Care Home: The Hermitage

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What the care home does well This is a random inspection and therefore not all the core standards are assessed. This means we do not look at all aspects of life at the home. Our inspection confirmed there are enough staff on duty, this means people who use the service can be supported as required. The night staff on duty had a clear understanding of their role and were seen to support people in a sensitive, thoughtful and caring manner. What the care home could do better: This is a random inspection and therefore not all the core standards are assessed. This means we do not look at all aspects of life at the home. We did establish that routines are not always as flexible and relaxed as they should be depending on which staff are on duty. This may mean that the home is being run for the benefit of those staff rather than the people using the service. Having discussed this with the manager it is now her responsibility to put systems in place to monitor the various shifts and staff teams to ensure this does not happen. It is also the registered individual`s legal responsibility to be involved in these quality assurance processes and to provide written support and feedback to the manager. It is important that the manager knows what is happening in the home and promotes the interests of the people who live there. The manager needs to promote an open culture in the home, whereby staff and people using the service feel safe to express their concerns, with the knowledge that appropriateaction will be taken. This open culture needs to extend to being co-operative and truthful with the regulator, the Care Quality Commission, and liaising with and referring to, where necessary, other professionals including safeguarding teams. The registered manager must be able to evidence her verbal statements. This means there is information to fully support the claims made. The home is not recording all complaints, we had received information about a concern since the last inspection; we checked the homes complaints log and it is not recorded. The handling of people`s complaints needs to improve, so people can be confident their concerns will be listened to and acted upon suitably. We can confirm the recruitment of staff is adequate but needs to be improved upon to fully protect people using the service. The responsible person needs to ensure that the practice and processes within the home are monitored on a regular basis. This means they can be confident the home is run in the best interests of the people who live there. The home needs to be fully conversant with safeguarding procedures to ensure everyone is adequately protected. Random inspection report Care homes for older people Name: Address: The Hermitage 66 Holly Road Uttoxeter Staffordshire ST14 7DU two star good service 07/01/2009 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Rachel Davis Date: 0 5 1 1 2 0 0 9 Information about the care home Name of care home: Address: The Hermitage 66 Holly Road Uttoxeter Staffordshire ST14 7DU 01889562040 01889565299 manager@uttoxeterhermitage.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Doctor Charles Bamford Convalescent Home Trust care home 11 Number of places (if applicable): Under 65 Over 65 3 15 11 6 dementia old age, not falling within any other category old age, not falling within any other category physical disability Conditions of registration: Date of last inspection Brief description of the care home 0 0 0 0 0 7 0 1 2 0 0 9 The Hermitage is a large detached Victorian house that has been extended to provide accommodation for eleven ladies, six of who may have a physical disability and three of whom may have dementia care needs. The home is provided by the trustees of the Charles Bamford Memorial Trust and managed by Louise Hurst. The home is situated close to the centre of the market town of Uttoxeter and within easy walking distance of local shops and a public house. A bus route passes the end of Care Homes for Older People Page 2 of 10 Brief description of the care home the drive. Access to the first floor is by staircase that has been fitted with a stair, chair lift. Communal facilities consist of a large lounge and a dining room. The lounges, dining areas and all other indoor and outdoor facilities are adequate. Fees charged range from £393 - £402 per week. For up to date information on fees contact the service directly. Care Homes for Older People Page 3 of 10 What we found: The focus of inspections undertaken by the Care Quality Commission is based upon outcomes for people who use the service. The inspection process considers the homes capacity to meet regulatory requirements, national minimum standards and aspects where the service requires further development. This was an unannounced random inspection undertaken by the inspector for the home and their line manager, we visited at 06:00. During the visit we looked at the outcomes relating to concerns,complaints and protection, the staffing and the conduct and management of the home. The primary reason for this visit was to establish whether information we had been offered was factual. We had been advised by an anonymous caller that some people who use the service were up as early as 05:00 am , staff were untrained and in some instances acted inappropriately. We had already asked the home to complete their own investigation and the registered manager had responded within the timescale we offered. We were not entirely satisfied with their response and therefore visited the home to undertake further investigation. We arrived at The Hermitage and used the night door bell to make ourselves known. This was pressed on a number of occasions but not answered. At 06:10 one of the night staff noticed we were outside and opened the door, she confirmed the bell does not work. There were two people up and about when we entered. One lady was in her bedroom and the other lady was in the lounge. They both confirmed they were happy to be up , one lady said she liked to get up at around 05:00. We talked to the night staff and were able to ascertain that choices and decisions are made by the people using the service with regard to their waking and rising routines. Staff were aware of choice and there was also information in plans of care to verify any decisions made. It was clear that people had been up too early in the past ( that is they were woken by the staff and assisted to dress) but it was considered to be much better now as a number of staff have left. Following further discussions with the manager, staff , people who use the service and looking at records we were able to verify that this practice does still happen occasionally. The manager confirmed her awareness