Inspection on 11/03/09 for Heath Bank Nursing Home

This inspection was carried out on 11th March 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Heath Bank Nursing Home 17/12/09

Heath Bank Nursing Home 26/10/06

Heath Bank Nursing Home 22/02/06

Heath Bank Nursing Home 17/08/05

Heath Bank Nursing Home 21/01/05

Heath Bank Nursing Home 06/07/04

Similar services:

Abbey The

Snydale Care Home

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Heath Bank Nursing Home Linden Road Halifax West Yorkshire HX3 0BS     The quality rating for this care home is:   two star good service 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 assessment of the service. We call this a ‘key’ inspection. Lead inspector: Mike ONeil     Date: 1 1 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Heath Bank Nursing Home Linden Road Halifax West Yorkshire HX3 0BS 01422352299 01422365557 heathbankoffice@yahoo.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Philip Bennett (Heath Bank New Co) Ltd Name of registered manager (if applicable) Mrs Pauline Jean Scott Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 57 The registered person may provide the following category of service only: 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: Old age, not falling within any other category - Code OP, maximum number of places: 47 Dementia - Code DE, maximum number of places: 10 Date of last inspection Brief description of the care home Heath Bank Care Home offers 24 hour nursing care to 57 residents.The registration also includes the provision to offer nursing care for three named persons under the age of 65 years. The home is in a quiet residential area of Halifax,approximately 10 to 15 minutes Care Homes for Older People Page 4 of 28 care home 57 Over 65 0 47 10 0 Brief description of the care home walking distance from the town centre. The home offers single and double bedrooms,a number of rooms have en suite toilets,some rooms also have en suite showers The home was extended at the end of 2005 when 18 new bedrooms,additional bathrooms and toilets and a large lounge were added. In May 2008 the home was registered to provide care and support for 10 people with dementia,within the overall total of 57 that can be accommodated. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This is what was used to write this report. Information about the home kept by the Commission for Social Care Inspection. Information from surveys that were returned to us by 7 people and 2 health professionals. In October 2008 the service had submitted an Annual Quality Assurance Assessment (AQAA) which detailed what the service was doing well, what had improved since the last inspection and any plans for improving the service in the next twelve months. The AQAA also included data as to when utilities and equipment at the home was serviced. A further AQAA was submitted by Pauline Scott ,registered manager, on 9th March 2009. Information from this AQAA is included in the main body of the report. An unannounced visit to the home. This was carried out by Michael ONeil and Shelagh Murphy, regulation inspectors on 11th March 2009 over a totalled period of 9.5 hours and included talking to 6 staff and Pauline Scott, Care Homes for Older People Page 6 of 28 registered home manager about their work and the training they have completed. And checking some of the records, policies and procedures the home has to keep. Some time was spent observing staff supporting people and talking with 7 people. We also looked at the information contained in 20 satisfaction surveys that had been recently completed by peoples families. We wish to thank the people living in the home, staff, and relatives for their time, friendliness and co-operation throughout the inspection process. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. What the care home does well: What has improved since the last inspection? What they could do better: To maintain peoples safety the temperature of radiator surfaces around the home must be monitored. Some areas of the home are still in need of redecoration and refurbishment. Care Homes for Older People Page 8 of 28 The lighting in the ground floor lounge should be improved. An audit of staffing levels should be undertaken. Staff should be consulted to highlight and address any areas of concern over the levels of staff employed. There needs to be more information displayed in the home that may help people with orientation. 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 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were individually assessed prior to admission to ensure their needs could and would be met. Evidence: Three care plans checked showed that people within the service had been assessed before moving into the home. Risk assessments and a plan of care reflected any specialist interventions. The assessment forms checked were detailed and fully completed. The manager and staff liaised with professionals, the person and their families to find out about peoples needs. Care Homes for Older People Page 11 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health is monitored and arrangements for dealing with health issues were met with support from health professionals. People were treated with respect and said they were very happy with the care they received. Medication policies and procedures were well managed ensuring the safe administration of medication. Evidence: Three peoples care plans were checked. The peoples care plans contained details about the persons biography, personality and their preferences and choices. Overall we felt the standard of the plans were good and they did focus on the individual person. (Person centred) Staff and the manager said that they had been working hard to improve peoples care plans so they are comprehensive clear and concise. Risk assessments were included within the documentation and included moving and Care Homes for Older People Page 12 of 28 Evidence: handling, skin integrity, and other risk factors. The care plans identified that a range of health professionals visited the home to assist in maintaining peoples health care needs. People said they had regular contact with their GP and other health professionals. There was evidence recorded to show that people and/or their relatives were involved in drawing up and reviewing the care plans. We did note one issue within the care plan documentation that did require staff attention. Staff, when writing peoples daily notes, were not being reflective of the information actually recorded in the persons care plan. Therefore, there were no records to evidence that staff had met certain care needs of people over several days. Documenting, for example ate good meal, sat watching television, relatives visited is not sufficient when recorded, in isolation, in a persons daily record. People looked clean, well dressed and had received