documentation. As part of this inspection the Commission sent a number of surveys to the home for people who live at, or are involved in the home to get their views of the service. Comments received at the time of writing this report were very positive showing that people are very satisfied with the care people receive at the home. On this occasion surveys were not sent to health care professionals involved with people at the home but feedback received prior to the last inspection was very complimentary of the healthcare provided to people living at the home. In writing this report, information and evidence was not only obtained by way of visiting the home but also from notifications and information sent to CSCI and from previous CSCI inspection reports. The inspector would like to thank the people living at the home, their relatives and staff for their time and assistance during this inspection. What the service does well: Staff at the home make sure that before people are admitted to the home they have been properly assessed, to make sure that the home will be able to meet their individual needs. They then develop care plans, bearing in mind individual’s personal preferences, needs, abilities and previous lifestyles to inform staff how to support those in their care. Staff develop good relationships with people’s relatives and friends and involve them in the care of the people who are living at the home. Hazel Garth DS0000034421.V357549.R01.S.doc Version 5.2 Page 6 Good procedures are followed to make sure that people living at the home are safe and that their views and the views of their relatives and friends are taken into account in the ongoing development of the home. The home provides a nice homely environment where people have the space to walk around, spend time with others or have some more quiet time. 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. Hazel Garth DS0000034421.V357549.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 Hazel Garth DS0000034421.V357549.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): 3and 6. People who use the service experience Good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People do not move into the home without first having their needs assessed and being given confirmation that the home is suitable for meeting their needs. EVIDENCE: In information supplied to the Commission prior to the visit, the manager said that senior staff visit people in their own homes whenever possible or they invite the person to visit the home several times before admission. This is to assess the persons suitability for the home by looking at their needs and the homes present group. During these visits a life diary is started and assessments are made which form the basis for an initial care plan. Prior to the last inspection one person who lives at the home said that they “went for a visit and lunch before moving” Completed pre admission assessment forms and life diaries were seen during the visit. The Home provides respite care but does not provide intermediate care. Hazel Garth DS0000034421.V357549.R01.S.doc Version 5.2 Page 9 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 who use the service experience Good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People are supported to make sure that all of their health and personal care needs are met in a way, which respects their dignity. EVIDENCE: The manager told the Commission that when a person is admitted, a care plan is commenced using information obtained from the life diaries (completed by families) assessments and discussions with the person and their carers. Four care plan files were looked at during the visit. Whilst all of the care plans contained sufficient detail, two of the care plans seen gave excellent information about the abilities, needs, preferences and behaviours of the person concerned and would give staff all the information they would need to support these people. This is particularly important for people living with dementia as their ability to communicate their needs and preferences can be severely affected. Care plan files also included nutritional and skin integrity assessments and newly developed informative moving and handling assessments. Observations during the visit were that staff are working to the instructions contained in the moving and handling assessments. Hazel Garth DS0000034421.V357549.R01.S.doc Version 5.2 Page 10 The manager said that all people are registered with a local G.P and are given a choice of surgeries in the area and district nursing services are used as required. Local dentists and opticians are also used on a regular basis. A relative of a person living at the home, seen during the visit, said that staff keep them well informed of their relatives health and wellbeing and let them know immediately of any accidents or illness. Observations made during the visit were of a relaxed atmosphere in the home with staff being respectful and caring and that people who live at the home having trust in and fondness for the staff. Systems for the management and administration of medication at the home were checked with no errors or problems found. The manager had informed the Commission prior to the visit that all senior staff have undertaken training to be able to administer medications. Hazel Garth DS0000034421.V357549.R01.S.doc Version 5.2 Page 11 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 who use the service experience Good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People are supported to enjoy good lifestyles but having a member of staff dedicated to providing activities would enhance this. EVIDENCE: The manager said that dedicated activities staff are not employed at the home but that care staff, time allowing, try to engage people in activities each morning. In addition to this, activities staff employed by the local authority visit the home approximately four times a month. It was discussed with the manager that as the home is particularly for people who are living with dementia and therefore would not necessarily have the ability to meet their own needs in relation to their recreational needs, it would be advantageous to employ a dedicated activities organiser. One person who is able to manage their own recreational needs said how much they enjoyed watching the various shopping channels on the television since the home has introduced digi-boxes to access additional channels. The manager said that religious services are held at the home every two weeks and every effort is made to meet the differing religious needs of people living at the home. Hazel Garth DS0000034421.V357549.R01.S.doc Version 5.2 Page 12 It was positive to see that people’s social, spiritual and recreational needs and preferences are now being recorded in their care plans. Observations made during the visit were that staff welcome visitors to the home and have a good relationship with them. Within the information provided to the Commission prior