Care Home: Hazelmere House Nursing Home

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What the care home does well Hazelmere House is a well run and managed home. A relative commented, "the staff are all very helpful and professional in the work they do." A staff member wrote, "it always looks after the residents and staff to the best of its ability. Make everyone feel valued." People have their needs assessed before they move into the home to make sure that their needs can be met at Hazelmere House. Staff at Hazelmere House have good working relationships with health professionals and make sure that people living in the home receive support and advice when they need it. This helps to make sure they stay as healthy as possible. The home provides various activities both on a one to one and group basis so that people are stimulated and have the chance to join in social activities. One relative commented, "staff care about meeting need, ensuring the patients` views are heard and attempt to organise activities in a way that provides a range of things with the patient at the heart." The standard of catering is good and visitors are made very welcome at the home. Hazelmere House offers a homely, safe and comfortable living environment that suits the needs of the people who live there. Overall, recruitment procedures and staffing levels at the home are good. Staff are trained to carry out their role. They enjoy working at the home and there is a low turnover of staff. One staff member wrote, "I thoroughly enjoy working at Hazelmere House and find both staff and residents a delight to work with. I feel very much valued and appreciated in my role as a care assistant". What has improved since the last inspection? Staff make sure that eye drops are dated on opening and that creams and other prescribed medicines are signed for on the Medicine Administration Record sheets so people living in the home get their medicines as prescribed. What the care home could do better: Staff should make notes of verbal complaints/concerns so that there is a record kept of the complaint and that they can be confident that they are responding to all aspects of the complaint. Staff should undertake periodic refresher training in safeguarding adults so they are aware of their responsibilities and what to do if they suspect someone is being abused. The manager should ensure that a reference is obtained from the staff member`s previous employer so that there is satisfactory information about the staff member`s previous employment. All staff should do refresher training in safe moving and handling techniques so they know the correct processes to use to make sure they and the people who live at the home are safe. All staff should undertake regular training in fire safety so they know what to do in the event of fire. Key inspection report Care homes for older people Name: Address: Hazelmere House Nursing Home Pinewood Road Summerfields Wilmslow Cheshire SK9 2RS     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: June Shimmin     Date: 1 0 0 7 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 25 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC 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: Hazelmere House Nursing Home Pinewood Road Summerfields Wilmslow Cheshire SK9 2RS 01625536400 01625536534 nazertr@bupa.com www.bupa.co.uk BUPA Care Homes (GL) Ltd Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Trudy Nazer Type of registration: Number of places registered: care home 60 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The home is registered for a maximum of 60 service users to include: Up to 60 service users in the category of OP ( old age not falling within any other category) Up to 10 service users in the category of PD (physical disability), aged between 55 and 65 years. Date of last inspection Brief description of the care home Hazelmere House is a two-storey care home providing nursing and personal care. It was built in 1991. It is a detached, brick built property in private grounds with landscaped gardens for the people who live there to enjoy. The home is in a residential area close to Wilmslow town centre. Hazelmere House is run by Goldsborough Limited, a subsidiary of BUPA. There 52 single and 4 twin rooms in the home plus Care Homes for Older People Page 4 of 25 Over 65 60 0 0 10 Brief description of the care home three lounges, a conservatory and two dining rooms. All the bedrooms have en-suite toilet and bathing facilities. Separate adapted bathrooms and toilets are situated throughout the home. Bedrooms are situated on both the ground and first floors of the home and a passenger lift is provided. The scale of charges range from 597.85 1053 pounds per week, which includes the nursing contribution of 106 pounds per week. The latest inspection report can be obtained from the manager. 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: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The last inspection on this service was completed on 26 June, 2007. The overall quality rating for this service is two stars. This means that the people who use the service experience good quality outcomes. This unannounced inspection visit took place over two days and lasted nearly nine hours. One regulatory inspector carried out the visit. The report will refer to we and us as it is written on behalf of the Care Quality Commission. This visit was just one part of the inspection. Other information received was also looked at. Before the visit the manager was asked to provide information about the home as part of this inspection process. We sent questionnaires to people living in the home, relatives and staff members to find out their views about Hazelmere House. We also spoke to several people living in the home and staff members during our visit to Care Homes for Older People Page 6 of 25 the home. Their views are incorporated into the findings of this report. During our visit we looked at various records and the premises. Records of care plans, medication and staff training records were also examined. 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: Staff should make notes of verbal complaints/concerns so that there is a record kept of the complaint and that they can be confident that they are responding to all aspects of the complaint. Staff should undertake periodic refresher training in safeguarding adults so they are aware of their responsibilities and what to do if they suspect someone is being abused. The manager should ensure that a reference is obtained from the staff members previous employer so that there is satisfactory information about the staff members previous employment. All staff should do refresher training in safe moving and handling techniques so they know the correct processes to use to make sure they and the people who live at the home are safe. Care Homes for Older People Page 8 of 25 All staff should undertake regular training in fire safety so they know what to do in the event of fire. 