Care Home: Hunters Creek Nursing Home

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What the care home does well Hunters Creek provides a homely, safe environment to the people who live there. The people spoken to during the inspection gave good feedback about the service. One resident said `I am really happy here and get well cared for.` Another said `I have no complaints, the staff are very kind and caring.` A relative said `I`m quite satisfied with everything, they do a good job.` The hairdresser said `I have been coming here for seventeen years now, the residents seem pretty happy and I think the care staff do very well. I see plenty of entertainment and activities going on.` Residents looked well cared for and had current individual care plans. Health care monitoring systems and medication systems are adequately and safely maintained. The residents have access to a wide range of suitable stimulation. The activity coordinator provides a monthly newsletter telling people whats on. There is a lot of activities and entertainment planned and the residents said that they are given a choice about what they want to do. Feedback about the food was very good. One resident said ` the food is very nice and we get a lot of choice. The food is nicely served.` The atmosphere in the dining room was relaxed and staff were very sensitive when assisting people with their meals. Staff are well trained and undertake training on specialist areas. Systems for quality monitoring and dealing with complaints are robust and people are encouraged to raise any concerns which are dealt with in a sensitive and non-discriminatory manner. What has improved since the last inspection? No requirements were made at the last inspection however since the last visit there has been improvements made to the management structure and quality auditing systems. Improvements have been made to the environment as an extensive refurbishment has been carried out. On walking into the home the atmosphere was very homely and vibrant. What the care home could do better: No requirements have been made. Only one recommendation was made and this was for areas of the care planning system to be more person centred as the aims and goals of individuals recorded are quite generic. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Hunters Creek Nursing Home 130 London Road Boston Lincolnshire PE21 7HB     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Alison Jessop     Date: 0 5 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 24 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Hunters Creek Nursing Home 130 London Road Boston Lincolnshire PE21 7HB 01205358034 01205361398 caroline.greaves@twhealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Caroline Greaves Type of registration: Number of places registered: Tanglewood (Lincolnshire) Ltd care home 83 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home Hunters Creek is a modern, two storey, purpose built home which is situated in a residential area on the edge of the market town of Boston. The home is within close proximity of the town centre and is on a bus route. The home is registered to accommodate eighty three service users. There are a number of small lounge and conservatory areas on the first and ground floor. Within the grounds, there are two single storey bungalows occupied by service users needing personal care only. The home provides nursing and personal care for people of over sixty five years, and also provides accommodation for up to twelve people under the age of sixty five. There is a car park to the side of the building. The gardens are landscaped, and well maintained. Service users have access to the garden, which, in the summer offers seating. A copy of the Service User Guide and Statement of Purpose can be obtained from the Care Homes for Older People Page 4 of 24 Over 65 83 0 0 1 Brief description of the care home manager. The current fees for this service range from £351 to £435 for residential care (£452 for physical disability) and £499 to £553 for nursing care. Care Homes for Older People Page 5 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced visit and it formed part of a key inspection, focusing on key standards, which have the potential to affect the health, safety and welfare of people who use the service. Throughout this report the terms we and us refer to The Commission for Social Care Inspection (CSCI). The visit lasted approximately six hours and we took into account previous information held by us including the previous inspection report, their service history and records of any incidents that we had been notified of since the last inspection. Before we made our visit the provider had returned the Annual Quality Assurance Assessment (AQAA). This gave us information about their own assessment of how well they are meeting standards and their plans to improve aspects of the service. Care Homes for Older People Page 6 of 24 The main method used to carry out the inspection is called case tracking, this includes following the care of a sample of four people through their records and assessing their care. We spoke to five people who use the service and saw rooms of those people who said we could and spoke to three staff members. We also spoke to one relative and the visiting hairdresser. The Registered Manager was present throughout the visit and the Provider/Director of the company was also present for the majority of time. The general outcomes of the visit were discussed with them both at the end of the inspection. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 24 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 24 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has a robust admission procedure which takes into account the diverse needs of the prospective residents. Admission is not agreed until the information gained has been carefully considered, this ensures that the persons needs can be met. Evidence: A qualified person, usually the Registered Manager carries out a comprehensive needs assessment prior to admission being agreed. The assessment takes into account the diverse needs of the prospective resident to ensure that their clinical, social and physical needs can be met. Information is also gained from their family or other representative and consultation made with external agencies. Care Homes for Older People Page 10 of 24 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care needs of the residents are fully met. Care is carried out in a dignified and sensitive manner. Evidence: Feedback about the care people receive was good. One resident said they look after me very well, Im quite satisfied. A visitor spoken to said they look after my relative very well, they are very comfortable here. Each resident has a care plan which is regularly reviewed. The care plan provides comprehensive information about how the persons needs are going to met and a life history of the person is recorded so that staff can relate to the residents social and emotional needs. One section of the care plan describes the persons aims, this was a generic statement observed on three care plans and was not written in a person centred way. Care plans describe how residents can maintain their independence. Risk assessments are completed and regularly reviewed to ensure the safety of the residents and staff. Where new residents are admitted in an emergency, a temporary Care Homes for Older People Page 11 of 24 Evidence: care plan is put in place and a full care plan is then implemented within 48 hours. The residents spoken to said that their health care needs are fully met. One resident said if I need to see the doctor or nurse I just have to ask, they are very good here like that. A chiropodist visits the home on a monthly basis and residents have access to other health services as required. We looked at medication procedures on the residential unit. Residents medication is safely stored and administered by Care Team Leaders. All staff who administer medication receive on-going training and practice is monitored for nurses and carers. Medication audits regularly carried out. Each resident has a care plan on the use of any homely remedies this includes any vitamins or herbal remedies taken to ensure these are taken safely. Care practice observed was carried out in a dignified and sensitive manner. This was particularly noticed during lunch where residents required assistance with eating their meals. One carer was smiling at the resident and only offered more food when the resident had finished chewing and seemed ready for more. The resident was not rushed and although this was a slow process the carer continued to smile and chat to the resident. Care Homes for Older People Page 12 of 24 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live in the home have access to a wide range of stimulating activities to suit their individual needs. Mealtimes provide a relaxed, sociable environment to the residents. Evidence: The home employs an activity co-ordinator and individual social care plans are developed to ensure that peoples social care needs are met. Each resident is given a monthly newsletter which tells the residents whats happening and lists residents birthday dates. Residents spoken to said they can choose which activities they can join. One resident said we have lots of things to do, we can do games and bingo, we also do some exercises. A religious service is also held regularly in the home. The Annual Quality Assurance Assessment states we plan to develop special celebration days and to promote family events for residents and staff. During the month of November a variety of events were advertised including a shoe box day where residents pack boxes with presents for charity where mince pies and sherry are served to make it a fun day. Also there is a knitting club, a visit from Jack the PAT dog, skittles, bingo, musical movement, arts and crafts, holy communion, a clothes sale, a children in need night where a member of staff has offered to shave his legs and chest Care Homes for Older People Page 13 of 24 Evidence: to raise money, a rock n jive, quiz, a film show and other entertainment. The home has an open door visitors policy where family and friends can visit at any time with the agreement of the resident. On the day of the inspection several visitors were seen around the home and the staff were friendly and welcoming towards them. The company employs a Head Group Senior Chef who visits all the Tanglewood services on a regular basis to ensure that the catering needs of the residents are met both nutritionally and by providing quality and choice. The food is freshly cooked. The feedback about the food was very good. One resident said the food is great, we get a good choice and we get alot of it. Another said I think the food is really nice, I especially like the pudding. Another said we get a cooked breakfast which I enjoy. The dining tables are nicely laid out and staff were observed chatting to the residents throughout the lunch time period. Care Homes for Older People Page 14 of 24 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management of complaints is handled in a way that ensures that people can feel confident about raising concerns and complaints. Systems are in place to ensure that complaints are handled in a supportive, non-judgemental and sensitive manner. Evidence: The service has received three complaints in the last 12 months. Two of which were resolved within the timescale of 28 days. One is still being investigated. The home has a clear complaints procedure and all complaints are investigated by the companys compliance manager or a director to ensure that an investigation is carried out by an impartial person in a transparent way. The manager stated that she has an open door policy and welcomes any concerns or complaints. All complaints are fully recorded and the manager ensures that any actions are taken to rectify and prevent any further issues. Residents who complain are given the opportunity to meet with the compliance manager or director/s away from the home. All residents spoken to said that they know how to make a complaint but all said they would be able to speak to staff informally if they had any concerns and felt confident that this would be dealt with. There has been one adult safeguarding investigation where an allegation of neglect was made by a relative however this was fully investigated and was not substantiated. The