to the visit, the manager said that people living at the home have access to The Independent mental capacity Advocate Service (IMCA) to ensure their rights and choices are promoted. The lunchtime meal during the visit was observed. The meal looked appetising and nutritious and condiments were available on tables. People were offered choices of both food and drinks and were given appropriate and discreet assistance as required. Hazel Garth DS0000034421.V357549.R01.S.doc Version 5.2 Page 13 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 who use the service experience Good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People are protected by the systems in the home for dealing with complaints and protection of people. EVIDENCE: The manager said that there have not been any complaints made to the home since the last inspection and the Commission has not received any complaints about this service. The home has a clear and comprehensive complaints policy, which is available within the Service User Guide, available in each person’s room and on notice boards in the home. A relative said that they can go to staff to discuss any issues as they arise and they take immediate actions to sort them out. Since the last inspection the manager has done some work with the local authorities safeguarding team who have also been to the home to deliver some training. Staff now have clear guidelines about what should be referred under multi-agency safeguarding procedures and how to do this. A number of referrals have been made under these procedures, all regarding minor altercations between people who live at the home and all of which have been dealt with appropriately with referrals to the mental health liaison team and risk assessments. Hazel Garth DS0000034421.V357549.R01.S.doc Version 5.2 Page 14 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 and 26. People who use the service experience Good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People live in a well maintained, clean and comfortable home. EVIDENCE: The home is spacious with large communal lounge and dining areas but also smaller very homely dining rooms with through lounges are available. One person spoken with chooses to spend their days in one of the smaller lounges where smoking is allowed and is very happy with this facility. The home was clean and tidy throughout and obviously well maintained. A sensory garden had been developed which people who live at the home will be able to access safely when the better weather comes. The manager said that they are planning to involve people in planting the new garden and growing vegetables. Hazel Garth DS0000034421.V357549.R01.S.doc Version 5.2 Page 15 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 who use the service experience Good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People are supported by a well trained and caring team of staff who are available in sufficient number. EVIDENCE: The manager said that she was happy with the current staffing situation but agreed that the provision of a dedicated activities organiser would improve outcomes for people who live at the home. The manager informed the Commission that all but one of the current care staff have achieved NVQ (National Vocational Qualification) level two in care and a number of staff have commenced the level three award. Staff training is ongoing and a matrix is available at the home. Mandatory training such as moving and handling is all up to date and in addition staff have continued in their studies in subjects relating to caring for people with dementia. Recruitment and personnel records are kept electronically and a number were seen during the visit. Recruitment procedures appear to be safe, with appropriate checks being taken for people working at the home. Hazel Garth DS0000034421.V357549.R01.S.doc Version 5.2 Page 16 A visitor and a person who lives at the home said that staff were kind and helpful. Observations during the visit were that staff were patient and empathetic whilst supporting people. Hazel Garth DS0000034421.V357549.R01.S.doc Version 5.2 Page 17 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 who use the service experience Good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The home is well managed and run in the interests of the people who live there. EVIDENCE: The registered manager of the home is a registered nurse with many years’ experience of managing a care home and has completed the registered managers award. Records show that she undertakes regular training and, along with other staff, has completed further training in caring for people living with dementia. The manager said that they are continuing in quality monitoring by asking people who live at the home and their friends and relatives for their opinions about the service and for any suggestions they may have for improvement. Hazel Garth DS0000034421.V357549.R01.S.doc Version 5.2 Page 18 Additionally, surveys are sent by the home to people who have had respite care at the home and their relatives for their comments about their experience and how they think it could be improved. A compliments and complaints book is available to people at all times. A report compiled by the manager as a result of last years quality monitoring was seen. Monthly quality monitoring visits are made to the home by a person nominated by Wakefield Metropolitan District Council (WMDC) and a copy of the report is sent to the Commission. Small amounts of people’s money is kept, at the individuals’ request, in the home’s safe. Documentation relating to this was checked and found to be appropriate. All three of the balances checked could be reconciled with the documentation made. Practices relating to health and safety and maintenance within the home are managed between the home’s manager, maintenance staff and the estates personnel from WMDC. Fire drills and training are held at the home on a regular basis. Hazel Garth DS0000034421.V357549.R01.S.doc Version 5.2 Page 19 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 X X 3 X X N/A 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 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Hazel Garth DS0000034421.V357549.R01.S.doc Version 5.2 Page 20 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. Standard Regulation Requirement Timescale for action 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 OP12 Good Practice Recommendations To better meet the recreational needs and to occupy the time of people living at the home, it would be advantageous to employ dedicated activities staff. Hazel Garth DS0000034421.V357549.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Brighouse Area Team First Floor St Pauls House 23 Park Square Leeds LS1 2ND National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 Hazel Garth DS0000034421.V357549.R01.S.doc Version 5.2 Page 22 - 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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