Care Home: Hazelbrook Christian Nursing Home

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What the care home does well Residents at the home were being cared for and supported well by the registered manager and her staff. Residents spoken to said the quality of care provided was very good. Residents said staff spoke to them respectfully and maintained their dignity, particularly when personal care was being given. Comments made included: `the care provided by the staff and the interest taken in the residents is second to none`, `in the last six months my relative`s health and well-being has improved tremendously due to the care they have received`, `staff are kind and helpful`, `the residents always appear to be happy and well cared for and the staff respond to personal needs quickly`, `I am very happy with the care I receive in this home, the staff can`t do enough for you`. The home was being managed to a high standard. This resulted in residents, their relatives and staff being confident that they were being supported properly and consistently. What has improved since the last inspection? The requirement made at the last inspection in respect of records relating to staff has been complied with appropriately. An ongoing programme of re-decoration and refurbishment continues to be implemented and the registered manager has been active in measuring how effective the service provided to residents is. The views of residents, relatives and staff are actively sought and changes implented if needed. Since the last inspection the registered manager has introduced the Gold Standard Framework programme at the home. This seeks to drive up the quality of care and support provided to residents towards the end of their life. This is to be commended. What the care home could do better: There are no requirements or recommendations as a result of this inspection. Discussion with the registered manager, responses in the AQAA document referred to above, and the outcomes of checks (audits) conducted at the home indicate that areas where improvement can be made are continiously identified and acted upon appropriately. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Hazelbrook Christian Nursing Home Albert Street Horwich Bolton Lancashire BL6 7AW     The quality rating for this care home is:   three star excellent 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: Michael Murphy     Date: 2 9 0 5 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 25 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 25 Information about the care home Name of care home: Address: Hazelbrook Christian Nursing Home Albert Street Horwich Bolton Lancashire BL6 7AW 01204693175 01204667344 hazelbrook@tiscali.co.uk 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) : Pindy Enterprises Limited care home 38 Number of places (if applicable): Under 65 Over 65 38 0 old age, not falling within any other category physical disability Additional conditions: 0 3 The home is registered for a maximum of 38 service users to include:- *Up to 38 service users in the category of OP (Old age not falling within any other category), *Up to 3 service users in the category of PD (Physical disability). Date of last inspection Brief description of the care home Hazelbrook Christian Nursing Home is located in Horwich town centre, close to the main shopping centre and a range of amenities. A former Methodist church and Sunday school building, it was originally built in 1867 and renovated and refurbished in 1988 to become a care home. The home provides nursing and personal care. There are 32 single rooms and 3 shared rooms. The aim of the home is to provide care in a Christian environment, but people not of the faith are also cared for. There is a small patio for residents use and a car park at the rear of the building. Fees range from 415.00 to 535.00 pounds per week per week (information provided by the home at the time of this inspection). For further details please contact the home. Care Homes for Older People Page 4 of 25 Care Homes for Older People Page 5 of 25 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: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This inspection included an unannounced visit to the home on the 29th of May 2009 between 8.30.am and 4pm. During the visit we talked to residents, relatives, staff and the registered home manager. We also looked at documents and records the home have to keep such as residents care records, medicine records, written policies and other records. Before the inspection, we also asked the registered home manager to complete a form called an Annual Quality Assurance Assessment (AQAA) to tell us what they felt they did well, and what they needed to do better. This helps us to determine if the management of the home sees the service they provide the same way that we see the service. We felt this form had been completed in sufficient detail and provided useful information. Care Homes for Older People Page 6 of 25 Care Homes for Older People Page 7 of 25 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 25 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 25 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. All prosective residents are appropriately assessed prior to admission to ensure their care and support needs can be properly met following admission. Evidence: All prospective residents are assesed prior to being admitted to the home. The homes registered manager (a qualified nurse) does the pre-admission assessment. Such an assessment is very important to ensure the home is able to decide if the prospective resident can be supported properly if they are admitted. Residents and relatives spoken to said that they felt they were actively consulted and involved before and after admission to the home and that it was their choice to enter the home. A detailed record of the pre-admission assessment is kept in each residents care records file. The pre-admission assessments carried out by the home manager were supported by assessments conducted by social workers and/or health professionals such as doctors. Care Homes for Older People Page 10 of 25 Care Homes for Older People Page 11 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents were confident that they were being properly supported to ensure their health and personal care needs are met appropriately. Evidence: Residents health, personal