Care Home: Hopwood Court

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What the care home does well Information is provided to prospective residents and their relatives. We saw that a copy of the home`s Statement of Purpose and Service User`s Guide is available in the hallway near to the main entrance of the home. In addition we also saw a copy of our reports and the home`s newsletter. We saw a copy of the Service User`s Guide within one of the bedrooms. The Service User`s Guide states that prospective residents are invited to visit the home for the day so that an assessment can be carried out. It continues to say that if an individual is unable to visit then the manager will visit the person concerned at home or in hospital to undertake the assessment. These details are also included within the AQAA which adds `When the assessment is completed we ensure that we are able to meet the needs of the perspective service user. This information is backed up where possible with a community care assessment undertaken by a social worker if applicable.`During our visit we spoke to a visitor who confirmed that the registered manager and her deputy had visited her relative to carry out an assessment prior to admission. The same relative confirmed that the placement was initially on a four week trial period. We viewed the files containing the care details of two recently admitted residents. Within both files we saw a copy of the assessment provided by the social worker. We also saw detailed assessments carried out by the manager to demonstrate that the service was aware of individual care needs. A care plan was devised to provide staff with the information needed for them to ensure these needs are met in a consistent way. We looked at two care plans and found them to be detailed and regularly reviewed to reflect changing care needs. Furthermore we saw risk assessments which were also reviewed. From discussions with care staff it was evident that they have a good knowledge of individual care needs. The AQAA states that the home has `a good working relationship with all health care professionals that visit Hopwood Court.` Community nurses visit the home regularly to provide medical and health care as needed. A relative confirmed that she is kept well informed about any changing care needs and that medical professionals are called out as needed. We saw written records showing that other professionals such as dentists and chiropodists visit the home periodically. The AQAA also makes reference to visits from opticians, audiologists, physiotherapist and psychologists, who visit when required. The AQAA confirms that if the service had any concerns regarding malnutrition or dehydration the resident`s GP would be called. We saw records regarding individuals weight and nutritional risk assessments within the care plans. Medication was, overall, well managed. We found medication to be held securely within a locked trolley or cabinets. Facilities are available for the safe storage of controlled medication. Records are maintained regarding the temperature of a dedicated fridge used for storing some medicines. We saw reports following a visit from the supplying pharmacy as well as a visit undertaken on behalf of the local Primary Care Trust (PCT). There were no concerns recorded upon these reports. The deputy manager demonstrated a keen desire to ensure that medication is managed correctly. She was keen to take on board areas detailed within the next section where changes to practice will improve systems further. We saw a senior member of staff administering some medication. The person concerned was carrying this task out in a competent way, ensuring that people received their medication as prescribed. Within the AQAA the manager wrote `Service users are treated kindly and with courtesy and their privacy and dignity is respected at all times along with their choice when dealing with personal care.` Throughout our time at Hopwood Court we saw staff interacting with residents in a calm and relaxed way. The atmosphere within the home was friendly with people using the service looking content. Residents appeared well attired taking into account gender and weather conditions. In the sun lounge we saw albums containing photographs of events both within the home as well as during outings to places such as a local safari park. We saw photographs of residents taken when a company brought some reptiles and small domestic animals to the home. Other photographs were of people during parties at the home as well as duringtimes when people were involved in daily routines such as making cakes. Within the AQAA the manager gave details of activities provided within the home. These include arm chair exercise to varying music three times a week from `trained outside providers`, quizzes, reminiscing, memory and board games, cards, crafts, flower arranging, bingo and sing a longs. During discussions with residents most of the above activities were mentioned. We saw a game taking place within the main lounge using a large pack of playing cards which involved the majority of people in the lounge. Residents were interacting with each other as well as with the person leading the event. The main mid day meal consisted of salmon fishcakes with mashed potato, broad beans, carrots and peas. An alternative was available for people who did not want the main option. The meal time was relaxed, where assistance was needed this was done discreetly. People were complimentary about the food provided, one resident described the fishcakes as `beautiful.