Inspection on 01/04/09 for Heavers Court Care Home for Dementia and Nursing

This is the latest available inspection report for this service, carried out on 1st April 2009.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Extracts from inspection reports are licensed from CQC, this page was updated on 07/08/2009.

CARE HOMES FOR OLDER PEOPLE Heavers Court Care Home for Dementia and Nursing 122-124 Selhurst Road Selhurst London SE25 6LL Lead Inspector Michael Williams Unannounced Inspection 1st April 2009 09:30 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 Heavers Court Care Home for Dementia and Nursing DS0000072786.V374757.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. Heavers Court Care Home for Dementia and Nursing DS0000072786.V374757.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Heavers Court Care Home for Dementia and Nursing 122-124 Selhurst Road Selhurst London SE25 6LL Address 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) London Borough of Croydon Garmit Wright Care Home 60 Category(ies) of Dementia (60) registration, with number of places Heavers Court Care Home for Dementia and Nursing DS0000072786.V374757.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 1. The registered person may provide the following category/ies of service only: Care Home - Code PC Care Home with Nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: 2. Dementia - Code DE 2. The maximum number of service users who can be accommodated is: 60 NA Date of last inspection Brief Description of the Service: Heavers Court is a new and purpose built care centre. The complex includes offices for professional agencies including a mental health services and the Alzheimer Society. The care home runs separately from these resources but is accessible to Heavers Curt care home. It is situated between Thornton Heath and South Norwood. It provides care for up to 60 residents and has been registered to provide nursing care for all persons living in this home whether they are admitted and funded as residents or patients. The home has been built to meet modern, national minimum standards for this type of service and so each bedroom has ensuite facilities including toilet and shower. The home is divided in group living or clusters of 10 residents and each group has its own lounge and dining area. There is a central courtyard and parking around the perimeter. The fees as at April 2009 were £600 to £700 per week. Additional charges will be made for personal items and if extra care is required the home may need to negotiate additional chargers if appropriate to do so. Heavers Court Care Home for Dementia and Nursing DS0000072786.V374757.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 the people who use this service experience good quality outcomes. The inspection was lead by Regulation Inspector Mr Williams. Christine Bennett, Local Area Manager also assisted in part of the inspection to address managerial issues and other matters. To monitor all aspects of care we ‘tracked’ the care provided to a sample number of service users, referred to in this report as residents, and triangulated the information including the documentation supporting care, the meals provided, the arrangement for medication, handling money, records of complaints and accidents. Staff providing care were interviewed, and we meet with a few visiting relatives and observed the residents. How they were supported by staff and the manner in which they spent the day. Questionnaires were distributed and written feedback in these was noted. What the service does well: What has improved since the last inspection? What they could do better: In the development of this service there were a number of potential pitfalls, areas that might inhibit the owners and manager from achieving their aims. The over size and layout of these new premises may make it difficult to achieve a homely atmosphere but the manager is aware of this and working to ensure a suitable atmosphere prevails. Secondly that management of the Heavers Court Care Home for Dementia and Nursing DS0000072786.V374757.R01.S.doc Version 5.2 Page 6 service being split between L. B. Croydon and Eldon Housing might reduce the single authority and control, of the person in charge, the registered manager, Mrs Wright. As Manager Mrs Wright is also aware of potential problems but feels she is able to strike the right balance of leadership and partnership. We have been given assurances that neither issue will inhibit the manager from meeting the needs of residents. Similarly, nurses working in the service will have dual management from the site manager and the primary (health) care trust (the PCT). This is something the Commission will monitor in the early stages of the service. It is commendable that very few requirements and recommendations arise in this first inspection. One requirement we do make, about meals, emphasises the importance of a single manager responsible for all aspect of the home including catering, domestic and maintenance services and nursing care. It is recommended that the Statement of Purpose be revised, in the section about criteria for admission, to reflect the aims of the home to provide a care service for older people. Although no age is specified in the registration certificate, it should be clear to anyone wishing to be admitted to this home what the make up of the client group is to be. We also recommend that colour schemes be reviewed to ensure they optimise residents’ orientation. Staffing level will also be kept under review because the home is divided into group living units, or clusters of ten residents, and this means the number of care staff on any one unit may be limited. 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. Heavers Court Care Home for Dementia and Nursing DS0000072786.V374757.R01.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 Heavers Court Care Home for Dementia and Nursing DS0000072786.V374757.R01.