Inspection on 10/08/06 for Heathcotes Care (Hucknall and Watnall)

This inspection was carried out on 10th August 2006.

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 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

Heathcotes Care (Hucknall and... 20/11/08

Heathcotes Care (Hucknall and... 21/02/06

Heathcotes Care (Hucknall and... 20/09/05

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

CARE HOME ADULTS 18-65 Heathcotes Care Home 220 Watnall Road Hucknall Nottingham Nottinghamshire NG15 6EU Lead Inspector Karmon Hawley Unannounced Inspection 10th August 2006 10:00 Heathcotes Care Home DS0000062904.V307185.R01.S.doc Version 5.2 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 Heathcotes Care Home DS0000062904.V307185.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 Adults 18-65. 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. Heathcotes Care Home DS0000062904.V307185.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Heathcotes Care Home Address 220 Watnall Road Hucknall Nottingham Nottinghamshire NG15 6EU 0115 9636379 0115 9638222 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) Heathcotes Care Ltd Keeley Ward Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Heathcotes Care Home DS0000062904.V307185.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users shall be within category LD A further bathing facility must be provided within 2 months (56 days) of registration. 21/02/06 Date of last inspection Brief Description of the Service: Heathcotes is a large detached house situated in an established residential area of Hucknall on the outskirts of Nottingham. The home is within a few minutes of local amenities including a garage, shop and public house. The building had been converted inside to provide accommodation for 6 people with a learning disability in single rooms with ensuite lavatories and washbasins. The home also had shared bathing, dining, laundry and lounge facilities. There was a large garden accessible to residents. The current weekly fees are as follows and are discussed on the point of enquiry: £1275 Nottingham County Council based upon 4 staff to 6 service users, there is an £8.50 per hour charge for extra staff. Heathcotes Care Home DS0000062904.V307185.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Prior to the site visit an analysis of the performance of the home over the previous year took place in line with the key national minimum standards. The evidence gained was assessed and thus the site visit planned in accordance with further evidence required to demonstrate compliance with the national minimum standards. One inspector undertook the site visit over three hours. The main method of gaining evidence during the site visit was case tracking, this is a method of sampling the records of four randomly selected service users to ascertain if the needs of service users are appropriately assessed and identified needs are being catered for by the home to maintain optimum health and wellbeing of the service user. Service users residing within the home experience varying degrees of learning disability therefore time was spent with service users and staff on an informal basis and observation of interaction took place. Two service users were spoken with so as to give the inspector an insight into the conditions and standards within the home. Service users were settled and meaningful interaction was observed to take place. Those service users spoken with were happy with life within the home. The manager assisted in the site visit and two members of staff were spoken with. Staff were able to demonstrate an understanding of service users needs and the core values and principles in relation to their job roles. What the service does well: A relaxed, kind and caring ethos was prevalent throughout the home and staff were observed to undertake meaningful interaction with service users. It was evident from the findings of the site visit that service users are fully supported to live a meaningful and independent life and exercise choice as able. Support plans also provide assistance where needed to develop and increase skills. Staff spoken with expressed dedication and were able to fully discuss the issues of how equality and diversity is enhanced within the ethos of the home. They also were able to discuss the core values and principles and how service users rights are maintained. Heathcotes Care Home DS0000062904.V307185.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: 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. Heathcotes Care Home DS0000062904.V307185.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Heathcotes Care Home DS0000062904.V307185.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 The quality rating for this outcome area is good this judgement was made using evidence available including a visit to the home. Prospective service users individual aspirations and needs are assessed. EVIDENCE: The manager visits prospective service users in the community and carries out a preadmission assessment. Service users and relevant others may also visit the home and spend time in the environment prior to making a decision. The assessment covers the requirements of the standard and there was evidence available within service users support plans to substantiate this process takes place. Heathcotes Care Home DS0000062904.V307185.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 The quality rating for this outcome area is good this judgement was made using evidence available including a visit to the service. Service users know their assessed and changing needs and personal goals are reflected in their individual plan, however it is recommended that plans are further developed to fully reflect how service users will be supported in meeting identified needs. Service users are enabled to make decisions about their lives with assistance as needed. Service users are supported to take risks as part of an independent life style; however further evidence is required to demonstrate that risk management plans are in place to ensure service users are fully protected. EVIDENCE: Four service users support plans were observed. There was evidence to demonstrate that full assessments had been undertaken as information available in regards to identified needs was in depth. There was recognition of service users preferences and how they wished support to be delivered. In respect of challenging behaviour and communication needs there was good information with regards to triggers that may cause this and the behaviour that may be presented, however there was limited information in regards to Heathcotes Care Home DS0000062904.V307185.R01.S.doc Version 5.2 Page 10 how staff would support service users in