Care Home: Hooklands Nursing Home

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What the care home does well People told us that Hooklands has a home from home atmosphere and that the staff are very friendly. We were told that routines are very flexible and visitors are made welcome at any time. People have their needs assessed before they are offered a care service at the home and there are opportunities for people to test-drive the service for periods of respite care and visits. People spoken with knew whom they would talk to if they were unhappy and staff were aware of safeguarding procedures. People are encouraged to make their bedrooms their own and bring familiar items and furniture to put on display in their rooms. What has improved since the last inspection? Care plans record the social history of people and what their interests are. There is more variety and oportunities to take part in social outings and activties of their choice within the home. There continues to be improvements to the environment with a record of renewal of fabric and redecoration, including a programme of what is to be done this year. Staff training has improved and includes safeguarding adults training. Water temperatures are now being monitored to ensure the safety of people living at the home. Fire equipment has been serviced and maintainence records for other services are kept. The Fire Officer has been consulted and the manager has told us that Requirements made by the Fire Officer have been carried out. What the care home could do better: Beds supplied to people must support their needs so that when there are continence support plans in place people have a bed, which promotes good infection control practice and can be easily cleaned. Environmental risk assessments must cover all risk including the practice of wedging doors open. Sharps boxes must be dated on opening so that they are returned if not full within 3 months. CARE HOMES FOR OLDER PEOPLE Hooklands Nursing Home West Bracklesham Drive Bracklesham Bay Chichester West Sussex PO20 8PF Lead Inspector Mrs Diane Peel Unannounced Inspection 30th June 2008 10:15 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 Hooklands Nursing Home DS0000024158.V365401.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. Hooklands Nursing Home DS0000024158.V365401.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hooklands Nursing Home Address West Bracklesham Drive Bracklesham Bay Chichester West Sussex PO20 8PF 01243 670621 F/P 01243 670621 brian.mcdowell3@btinternet.com 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) Mr Mohammed Saleem Chaudhry Dr Lubna Ezad Mrs Jeanette Louise McDowell Care Home 27 Category(ies) of Old age, not falling within any other category registration, with number (27) of places Hooklands Nursing Home DS0000024158.V365401.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th September 2007 Brief Description of the Service: Hooklands is a care home providing personal, social and nursing care for up to 27 older people. It is situated directly on the seafront at Bracklesham Bay, West Sussex. Bedroom accommodation is situated on the ground, first and second floors. The home has a vertical lift. There is a garden that has direct access to the beach. Access to the home is via a residential road and the home provides a small number of car parking spaces. There is a ramp for easy access into the home. The registered manager who is in charge of the day-to-day running of the home is Mrs Jeanette McDowell. The providers are Mr Chaudhry and Dr Ezad. The current fees range between £263 and £650 per week. Hooklands Nursing Home DS0000024158.V365401.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 stars. This means the people who use this service experience good quality outcomes. This unannounced visit to Hooklands was carried out by Mrs Diane Peel on the 20th June 2008. During this visit the intended outcomes for 30 standards were assessed; these included the key standards for care homes providing a service to older people. The Annual Quality Assurance Assessment (AQAA) was returned to The Commission for Social Care Inspection (CSCI) prior to this visit to the home and this was used to address areas of improvements during the inspection process. During the course of the visit we met with people living at the home to discuss their experiences of living at Hooklands and spoke to two visitors to get their views of the service. Staff spoke to us about their experiences of working at the home, the training provided and the process of recruitment. All people consulted with had positive comments to make and complimented the management style of the registered manager who couldn’t be present during our visit. A case tracking exercise was undertaken for three people living at the home to see how the assessed needs of these people were being met. We looked at other records in the home at random to make sure that the homes record keeping and working practices promote and protect people living at the home. After the visit we spoke to the registered manager to address any issues, which, needed clarification and provide feedback about our visit. Hooklands Nursing Home DS0000024158.V365401.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? Care plans record the social history of people and what their interests are. There is more variety and oportunities to take part in social outings and activties of their choice within the home. There continues to be improvements to the environment with a record of renewal of fabric and redecoration, including a programme of what is to be done this year. Staff training has improved and includes safeguarding adults training. Water temperatures are now being monitored to ensure the safety of people living at the home. Fire equipment has been serviced and maintainence records for other services are kept. The Fire Officer has been consulted and the manager has told us that Requirements made by the Fire Officer have been carried out. Hooklands Nursing Home DS0000024158.V365401.R01.S.doc Version 5.2 Page 7 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. Hooklands Nursing Home DS0000024158.V365401.R01.S.doc Version 5.2 Page 8 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 Hooklands Nursing Home DS0000024158.V365401.