Inspection on 07/12/05 for Healey House

This inspection was carried out on 7th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Healey House 24/02/08

Healey House 14/09/07

Healey House 27/03/07

Healey House 06/07/05

Healey House 01/02/05

Healey House 03/09/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Healey House 3 Upper Maze Hill St Leonards-on-sea East Sussex TN38 0LQ Lead Inspector Liz Daniels Unannounced Inspection 7th December 2005 10:45 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 Healey House DS0000021131.V270020.R01.S.doc Version 5.0 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. Healey House DS0000021131.V270020.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Healey House Address 3 Upper Maze Hill St Leonards-on-sea East Sussex TN38 0LQ 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) 01424 436359 Hastings and Rother Voluntary Association for the Blind Mrs Beryl Quigley Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places Healey House DS0000021131.V270020.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of service users to be accommodated is twenty-eight (28) Residents on admission will be visually handicapped Date of last inspection 6th July 2005 Brief Description of the Service: Healey House is owned and managed by the Hastings and Rother Voluntary Association for the Blind, a registered charity. The Home is not purpose built but enjoys the advantages of being a detached property set in its own grounds some distance from the road. The Home provides twenty-six single bedrooms and one double room, currently used as a single. Twenty-four of the rooms have en-suite facilities. The Home has level access throughout the building, with a passenger lift to all floors. There are handrails to accommodate visually impaired residents. Two sitting rooms, a music room and dining room provide communal space. The Home has its own dedicated activity centre adjacent to it and structured weekly activities are organised in-house. Healey House DS0000021131.V270020.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over a period of five and a half hours beginning at 10.45am. The Inspector met with the Registered Manager, Deputy Manager and two other staff. There was also the opportunity to meet both the Chairman and the Secretary for the Hastings and Rother Voluntary Association for the Blind: they visited the Home on the day of inspection to attend a Christmas party that had been organised for the residents. Although a full tour was not undertaken on this occasion, the Inspector met with several of the residents who were spending time in the lounge area and chatted with two residents in private. A range of documentation and key records was then inspected. This report should be read in conjunction with the report from the first inspection this year, on 6th July 2005. What the service does well: What has improved since the last inspection? What they could do better: The Care Plan assessment needs to be trialled and evaluated to assess its suitability as a pro-forma for a pre-admission assessment for prospective Healey House DS0000021131.V270020.R01.S.doc Version 5.0 Page 6 residents. The Manager must then confirm in writing that following the preadmission assessment, the Home can meet the resident’s needs in respect of health and welfare. This was a Requirement of the last Inspection. Although there are training opportunities for staff, they must all receive a minimum of three paid days training per year and staff must have training in Moving & Handling. Staff are well supervised in their practice but the Homes format for supervision should be expanded upon to allow for discussions regarding career development, training needs and the sharing of views about the service provided for the residents. Supervision should be offered at least six times per year for each member of care staff. Bedroom doors and other fire doors must not be held open unless with a door guard that will release if the fire alarm is activated. 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. Healey House DS0000021131.V270020.R01.S.doc Version 5.0 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 Healey House DS0000021131.V270020.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 and 6 Good practise is in place by ensuring all residents are aware of their Terms & Conditions of residence and by providing these in both written & Talking Tape format. The Care Plan assessment needs to be trialled and evaluated to ensure its suitability as a pro-forma for a pre-admission assessment for prospective residents. The Manager must confirm in writing that following the preadmission assessment, the Home can meet the resident’s needs in respect of health and welfare. This was a Requirement of the last Inspection. EVIDENCE: Healey House has a comprehensive residents guide, which is given to all new residents. The Terms & Conditions of residency are included and have been circulated and discussed with all residents. These are signed by the residents if able, and kept in their file with their Care Plan. This meets the Requirement from the last inspection. The Terms and Conditions have also been put onto Talking Tape for the residents. Within them is the procedure for making a complaint, including the contact details for the Commission. Unplanned admissions to Healey House are avoided where possible. Since the last inspection two residents have been admitted for respite care. The Care Plan assessment was used to assess them prior to their admission. The Manager reported that whilst this appeared to provide sufficient information, Healey House DS0000021131.V270020.R01.S.doc Version 5.0 Page 9 they had not yet had the opportunity to trial it for a resident who was seeking admission on a permanent basis. Current practice is that the Manager (or whoever undertakes the assessment) then informs the prospective resident verbally whether or not the Home is able to meet their assessed needs. Residents then move in for a four-week trial period to ensure the Home’s suitability for them. One resident spoken with knew of the Home through the clubs she attended so was happy to move in on a trial basis. Another did not visit himself but relatives visited on his behalf. Both are very happy at Healey House. Healey House does not offer intermediate care. Healey House DS0000021131.V270020.