fully meeting these needs and the methods they would employ. In addition the home uses work books in differing formats to assist service users understanding of various issues. One in use was “How to Make Choices about Taking Medication”. The manager stated that she is researching further booklets at present. No one is currently able to handle their own finances therefore a small amount is kept in the homes safe. These were checked and corresponded with the accounting sheet. Advocates or relatives are used if required. The manager stated that risks are initially assessed and the service users past history is taken into consideration. Risks are also discussed at team meetings and also during basic in house training. Staff spoken with were able to substantiate this. Training in regards to challenging behaviour has been booked and once undertaken senior staff will then cascade this to support staff. On observation of service users support plans there was no evidence of risk assessments in place despite risks being identified in regards to challenging behaviour and one service user who had run into the road into oncoming traffic. Heathcotes Care Home DS0000062904.V307185.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 The quality rating for this outcome area is excellent this judgement was made using evidence available including a visit to the service. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users have appropriate personal, family and sexual relationships. Service users rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. EVIDENCE: The routine of the home was stated to be flexible and service users may choose how they spend the day. There are a range of activities on offer should service users wish to participate. One service user spoke of a forthcoming camping trip that is being arranged at present. Service users were observed to undertake activities of their choosing supported by staff as required. Service users and staff have recently been on holiday to Butlins for a week, those spoken with stated that they had enjoyed this. Activities may be spontaneous depending on what service users wish to do. There are also various activities available to develop skills and staff work with service users on a one to one Heathcotes Care Home DS0000062904.V307185.R01.S.doc Version 5.2 Page 12 basis. Staff were observed to communicate with one service users using Makaton. Service users are also supported when using public transport and local amenities and several service users had visited the town with staff during the site visit. Residents use local shops, pubs and swimming bath. Two service users are due to start college in September, one service user spoken with was looking forward to this. One service user attends school. A people carrier is available for service users for home visits and to attend any appointments. Service users if they wish may vote and are supported by staff in doing so. The manager and staff were fully able to discuss the issues of equality and diversity and were passionate in ensuring that service users experienced this fully and were part of the community. Visitors may be received in private in service users own rooms or the dining room as required. There is no restriction on visiting imposed. Staff are instructed on ensuring privacy and dignity of service users is maintained, staff spoken with were able to discuss the core values and principles. Service users receive all mail unopened, this was evidenced on the day of inspection. There is also access to a public telephone should it be required, the office telephone may be used should more privacy be required. There was evidence within service users care plans that service users are addressed by their preferred name. The home operates as a domestic household. The residents make shopping lists and go to the supermarket with the assistance of staff. Household chores are shared with the staff and service users have keys to their own rooms. The service users and staff displayed relationships of mutual respect during the inspection and the service users said they liked the staff. The community nurse visits the home offers dietary advice and hold staff workshops to ensure staff are fully informed in this area. All service users undergo dietary monitoring to ensure their needs are fully met. There are no set menus; service users may choose what they want at each mealtime. There are different mealtimes as service users prepare and eat as they wish. Meal times are relaxed and the inspector observed the lunchtime meal during the visit. This substantiated that service users were eating meals of their choice and staff were having their lunch with service users, which offered a homely atmosphere. One service user spoken with discussed their lunch and the preparation; staff as required supports service users and all have attained the basic food hygiene qualification. Heathcotes Care Home DS0000062904.V307185.R01.S.doc Version 5.2 Page 13 Heathcotes Care Home DS0000062904.V307185.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 The quality rating for this outcome area is excellent this judgement was made using evidence available including a visit to the service. Service users receive personal support in the way they prefer and require. Service users physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the homes policies and procedures with dealing with medicines. It is recommended that hand written entries are signed by two members of staff to demonstrate these have been checked as correct. EVIDENCE: There was evidence within service users plans to demonstrate that service users wishes on how personal support is to be given is respected and documented. Staff were observed to be sensitive and flexible in their approach. Support plans are also designed to develop and increase skill and maintain independence as able. Staff spoken with were able to discuss the core values and principles, service users needs and how they are supported in meeting these. One service user spoken with substantiated that staff respect privacy and knock on doors prior to entering. The manager stated that prior to service users moving in to the home services are discussed and set in place to ensure consistency. There was evidence within service users support plans to demonstrate that service users are Heathcotes Care Home DS0000062904.V307185.R01.S.doc Version 5.2 Page 15 supported in accessing the multidisciplinary team and other specialist services as required. Relevant policies and procedures were in place with regards to medication and there was evidence available to demonstrate that medication was satisfactorily maintained. In the case of hand written entries on the medication chart two members of staff did not sign these. Service users if able are supported in administering medication as able and measures are in place to support this. Heathcotes Care Home DS0000062904.V307185.