Care Home: Hulton Care Home

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What the care home does well The admission procedures in the home made sure that people`s care needs were assessed and written down so that a decision could be made about whether or not Hulton Care was a suitable place for them. Residents who were spoken with, and who completed questionnaires, were complimentary about the care in the home. One resident said the home was "wonderful", another said it was "champion". One said that the "staff work very hard".The written plans for residents` care were detailed and well written, and contained useful information regarding the residents` health, personal and social care needs. These care plans were regularly reviewed and updated. The residents` health was monitored and appropriate action taken. Routines were flexible enough to suit individual preferences and residents were satisfied with the level of choice they had in such things as meals, and going to bed and getting up times. The home employed an activities organiser, and there was a wide programme of interesting and enjoyable activities, including trips out. Residents said that there was "plenty going on". One resident said, "I enjoy joining in everything". Most residents have complimented the meals over a period of time, and the menus showed that the food served was nutritious and appetising. One resident said, "The food is marvellous". Hulton Care provided modern, pleasant, bright, and well - maintained accommodation throughout, which was decorated and furnished to a high standard. It was clean with no unpleasant odours. The outside areas were attractively arranged with flower tubs and landscaped areas and were well maintained. This provided a pleasant area for residents to enjoy. Residents said they appreciated their bedrooms and the outside areas. The dementia unit also provided a homely pleasant, bright relaxing environment in accordance with guidance published for care homes looking after people with dementia. A high proportion of the staff in the home had gained the qualifications recommended for people working in care homes, and the further training that staff completed was relevant and useful and helped them understand the needs of the residents. Staff were complimentary about working in the home and felt it was a good place to work. There had been a stable management team for the last three years that helped ensure the smooth running of the home and helped to ensure that there was continuity of care for the residents. The home provided a safe place for residents to live in and for staff to work in.Hulton Care HomeDS0000022503.V360064.R01.S.docVersion 5.2Page 7 What has improved since the last inspection? The written information about the home had improved and it was now made clear that there was a specialised dementia unit in the home where people with specialist needs lived. The way medication was administered and managed in the home had improved and practices and procedures were safer than at the previous inspection. The residents were more involved in the running of the home and were now encouraged to fill out questionnaires about the home and the services. What the care home could do better: There should be more supporting evidence and information about people`s specialist needs when transferred to the dementia unit from the other part of the home. This is so it is clear why this move has taken place and that the dementia unit is the best place for people. The assessment of risks associated with people`s lives could be further improved so that the risks are clearly identified and what action needs to be taken to reduce or eliminate the risk for people. Medication could be further improved by putting more useful information on the Medication Administration Records about when medication should be given. CARE HOMES FOR OLDER PEOPLE Hulton Care Home Hulton Drive Off Halifax Road Nelson Lancashire BB9 0EY Lead Inspector Mrs Pat White Unannounced Inspection 14th May 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 Hulton Care Home DS0000022503.V360064.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. Hulton Care Home DS0000022503.V360064.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hulton Care Home Address Hulton Drive Off Halifax Road Nelson Lancashire BB9 0EY 01282 617773 01282 614445 hultonnelson@schealthcare.co.uk 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) Southern Cross Care Homes Limited Donna Marie Laird Care Home 30 Category(ies) of Dementia (2), Dementia - over 65 years of age registration, with number (5), Old age, not falling within any other of places category (22), Physical disability (1) Hulton Care Home DS0000022503.V360064.