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 and 9 There are very good Care Plans and Risk Assessments in place and good processes to ensure they are updated and remain contemporary. The staff work hard to include residents, when drawing up and reviewing their Care Plans. By signing them, they demonstrate that they agree with them. This meets the Requirement from the last three inspections. Good processes are in place for the ordering, administration and disposal of medication. EVIDENCE: Three resident’s files were viewed. One of those was for a lady currently at Healey House for respite care. Each resident has a Care Plan, which reflects the care needed to meet their health, personal and social care needs. The Care Plans had been reviewed by the key workers and any changes recorded on a monthly review form. The Deputy Manager then reviews the monthly review forms every six months, updating the Care Plan if needed. A daily record is also kept. Residents discuss their Care Plans and Risk Assessments with the staff and if able, sign as an indication that they agree with them. Residents are asked on admission as to whether they wish to administer their own medication or wish to hand over the responsibility to the Home. If they wish to self medicate, a Risk Assessment is undertaken and signed by a staff member and by the resident. Their suitability is also confirmed with their GP. Healey House DS0000021131.V270020.R01.S.doc Version 5.0 Page 11 2 residents currently self medicate and the medication is stored in their room. There is informal monitoring of usage by the staff and if there is concern that medication is not being taken, as needed, a further Risk Assessment is undertaken. The medication for the Home is kept in a locked cupboard in the office. All the medication is stored in measured doses for a 4-week period. The medicine charts were seen and were correctly maintained. Photographs of all the residents are kept in the resident’s file. A ‘Boots’ pharmacist audits the medication and all unwanted medications are collected and disposed of by ‘Boots’. Healey House DS0000021131.V270020.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 and 14 The staff at Healey House recognise the importance of ensuring individual needs and beliefs are met, offering choice and flexibility for the routines of daily living. A good programme of activities is in place. Good financial management of personal monies are in place. EVIDENCE: On the day of Inspection the atmosphere within the Home appeared happy and comfortable. Residents were choosing to spend time either in their own bedroom, or in the main lounge. Staff confirmed that visitors are welcome at any time. Activities are organised most days, within the Home and trips out are arranged. Residents are also encouraged to attend the Taplin Day Centre nearby. They are told verbally about forthcoming events and there is an outline of some of the main activities in the Resident’s Guide. Residents of differing denominations are supported in their religious observance, dependant on their wishes. The Home does not act as the appointee for any resident but does hold a balance of money for some residents. All money is held separately in a locked cupboard. Records are kept of any transactions. Residents are encouraged to bring their own possessions into the Home and there was evidence during the Inspection that rooms had been personalised with furnishings and small items of furniture. A lockable facility is provided in each bedroom. Healey House DS0000021131.V270020.R01.S.doc Version 5.0 Page 13 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were assessed at this inspection. Please refer to the report from the inspection on 6th July, when both core standards (16 and 18) were assessed. EVIDENCE: Healey House DS0000021131.V270020.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were assessed at this inspection. Please refer to the report from the inspection on 6th July, when each standard was assessed. EVIDENCE: Healey House DS0000021131.V270020.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 A team of care staff is employed to meet the needs of residents and an appropriate skill mix is in place throughout the 24-hour period. Currently 50 of the care staff are training / trained in NVQ level 2. Correct recruitment procedures are in place and new staff receive an induction into the Home. Although there are training opportunities for staff, they must each receive a minimum of three paid days training per year. Staff must have training in Moving & Handling. EVIDENCE: There are 16 care staff, a Deputy Manager and Manager, employed at Healey House. There is a staff rota in place to cover the 24-hour period. 3 carers are rostered to work with a senior carer or the Head of Care each morning and 2 carers with a senior carer or the Head of Care for the afternoon and evenings. 2 carers are on duty for each night. Catering, domestic and maintenance staff are also employed. The Manager and Deputy Manager work alternate weekends and overlap one shift each week, to ensure continuity. 