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,4,5,6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People have their needs assessed prior to moving into the home and trial visits are encouraged so that people will know that they can settle in the home and it will meet their needs. EVIDENCE: During this visit to Hooklands we saw the Statement of Purpose and Service User Guide present in some peoples bedrooms who had recently moved to the home or who was having a period of respite care at the home. Hooklands Nursing Home DS0000024158.V365401.R01.S.doc Version 5.2 Page 10 A person living at the home told us that their son had found the home for them and came to look around. They had not looked at any other homes because “ he already knew the matron and some of the staff so they knew that it would be all right.” This person told us that they had come to the home for a short stay but had decided to stay. We spoke to two visitors to the home who were visiting relatives. Both told us that they had helped their relative living at the home make the choice of Hooklands because of previous contact with the home. For one visitor it was because another relative had lived at the home and they knew the “matron” and staff and for another it was also because they knew the “manager and other staff”. The manager had visited their relative before they had moved to the home. We looked at pre admission assessments which had been carried out for the last two people who moved into the home and saw that together the assessment of need and care plans address all aspects of peoples health and social care needs. The AQAA returned to us states: “Before any resident comes to Hooklands a full assessment is performed by a qualified nurse. All details are discussed with the resident and their relatives. This ensures that we are able to care for each persons individual and special needs.” Intermediate care is not offered at Hooklands. Hooklands Nursing Home DS0000024158.V365401.R01.S.doc Version 5.2 Page 11 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): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home have a plan of care which details the action which needs to be taken by care staff to ensure that all aspects of peoples health, personal and social care needs are met. EVIDENCE: During our visit to Hooklands we looked at the care plans and other associated care records for three people, which included two people who had most recently moved into the home. They had been developed from the assessment of need and included: medical history, social history, use of aids and adaptations, and covered aspects of Hooklands Nursing Home DS0000024158.V365401.R01.S.doc Version 5.2 Page 12 activities for daily living such as peoples appetite, skin condition, neurological well being, mobility, psychological well being, sleeping, and leisure and hobbies. There was also a nursing care plan, which described how aspects of people’s medical needs would be met. Risk assessments were also observed to be in place, which included pressure care risks, fire risk assessments, falls risk assessments and general risk assessments when a particular risk to an individual had been identified. Nutritional screening tools were also observed to be in place. Care plans observed had been reviewed regularly and showed a pattern of monthly review. We also saw that daily monitoring records are kept and saw them being completed at the handover from am staff to pm staff. A Statutory Requirement made at our last visit to Hooklands requiring that peoples social history was included in care plans has now been met. Whilst looking around the home we saw records of fluid intake being used in people’s bedrooms where this had been identified as a problem. One person living at the home told us that the staff used a hoist when getting them in and out of bed and that it was two staff that assisted them with the hoist. Another person living at the home told us that they had a doctor who visited them at the home when they needed to see a doctor and we saw records which showed that people have access to the usual health care professionals should they need them. The AQAA returned to us states “ Each Service User has an individual Care Plan, based on our Pre-Admission Assessment. All aspects of health, personal and social care needs are detailed. All Service Users are registered with the local GP Practice. All Service Users have access to specialist medical, nursing, dental pharmaceutical, chiropody and therapeutic services and care from hospitals. All Service Users are visited annually by an optician. Only nurses administer medication.” Medication was observed to be kept in a locked trolley attached to the wall and in additional locked storage. A monitored dosage system is used and each person has a photograph on front of his or her medication record sheet. Hooklands Nursing Home DS0000024158.V365401.R01.S.doc Version 5.2 Page 13 At lunchtime we observed the medication being administered to people having lunch in the dining room and looked at the medication records, which were clear and up to date. The person in charge on the day of our visit told us that nobody living at the home currently looked after their own medication and that there was no controlled medication being administered and that only qualified nurse administer medication. Information in the AQAA returned to us informed us that at the time of completing the AQAA one person living at the home chose to self medicate and that “ we have relevant paper work and lockable storage for that purpose.” Pharmacy waste disposal and clinical waste disposal agreements were observed during our visit Hooklands Nursing