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Archived: Haddon Court Nursing Home Requires improvement

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Inspection report

Date of Inspection: 23 June 2014
Date of Publication: 22 July 2014
Inspection Report published 22 July 2014 PDF

People should get safe and appropriate care that meets their needs and supports their rights (outcome 4)

Meeting this standard

We checked that people who use this service

  • Experience effective, safe and appropriate care, treatment and support that meets their needs and protects their rights.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 23 June 2014, observed how people were being cared for and talked with people who use the service. We talked with carers and / or family members, talked with staff, reviewed information given to us by the provider and reviewed information sent to us by commissioners of services. We reviewed information sent to us by other authorities and reviewed information sent to us by local groups of people in the community or voluntary sector.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

We were supported on this inspection by an expert-by-experience. This is a person who has personal experience of using or caring for someone who uses this type of care service.

Our judgement

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.

Reasons for our judgement

We spoke with 12 people to ask about their views of living at the home. Comments included, "I like it here. It’s a pleasure to be here,” “Staff are very nice. There are no arguments,” “Not too bad. Nobody upsets me,” “It’s awful. People don’t understand me. I feel unwell and can’t talk to anybody. I sit here because I feel unwell and I know they can see me. If I’m in my room, they wouldn’t come. I tell them I’m not feeling well and they just say that I’ll feel better soon,” “When they come to cream my legs they don’t wash their hands and they don’t wash my legs first. I say, why haven’t you washed my legs first? Then they will wash my legs but I have to ask first” and “I only get a shower twice a week because they’re too busy. I asked for a shower but was told they were too busy and short staffed. I was so upset that I phoned my daughter to tell her I couldn’t have a shower. I don’t want to aggravate the staff but when I complained (about the shower) I was told that they are short staffed and there are only two of us looking after eighteen people. That’s not my problem.”

We spoke with three relatives. One person’s relatives told us the home had made contact with them in the early hours suggesting they might like to come as their family member was unwell. They said, “Our [family member] has been looked after very well. They were admitted to the home with their spouse and until this period they had been given adjoining rooms. Their spouse has Alzheimer’s so is not entirely aware of the situation but arrangements are being made to bring the couple together today.”

When we asked a relative if they had been involved in their family member's care planning they said, “I visit nearly every day and staff always talk to me and tell me exactly how my relative is. When my relative isn't well, I'm informed straight away."

Relatives who were visiting the home told us they visited frequently and there were “no obstacles” in the way of visiting whenever they wished.

During our visit, we found people were provided with the support they needed. However we observed people often had to wait as staff were very busy. We found staff knew people well and were aware of their individual preferences. We saw people approach staff and engage in conversation, or ask for something and staff responding as soon as they were able. We found staff treated people in a kind manner.

We observed one person had dressings on both lower legs. There was leakage through the dressing on the left leg and the leg was malodorous. The person told us the dressings were changed daily. Staff spoken with said the district nurses came to change the dressings. We checked back later in the day and the soiled dressings had been removed, the person’s legs were elevated and they were asleep and appeared comfortable.

We examined five people's care files. All the care files contained information about the person's biography, physical, medical and personal support needs. They also included people's likes, dislikes and preferences. All the care files had a range of individual risk assessments. There were clear links between the risk assessments and the care plans. All the care plans were reviewed at least each month, but more frequently if people's needs changed.

There was evidence in the care files that a range of healthcare professionals were involved in supporting staff to meet the needs of people as required. The care files recorded information provided by relatives which was reflected in the care plans as appropriate.

We observed one person in a lounge who had a problem with a productive cough and she had phlegm on her hands and clothing. This went unnoticed by one care worker who was sat doing paperwork opposite the person. A second care worker came in and put a bib on the person and wiped the person with paper towels.

We saw one person had extensive bruising to both arms. There were bruises on the person’s outer arms and more significant bruising on their inner arms. Th