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): 1, 2, 3, and 5; 6 not applicable. Quality in this outcome area good. This judgement has been made using available evidence including a visit to this service. The home is providing suitable and relevant information and opportunities for prospective residents to visit so residents can be assured the home would be able to meet their needs. EVIDENCE: To assess this section of the report we spoke to a number of residents, to their visitors, to staff and to the manager. We also checked the documentation that is provided to prospective residents and the documentation used for assessments and care planning. The home has in place the required Statements of Purpose and a Residents Handbook, or Guide. These are well laid out, with clear, legible print and is available in alternate formats if requested. We recommend that the section about the criteria for admission be clarified so as to make clearer which prospective residents would be best suited to this home; in particular that it is a home for older people rather than young adults. We found that assessments were in place include in-house assessments and assessments provided by suitably qualified person such as care managers and nurses. In those files we checked we find that service are being given a Heavers Court Care Home for Dementia and Nursing DS0000072786.V374757.R01.S.doc Version 5.2 Page 9 contract or agreements and that is includes details about fees and funding arrangements. Many residents in Heavers Court transferred from the old LB Croydon Care Homes, Stroud Green Lodge and Langley Oaks, and so were familiar with the staff. Residents were given the opportunity to visit this new service and were given the opportunity to remain with the same group of residents they were living with in the old homes. To achieve this Heavers Court in divided into what the service refer to as ’clusters’. That is, units with ten residents in each group. The residents we spoke to seemed very pleased with the new setting and often said the home was “very nice”. Friends and relatives were also very positive about the home and have been meeting with staff at various events such as open days and residents/relatives meetings. We have assessed this section as providing good outcomes for residents and we make one recommendation, to refine the statement of purpose in respect of age criteria for admission. Heavers Court Care Home for Dementia and Nursing DS0000072786.V374757.R01.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): NMS 7 to 10: Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be assured that the service has well documented assessments and care plans so as to ensure needs are assessed and can be met. EVIDENCE: As with other sections of this report we assessed this one by visiting the care home, speaking to residents and their visitors; we interviewed staff and the manager and we checked documentation. We also toured the premises intermittently throughout the day of our visit so as to observe practice. As District/Community Nurses were on site during our visit we were also able to check that they were happy with the care being provided and that any advice or guidance they give to staff in relation to the nursing needs of residents is being acted upon. These Nurses had no concerns about the quality of care being provided at this time. The residents case files are in two main parts, that held in the office with initial information and contracts and a working folder kept in each ‘cluster’ where the residents lives. We confirmed that detailed assessments are in place to guide the planning of care and the assessments are being undertaken by a range of agencies including care managers and health agencies. It is also to be noted that many Heavers Court Care Home for Dementia and Nursing DS0000072786.V374757.R01.S.doc Version 5.2 Page 11 residents transferred from the old care home and so their needs were well understood before they transferred to Heavers Court. The care plans follow and a standard format that is easy to follow and makes provision for a wide range of needs including health, mental and social/emotional care. These care plans follow the accepted form including needs, goals and actions to be taken and by whom. There is provision for data such as date of plan, date for review and space for both resident and a member of staff to sign. In one of the care plans we saw that it had not been signed by the resident but it is likely that the resident would lack the capacity to sign in any meaningful manner. We were assured that when this is the case the care needs are discussed with family and friends so as to ensure a full understanding of needs is gained by staff. If a resident lacks capacity and has no relatives or a person appointed as representative then the home should consider involving the local Social Service Department in appointing a Mental Capacity Act Advocate. The home must also be mindful of any advance directive that may be in place. No residents are able to or want to deal with their own medication so staff deal with this. We checked the medication procedures to ensure they were safe and this includes the arrangements for ordering medication, the storage of medication, its administration and disposal and the written records for all these steps. In summary we found this home’s practices to be safe and efficient. We make a requirement, to have medicine trolleys locked to a secure, fixed point when not being used to deliver medicines to residents. Throughout the day we observed that staff were treating residents with kindness and courtesy and clearly staff have very good and friendly relationships with residents; staff were very patient and gentle as they supported residents. In respect of privacy, the home has made provision for this in its environmental standards so that there are suitable door locks on bedrooms and toilets, lockable cabinets in each bedroom and staff respect privacy by knocking doors before entering. The home is spacious but we saw no designated visitors rooms in each cluster, this means visitors either meet in public rooms such as the lounge or in the residents own bedrooms. We assessed thus section as met to a good standard and make one recommendation to review the security of medicine trolleys. Heavers Court Care Home for Dementia and Nursing DS0000072786.V374757.R01.