Home DS0000024158.V365401.R01.S.doc Version 5.2 Page 14 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): 12,13,14,1,5 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People living at the home are encouraged to maintain contact with their family and friends so that they can satisfy their social and emotional needs and the activity programme is flexible to cater for individual residents abilities and to offer variation to daily living. EVIDENCE: The AQAA returned to us states that “All Service Users have choice in social activities, outings, food, routines and religious observance.” “On admission, we take note of all their interests.” During our visit we saw peoples interests recorded in their care records and we saw that the home keeps a file recording what activities people have taken part in. Hooklands Nursing Home DS0000024158.V365401.R01.S.doc Version 5.2 Page 15 Whilst visiting people in their bedrooms we spoke to one person who had worked in the theatre and who was watching a ballet on video they told us that this was what they liked to do as they had an interest in ballet. We also spoke to someone who was knitting. They told us that they liked to continue to be useful and knitted squares which someone else’s relative sewed together to make blankets for the children’s hospice. We spoke to staff about routines in the home, which they told us were flexible and one member of staff told us that they had been on a course about providing activities for the home. We saw on the notice board in the dining room timetables of activities and events which had taken place, these included: pottery and painting, manicures, outing to West Dean, visiting entertainer called Sylvia, jig saw puzzles, hand massage, a visiting mobile shop. There was also record of an outing to Havant, a play at West Witterings and Holy Communion, which the activity records recorded, was attended by three people in June at the home. During our visit we also saw the crockery, which people had decorated in the craft activity and paintings on the wall. The two visitors to the home who we spoke with during our visit were complimentary about the flexibility of visiting Hooklands. One visitor told us that they visited every morning to play dominoes and on the day of our visit this person stayed for lunch with their relative living at Hooklands. We were told, “it was very pleasant.” Another visitor arrived to collect their relative living at Hooklands and took their relative home for lunch. When we arrived at the home another person was just leaving to spend the night at a relatives home. The visitor’s book in the entrance to the home shows regular visitors to the home. The service user guide outlines the arrangements for mealtimes: 8am breakfast with a choice of toast, cereal or cooked breakfast; 10am coffee, 12.30 lunch, 3pm tea and biscuits, 5pm supper and 7.30 pm evening drinks and snacks. Hooklands Nursing Home DS0000024158.V365401.R01.S.doc Version 5.2 Page 16 On the day of our visit we saw that the main meal of the day was fish and chips but we also saw that some people had chosen to have an omelette. One member of staff who we spoke to told us that people are asked during the morning what they would like from the days menu and then later in the afternoon they are asked what they would like for their supper. We looked at the store of food in the home and saw that there was plenty of fresh fruit and vegetables in store Hooklands Nursing Home DS0000024158.V365401.R01.S.doc Version 5.2 Page 17 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): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Policies and procedures are in place for responding to complaints and allegations of abuse and neglect so that people can feel safe. EVIDENCE: The complaints procedure was observed to be on display in the entrance to the home and included in the Statement of Purpose and Service User Guide. The AQAA returned to us states, “There is a Complaints Book. When complaints are recorded, they are noted and investigated, and action, where appropriate, is taken.” Data in the AQAA told us that there has been 3 complaints received in the last 12 months and these were all up held and responded to within 28 days. The two relatives visiting the home who we spoke to during our visit told us that they knew how to make a complaint and two people who live at Hooklands Nursing Home DS0000024158.V365401.R01.S.doc Version 5.2 Page 18 Hooklands who we spoke to about making complaints told us that they would make a complaint to “the matron, Jeanette.” During our visit to the home we observed that the home has a copy of the West Sussex Multi Agency Safeguarding Adults procedures besides its own policies and procedures on safeguarding adults. The AQAA completed in April 2008 reported that that the service had not made any safeguarding adults referrals and we had not been made aware of any safeguarding matters from any other source. Staff training records, which we saw, showed us that staff had attended safeguarding adults training in March 2008. Hooklands Nursing Home DS0000024158.V365401.R01.S.doc Version 5.2 Page 19 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): 19,20,21,22,23,24,25,26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The environment continues to improve so that people have more pleasant and comfortable home to live in. EVIDENCE: On this visit to Hooklands we had a look around the building and spoke to people who live at the home who liked the home and were satisfied with their rooms. We also spoke to visitors and found that they were satisfied with the environment. Hooklands Nursing Home DS0000024158.V365401.R01.S.doc Version 5.2 Page 20 We spoke to the maintenance person who told us that when a room becomes vacant, it is redecorated and when people come to view a vacant room they can tell him what colour they want it decorated. We were also told that bedroom furniture is gradually being replaced and we saw evidence of this when we