` Hopwood Court is a very pleasant place in which to live. The home was clean and tidy throughout. The decor in communal areas is good and lighting is domestic in style. The seating in the main lounge is arranged in a way that encourages people to interact with each other. People are encouraged to personalise their own bedroom with items of furniture and other belongings. The home is set in extensive grounds which can be seen from communal areas and bedrooms. There is a patio to both the front and rear of the property. The home has a good staff recruitment process which makes sure that the required checks are undertaken prior to a new member of staff starting work. We saw that the service ensures it has a CRB (Criminal Records Bureau) disclosure and written references in place. Having these checks helps to reduce the risk of someone who is unsuitable gaining employment within the home. One relative wrote that the manager `runs a very happy and caring home and always puts residents first` and `T What the care home could do better: Hopwood Court continues to provide an excellent service. We have confidence that the areas we found needing some improvement will receive suitable action to ensure the health, safety and well being of people using the service. The management of medication was found to be overall in good order and people receive their medicines as prescribed. Some improvements are needed which will assist in providing a safer system. Medication needs to be maintained at or below 25 degrees Centigrade. At the time of our visit we found that records were not maintained regarding the temperature of the room. A thermometer was available and showed that the temperature was close to the optimum level.The system in place for when a date is entered on to boxed medication resulted in making the auditing of medication difficult. The deputy manager appreciated what we were saying and undertook to change the system. In addition the use of a certain code on a Medication Administration Record sheet did not always demonstrate who had administered medication. We found two windows on the first floor, one in a bedroom and one in a bathroom, without a restrictor in place. As a result the window could be fully opened. Having suitable restrictors in place safeguards people from accidental or deliberate falling from the window. The registered person`s were unable to account for this shortfall as they believed all windows were checked. We also discussed with one of the providers the catches on some windows as these could be overridden. No risk assessment was in place regarding these catches. Immediate action was taken to resolve the shortfalls found although some of these were short term actions while a method to reduce the risk more long term could be sought. We also brought to the attention of the registered persons a very hot water pipe going down the wall to feed a radiator. Although radiators were covered to prevent accidental scalding this pipe was not and could, therefore, be a potential risk. Random inspection report Care homes for older people Name: Address: Hopwood Court Birmingham Road Hopwood Alvechurch Worcestershire B48 7AQ three star excellent service The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Andrew Spearing-Brown Date: 1 2 0 4 2 0 1 0 Information about the care home Name of care home: Address: Hopwood Court Birmingham Road Hopwood Alvechurch Worcestershire B48 7AQ 01214454743 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Michelle Birchill Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mrs Carole Roach,Mr John William Roach care home 23 Number of places (if applicable): Under 65 Over 65 0 23 0 dementia old age, not falling within any other category physical disability Conditions of registration: 23 0 23 Age: Dementia (DE) age 55 and above Physical Disability (PD) age 55 and above The maximum number of service users who can be accommodated is: 23 The registered person may provide the following category of service only: Care Home Only (Code PC); To service users of the following gender: Either; Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) 23 Dementia (DE) 23 Physical Disability (PD) 23 Care Homes for Older People Page 2 of 10 Date of last inspection Brief description of the care home Hopwood Court provides personal care for up to 23 older people who may have a physical disability and/or a dementia illness. The home is situated in its own grounds off the main Birmingham Road and affords countryside views on all sides. It is approximately a mile and a half from Alvechurch village and there is a local public house. The home is on two floors and access to the first floor is by stair lift. Handrails are fitted throughout and adapted bathing and toilet facilities are available. Accommodation is provided in three double rooms and seventeen single rooms, seven of which are ensuite. There are communal bathrooms with toilets on each floor and six separate toilets. There are also communal lounges and a dining area. The home is owned by John William Roach and Carol Roach and the registered manager is their daughter Michelle Birchill For information upon the current fees and additional charges the reader should contact the service directly. Care Homes for Older People Page 3 of 10 What we found: This inspection visit was unannounced therefore nobody within the home knew we would be coming. The inspection was carried out by one inspector over a period of one day. The last key inspection at Hopwood Court was