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): NMS 12 to 15: Quality in this outcome area adequate. This judgement has been made using available evidence including a visit to this service. The home is making suitable arrangements so the social life of residents, including their meals and mealtimes is ensured. EVIDENCE: From the outset of our visit in April 2009 the home had a calm and relaxed atmosphere. This is a large, spacious care home with plenty of room for residents to wander in safety and this is what they were doing. The central courtyard was also in use provided a safe and sheltered area for residents, visitors and staff to sit. To avoid the usual serried ranks of armchairs against the wall chairs in the lounges were arrayed in a semi circle and this did give a slightly more homely impression. The homes in which most of the residents used to live, Stroud Green Lodge and Langley Oaks, each had been providing a very good social life for residents and this has been brought into Heavers Court. At different times of the day the staff were engaging residents in activities such as table top entertainment or walks in the garden. We were impressed by the sensory room provided on the ground floor. This has seating, lighting, sound and vision to create a quiet peaceful atmosphere. It is not to every resident’s liking we were told but this room provides an excellent opportunity for innovative social and emotional support and is commended. In addition to in-house activities and events there is programme of entertainers. We were also impressed by the contribution made by relatives Heavers Court Care Home for Dementia and Nursing DS0000072786.V374757.R01.S.doc Version 5.2 Page 13 who have been helping in the grounds, planting flowers and setting up a vegetable plot. This is also very commendable and demonstrates good will and a positive approach to working together. To this end the home has already arranged a number of meetings for friends and families so they can contribute to the running of the home. We spoke to several relatives and they spoke of their confidence in the management of the service. In respect of the meals we have made a number of suggestions. For a home for 60 persons we consider a choice of two main hot dishes plus special choices such as vegetarian or ‘ethnic’. We found that the registered manager of the home has less influence on meals than we would expect because catering, along with laundry and maintenance is ‘contacted out’ to Eldon Housing and so it is under their control. The manager of the home is required to negotiate with the contractors if she wants changes to any of these services. We were given assurances that there is a good working relationship between home and contractors but it was evident that Eldon Housing work to ‘spec’ (specifications in contract) as their representative explained. We also observed that the delivery of the meals was not well ordered, it was slow and cumbersome. It would be assisted by having one hot trolley per unit and with care staff checking that it contains all the planned-for meals and extras. We saw for example that there was very little communication between the kitchen assistant and care staff and little choice offered to residents at the point of service. We also noted that a special ‘ethnic’ meal for a resident had not been delivered in the trolley and the kitchen assistant was about to pour meat based gravy onto non-meat meal. We are also a little concerned that Eldon Housing are expecting residents, with dementia, to order their meals the day before; inevitably they will have forgotten what they ordered by the time their meal arrives. A choice at the time of service would be preferable and give residents real choice. Whilst some planning is clearly needed, sufficient food should be delivered to each unit so residents have choice when they see and smell the food so a requirement is made about this aspect of choice of meals. We make another requirement in this section and this is about the care plans; whilst they do include, in the standardised forms, sections covering the social and emotional elements of a resident’s life in the home they are not in the same detail of other sections about health care. These sections do not give clear examples of expressed or known wishes and preferences of the resident and family even though they may be known to staff. Social life relies upon staffing having this knowledge and acting upon it, which they often do, but we require this to be reflected in more detail in the written care plans so as to reflect the good practice. Heavers Court Care Home for Dementia and Nursing DS0000072786.V374757.R01.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): NMS 16 to 18: Quality in this outcome area good. This judgement has been made using available evidence including a visit to this service. Residents are being protected by good complaints and safeguarding policies and practices and the manager is well informed about the new legislation (Mental Capacity Act) so as to ensure the protection the rights of residents. EVIDENCE: We checked the complaints policy/procedure and the record of complaints and found this satisfactory. There have been a number concerns raised by friends and relatives and the records indicate they are being managed in an acceptable manner. We spoke to a relative who also confirmed that she has raised issues with the management and such was her confidence in the home that she has happy to pursue the in-house procedures and did not feel the need to explain the issues in detail to the Commission. One of the issues that was drawn to our attention was the laundry service. We were told that Eldon Housing had decided to reduce laundering personal items of clothing to one wash per week. Dirty linen is kept in a basket in each resident’s bedroom. Since the residents have dementia it is not always possible for staff to stop residents taking unwashed clothing from the basket. Neither the staff nor relatives thought this a good idea. It seemed somewhat undignified to have a transparent basket in each bedroom with dirty laundry on display to all who visit. In response to the concerns raised the manager is negotiating with the contractors on this point. We were assured by the manager that heavily soiled items would be dealt with without this delay. We spoke to the manager about the new Mental Capacity Act which will have implications for residents. The manager was well informed