Care Home: Hyde Crook House

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What the care home does well People considering moving into the home receive a full assessment and are provided with the opportunity to visit and spend time at the home to make sure that it is able to meet their needs. The home is a well-appointed, suitably equipped and comfortable environment for elderly people requiring nursing care. On the day of inspection the home was clean and adequately staffed. Meals are nutritious and appetising and the choice and variety is good. What has improved since the last inspection? This was the first inspection of the service. What the care home could do better: The home has been without a registered manager since April 2008; it is required that this circumstance be rectified within the stated timescale. This report contains recommendations for a minor improvement to an aspect of care planning, for clarification of the policy/procedure for the safeguarding of vulnerable people, for additional processes of internal audit and expansion of the fire safety escape plan. CARE HOMES FOR OLDER PEOPLE Hyde Crook House Frampton Dorchester Dorset DT2 9NW Lead Inspector Gloria Ashwell Key Unannounced Inspection 3rd September 2008 10:30 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 Hyde Crook House DS0000071821.V368152.R02.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. Hyde Crook House DS0000071821.V368152.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hyde Crook House Address Frampton Dorchester Dorset DT2 9NW 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) 01300 320098 01300 320970 Hyde Crook Nursing Home Limited Post Vacant Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (22) of places Hyde Crook House DS0000071821.V368152.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home with Nursing - Code N to service users of either gender whose primary care needs on admission to the home are within the following category: 2. Old age, not falling within any other category (Code OP) The maximum number of service users who can be accommodated is 22. New service Date of last inspection Brief Description of the Service: Hyde Crook House is situated on the A37 road, close to the village of Frampton, approximately five miles northwest of Dorchester. The home is well established and during March 2008 was registered to a new provider who operates other registered premises in a neighbouring county. The home is registered to provide nursing care, accommodating a maximum of 22 older people, aged sixty-five and over. Hyde Crook House is set in its own grounds, in a rural position with picturesque views. At the front of the house is a terrace overlooking gardens; the gardens extend to woodland at the back and side of the home. Car parking spaces are available for visitors and staff. Accommodation is arranged over two floors with a passenger lift giving access to the first floor. There are sixteen single bedrooms and three two-bedded rooms. On the ground floor are two lounges; a central room provides a dining area. A registered nurse and care staff are provided at all times including wakeful night staff. The fee range quoted in the service user guide at the time of inspection was £545 to £685. Up to date fee information may be obtained from the service. Additional charges are made for hairdressing and chiropody. Hyde Crook House DS0000071821.V368152.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service receive good quality outcomes. This was a statutory inspection required in accordance with the Care Standards Act 2000 and was the first inspection of this new service. The inspection was unannounced; the inspector arrived at 10:30 on 3 September 2008, toured the premises and spoke to residents, staff, observed staff interaction with residents and the carrying out of routine tasks and together with the Operations Manager and Acting Manager discussed and examined documents regarding care provision and management of the home. The duration of the inspection was 4 hours. During the inspection, particular residents were ‘case tracked’; for example, for evidence regarding Standards 3, 7 and 8, records relating to the same residents were examined and the residents spoken with. During this inspection compliance with all key standards of the National Minimum Standards was assessed. What the service does well: What has improved since the last inspection? This was the first inspection of the service. Hyde Crook House DS0000071821.V368152.R02.S.doc Version 5.2 Page 6 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. Hyde Crook House DS0000071821.V368152.R02.S.doc Version 5.2 Page 7 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 Hyde Crook House DS0000071821.V368152.R02.S.doc Version 5.2 Page 8 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): 3 (The home does not provide intermediate care so St 6 does not apply) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prior to admission, the needs of each proposed resident are assessed to ensure the home will be properly able to meet them. EVIDENCE: The records of 2 recently admitted residents included details of pre-admission assessments carried out by senior staff visiting the prospective residents at their previous addresses. In advance of making the decision to enter the home the prospective residents or their representatives