and social care needs are set out in their individual care plans. The care records of three residents were looked at during this inspection. These identified how staff were to care for and support residents in their daily lives. Care plans were highly individualised and were developed and reviewd with individual residents (where possible) and their relatives. Care records also contained risk assessments. These identify potential threats to the health and safety of residents and identify ways to keep them safe as well as maximising their independence and freedom. For example risk assessments were conducted in respect of mobilty, moving and handling, nutrition and the use of specialist equipment. Care records were being kept up to date. All residents are registered with a local GP. Discussion with residents, relatives and staff and inspection of care records reflect that residents are very actively supported to Care Homes for Older People Page 12 of 25 Evidence: access the services of those healthcare professionals required. Such interventions are recorded in the individual residents care records. The way residents medicines were being looked after was safe and secure. The qualified nurses are resposible for managing residents medicines (each resident has their own individual supply of medicines that have been prescribed by their GP). A medication administration record is maintained for each resident. These records had been completed appropriately. Care staff who assist the nurses with the administration of residents medicines have been provided with training to do so. The registered manager regularly conducts checks (audits) to ensure the management of medicines within the home continues to be safe and secure. Residents spoken to expressed the view that staff treat them with respect and maintain their dignity, particularly when personal care is being provided. For example they said staff knock on bedroom doors before entering, preserve their modesty, have a nice/friendly manner, and that they respect residents choices/preferences - this was supported in discussions with relatives on the day of inspection and responses in preinspection surveys sent to residents and relatives. Comments made included: the care provided by the staff and the interest taken in the residents is second to none, in the last six months my relatives health and well-being has improved tremendously due to the care they have received, staff are kind and helpful, the residents always appear to be happy and well cared for and staff respond to personal needs quickly, I am very happy with the care I receive in this home, the staff cant do enough for you. Residents are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The registered manager has introduced the Gold Standard Framework programme, the purpose of which is to enable the home to deliver a high standard of care for residents nearing the end of their lives. All staff at the home had been accessing a wide range of training to assist them in achieving the aims of the programme. There was a strong commitment by the registered manager and her staff to providing terminal care. Care Homes for Older People Page 13 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents were able to enjoy a stimulating lifestyle and access an extensive variety of social and leisure activities to engage in. Residents were helped to make as many personal choices in their daily lives as possible, and the general view of food provision was very positive. Evidence: The routines of daily living and activities made available are flexible and varied and meet residents expectations, preferences and capacities. Residents are supported to access a wide range of social and leisure activities and entertainments. Forthcoming events, activities and entertainments are prominently displayed. Residents said they highly valued the programme of activities available. They are also able to discuss the content of the programme at the regular resident committee meetings. Relatives and friends of residents are actively encouraged to participate in all the social and leisure activities available - and a significant number choose to do so. Religious observance is an important aspect of life at the home and as in other areas of life in the home residents are able to exercise their own personal choices in respect of this. Residents and relatives spoken to said there were no unreasonable restrictions on visiting at the home. Residents may receive their visitors in the privacy of their own room or quieter Care Homes for Older People Page 14 of 25 Evidence: lounge area of the home if preferred. Residents also said they were able to exercise choice and independence in their daily lives. Comments made included: I am able to decide when I get up and go to bed, I decide what I want to do and if I want to Join in activities or not, sometimes I like to stay in my room for some privacy and that is not a problem, I can go out with my family when I want to, the staff always ask me what I want to wear before they help me in the morning. Menus were prominently displayed and also available in an appropriate form for residents with memory impairement. Menus were varied, balanced and provided choice. Residents said they can always request an alternative from the menu if they wish and are comfortable to do so. comments regarding the food included: very good, good home cooking, there are good portions and the food is nice the food is usually very good and there is plenty of it. Food provision and menus are discussed at regular residents committee meetings and action is taken in respect of comments/suggestions made. Lunch was observed on the day of inspection. This was a hot and substantial meal. Staff served and assisted residents appropriately and sensitively. The dining room was comfortable, suitably furnished and appropriate for residents to take their meals in. Care Homes for Older People Page 15 of 25 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. There is an accessible procedure in place to deal with complaints. Staff have been provided with recent safeguarding training and there are procedures in place that describe how to protect residents and keep them safe. Evidence: Information on how to make a complaint was prominently displayed in the home. This information detailed who to contact and how the complaint would be dealt with. A complaints