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 30 service users to include:*Up to 2 service users in the category of DE (Dementia) *Up to 5 service users in the category of DE (E) (Dementia over 65 years of age) *Up to 22 service users in the category of OP (Old age not falling within any other category). *Up to 1 service user in the category of PD (Physical disability) 7th June 2007 Date of last inspection Brief Description of the Service: Hulton Care Centre is a purpose built care home situated in a residential area on the outskirts of Nelson. It is owned by a national organisation called Southern Cross. There are extensive grounds to the front and sides of the home that are pleasant, well kept and accessible, and include lawned areas and car parking space. The home is able to accommodate up to thirty people, both men and women. Twenty-two places are available for older persons who require personal care and there is a seven-bed unit, for service users who have dementia. All the bedrooms in the home are single rooms, and include ensuite toilet and hand basin. There is a lounge, a conservatory, a dining area and a smoking area for residents. Fees charged per week are between £366 and £512, with additional charges for hairdressing, chiropody and some activities. The home has a Statement of Purpose and Service User Guide providing information about the care provided, the qualifications and experience of the owner and staff and the services residents can expect if they choose to live at the home. A copy of the Service User Guide and most recent inspection report is issued to all prospective residents and their relatives/representatives to help them make an informed choice about whether to move into the home. Hulton Care Home DS0000022503.V360064.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 Star. This means that people who use the service experience good outcomes. This inspection site visit, carried out on the 14th May 2008, was part of an inspection to determine an overall assessment on the quality of the services provided by the home. This included checking important areas of life in the home that should be checked against the National Minimum Standards for Older People, and checking the progress made on some matters that needed improving from the previous inspection. The inspection included: talking to residents, touring the premises, observation of life in the home, looking at residents’ care records and other documents, discussion with members of staff and discussion with the manager, Mrs Donna Laird. Survey questionnaires from the Commission were sent to the home for residents, relatives and staff to complete. Twenty residents and 11 staff returned these questionnaires. At the time of writing this report no relatives had returned questionnaires. Seven residents and 3 staff were spoken with in some depth, and their views are included in the report. Other residents were spoken to but were unable to give their views about the home. In addition the home provided the Commission with written information about the residents, staff and services provided, and some of this is also included in the report. What the service does well: The admission procedures in the home made sure that people’s care needs were assessed and written down so that a decision could be made about whether or not Hulton Care was a suitable place for them. Residents who were spoken with, and who completed questionnaires, were complimentary about the care in the home. One resident said the home was “wonderful”, another said it was “champion”. One said that the “staff work very hard”. Hulton Care Home DS0000022503.V360064.R01.S.doc Version 5.2 Page 6 The written plans for residents’ care were detailed and well written, and contained useful information regarding the residents’ health, personal and social care needs. These care plans were regularly reviewed and updated. The residents’ health was monitored and appropriate action taken. Routines were flexible enough to suit individual preferences and residents were satisfied with the level of choice they had in such things as meals, and going to bed and getting up times. The home employed an activities organiser, and there was a wide programme of interesting and enjoyable activities, including trips out. Residents said that there was “plenty going on”. One resident said, “I enjoy joining in everything”. Most residents have complimented the meals over a period of time, and the menus showed that the food served was nutritious and appetising. One resident said, “The food is marvellous”. Hulton Care provided modern, pleasant, bright, and well - maintained accommodation throughout, which was decorated and furnished to a high standard. It was clean with no unpleasant odours. The outside areas were attractively arranged with flower tubs and landscaped areas and were well maintained. This provided a pleasant area for residents to enjoy. Residents said they appreciated their bedrooms and the outside areas. The dementia unit also provided a homely pleasant, bright relaxing environment in accordance with guidance published for care homes looking after people with dementia. A high proportion of the staff in the home had gained the qualifications recommended for people working in care homes, and the further training that staff completed was relevant and useful and helped them understand the needs of the residents. Staff were complimentary about working in the home and felt it was a good place to work. There had been a stable management team for the last three years that helped ensure the smooth running of the home and helped to ensure that there was continuity of care for the residents. The home provided a safe place for residents to live in and for staff to work in. Hulton Care Home DS0000022503.V360064.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Hulton Care Home DS0000022503.V360064.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 Hulton Care Home DS0000022503.V360064.