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 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 10 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. People have their needs assessed before admission so they know the home can meet their needs. Evidence: We looked at the assessments of three people who had recently moved into Hazelmere. The registered manager told us that either she, her deputy or one of the nurses working in the home carry out assessments so that assessments are done by appropriately qualified staff. The assessments included sufficient information about the care needs of people, any identified risks relating to their care and other information about their family, social and leisure life so that a care plan could be drawn up based on this information. There was also information about other needs such as spiritual needs so that staff would be aware of those specific needs. One person wrote to us about the admission process, I came here straight from hospital. My sister visited the home prior to my arrival. I would have liked to have seen more pictures of the home and written information. We spoke to several people Care Homes for Older People Page 11 of 25 Evidence: who had come to live at Hazelmere and they said that they had been given written information about the home so knew about the facilities and services available and appeared to have settled in well. Care Homes for Older People Page 12 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Promotion of health is taken seriously, peoples welfare is monitored and health needs are met. Evidence: We looked at the care plans of four people living in the home, three of these in detail. We spoke to the people who had been admitted where this was possible. Care plans for most care needs were usually drawn up within five days of admission so that care needs could be promptly identified and staff would know what to do to meet those needs. Various risk assessments were also written within this timescale so that any identified risks could be monitored. The care plans were written in a way that focused on the individual and which were person centred. They had been kept under review so that changing needs were monitored and care plans amended accordingly. Records also indicated that, where appropriate, advice was sought from a variety of health care professionals such as GPs, specialist nurses and other professions allied to health. A nurse told us that a GP from a local practice visits the home once weekly under the Nursing Home GP scheme to monitor the health care needs of people. Overall the privacy and dignity of people living in the home was maintained and Care Homes for Older People Page 13 of 25 Evidence: preferences regarding male and female carers were documented in care plans. However, during our visit we noticed that two male carers were working together although there were other female carers on duty, which might mean that the preferences of some people to have a female carer might not be met. This is particularly important when very dependent people may be unable to voice their opinions. We also looked at the way in which medication was being managed. This was of a good standard overall. We pointed out that reasons should be recorded when medication is omitted so the home can demonstrate that it has taken reasonable steps to ensure that people receive their prescribed medication. Care Homes for Older People Page 14 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home will enjoy a good quality of life through the provision of a varied programme of activities and a nutritious diet. Evidence: Hazelmere employs two staff to organise and deliver activities so that people are given the opportunity to take part in activities if they wish. We observed information about activities displayed on notice boards in various parts of the home and we were told that the activity organisers visit people in their own rooms to find out what they would like to do and to inform them what is happening. This means that people can enjoy one to one activities or group events according to their preference. On the first day of our visit one to one activities were taking place and Holy Communion was available for those people who wished to receive it. The registered manager told us that clergy of various denominations visit people in the home so that peoples spiritual needs are met. Group activities included an imaginary world cruise and the home had recently held a fundraising event for a local charity. We received a number of comment cards from relatives, all of whom made complimentary remarks about Hazelmere. One commented that the home had increased activities and that there was a varied programme, another, good activities and services. One relative wrote that perhaps more trips out for those residents who Care Homes for Older People Page 15 of 25 Evidence: are capable. We were told that the home has managed to get the support of a minibus company with tailgates, which means that more people living in the home will be able to enjoy trips out. We also looked at catering arrangements in the home. The standard of food provided was good and people were offered a choice at every meal. People are given a menu card the day before and if necessary given assistance to complete it so they know what food is to be provided. The menu card is given to the person on the day so they can recollect what the meal is. Also the menu is displayed on a notice board on the ground floor. A number of people living in the home sent us comment cards and several were not totally satisfied with the standard of catering, the food could be better. However, we spoke to several people who said that the food was excellent and that they had choice. On the day of our visit we observed people during the lunch period and the meal was not rushed and the people accommodated on the ground floor enjoyed the services of a waitress during the meal. The dining room on the ground floor is spacious and is a pleasant environment in which to enjoy eating a meal. However, the dining room on the first floor is quite cramped as it is also a lounge so people do not have the benefit of a separate dining room. We were told that people who are able can come downstairs for their meal. Care Homes for Older People Page 16 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. Systems are in place to ensure that people are protected from abuse and harm and they know who to contact if they want to make a complaint Evidence: Hazelmere has a complaints policy and procedure. The procedure is displayed in the reception area of the home and includes our details if anybody wishes to contact us. We looked at the record kept of complaints and none had been received in the last year. However, a relative contacted us in May 2009 about a concern regarding the home but this had not been recorded. It is good practice to record concerns as well as complaints so the home can demonstrate that action has been taken to resolve any issues. We also looked at how the home manages safeguarding issues. The home has policies and procedures for this but these have not ben reviewed since December 2006. The registered manager told us that BUPA are currently