visited people’s bedrooms along with carpets, which had also been replaced. Some people had chosen to bring items of furniture to the home as well as photographs, ornaments and pictures to have on display in their rooms. The communal areas of the home consist of two lounges and a dining room with a sitting area. Staff spoken with told us that one of the lounges at the rear of the property wasn’t used very much but we saw that the other lounge was well used although some of the furniture was starting to show signs of wear and tear. At the last visit to the home we made statutory requirements about the environment, which included the state of repair externally and internally, and the decoration and furnishing of bedrooms, bathrooms and toilets and the control of hot water. The AQAA returned to us in April 2008 reported the following improvement to the environment: “We are now keeping a record of renewal of fabric and redecoration, including a programme of what we will do this year. Risk assessments are on display wherever there are ramps within the home. New wooden furniture has been installed in eight rooms, including a lockable drawer for valuables and medicines. Rooms 5, 14, 17 and 21 have been re-carpeted. Twelve ground floor rooms have new double-glazed windows; five upstairs rooms have had their glass replaced; and the dining room and both lounges have all had new double-glazing fitted in the last twelve months. Radiator covers have been fitted to all the communal areas this year, including corridors, both lounges, and dining room. Boilers have been over-hauled. One downstairs toilet has been replaced and the flooring renewed. The laundry has been re-tiled and re-floored. Ten toilet seats have been replaced. The top floor landing has been redecorated. Rooms 8, 9, 10, 19, 21 and 27 have been redecorated.” We were also told that further improvements planned include: “materials have been bought for windbreakers. The making of these has been delayed because we lost a lot of our fence panels in the big storm last month. Hooklands Nursing Home DS0000024158.V365401.R01.S.doc Version 5.2 Page 21 We will install a grab rail this year in the main corridor. New furniture has been ordered for a further eight rooms. Screen trellising has been bought to screen our bin area in the car park at the front of the Home. We saw during our visit that hot water temperature are being regularly monitored and on the day of our visit the person in charge told us that the water temperature of hot water leaving the tap of the bath on the first floor which they had just measured was 36 degrees centigrade. Another statutory requirement made at our last visit to the home was to ensure that the fire escape door on the second floor was operable. We checked in the presence of the person in charge on the day of our visit and found it to be working. Kitchen staff spoken with during our visit told us that the dishwasher had broken down and during telephone conversation with the manager after the visit she confirmed that a new dishwasher was due to be delivered. During our tour of the home we expressed concern about one bedroom identified to the person in charge, which had an unpleasant odour. The problem was the bed base, which was not easily cleanable so we have made a statutory requirement at this visit that the bed be replaced because it is an infection control hazard. On the day of our visit other areas of the home were observed to be clean and tidy and we spoke with the cleaner/maintenance person who told us that they worked six days a week at the home in the capacity of cleaner and handyman. Hooklands Nursing Home DS0000024158.V365401.R01.S.doc Version 5.2 Page 22 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): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are protected by the recruitment practices of the home and staff receive training so that people living at the home know that the staff team will be able to meet their needs. EVIDENCE: On the day of our visit to Hooklands there was an agency nurse in charge of the home because the registered manager had a pre arranged time off. There were also five care assistants, one cook, a domestic and a kitchen assistant on duty. The AQAA returned to us reported that there is three staff on duty at night, which includes a registered nurse. We saw rotas, which confirmed staffing levels at night, included a registered nurse. Hooklands Nursing Home DS0000024158.V365401.R01.S.doc Version 5.2 Page 23 The AQAA returned to us in April 2008 reported that there is a diverse staff team so that people can have a choice of male, female and age related preferences. Other data in the AQAA returned to us stated that seven out of the thirteen care assistants have achieved an NVQ level 2 and that six carers have commenced the NVQ level 3. We were unable to look at staff records during this visit to Hooklands because the registered manager was unavailable on the day of our visit although she made herself available for telephone contact. At our last visit the staff recruitment practice and records were good so after our visit we contacted the registered manager to ask if anything had changed with the recruitment practice. She told us that no changes had been made. “Vacancies are advertised in the Job centre and after interview people only start work if the CRB, POVA disclosures and references are received.” The AQAA returned to us in April 2008 stated, “ Two references are obtained after interview and all gaps in education and employment are explored. New staff have employment confirmed after successful CRB and reference checks.” Staff spoken with during our visit told us about the training that they had at Hooklands. Staff told us that they had finished their NVQ 2 and were now doing NVQ 3. Other staff spoken with told us that they had done “safeguarding training, manual handling, first aid, fire training and food handling training” We looked at staff training records during our visit and saw