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. Standard 6 not applicable Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There was useful information about the home to help people make a choice about whether or not to live there. The home’s admission procedures, including pre admission assessments, helped to determine whether or not the home could meet people’s needs and residents and relatives were confident that their needs were being met. EVIDENCE: The Statement of Purpose and the Service User Guide provided useful information about the home to residents, prospective residents and visitors. This information was seen in residents’ rooms. Since the previous inspection these documents had been updated and developed to give a better picture of the home. Hulton Care Home DS0000022503.V360064.R01.S.doc Version 5.2 Page 10 All 20 residents who completed the questionnaires said they had enough information to help them make a decision about whether or not to live in the home. There was evidence from the records viewed, and talking to people, that the manager carried out a suitable assessment of needs with prospective residents before admission, to help determine whether or not the home could meet their needs. After this assessment the home also confirmed the outcome of the assessment in writing. Residents and relatives had the opportunity of visiting the home prior to a decision being made and some residents said that they and their relatives had chosen Hulton Care. However the records of one resident in the dementia unit, who had been transferred from the older person’s part of the home, showed that the home was still not carrying out a comprehensive assessment of mental health needs that demonstrated that the transfer was appropriate. However some improvement in this process was evident, as the records showed that the community mental health team and the relatives had been involved in the decision. Discussion with residents, and the survey questionnaires from residents and staff indicated that those concerned felt the home in general met the diverse needs of the different residents, including those with dementia. Hulton Care Home DS0000022503.V360064.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. All residents had written care plans that contained useful information about their personal, health and social care needs, to assist the care staff in providing care to residents. However some of the written risk assessments could be improved to assist staff. Residents’ medical care needs were promoted and medication procedures ensured that medication was managed and administered safely. Residents’ privacy and dignity were respected. EVIDENCE: All the residents had detailed care plans that were developed from the assessment. The records showed that there were risk assessments for most aspects of care, including for pressure areas, continence, nutrition, moving and handling, medication, falls and bed rails/ wedges. Detailed care plans were also developed from these risk assessments. Some care plans also included more details than at the last inspection about how people wanted their personal care to be provided, what they could do for themselves, and about Hulton Care Home DS0000022503.V360064.R01.S.doc Version 5.2 Page 12 social activities. There was evidence that the care plans were reviewed frequently and that residents and relatives were involved in the reviews. However some of the written risk assessments and care plans viewed could still be improved. For example one risk assessment underpinning the measures used to protect people from falling out of bed did not show why rails were used and not wedges. For one resident whose records were viewed the falls risk assessment did not have a suitable care plan/action plan. Both these records had been developed accordingly at the end of the site visit. There was evidence that the residents’ health was monitored and maintained and residents had access to all the health care services. Most health matters were recorded in detail on the care plans, including pressure areas and continence issues. The intervention required to prevent pressure areas was also detailed and informed staff about what to do. Medical appointments and district nurses’ visits were recorded and showed that residents had access to the appropriate medical services including the mental health services for older people. There were detailed policies and procedures for handling and recording medication, and the procedures and practices carried out by staff had ensured that residents were given medication safely and at the right time. Rigorous auditing by senior members of staff had ensured practices had improved and that good practices were maintained. Examination of Medication Administration Record charts (MARs), together with an audit of the medication of 3 residents, showed that accurate records were kept of all medication being received into the home and administered to residents. Accurate records were also kept of medication being returned to the pharmacist. Changes to people’s medication in the middle of the cycle had been suitably recorded with dates and witness signatures. Controlled drugs were safely stored and administered correctly. Since the previous inspection good written instructions for the administration of “when required” medication had been developed. However on one MAR viewed the entry for a “when required” medicine did not state this. Also some important information for one medicine, regarding the timing of administration in relation to food and the position of the resident, had not been written on the MAR. There was therefore the risk that the resident might receive this medicine at the wrong time. This could cause it to lose effectiveness or increase the side effects. Residents were satisfied that staff respected their rights to privacy and dignity. They said that