a good level of personal care. The overall feedback from all interested parties was that the care delivered by staff at Heath Bank was good. Individually: Peoples comments included The staff are good, lovely ladies and the male nurses are good too The care staff are wonderful Im very happy here. Health professionals said that they felt the care delivered at Heath Bank was good. Relatives said The staff at Heath Bank are excellent . Medicines were securely stored in locked cupboards or trolleys that were secured to a wall. Medication records were up to date with no gaps. The Controlled Drugs Register was checked and this had been completed correctly with two signatures and a diminishing total. Staff were observed dispensing medication in a safe and hygienic way. Care Homes for Older People Page 13 of 28 Evidence: People were treated with respect and dignity and addressed by their preferred name. Staff were observed interacting in a friendly and pleasant way. Staff took time to explain what task or support they were about to offer people. We saw some peoples faces light up when certain members of staff came to talk to them or help them with personal care. Overall we were very impressed with the professional yet friendly way in which staff assisted people in the home. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People had a choice of lifestyle within the home and were able to maintain contact with family and friends ensuring that they continued to be involved in community life. People were able to make choices about daily living and be involved in some social activities. Meals served at the home were of a good quality and offered choice to ensure people receive a balanced diet. Evidence: People said they were able to get up and go to bed when they chose and generally how they spent their day and evenings. They said they often went out with their families. Relatives said they were able to visit at any time and were made to feel very welcome. People and relatives said that there were some activities planned. Events had been held at the home over the past month and some people were looking forward to a trip to the theatre that evening. Some relatives and staff felt there needed to be more stimulation and activities available for people. There is no activities coordinator Care Homes for Older People Page 15 of 28 Evidence: employed at the home at the moment and some people did say they got bored. Some people said that they welcome the opportunity to undertake simple activities or talk to staff or other people in the home more frequently. In some areas of the home staff were making an effort to provide a stimulating environment for the people. Staff and people were talking and watching sport together on the television. One staff member was trying to include as many people in this activity as she could. Staff were enthusiastic about expanding their knowledge and said they had really enjoyed recent training they had received on person centred care and caring for people with memory loss. Within one lounge there was not enough information displayed that may help people with orientation also there was little or inappropriate stimulation offered for the 10 people sat in the lounge. It was understandable why six of the people were sleeping. Staff did not seem to visit or pass through this lounge as much as the other communal areas. The clock in this lounge was small and difficult to see, the lounge was dark, additional lighting is needed, and there was no information displayed such as the date the weather or a news item. However we did find that positive initiatives have been introduced into Heath Bank these included: Links with local churches and schools have been maintained and improved. A PAT dog and her owner visit the home twice a week. People said they looked forward to meeting Suzy, the dog. Memory boxes containing peoples treasured and personal items have been made and sited outside peoples individual rooms. The mealtime experience for people in the home was very positive. The tables were set nicely with cloths, condiments and matching crockery and when the meal was served people said The food is very good. Staff tried very hard to accommodate peoples choices for lunch. Staff were supporting people with their meal in a polite and discreet way. People said they were always offered a choice and asked what they wanted for their breakfast, lunch and teatime meals. People said they were offered drinks on a regular basis throughout the day. Care Homes for Older People Page 16 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints procedures were in place and people felt confident that any concerns they voiced would be listened to. Staff had an understanding of the procedures to be followed should they suspect any abuse at the home, so helping to ensure that people were protected from abuse. Evidence: People had been provided with a copy of the homes complaints procedure, which was also on display in the entrance hall and in peoples bedrooms. This contained details of who to speak to at the home and who to contact outside of the home to make a complaint should they wish to do so. People said that they felt very comfortable in going to the manager of Heath Bank knowing that any concerns they may have would be addressed without delay. Regarding safeguarding adults, the safeguarding policies and procedures were available to the staff. Staff said they had undertaken Safeguarding Adults training, and the manager was able to evidence this by producing the training records. Care Homes for Older People Page 17 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. In the main the home was clean, pleasant and hygienic although some areas of the home are in need of redecorating and refurbishing. Evidence: The home was generally clean and tidy. An unpleasant odour was noticeable at times on Cherry Tree unit. Staff said the smell was due to previous spillages of nutritional feed on the carpet .The carpets need either a thorough clean or replacing. People, and relatives said the home was always kept very clean. Lounge and dining areas were domestically furnished to a good standard. People said they were very comfortable at the home. They had a variety of furniture and touches such as ornaments and pictures that gave their rooms a homely feel. Some areas, particularly in the older part of the home, are in need of refurbishment and redecoration. A rolling programme of refurbishment should continue. In particular the paintwork in some bedrooms and corridors is damaged and these areas need redecorating. Care Homes for Older People Page 18 of 28 Evidence: As highlighted earlier in the report the ground floor lounge was dark, additional lighting is needed to improve the aesthetics of this room. Care Homes for Older People Page 19 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. In the main staff were employed