about the new legislation and in particular the ‘Deprivation of Liberty Safeguards’ (DOLS) which deal with restraint, the deprivation of liberty for people lacking the Heavers Court Care Home for Dementia and Nursing DS0000072786.V374757.R01.S.doc Version 5.2 Page 15 capacity to protect themselves and how to register DOLS with the local Social Service Department. We confirmed, and know from examples in the past, that staff and managers are well informed about ‘Safeguarding, that is, the protection of adults from abuse. All staff have received training about this and those that we spoke to knew how to report any suspicion of abuse. No complaints or intimation of abusive practices were drawn to our attention during our visit. Heavers Court Care Home for Dementia and Nursing DS0000072786.V374757.R01.S.doc Version 5.2 Page 16 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): NMS 19 to 26: Quality in this outcome area good. This judgement has been made using available evidence including a visit to this service. Heavers Court provides a safe, comfortable and well maintained environment in which to live so residents can be assured that this accommodation will met their needs. EVIDENCE: During the course of our visit to this new care home we toured the building several times and spoke to various people about the accommodation and how well it is meeting its stated aims of providing and modern home that meets modern standards of care. The home was registered in October 2008 when a range of documentation and environmental checks were made including safety certificates such as fire, water, gas, electricity and so forth. The home was also at the time assessed as fit for purpose and suitable for the proposed registration - to provide care for older people, including nursing care, for people with dementia. Each resident has a single bedroom with ensuite toilet and shower. The bedrooms have been furnished to national minimum standard with bed, seating and storage space. The room are light and airy and pleasantly decorated. They have suitable door locks and fire safety fittings in place. We Heavers Court Care Home for Dementia and Nursing DS0000072786.V374757.R01.S.doc Version 5.2 Page 17 saw that one door closer was broken but the on-site maintenance person fixed it within hours. We note that in some bedrooms the size and layout of furniture made the roomed appeared somewhat cramped, for example the space between desk and the end of bed. The over-bed light switch and call bell are in fixed positions, this limits the scope for moving furniture around and in some instances the switch for the overhead light was a little inaccessible. The home was clean and tidy and free of offensive odours. Whilst storage space seems limited other aspects of the home are very good, the enclosed courtyard for example. The entrance lobby is very spacious and like the rest of the home is bright and airy. As this is a very big care home with large, open, and spacious areas the manager is working hard to ensure a homely atmosphere is experienced by residents. The large windows make the home very bright and residents enjoy the views over the play ground and allotments. We saw that each unit or cluster has a small, open-plan kitchenette but they did not seem to be used as such; we were told that food cannot be kept in the fridge and the ovens are not in use. Whilst safety might be an issue it is to hoped that in the future these kitchenettes can be better used for simple meal preparation that might include residents helping, cakes for example or hot breakfast and other snacks. If these areas are found to be too unsafe for daily use then that would suggest poor design and layout of the dining areas for this client group. The sensory room is on the ground floor and is a commendable asset to the home. Given its location it may well become a multi-purpose activity room as well. The clinic rooms are spacious but would probably benefit from more storage cabinets and shelving. We were told that incontinence pads are delivered in bulk and there is little space to store them so it was not surprising but unfortunate we saw boxes of them in a bedroom. The boundaries of the building are secure with suitable fire doors and closed circuit television. We note that final exits were fitted with deadlocks but we were give an assurance that keys are never used, instead the doors cannot be opened from the outside and they have an audible alarm that sound when opened. Other potential hazards such as radiators and hot water are also kept safe with suitable thermostats and/or covers. The kitchen has already been inspected by the Environmental Health Authority and found to be to a good standard and has been awarded four stars (in a five star rating) confirming the home has a good, clean and hygienic catering section. Maintenance of the building. Like catering and laundry is contracted out to Eldon Housing. This might be a problem if for example access to maintenance were through a call centre. However, in Heavers Court there is a maintenance person based in the building and he can attend to damage and breakages promptly and safely. Heavers Court Care Home for Dementia and Nursing DS0000072786.V374757.R01.S.doc Version 5.2 Page 18 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): NMS 27 to 30: Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staffing arrangements are suitable, recruitment is safe and induction, training and support is in place so as to assure residents they will be safe in staff hands. EVIDENCE: Regulations require that the home has sufficient numbers of staff with the correct training and experience to meet the needs of the residents and we were assured by the manager that this is the case. Although registered to provide nursing care, at present no on-site nursing is provide in Heavers Court because recruitment is still underway for suitably qualified nurses. So, the current residents are supported by a team of care staff, two per unit or cluster. Nursing care for these ‘residents’ is provided by visiting District/Community Nurses who were on site to confirm this was the case. The home has clarified with the Commission the arrangements for nursing in the future. Although there may be a mix of residents and patients funded