visited the home to view the premises and meet residents and staff. Hyde Crook House DS0000071821.V368152.R02.S.doc Version 5.2 Page 9 Following pre-admission assessment of each prospective residents needs and circumstances the home writes to them confirming the agreement and ability to provide accommodation and care. Hyde Crook House DS0000071821.V368152.R02.S.doc Version 5.2 Page 10 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. The health and social care needs of residents are met by suitably trained staff; doctors and other professionals visit as necessary and residents receive the medicines they have been prescribed. EVIDENCE: The care records of 4 people who live at the home were examined and found to contain risk assessments forming the basis for care plans and daily records describing the care of each person. There was evidence that individual residents or their representatives had been involved in the development and review of planned care provision. For the further improvement of care plans it is recommended that detailed information about the individual needs of persons with diabetes be recorded. Hyde Crook House DS0000071821.V368152.R02.S.doc Version 5.2 Page 11 Medicine handling is carried out by staff trained in this work. Residents wishing to do so can manage their own medicines in accordance with a risk assessment process; none of the currently accommodated residents manage their own medicines. Medication records were properly kept indicating that residents receive prescribed medicines at the correct times and in correct amounts. Residents spoken to during the inspection said they are treated with respect and their privacy and dignity is protected at all times. Hyde Crook House DS0000071821.V368152.R02.S.doc Version 5.2 Page 12 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. Residents have opportunities to engage in social and recreational activities and are encouraged and supported to pass the time according to individual preference. A choice of menu is provided and meals are nutritional and appetising. EVIDENCE: The home employs an Activity Organiser for 20 hours each week to arrange local excursions, visiting entertainers, one-to-one and small group social and recreational activities. In addition, a visiting exercise therapist attends the home each week to lead a ‘gentle fitness’ session. Visitors are welcome at any time and those spoken to during the inspection said they are always made to feel welcome and placed at ease by the staff. Hyde Crook House DS0000071821.V368152.R02.S.doc Version 5.2 Page 13 Residents believe they are shown respect and properly treated; comments made during the inspection included “ (the staff) are all so good…nothing is too much bother for them”. Meals provide good nutrition and are liked by residents. Most residents take meals in the large dining room on the ground floor; others receive them in their bedrooms. Residents make their lunch menu selection during the morning; lunch is the main meal of the day and comprises the choice of two hot meals, salad or a jacket potato. Residents said they have plenty to eat and the quality of meal provision is very good. Hyde Crook House DS0000071821.V368152.R02.S.doc Version 5.2 Page 14 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. People know how to complain and are confident their complaints would be listened to. Service users are safeguarded against risks of abuse in its various forms. EVIDENCE: Residents know how to complain and feel confident that if they had concerns or complaints they will be listened to and taken seriously. The home has a complaints policy and procedure; no complaints have been received and there have been no allegations or investigations regarding the ‘safeguarding of vulnerable adults’. All staff receive training on the safeguarding of vulnerable persons and the home has a written policy and procedure for the protection of vulnerable adults, but information on reporting and investigating alleged or suspected abuse should be improved to ensure staff have appropriate guidance. Discussion with the Operations Manager confirmed her understanding of the correct procedure. Hyde Crook House DS0000071821.V368152.R02.S.doc Version 5.2 Page 15 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 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is comfortable, clean, well equipped and suited to the needs of residents. EVIDENCE: Hyde Crook House is a partly traditionally built house, and partly purpose built extension. There is an ongoing programme of modernisation and maintenance to ensure continued provision of an attractive and essentially domestic environment. Hyde Crook House DS0000071821.V368152.R02.S.doc Version 5.2 Page 16 On the day of inspection the home was clean, tidy and comfortable throughout; there were no unpleasant odours. A passenger lift provides access to the first floor; some areas of corridor have shallow ramps to overcome the necessity for steps linking slightly different floor levels. All bedrooms have good natural light and many have far-reaching views of the countryside. Most bedrooms are for single occupancy. There are three shared bedrooms, for the accommodation of two persons who have chosen to share the room. There are bathrooms equipped for the use of persons requiring assistance and comfortable communal rooms. The laundry room is equipped with