in sufficient numbers. Recruitment procedures promoted the protection of people. People received care from a well-trained staff team who had the skills to maintain the safety of themselves and other people at the home. Evidence: People spoke highly of the staff team and said staff always listened and acted on what they said. People said that staff were always available when needed. The manager reported that the home is staffed each day as follows: Mornings 2 qualified nurses plus 7 care staff. Afternoons 2 qualified nurses plus 5 care staff. Nights 1 qualified nurse plus 4 care staff. Some staff and relatives felt that there were not enough staff employed at times this was due to the increased dependency levels of people resident and being admitted to Heathbank. We spoke with the manager about the current staffing levels who felt that the dependency levels of people were high. Care Homes for Older People Page 20 of 28 Evidence: In view of the comments made and due to the possible changing needs of people, an audit of staffing levels should be undertaken. Staff should be consulted to highlight and address any areas of concern over the levels of staff employed. The staff training records and the AQAA provided the evidence that the staff have all of the training needed to make sure that they can care for people. This included all of the mandatory health and safety training specific to the needs of people at Heath Bank. Staff were able to talk about the various training courses that they had attended. Staff said training opportunities had significantly increased over the past few months. A sample of development and training records were checked. These records showed when staff had completed mandatory training and refresher training. The manager said that she was committed to encourage a training ethos amongst staff and to further develop the principles of person centred care within the home. Three staff files were checked at this visit. The files contained a range of information including two references and a declaration of health and identification. The staff had undertaken a criminal record bureau check (CRB), at the enhanced level. This confirmed thorough recruitment practises were in place, which was sufficient to safeguard people. Care Homes for Older People Page 21 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The procedures and ethos of the home ensure that the home is run in the best interests of people who use the service. The homes procedures promote the health, safety and welfare of people who use the service and the staff. Evidence: Pauline Scott has many years experience within the nursing and caring profession. She became registered manager of Heath Bank last month but has been in the post as manager since October 2008. She has registered with a training body to undertake the Registered Managers Award. Staff, people and relatives spoke highly of the manager and said she was always available and very approachable. Comments included She is fantastic She is a breath of fresh air for Heath Bank. The manager and provider had ways in which to check out the quality of the service Care Homes for Older People Page 22 of 28 Evidence: that they were providing. Regular staff meetings were arranged. Management audits for health and safety, the kitchen, cleaning, record keeping and medication were completed. The responsible individual visited the home on a regular basis, a report was written following the visits and any identified actions taken. People who use the service and their families met with the management of the home on a regular basis. Minutes of the last two meetings held in January and February 2009 were seen. The results of completed questionnaires returned from people and relatives had been collated to determine satisfaction ratings. A sample of monies that was looked after on behalf of people living at the home was checked. Records were kept and money tallied with the records. However the system used to record deposits and withdrawals from peoples accounts does need improving. New improved records had been introduced before we left the service. The AQAA provided information of the dates that equipment and systems within the home had been serviced and maintained. A fire risk assessment was in place at the home. A plan had been implemented to address the issues in the plan that require attention. Staff said they had received recent fire safety and other health and safety training .A sample of records showed that staff were receiving this statutory training. At the time of the visit fire exits were clear and hazardous products were safely stored in the home. This will promote the safety and welfare of the people. The surface temperatures of two radiators in bedrooms on the first floor of the home were found to be excessively high. This may have posed a risk of causing serious burns to some people. There were no records available to show that radiator surfaces around the home were being monitored. The manager immediately sort assistance from a joiner and radiator guards were fitted to the radiators before we left the home. Despite a requirement being made under the Care Home Regulations evidence shows that people at Heath Bank experience good outcomes relating to the management of the home. This judgement is based on the evidence that the service has far more strengths than areas for improvement. The manager was also able to act promptly to address the issues in need of immediate improvement. Care Homes for Older People Page 23 of 28 Care Homes for Older People Page 24 of 28 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, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 28 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, Care Homes 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 38 13 To maintain peoples safety the temperature of radiator surfaces around the home must be monitored. The surface temperatures must be maintained within safe limits. To keep people safe. 01/07/2009 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 2 3 4 5 6 7 12 12 19 25 26 The persons daily notes should reflect the information actually recorded in the persons care plan. People should have the opportunity to exercise their choice in relation to social and leisure activities. Arrangements should be improved so that people can be orientated to date, time and place. The programme of renewal of the fabric and decoration to improve the environment should be continued. The lighting in the ground floor lounge should be improved. All parts of the home should be kept clean and free from unpleasant odours. (Carpets Cherry Trees unit) Page 26 of 28 Care Homes for Older People Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or 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. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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