for nursing care in the home the on site nursing staff will be permitted to provide nursing care to all residents and patients whatever the fees and funding arrangements. This was confirmed by the Commission during the inspection. In addition to the carers there are ancillary staff, as noted earlier in the report this includes cleaners, catering, laundry and maintenance staff who are all employed under contract with Eldon Housing. Whilst this is not at entirely unusual arrangement it does mean that these staff, and the services they provide, are subject to management by the contractor (Eldon) and not the registered manager of the unit. Heavers Court Care Home for Dementia and Nursing DS0000072786.V374757.R01.S.doc Version 5.2 Page 19 The manager is registered with the Commission as person fit and competent to run the home. She has many years experience in the field of dementia care and has appropriate qualifications for her role as site manager. The staff’s qualifications are experience are outlined in both the Residents Handbook and in the AQAA (Annual Quality Assurance Assessment form) they sent us. Staff have a wide range of skills and experience including National Vocational Qualifications. Their recruitment records for this home can be held centrally as agreed with the Commission but we have on numerous occasions confirmed that the providers, L B Croydon, have safe recruitment arrangements in place including police checks and references plus induction, training and supervision well organised. We spoke to staff to confirm this remains the case in this new setting. Heavers Court Care Home for Dementia and Nursing DS0000072786.V374757.R01.S.doc Version 5.2 Page 20 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, 37 and 38: Quality in this outcome area good. This judgement has been made using available evidence including a visit to this service. Management of this home is competent and skilled so as to ensure the well being of residents and those employed in the home. EVIDENCE: As noted under the general staffing section above the manager is registered with the Commission and was found to be qualified and competent to manage this home. In talking to residents, to visitors to staff and the management team on site it was evident that this home is being run in the best interests of the residents. The words most frequently used were “this (home) is very nice” and “they (staff) are very good”. We checked the system for handling residents’ money, which has not substantially changed from previous arrangements, and it remains acceptable. The audit trail is clear from the deposit of the money to its return or expenditure. As well as our checks the money is also subject to other formalised audits. Heavers Court Care Home for Dementia and Nursing DS0000072786.V374757.R01.S.doc Version 5.2 Page 21 Record keeping is clear and efficient such as residents case files, staff files, fire safety, kitchen, visitors, complaints, residents money and so forth. We checked a range of these to ensure this was the case. As noted in earlier parts of this report, the ancillary staff are under with Eldon Housing. Whilst this is not at entirely unusual arrangement it does mean that these staff, and the services they provide, are subject management not by the registered manager but the contractors and is therefore reflected in several sections of this report. The Commission will seek assurances by way of a recommendation that this will not compromise the registered persons in complying with any recommendations or requirements we may make. No hazards were identified during our visit. We checked potential hazards such as hot radiators, hot water, windows, chemical storage, trip hazards and so forth and found all these areas are being well managed. Heavers Court Care Home for Dementia and Nursing DS0000072786.V374757.R01.S.doc Version 5.2 Page 22 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 3 3 X 3 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 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 3 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 3 X 3 X 3 3 Heavers Court Care Home for Dementia and Nursing DS0000072786.V374757.R01.S.doc Version 5.2 Page 23 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 OP7 Regulation 15 Timescale for action Social life, it is required that the 30/06/09 care plans provide a greater degree of detail in the social and emotional sections of the plans so that it reflects best practice. Choice, the management of 30/06/09 catering must not prevent residents from making a choice at the time meals are served. This is because residents with dementia will not always remember or want what they chose the day before. Medicines, the home shall ensure 30/06/09 medicine trolleys are secured to a wall when not in use. This is to ensure the security of medicines. Requirement 2 OP15 16(2)i 3 OP9 13(2) Heavers Court Care Home for Dementia and Nursing DS0000072786.V374757.R01.S.doc Version 5.2 Page 24 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 3 Refer to Standard OP1 OP12 OP31 Good Practice Recommendations Statement of Purpose; it is recommended this document is revised so as to make clear the age range and criteria for admission that the home is aiming for. Social life; it is recommended that the care plans provide a greater degree of detail in the social and emotional sections of the plans so that it reflect best practice. Management: It is recommended that the providers give a written undertaking to the Commission that the contracting-out of certain services will not compromise their ability to meet requirements and recommendations. This is to ensure the residents know the home can be run in their best interests. Environment: It is recommended that the use of colour schemes is reviewed so as to optimise to orientation of residents. Advocates, it is recommended that the home support residents to be represented by mental capacity act advocate if no other formal arrangement for representation is available to the resident. 4 5 OP19 OP3 Heavers Court Care Home for Dementia and Nursing DS0000072786.V374757.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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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