that recent training included: Continence 10/1/08 Fire training 21/3/08 Manual handling 13/3/08 Safeguarding vulnerable adults 25/3/08 Basic first aid 27/3/08 and 31/3/08 Food handling 10/4/08 Other staff had also attended a pressure care study day in April 2008. A requirement made at our last visit to the home for staff to attend safeguarding adults training is now met. Hooklands Nursing Home DS0000024158.V365401.R01.S.doc Version 5.2 Page 24 Visitors who we spoke to on the day of our visit to Hooklands were complimentary about the staff with comments such as “ the staff are lovely, they really care.” and another visitor told us “the staff are very friendly.” Hooklands Nursing Home DS0000024158.V365401.R01.S.doc Version 5.2 Page 25 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): 31,33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Systems are in place to ensure the management of the home but to ensure that people are fully protected all areas of risk must be considered. EVIDENCE: Hooklands Nursing Home DS0000024158.V365401.R01.S.doc Version 5.2 Page 26 The registered manager of Hooklands has managed the home for many years. She is a registered nurse who also has the NVQ level 4 Registered Managers Award. Training records, which we saw during our visit, showed us that the registered manager updates her knowledge and skills by attending further training. Recent courses attended were recorded as: basic tissue viability, drug and alcohol awareness and leading and managing services. After our visit to the home we spoke to the registered manager about Quality Assurance systems and she told us that “ surveys were recently sent out to families in May but not many had come back in yet so they hadn’t been collated.” The AQAA returned to us reported “ Feedback is gathered from service users via anonymous questionnaires and the Residents Association meetings” and “There is an objective quality assurance system in place, which involves the service users.” “There is an annual development plan for the Home, based on monitoring and reviewing.” We also discussed the arrangements for managing peoples monies with the registered manager after our visit to Hooklands. She told us that there had been no changes to the system in place since our last visit. The AQAA returned to us stated “ Written records are maintained of all financial transaction for those Service Users whose finances we manage. Personal monies are not pooled and records and receipts are kept.” “ Secure facilities are provided for the safekeeping of monies and valuables.” At our last visit to Hooklands we expressed concern about the safe supply of hot water provided in all parts of the home to which people living at the home had access. A Statutory Requirement was made to ensure peoples safety when using hot water outlets within the home. In particular the bath in the first floor bathroom. During this visit we saw that hot water temperatures are being monitored and records kept. The person in charge on the day of our visit recorded the bath temperature in question as 36 degrees centigrade. This statutory requirement has now been met. We also had three concerns about fire safety during our last visit to the home, which we made Statutory Requirements to protect the people living at Hooklands. As a result of this and a visit by the Fire Service, the Fire Officer made a number of Requirements. The registered manager told us after our visit to Hooklands that the requirements of the Fire officer have been fully carried out. Hooklands Nursing Home DS0000024158.V365401.R01.S.doc Version 5.2 Page 27 During our visit we saw fire risk assessment on the walls in different areas of the building and saw that an external fire door which was not operable at are last visit was working and leading out to a clear maintained fire escape. We also saw service records, which demonstrated that, the fire alarm system, emergency lighting system, nurse call system and hoists had been serviced in April 2008. The pharmacy waste disposal agreement, which we saw, was dated 9/4/08 and the controlled waste disposal agreement was dated 1/4/08. Fire extinguishes were dated as been serviced 20/9/07 and the stand aid equipment was last serviced 15/5/08. During this visit to Hooklands we observed a number of bedroom doors being wedged open that did not have self releasing systems and which were not included in any risk assessments. A Statutory Requirement has been made to risk assess this practice to protect people living at the home. We also saw that Sharps boxes are not being dated on opening so there is no way of telling when they must be returned if they do not become full before the end of a three month period. This matter was discussed with the registered manager after our visit. Hooklands Nursing Home DS0000024158.V365401.R01.S.doc Version 5.2 Page 28 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 3 3 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 4 13 4 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 2 3 3 2 3 2 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 2 Hooklands Nursing Home DS0000024158.V365401.R01.S.doc Version 5.2 Page 29 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP26 Regulation 16.2(c) Requirement Soiled or damaged beds including bases must be replaced. The beds provided must be easy to clean to avoid unnecessary infection control hazards and unpleasant odours. Environmental risk assessments must cover all risk areas including identifying the risk from the practice of wedging doors open and these risks must be eliminated or at least reduced where possible. Timescale for action 01/08/08 2 OP38 13.4 01/08/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Hooklands Nursing Home DS0000024158.V365401.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Hooklands Nursing Home DS0000024158.V365401.R01.S.doc Version 5.2 Page 31 - 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. 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