3 carers are currently studying for their NVQ level 3, 4 are trained to NVQ level 2 and 1 is currently undertaking it. Three staff files were reviewed and the Inspector then also met with two of those staff. References had been received prior to appointment and copies of identification are retained on file. A copy of the Terms & Conditions of the post and the Job Description are also retained on file. All files seen had evidence of CRB disclosures. All the files seen had evidence of training undertaken and the staff that met with the Inspector confirmed that there are good training opportunities although not all staff have had the minimum of three paid days per year. Most Healey House DS0000021131.V270020.R01.S.doc Version 5.0 Page 16 of the training is organised internally and local resources such as health professionals and medical companies are also accessed. The Deputy Manager has almost completed her training to be a trainer and assessor in Moving & Handling. It was agreed at the Inspection that as staff have not had their Moving & Handling training for over a year, a programme of training to train all staff would commence by March 06. All new members of staff undertake induction training. Healey House DS0000021131.V270020.R01.S.doc Version 5.0 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 35, 36 and 38 An experienced Registered Manager runs the Home very well. By working alongside the Manager, the deputy has received a good induction to become the new Manager, before applying to the Commission to become the Registered Manager. Staff are well supervised in their practice but the Homes format for supervision should be expanded upon to allow for discussions regarding career development, training needs and the sharing of views about the service provided for the residents. Supervision should be offered at least six times per year for each member of care staff. Bedroom doors must not be wedged open. EVIDENCE: The Inspection was facilitated by the Home’s Manager who has many years experience managing Healey House and caring for older people. She has studied for both the NVQ level 4 and the Registered Manager’s Award (RMA). The Manager will be retiring from the Home at the end of this year: the current Deputy Manager has been appointed to become the new Manager. She is a trained nurse who has worked at Healey House for over a year and previously Healey House DS0000021131.V270020.R01.S.doc Version 5.0 Page 18 has worked with older people in a variety of care settings. Once in post she will apply to the Commission to become the Registered Manager. Some of the residents handle their own financial affairs, or relatives and solicitors are appointed to act on their behalf. The Home’s management team do not act as the appointee for the financial affairs of any of the residents but the Home does hold a balance of money for some residents and cash is then given to them as they ask for it. It is also used to buy sundries or services not covered by the fees, if the resident wishes. Any money held on behalf of the residents is kept separately in a locked cupboard. Records are kept of all transactions. The staff are offered formal supervision sessions, offering an opportunity to discuss their individual progress and any learning needs. Each session is documented and signed by both the supervisor and the staff member. These sessions tend to be held up to four times per year. The need for the frequency of these sessions to increase to be at least six times per year was discussed. It was also identified that the sessions could be expanded to cover other areas. However, the staff that met with the Inspector said they feel they are well supported by the management team and other staff. Standard 38 and the health, safety and welfare of residents was not fully assessed during this inspection. However, it was observed that several bedroom doors were wedged open. The doors have a self-closing facility but the Manager reported that many of the residents prefer not to have their door closed when they are in their room during the day. The Manager agreed that the risk of propping fire doors open would be raised at the next staff meeting and alternatives sought. Healey House DS0000021131.V270020.R01.S.doc Version 5.0 Page 19 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 2 x X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 x X X X X X X X x STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X 3 3 X 2 Healey House DS0000021131.V270020.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? Yes 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 OP3 Regulation 14 Requirement Following an assessment of a prospective client, the Home should confirm in writing that they could meet their needs in respect of health and welfare. This was a Requirement from the last inspection. Timescale for action 31/03/06 2. OP30 18 (1)(c)(i) Although there are training 31/03/06 opportunities for training, staff must receive a minimum of three paid days training per year and staff must have training in Moving & Handling. Bedroom doors and other fire 31/03/06 doors must not be held open unless with a door guard that will release if the fire alarm is activated. 3. OP38 23 (4) Healey House DS0000021131.V270020.R01.S.doc Version 5.0 Page 21 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. Refer to Standard OP3 Good Practice Recommendations The Care Plan assessment needs to be trialled and evaluated to assess its suitability as a pro-forma for a preadmission assessment for prospective residents. Staff are well supervised in their practice but the Homes format for supervision should be expanded upon to allow for discussions regarding career development, training needs and the sharing of views about the service provided for the residents. 2. OP36 Healey House DS0000021131.V270020.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT National Enquiry Line: 0845 015 0120 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. Extracts may not be used or reproduced without the express permission of CSCI Healey House DS0000021131.V270020.R01.S.doc Version 5.0 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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