staff treated them appropriately, and that personal care was carried out in a way that respected their dignity. All bedrooms were single and en suite, with appropriate door locks with keys to enhance people’s privacy. Residents could spend time in their rooms and eat there if they wished. The importance of respecting residents’ privacy and dignity was part of the staff Induction training. Hulton Care Home DS0000022503.V360064.R01.S.doc Version 5.2 Page 13 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 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Routines were flexible enough to suit individual preferences, and residents had reasonable choices in their every day lives, including enjoyable and interesting activities. Residents were encouraged to maintain links with family and the outside community. The food served was appetising, wholesome and suited residents’ preferences. EVIDENCE: Residents spoken with at the site visit confirmed that some routines were flexible to suit individual preferences such as rising and retiring times and being able to spend time in the privacy of their own room. Some of these preferences and hobbies and interests were recorded on the care plans. The home employed an activities organiser who ensured a variety of activities and events, some of which had been developed since the previous inspection, including a “coffee bar” each week for residents and relatives. There had been a number of recent trips out. Residents spoke positively of the activities and Hulton Care Home DS0000022503.V360064.R01.S.doc Version 5.2 Page 14 one resident said, “I enjoy joining in everything”. The residents in the dementia unit also had the opportunity of taking part in activities, though there was no evidence of activities specifically suited to people with dementia. Residents enjoyed being outside in the attractive grounds in good weather. There was evidence that residents’ religious preferences were respected and ministers from some denominations and faiths attended the home. Visitors were welcome in the home at any reasonable time and visitors were seen coming and going throughout the day. The visiting policy was outlined in the Service User Guide. There was sufficient space in the home for people to visit residents in private. Residents kept in touch with the local community through visits by clergymen, events for the local community held in the home and trips out. Residents were encouraged to be as independent as possible and exercise choices, such as being able to smoke in the smoking area. Residents could bring items of furniture with them and bedrooms were personalised. Residents meetings were held which enabled residents to air views on, for example what food should be served and what leisure activities they preferred. Residents spoken with confirmed that they were consulted about some aspects of life in the home and confirmed that residents meetings were held. The food served on the day of the inspection was appetising, wholesome and nutritious and offered the residents a choice of food at tea - time. The dietary preferences and cultural requirements of residents were accommodated, such as the provision of Halal meat. Residents ate in the dining room but could have their meals in their bedrooms if they wished. Since the previous inspection new menus had been introduced, and discussed at length with the residents to make sure they were in agreement. Also a choice of two hot meals at lunch time had been introduced, in order to please more people, and the cook spoke with individuals to make sure that everyone had their preferences catered for. There was written information in the kitchen about the requirements of those residents with diabetes. The residents spoken with at the site visit praised the food served. However observation at the site visit showed that the way a particular resident was assisted with feeding could be improved and this was discussed with senior staff at the time of the site visit. Hulton Care Home DS0000022503.V360064.R01.S.doc Version 5.2 Page 15 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. There was a clear complaints procedure accessible to residents and relatives in the information pack given to people on admission. Residents and relatives knew how to make a complaint and were confident that their concerns would be taken seriously. The home had appropriate procedures and practices to protect the residents from abuse. EVIDENCE: According to the information supplied by the home prior to the inspection, and discussions with the manager, there had been 3 complaints, which had been recorded and investigated, since the previous inspection. Also everyday grumbles and concerns appeared to be taken seriously and acted upon. The home had a complaints procedure that was given to residents and relatives as part of the admission pack. Residents spoken with stated that they had no complaints and most who completed the survey questionnaires stated that they knew who to speak to if they were not happy with anything and knew how to make a complaint. However some people who lived in the dementia unit would not be able to use the complaints procedure and may not be able to communicate any concerns to the staff. Hulton Care Home DS0000022503.V360064.R01.S.doc Version 5.2 Page 16 There were policies and procedures to protect the residents from different kinds of abuse. These included a “whistle blowing” procedure for staff and step –by - step procedures for staff to follow in the event of a suspicion or allegation