reviewing all its policies and procedures to make sure they are up to date. The registered manager told us that BUPA expects staff to undertake annual updates regarding safeguarding but the training matrix indicated that a number of staff had not done this in the last year. However, all care staff cover this topic during induction and it is also covered during NVQ training so care staff should be aware about how to recognise abuse and what to do. Care Homes for Older People Page 17 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. Hazelmere provides a clean, comfortable and pleasant living environment. Evidence: We walked around the home and found it to be clean, tidy and fresh smelling. The registered manager sent us information before the inspection, which indicated that the home is well maintained and equipment and facilities are serviced on a regular basis. The shared living areas on the ground floor are spacious, pleasant and offer people living in the home a variety of environments in which to sit and relax other than their bedrooms. The shared accommodation on the first floor is limited and there is a joint lounge and dining room. The fixtures and fittings in this lounge/dining room appeared tired and shabby so this may not offer the same degree of comfort as to people living on the ground floor. However, the registered manager told us that those people on the first floor who are able can choose to come down to the ground floor if they wish. We also received information before the inspection in which the registered manager told us that 40 bedrooms will be refurbished during the next twelve months. One relative said, bedrooms need modernisation and a person living in the home wrote, home is kept well presented and clean. 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. Staffing levels at Hazelmere are generally satisfactory and staff are skilled in their role so that people receive the care they need. Recruitment practices need to be more thorough so that people living in the home are protected. Evidence: We received comment cards from several staff and also spoke to staff during our visit. All said they enjoyed working at the home, I have worked in several homes and this in my opinion is the nicest and most friendly and openly run home and another, I thoroughly enjoy working at Hazelmere House and find both staff and residents a delight to work with. We looked at staffing levels in the home and these were generally sufficient to meet the needs of people living in the home. However, several staff commented that the staffing levels during the afternoon and evening could be better as many of the people living in the home and particularly on the first floor were very dependent and needed a lot of support and care. One staff member wrote, employ more staff to assist residents to be able to spend time with them instead of rushing tasks. We looked at recruitment records and these were of a good standard overall and indicated that the home had obtained all necessary information about employees, including security checks so that people living in the home were protected. There was one minor issue with the references of one person, in that there was no reference from the persons previous employer so that the home could not be sure that the Care Homes for Older People Page 19 of 25 Evidence: persons work history was satisfactory. The home has a training matrix so that it knows when staff are due to undertake refresher training in various compulsory subjects such as safe moving and handling. The registered manager told us that half the carers working at the home have achieved a minimum NVQ2 in care qualification so are skilled to carry out their role. Many of the remaining staff are being supported to start their NVQ training during the coming months. Staff also receive supervision on a regular basis so they are given feedback about care issues and support regarding training. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Hazelmere is well managed and run in the best interests of people living there. Evidence: The registered manager has been in post for approximately 16 months and has a legal and managerial background. She has also worked with a major charity for older people and has a good knowledge of the needs of older people. The registered manager said that although she does not have a nursing qualification her deputy is a qualified and experienced nurse who takes responsibility for the clinical supervision of nursing staff and care of the people living at Hazelmere House. During our visit the registered manager was open and appeared to be very approachable so that people living in the home and staff would find her easy to talk to. We received the following comments about the manager firstly from a relative, change of manager - more approachable and considerate and from a staff member, the manager has an open door policy and is approachable and fair. Hazelmere House uses various methods to find out if the service provided is good. During our visit the regional manager for BUPA was present carrying out her own Care Homes for Older People Page 21 of 25 Evidence: survey into standards at the home. The home conducts monthly audits of different aspects of the homes management and keeps records of these. The results of an annual questionnaire were also available in the reception area and indicated that people were satisfied with the care and facilities provided. We looked at how the home manages the finances of people living there and these were well maintained. Training records for moving and handling and fire safety suggested that a number of staff had not done recent refresher training in these areas and may not be up to date in both regards. The registered manager acknowledged this and said that training sessions were to be held in the near future so that people living and working in the home are safe. 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 1 16 The registered manager should keep a record of any concerns as well as complaints so that people know their concerns are being listened to and acted upon. All staff should undertake regular refresher training in safeguarding adults so they know how to recognise possible abuse and what to do if they suspect someone is being abused. The registered manager should ensure that a reference is obtained from the staff members previous employer so that the home knows that the person is suitable to work in the home. The registered manager should ensure that all staff involved in moving and handling procedures undertake annual refresher training so that they and the people living in the home are protected. The registered manager should ensure that all staff undertake regular fire safety training so that they know what to do if there is a fire and so that people living and working in the home are protected. 2 18 3 29 4 38 5 38 Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 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) Care Quality Commission (CQC). 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. 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