record is kept by the home. Complaints appeared to have been dealt with properly. Discussion with residents and relatives indicated that manager and senior staff are available and that any issues raised are dealt with promptly and rarely need to become formal complaints. The home operates safeguarding and whistle-blowing policies (including those developed locally and operated by Bolton social services) that seek to keep residents safe. Staff spoken to were aware of the importance of safeguarding and protecting residents and described their role in doing so. They confirmed they have been provided with recent safeguarding training. Inspection of training records revealed that safeguarding training has been provided to all staff at the home. Care Homes for Older People Page 16 of 25 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 provided a clean, pleasant, comfortable and suitably adapted environment for residents. Evidence: The building appeared to be in a good state of repair and decoration. The lounges and dining areas were clean, appropriately and adequately heated, comfortably and appropriately furnished and provided a suitable environment for residents to be cared for and supported properly. Televisions, music centers and other leisure equipment were available throughout the home. Suitably adapted bathing and toilet areas were provided. The home has generally been suitably adapted and equipped to meet the needs of residents. For example there is an adequate provision of hoists, grab rails, and other equipment. Individual residents specialist needs are met after referral to the appropriate health care worker for assessment. Residents bedrooms that were inspected were clean, suitably furnished and equipped and some were very personalized. The home was very clean and free of bad odours. Suitable arrangements were in place to manage residents laundry needs. And appropriate measures were being taken to minimize the potential spread of infection within the home such as adequate hand washing facilities and the provision of protective clothing for staff as well as appropriate cleaning practices within the home. Care Homes for Older People Page 17 of 25 Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staffing arrangements, staff recruitment process and the training arrangements at the home seek to ensure residents are cared for and supported safely and appropriately. Evidence: Staffing arrangements at the home were supporting residents and ensuring their needs were met. There is always a qualified nurse on duty who leads a team of carers. Discussion with residents revealed they were of the view sufficient staff were available to make sure they were looked after. There are also appropriate arrangements were in place to ensure there were sufficient staff in respect of the administration, catering, laundry and housekeeping functions of the home. There is a proper process in place in respect of recruiting staff. This is important to ensure residents are being cared for and supported by suitable people. The recruitment process included making police checks and another check regarding the suitability of the applicant working with vulnerable people. The arrangements for training staff ensure that residents care and support needs are being met by competent staff. Discussion with the registered manager, staff and inspection of training records revealed that a well organized and suitable training programme is in place in respect of all staff employed at the home. Training is provided at the home and through the local authority training partnership. Training Care Homes for Older People Page 19 of 25 Evidence: records were detailed and up to date. Over 75 of the care staff have obtained a national qualification in care (NVQ). The remaining carers were undergoing this training or expected to do so in the near future. Care Homes for Older People Page 20 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was being very effectively managed by the registered manager. This ensured that residents were confident that they were safe and being looked after properly. Evidence: A new home manager has been appointed since the last key inspection in 2007. The current manager is a very experienced qualified nurse who has provided care and support for older people for many years. Discussion with residents, their relatives and staff revealed that the manager creates an open, positive and inclusive atmosphere at the home and provides strong leadership. Since the last inspection the manager has been particularly active in the introduction of the Gold Standard Framework at the home. This seeks to drive up the quality of care and support provided to residents towards the end of their life. This is to be commended. The manager also is very active in measuring how effective the service provided to residents is. The views of residents, relatives and staff are actively sought. Discussion Care Homes for Older People Page 21 of 25 Evidence: with these groups of people reveal that the manager and owners listen to any issues/suggestions raised and respond appropriately. The manager also conducts her own checks (audits) on how effective different aspects of the the way home is run. For example regular checks are made in respect of residents medicines, how care records are maintained and the state of the environment. The arrangements to support residents with their money (personal allowances only) were secure and appropriately documented. The arrangements for the health and safety of residents (and others) in the home were adequate and appropriate. Staff are provided with regular training in respect of moving and handling, fire safety, food hygiene and the prevention of infection. Hazardous substances were being securely stored and gas and electrical systems had been checked/certificated regularly, we were informed hot water temperatures are controlled by special valves. Checks for legionella bacteria in the homes water systems had been conducted recently. Procedures were in place for the appropriate reporting of accidents, illnesses and injuries. Care Homes for Older People Page 22 of 25 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 23 of 25 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 Care Homes for Older People Page 24 of 25 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. 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