carried out during June 2007. The outcome of that inspection was that we rated the service as Excellent. Since the last key inspection we have carried out two Annual Service Reviews (ASR). An ASR is when we write a report about a service using the information we have received without carrying out a visit to the service itself. As this was a random inspection we wanted to gain an assessment of peoples experience within the home. This was to make sure that the standards highlighted within our previous report continue to be maintained. During our visit we looked at some documents such as care records, medication records and staffing records. We spent time having a look around the home and observing what was happening. As part of this inspection, in addition to the visit to the home, we also took into account other information we had received about the service. Prior to our visit we requested an Annual Quality Assurance Assessment (AQAA) from the registered persons. This is a document within which providers of care services are able to demonstrate to us where they believe they are providing a good service and of any further improvements they are intending to make. The AQAA was returned to us and contained clear and accurate information. We also sent out surveys to some people using the service and some members of staff. We have taken these into account within our report. During the inspection we had discussions with the registered manager, the deputy manager, one of the registered providers, some members of staff, some people living at the home and a visitor. What the care home does well: Information is provided to prospective residents and their relatives. We saw that a copy of the homes Statement of Purpose and Service Users Guide is available in the hallway near to the main entrance of the home. In addition we also saw a copy of our reports and the homes newsletter. We saw a copy of the Service Users Guide within one of the bedrooms. The Service Users Guide states that prospective residents are invited to visit the home for the day so that an assessment can be carried out. It continues to say that if an individual is unable to visit then the manager will visit the person concerned at home or in hospital to undertake the assessment. These details are also included within the AQAA which adds When the assessment is completed we ensure that we are able to meet the needs of the perspective service user. This information is backed up where possible with a community care assessment undertaken by a social worker if applicable. Care Homes for Older People Page 4 of 10 During our visit we spoke to a visitor who confirmed that the registered manager and her deputy had visited her relative to carry out an assessment prior to admission. The same relative confirmed that the placement was initially on a four week trial period. We viewed the files containing the care details of two recently admitted residents. Within both files we saw a copy of the assessment provided by the social worker. We also saw detailed assessments carried out by the manager to demonstrate that the service was aware of individual care needs. A care plan was devised to provide staff with the information needed for them to ensure these needs are met in a consistent way. We looked at two care plans and found them to be detailed and regularly reviewed to reflect changing care needs. Furthermore we saw risk assessments which were also reviewed. From discussions with care staff it was evident that they have a good knowledge of individual care needs. The AQAA states that the home has a good working relationship with all health care professionals that visit Hopwood Court. Community nurses visit the home regularly to provide medical and health care as needed. A relative confirmed that she is kept well informed about any changing care needs and that medical professionals are called out as needed. We saw written records showing that other professionals such as dentists and chiropodists visit the home periodically. The AQAA also makes reference to visits from opticians, audiologists, physiotherapist and psychologists, who visit when required. The AQAA confirms that if the service had any concerns regarding malnutrition or dehydration the residents GP would be called. We saw records regarding individuals weight and nutritional risk assessments within the care plans. Medication was, overall, well managed. We found medication to be held securely within a locked trolley or cabinets. Facilities are available for the safe storage of controlled medication. Records are maintained regarding the temperature of a dedicated fridge used for storing some medicines. We saw reports following a visit from the supplying pharmacy as well as a visit undertaken on behalf of the local Primary Care Trust (PCT). There were no concerns recorded upon these reports. The deputy manager demonstrated a keen desire to ensure that medication is managed correctly. She was keen to take on board areas detailed within the next section where changes to practice will improve systems further. We saw a senior member of staff administering some medication. The person concerned was carrying this task out in a competent way, ensuring that people received their medication as prescribed. Within the AQAA the manager wrote Service users are treated kindly and with courtesy and their privacy and dignity is respected at all times along with their choice when dealing with personal care. Throughout our time at Hopwood Court we saw staff interacting with residents