of abuse. Since the previous inspection there had been no recent allegations or suspicions of abuse. Staff had appropriate training in the Protection of Vulnerable Adults and those spoken with knew what to do if they had concerns or suspicions of abuse. Residents spoken with felt staff always treated them appropriately and felt safe living in the home. Hulton Care Home DS0000022503.V360064.R01.S.doc Version 5.2 Page 17 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, 23, 24, 25 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provided clean, pleasant, well - furnished and comfortable accommodation for the residents, including communal and bedroom space. The residents’ own rooms suited their needs with some of their own possessions around them. EVIDENCE: Hulton Care is a purpose built care home and there was a separate self contained unit for seven residents with a diagnosis of dementia and in need of specialist care. The premises at the time of the inspection were well maintained and pleasantly decorated and furnished throughout. The home had a programme Hulton Care Home DS0000022503.V360064.R01.S.doc Version 5.2 Page 18 of redecorating and refurbishment and a maintenance person was employed in the home so that some jobs could be completed quickly. Since the previous inspection some bedrooms had been redecorated and carpets replaced. The communal areas comprised of a dining room, a non - smoking lounge, a conservatory and a smoking room for residents. This together with their personal bedrooms gave the residents choice of space. There were attractive additions to some of the communal areas such as candles, ornaments and flowers. The grounds were also well maintained and attractive with seating areas. All bedrooms were single and en suite with WC and hand basin. The bedrooms were pleasantly decorated and furnished. Residents had small items of their own furniture and the bedrooms met individual’s needs. However in spite of regular water temperature checks being carried out, the hot water at some of the bedroom taps on the first floor was too hot and potentially put residents at risk. This was outstanding from the previous inspection and there was no evidence to indicate how residents were protected. This was discussed fully with the manager who said that some work was being carried out to the water system and this should improve the regulation mechanism. Also subsequent to the site visit we were informed that the hot water system had again been adjusted and that thermostatic mixer valves were to be fitted on taps that were a problem. The home was clean and fresh in all areas that were seen. Laundry procedures were satisfactory for the control of infection, and ensuring residents’ clothes were maintained in a smart condition. There was a rolling programme of training in infection control and a number of staff had undertaken such training earlier this year. The resident questionnaires indicated that the home was always fresh and clean. Hulton Care Home DS0000022503.V360064.R01.S.doc Version 5.2 Page 19 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. The home had sufficient numbers of staff on duty with sufficient training and qualifications to meet the needs of the residents. The home’s staff recruitment policies and procedures were thorough and helped to protect the residents from unsuitable staff. The home had a good staff training programme that was being developed to meet the needs of the residents and the staff group. EVIDENCE: On the day of the site visit the number of staff on duty and the skills of the staff team appeared sufficient for meeting the needs of the residents. A cook and a cleaner were employed in the home for sufficient hours to enable good standards of food and hygiene to be maintained. Since the previous inspection the staffing levels in the dementia unit had been increased to 2 care staff for another hour between 4:00pm and 5:00pm due to the increasing number of residents requiring 2 carers to assist. Staff spoken with said that this had improved the situation and that it had reduced the number of occasions when staff moved from the old persons section to assist in the dementia unit. However there was only one member of staff in the dementia unit at the times of the day when residents are getting up and going Hulton Care Home DS0000022503.V360064.R01.S.doc Version 5.2 Page 20 to bed and this means that staff will have to assist from the older persons part of the home. Therefore there was still a possibility in both parts of the home of residents having to wait for assistance, particularly at weekends, when the manager was not on duty or the activities organiser was not working in the home. Whilst there was no evidence that this was a problem at the time of the site visit, 4 out of 7 members of staff who completed the questionnaires said that they felt there were only “sometimes” enough staff on duty. One said “we should have an extra member of staff on duty to meet the needs of all the residents correctly”. Information supplied for this inspection stated that 80 of care staff were qualified to at last NVQ level 2, and a number of staff had NVQ level 3. Staff had undertaken a variety of short training courses in addition to NVQ courses, and according to their own needs and those of the residents, such as fire safety, moving and handling, first aid, understanding diabetes, challenging behaviour and Protection of Vulnerable adults. Staff working in the dementia unit had undertaken a short course on caring for