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 The quality rating for this outcome area is good this judgement was made using evidence available including a visit to the service. Service users feel their views are listened to and acted upon. Service users are protected from abuse, neglect and self-harm. EVIDENCE: Relevant polices and procedures were in place with regards to dealing with complaints should they arise. A small number of minor concerns had been received from the next door neighbour since the previous inspection these were observed to have been dealt with appropriately. Staff spoken with were able to discuss how complaints would be dealt with should they be received. Service users spoken with expressed no concerns. All staff have current criminal record bureau checks in place and the majority have undergone training in the protection of vulnerable adults. Staff spoken with were able to discuss relevant issues with the inspector. There was evidence within service users support plans that these issues are fully considered. Heathcotes Care Home DS0000062904.V307185.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 The quality rating for this outcome area is good this judgement was made using evidence available including a visit to the service. Service users live in a homely, comfortable and safe environment. The home is clean and hygienic. It is recommended that the laundry room floor is replaced with a suitable floor covering. EVIDENCE: The home offers a very good standard of accommodation and it had been well furnished and decorated. The current service users did not require any adaptations or equipment to maximise independence. The home was clean, tidy and free of any observable health and safety hazard. Staff and service users work together in the cleaning of the home and a comfortable environment was observed. One service user spoken with was discussing the cleaning of their room. Service users rooms were noted to be personalised during the tour of the home. The laundry room floor had been painted since the previous inspection, however this was again nearing the stage of needed attention to ensure it remains clean and impervious. Heathcotes Care Home DS0000062904.V307185.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 The quality rating for this outcome area is good this judgement was made using evidence available including a visit to the service. Competent and qualified staff supports service users. Service users are supported and protected by the homes recruitment policy and practices. Service users individual and joint needs are met by appropriately trained staff. EVIDENCE: The duty rotas observed demonstrated that sufficient staff are employed to meet service users needs. Four staff files were observed and each contained all the required documentation. All members of staff are now registered on the National Vocational Qualification (NVQ) training. Team leaders are working towards level three and support staff are working towards level two. NVQ’s are based upon the Learning Disability Framework. All new staff undergo an induction which covers the requirements of this standard. One member of staff spoken with substantiated this. Each member of staff has an individual training plan which covers mandatory training. There was evidence available to demonstrate that staff are working Heathcotes Care Home DS0000062904.V307185.R01.S.doc Version 5.2 Page 19 towards completing this. Staff spoken with stated that training is at a good level and they felt supported in their job role. Heathcotes Care Home DS0000062904.V307185.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 The quality rating for this outcome area is good this judgement was made using evidence available including a visit to the service. Service users benefit from a well run home. Service users are confident their views underpin all self-monitoring, review and development of the home. The health safety and welfare of service users are promoted and protected. EVIDENCE: The manager has been at the home for two years. She has completed the registered managers award and has also attained various qualifications in relation to the service user group in her care. She ensures she maintains up to date in all mandatory training. Staff spoken with stated that the manager was approachable and that the home was well run. It was evident on observation that service users felt at ease with the manager and a good rapport was observed. In regards to the atmosphere and ethos of the running of the home a true feeling of independent living is evident, service users are enabled to live an Heathcotes Care Home DS0000062904.V307185.R01.S.doc Version 5.2 Page 21 independent life with support as required and assisted by the direction of management. Monthly quality assurance monitoring takes place, which covers administration, communication, health and safety, training and service users expectations. Following this an action plan is devised to address any issues and sent to head office. The manager also endeavours to carry out informal quality assurance on a continual basis by being readily available and approachable to service users and relatives. All relevant documentation with regards to maintenance and health and safety were observed. Heathcotes Care Home DS0000062904.V307185.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 Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 X 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 2 X 3 X 3 X X X 3 Heathcotes Care Home DS0000062904.V307185.R01.S.doc Version 5.2 Page 23 No Are there any outstanding requirements from the last inspection? 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 YA9 Regulation 13(4,a) Requirement To ensure risk management plans are available for highlighted risks to ensure service users are fully protected. Timescale for action 10/09/08 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 YA6 YA20 YA30 Good Practice Recommendations To further develop support plans in regards to challenging behaviour and communication to demonstrate staff support to be offered to ensure needs are fully met. Two staff to sign for handwritten entries on medication charts to demonstrate these have been checked and are correct. To replace/make good the laundry floor to ensure it is impervious. Heathcotes Care Home DS0000062904.V307185.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Heathcotes Care Home DS0000062904.V307185.R01.S.doc Version 5.2 Page 25 - 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. 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