in a calm and relaxed way. The atmosphere within the home was friendly with people using the service looking content. Residents appeared well attired taking into account gender and weather conditions. In the sun lounge we saw albums containing photographs of events both within the home as well as during outings to places such as a local safari park. We saw photographs of residents taken when a company brought some reptiles and small domestic animals to the home. Other photographs were of people during parties at the home as well as during Care Homes for Older People Page 5 of 10 times when people were involved in daily routines such as making cakes. Within the AQAA the manager gave details of activities provided within the home. These include arm chair exercise to varying music three times a week from trained outside providers, quizzes, reminiscing, memory and board games, cards, crafts, flower arranging, bingo and sing a longs. During discussions with residents most of the above activities were mentioned. We saw a game taking place within the main lounge using a large pack of playing cards which involved the majority of people in the lounge. Residents were interacting with each other as well as with the person leading the event. The main mid day meal consisted of salmon fishcakes with mashed potato, broad beans, carrots and peas. An alternative was available for people who did not want the main option. The meal time was relaxed, where assistance was needed this was done discreetly. People were complimentary about the food provided, one resident described the fishcakes as beautiful. Hopwood Court is a very pleasant place in which to live. The home was clean and tidy throughout. The decor in communal areas is good and lighting is domestic in style. The seating in the main lounge is arranged in a way that encourages people to interact with each other. People are encouraged to personalise their own bedroom with items of furniture and other belongings. The home is set in extensive grounds which can be seen from communal areas and bedrooms. There is a patio to both the front and rear of the property. The home has a good staff recruitment process which makes sure that the required checks are undertaken prior to a new member of staff starting work. We saw that the service ensures it has a CRB (Criminal Records Bureau) disclosure and written references in place. Having these checks helps to reduce the risk of someone who is unsuitable gaining employment within the home. One relative wrote that the manager runs a very happy and caring home and always puts residents first and The staff here follow her lead - kind and caring. What they could do better: Hopwood Court continues to provide an excellent service. We have confidence that the areas we found needing some improvement will receive suitable action to ensure the health, safety and well being of people using the service. The management of medication was found to be overall in good order and people receive their medicines as prescribed. Some improvements are needed which will assist in providing a safer system. Medication needs to be maintained at or below 25 degrees Centigrade. At the time of our visit we found that records were not maintained regarding the temperature of the room. A thermometer was available and showed that the temperature was close to the optimum level. Care Homes for Older People Page 6 of 10 The system in place for when a date is entered on to boxed medication resulted in making the auditing of medication difficult. The deputy manager appreciated what we were saying and undertook to change the system. In addition the use of a certain code on a Medication Administration Record sheet did not always demonstrate who had administered medication. We found two windows on the first floor, one in a bedroom and one in a bathroom, without a restrictor in place. As a result the window could be fully opened. Having suitable restrictors in place safeguards people from accidental or deliberate falling from the window. The registered persons were unable to account for this shortfall as they believed all windows were checked. We also discussed with one of the providers the catches on some windows as these could be overridden. No risk assessment was in place regarding these catches. Immediate action was taken to resolve the shortfalls found although some of these were short term actions while a method to reduce the risk more long term could be sought. We also brought to the attention of the registered persons a very hot water pipe going down the wall to feed a radiator. Although radiators were covered to prevent accidental scalding this pipe was not and could, therefore, be a potential risk. 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 2. Care Homes for Older People Page 7 of 10 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 8 of 10 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, 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 9 A record of the room temperature where medication is stored should be maintained to ensure that it remains at or below 25 degrees Centigrade. A review of the medication system such as when boxed items are dated as opened should take place to ensure full and accurate audits can be undertaken. A review of systems to ensure that all parts of the home are safe and free from potential hazards should be undertaken. 2 9 3 38 Care Homes for Older People Page 9 of 10 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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