equipment which complies with hygiene requirements, including a sluice cycle washing machine. Hyde Crook House DS0000071821.V368152.R02.S.doc Version 5.2 Page 17 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 employs enough staff to meet the needs of residents and to ensure their safety and comfort and maintenance of the good condition of the premises. The home promotes the achievement of nationally recognised care qualifications. EVIDENCE: The home is at all time in the charge of a trained nurse and staffing levels are provided in accordance with the assessed needs of residents to ensure that at all times sufficient staff are available to properly meet their needs. All staff spoken with during the inspection were enthusiastic about their work and felt that they provided a good standard of care to residents and are properly supported by the management and training provision. The records of a recently employed staff member was examined and found to contain all essential information including written references and evidence of identity. Criminal Records Bureau (CRB) disclosures are obtained for all staff in Hyde Crook House DS0000071821.V368152.R02.S.doc Version 5.2 Page 18 advance of employment. To gain evidence of the recently improved recruitment process, including recording of an interview assessment and health details, the records of an application currently being processed by the home were examined and demonstrated that a robust and reliable system is in use. The home has developed and implemented a comprehensive induction process for all staff, designed to ensure their familiarity with all aspects of the home and a clear understanding of their responsibilities. There is an enthusiastic approach to staff training; the deputy manager is the designated trainer for moving and handling and all staff are required to undertake (and as necessary update) training in core subjects including fire safety, moving and handling, food hygiene and emergency aid. At present at least 50 of the care staff hold National Vocational Qualification in care, or an equivalent qualification; the home thereby meets the associated standard. Hyde Crook House DS0000071821.V368152.R02.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is at present without a registered manager but operates in the best interests of service users and protects them from risks of harm. EVIDENCE: The post of registered manager has been vacant since April 2008; an Acting Manager is at present in charge of the home. The registered provider is endeavouring to recruit a suitable candidate. On behalf of the registered provider, an Operations Manager regularly visits the home to support the Acting Manager. Hyde Crook House DS0000071821.V368152.R02.S.doc Version 5.2 Page 20 The home has processes for quality assurance; satisfaction surveys are periodically issued but the home is recommended to develop and implement additional processes of internal audit reflecting aims and outcomes for service users. The home does not manage the finances of residents; residents who are unable to undertake this responsibility personally have nominated relatives, friends or other representatives to do this on their behalf. There are good processes for staff recruitment, induction, training and formal supervision. Records are kept of all accidents and a periodic audit is carried out to identify any trends and to then determine means of minimising risks. To support the registration of the service documentation relating to the safety of the premises and equipment was submitted to the Commission earlier this year and during the inspection a sample of records regarding equipment servicing and maintenance were examined and found to be in good order. It is recommended that the fire safety assessment and escape plan be expanded to make specific reference to the currently accommodated residents. Hyde Crook House DS0000071821.V368152.R02.S.doc Version 5.2 Page 21 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X X STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 Hyde Crook House DS0000071821.V368152.R02.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP31 Regulation 8 Requirement The registered provider shall appoint an individual to manage the care home unless the registered provider intends to be in full-time day-to-day charge of the care home. Within the stated timescale application for registration must be made to the Commission by a suitable applicant. Timescale for action 01/12/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP7 OP18 Good Practice Recommendations Detailed information about the individual needs of persons with diabetes should be recorded. The policy/procedure for reporting and investigating alleged or suspected abuse should be improved to ensure staff have clear and correct guidance. Hyde Crook House DS0000071821.V368152.R02.S.doc Version 5.2 Page 23 3. 4. OP33 OP38 Additional processes of internal audit reflecting aims and outcomes for service users should be developed and implemented. The fire safety assessment and escape plan should be expanded to make specific reference to the currently accommodated residents. Hyde Crook House DS0000071821.V368152.R02.S.doc Version 5.2 Page 24 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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. 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