service has comprehensive recruitment procedures and risk assessments are carried out by the Registered Manager and Directors if any issues arise on receipt of Care Homes for Older People Page 15 of 24 Evidence: references and Criminal Record Disclosures. All staff spoken to fully understood the Adult Safeguarding procedures and copies of this are displayed throughout the home. The Annual Quality Assurance Assessment states that following recent training on dementia care, staff have more awareness of the vulnerability of the residents. There are leaflets on safeguarding adults in the reception area which residents and visitors can take. Care Homes for Older People Page 16 of 24 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Hunters Creek provides a comfortable, homely and safe place for people to live. Evidence: The home has received an extensive refurbishment. On entry to the home the reception room is attractively decorated and provides a comforatble area for the residents to sit. The bedrooms are also nicely decorated and residents are encouraged to bring personal possessions to help them to feel at home. One resident said its loverly here, its like being in a posh hotel. Residents have access to outdoor facilities in the warmer weather and during the winter months the residents have sun lounges where they can sit and look out into the garden. The home is very clean and well maintained. Staff were observed to follow current good practice in infection control procedures and the carpets are thoroughly cleaned. No malodours were detected and residents commented on how clean the home is. Care Homes for Older People Page 17 of 24 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff working in the home are well trained and provide a variety of experience and skill. Recruitment procedures are robust and protect residents from harm. Evidence: The home employs a stable staffing team and a lot of staff have been working in the home for more than fifteen years. Generally the residents said that there needs are met by the staffing numbers available however two people said that they sometimes have to wait for assistance. One said we need more carers. There was no evidence seen to suggest that staffing levels are inadequate, people said that there needs are met and call bells were answered promptly. Feedback about the staff was good, one resident said the staff are very kind to me, they are very caring. Another said they are friendly and I like to have a good laugh with them. The manager stated that agency carers will be used as a last resort where regular staff cannot provide cover. The provider stated that if staffing shortages are reported due to sickness or holidays then the manager has the authority to commission agency staff as there are no restrictions on staffing budgets. Staff confirmed that they receive regular training and not only for mandatory subjects but for specialist areas. Nurses are constantly updating their knowledge on clinical Care Homes for Older People Page 18 of 24 Evidence: practice. Staff spoken to said that they feel confident in performing their role with the support of the management team. Although the service does not have dementia registration, staff have been trained in dementia care so that they can be aware of the needs of residents should their mental health deteriorate. The Annual Quality Assurance Assessment states that fifteen staff have completed NVQ level 2 or above. On the day of the inspection the manager stated that a further twelve staff are completing an NVQ qualification. The deputy manager is completing the Registered Managers Award and NVQ Assessors Award. The home has a staff recruitment procedure which is followed and all staff are thoroughly vetted prior to contracts being offered. All new staff are interviewed by the Registered Manager and the homes administrator ensures that all references and Criminal Record disclosures have been returned and have been vetted by the manager prior to starting employment. Care Homes for Older People Page 19 of 24 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed by a person who is experienced and qualified to do so. Quality Assurance systems ensure that peoples needs are safely met and that continuous improvements are made to the service. Evidence: The manager has a Registered Managers Award and a deputy manager is employed who is also currently completing her Registered Managers Award. The Directors visit the home on a regular basis and along with the new Compliance Manager support the homes management structure and quality auditing. The management team also benefits from an efficient administrator who has good communication skills with the staff, residents and relatives. The service has an annual quality assurance survey where residents, relatives and other stakeholders views are sought and action taken to continuously improve the service. Residents said that are able to communicate their views on a daily basis or Care Homes for Older People Page 20 of 24 Evidence: during more formal meetings and leaving comments in the suggestion box. There is a safe procedure for the safe storage of residents personal monies. residents can choose to manage their own personal finances and have access to lockable facilities. As part of the Quality Assurance processes the residents have decided that the Registered Manager should be referred to as Matron. The company has employed a compliance manager who carries out quality audits and deals with concerns and complaints. Health and safety systems are reviewed by a consultant and risk assessments are in place and are regularly reviewed. Audits and staff supervision ensure that staff are working in accordance with health and safety procedures. Care Homes for Older People Page 21 of 24 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 22 of 24 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 It is recommended that a more person centred approach is used where the future aims and goals of a person are identified and recorded on care plans. Care Homes for Older People Page 23 of 24 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 24 of 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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