of the problem and had considered the matter was now closed. We consider the home has further work to do to ensure it is run in the best interests of the people who live there. We spoke with the manager at length about the way the complaint had been handled, it was clear peoples anonymity had not been considered and therefore Whistleblowing may have been compromised. The staff need to feel confident and able to discuss any concerns; they need to feel protected by the homes policies and procedures and know their confidentiality is maintained. This was not the case when the home had carried out their investigation and therefore further work is required to fully conclude the matter. Care Homes for Older People Page 4 of 10 The manager had had previous concerns with some staff but had not considered to refer her concerns through safeguarding , she had not shared her thoughts with the local authority or the Care Quality Commission. This means all issues were dealt with internally and without other professional input. We consider the home should have liaised with other professional agencies to try to ensure improved outcomes for the people who use their service. The manager advised us she has done spot checks in the past but had not recorded these visits. She confirmed none had been done following the recent complaint. The complaint was not logged in the complaints log as required. We checked one staff file to ensure people were recruited appropriately. Overall the manager has the necessary information on file but we consider the application should contain more information and there should be a direct question with regard to convictions to meet with legislation. The application states, give details of any unspent convictions. It does not ask for a declaration from the applicant to confirm they will not have any convictions on their enhanced criminal disclosure. We feel the information offered to applicants regarding this should be clearer. We asked the manager when the responsible individual last completed a Regulation 26 visit. These visits are to monitor the quality of the service. The responsible person has not carried out and recorded these visits as required. It is the responsibility of this individual to complete monthly inspections of the home to monitor the quality and outcomes for the people who use the service. What the care home does well: What they could do better: This is a random inspection and therefore not all the core standards are assessed. This means we do not look at all aspects of life at the home. We did establish that routines are not always as flexible and relaxed as they should be depending on which staff are on duty. This may mean that the home is being run for the benefit of those staff rather than the people using the service. Having discussed this with the manager it is now her responsibility to put systems in place to monitor the various shifts and staff teams to ensure this does not happen. It is also the registered individuals legal responsibility to be involved in these quality assurance processes and to provide written support and feedback to the manager. It is important that the manager knows what is happening in the home and promotes the interests of the people who live there. The manager needs to promote an open culture in the home, whereby staff and people using the service feel safe to express their concerns, with the knowledge that appropriate Care Homes for Older People Page 5 of 10 action will be taken. This open culture needs to extend to being co-operative and truthful with the regulator, the Care Quality Commission, and liaising with and referring to, where necessary, other professionals including safeguarding teams. The registered manager must be able to evidence her verbal statements. This means there is information to fully support the claims made. The home is not recording all complaints, we had received information about a concern since the last inspection; we checked the homes complaints log and it is not recorded. The handling of peoples complaints needs to improve, so people can be confident their concerns will be listened to and acted upon suitably. We can confirm the recruitment of staff is adequate but needs to be improved upon to fully protect people using the service. The responsible person needs to ensure that the practice and processes within the home are monitored on a regular basis. This means they can be confident the home is run in the best interests of the people who live there. The home needs to be fully conversant with safeguarding procedures to ensure everyone is adequately protected. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 6 of 10 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 7 of 10 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 31 12 Regulation 12(1)(a) 12(4)(a) The home needs to promote the health and safety of the people who live there. This means the service is suitably managed and monitored. 10/12/2009 2 38 26 Regulation 26 (2)(4) 10/12/2009 The responsible individual needs to visit the care home and seek the views of the people who use the service. They must write a report and include all the necessary information. This will ensure the responsible individual oversees and monitors the development of the home. Care Homes for Older People Page 8 of 10 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 Peoples plans of care and other records should be reviewed to incorporate all the necessary updated information. This means staff have the most up to date information to hand. All complaints should be recorded. This means the manager can evaluate complaints , grumbles and concerns to see if there are any specific patterns and trends. The registered manager should ensure she is fully conversant with safeguarding procedures and ensure a referral is completed as and when required. This means people are suitably protected. All staff should revisit their Whistleblowing policy to ensure they understand its meaning. This means everyone has a clear understanding of its content. The registered manager should ensure that all doorbell systems are in working order. This means a timely response is offered to visitors. The registered manager should consider task orientated working patterns and look at ways to ensure staff are working in a way that promotes peoples choices, lifestyle and dignity. The registered manager needs to ensure their verbal statements can be evidenced in written records to verify their existance. Staff meetings should take place to ensure a consistent way of working is in place and understood. 2 16 3 18 4 18 5 19 6 31 7 31 8 36 Care Homes for Older People Page 9 of 10 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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