people with dementia to help them understand these residents’ needs. The home’s induction training programme had been developed in accordance with Government guidance. The 11 staff who completed questionnaires said that the Induction had prepared them for their work, and all staff felt that the training offered was relevant and useful. Those spoken with at the site visit felt there were good training opportunities. Staff records showed that staff recruitment procedures were in accordance with the Care Homes Regulations and that staff did not commence work unsupervised until all police checks and written references had been obtained. The records also indicated that a new member of staff had completed a suitable induction. Hulton Care Home DS0000022503.V360064.R01.S.doc Version 5.2 Page 21 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 & 38 Quality in this outcome area is good. This judgement has been made using available evidence, including a site visit to this service. The manager was qualified and competent to run the home. The residents were consulted in a number of ways about aspects of the home, and their views were taken into account. Health and safety policies and procedures ensured a safe environment for residents and staff. EVIDENCE: The manager had been in post for about three years and was registered with the Commission. She had gained the Registered Managers Award and at the time of the site visit had successfully completed NVQ level 4 in Care. The deputy manager had also completed this qualification. An Operations Hulton Care Home DS0000022503.V360064.R01.S.doc Version 5.2 Page 22 Manager of Southern Cross visited the home regularly, and this included monthly unannounced visits as required under Regulation 26 of the Care Homes Regulations. Hulton Care carried out quality monitoring measures according to Southern Cross company policy. This included an annual resident and relative survey using questionnaires. Residents meetings were held regularly, and informal conversations with residents were also used to influence the way the home was run. Internal audits were carried out e.g. medication, health and safety and environment. The management of residents’ finances was not fully assessed but we were informed that residents’ personal allowances were no longer being pooled, and separate accounts were used. This was in line with guidance to protect residents’ finances. Clear records were kept of monies paid into and withdrawn, and indicated what the money was spent on and how much. The health and safety policies and procedures ensured the safety of the residents and staff. According to the information supplied by the home, and records kept in the home, all appliances and equipment, including fire equipment had been tested appropriately and had current certificates. Radiators were covered and residents were therefore protected from the hazards of hot surfaces. There was a rolling programme of moving and handling training to ensure that all staff had up to date skills and assisted residents safely. Staff also undertook training in fire safety first aid and infection control. The home notified the Commission according to guidance of all incidents affecting the welfare of the residents such as accidents and injuries so that these could be monitored. Hulton Care Home DS0000022503.V360064.R01.S.doc Version 5.2 Page 23 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 2 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 x x 3 3 2 3 STAFFING Standard No Score 27 2 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x x x x 3 Hulton Care Home DS0000022503.V360064.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP3 Good Practice Recommendations Before residents are transferred from the older people’s part of the home to the dementia unit there should be sufficient supporting information such as a comprehensive dementia/ mental health assessment to demonstrate that the person concerned has specialist needs and is in need of a specialist placement. Written risk assessments should be fully completed with a care plan/action plan, so that it is clear what action needs to be taken to protect people, for example from falls, and why certain measures are used to prevent people from falling out of bed. The Medication Administration Records should contain all important details to assist staff such as whether or not medication is “when required”, and what time medicines should be administered in relation to food, to ensure that residents take their medication at the right time. DS0000022503.V360064.R01.S.doc Version 5.2 Page 25 2 OP7 3 OP9 Hulton Care Home 4 5 OP12 OP25 Specific activities for individuals in the dementia unit should be sought to maintain their skills and interest. The hot water outlets should be regulated so that hot water runs within the recommended range to ensure the comfort and safety of the residents. The staffing levels should be kept under review and particularly in the dementia unit regarding the changing dependency levels of the residents and adjusted accordingly so that there are always sufficient staff with the right skill on duty throughout the home. 6 OP27 Hulton Care Home DS0000022503.V360064.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Manchester Local office 11th Floor West Point 501 Chester Road Manchester M16 9HU 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 Hulton Care Home DS0000022503.V360064.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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