Inspection on 08/10/08 for Heather House

This inspection was carried out on 8th October 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Blenheim House

Prince Bishop Court

Park View (15)

Craigmore House

Extracts from inspection reports are licensed from CQC, this page was updated on 30/01/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Heather House Cheshire Avenue Barley Mow Birtley Tyne and Wear DH3 2BA     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: Irene Bowater     Date: 1 0 1 0 2 0 0 8 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. the things that people have said are important to them: They reflect 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 Adults (18-65 years) 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 Adults (18-65 years) Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Heather House Cheshire Avenue Barley Mow Birtley Tyne and Wear DH3 2BA 01914100712 01914100712 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Peter Malcolm Raynor Type of registration: Number of places registered: Dolphin Property Co Ltd care home 14 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: The maximum number of service users who can be accommodated is:14 The registered person may provide the following category of service only: Care home only code PC to service users of the following gender:Either whose primary care needs on admission to the home are within the following categories: Learning Disability Code LD, Maximum number of places 14, Physical Disability, Code PD Maximum number of places 1 Date of last inspection Brief description of the care home Heather House is a detached house located in the residential area of Birtley near to Gateshead and Chester le Street.Close by is access to transport,community services including healthcare centres,shops and leisure facilities. The house is a two storey building and it provides personal care for thirteen adults who have a learning disability and one person who has a physical disability. On the ground floor there is a Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 0 14 1 Brief description of the care home lounge,dining room,kitchen and laundry.A small conservatory has been added to the rear of the home. There is a small garden around the home with a patio at the rear. Most of the bedrooms are on the first floor but there are some on the ground floor of the home.Bathrooms,showers and toilets are located throughout the home. Most of the people living in the home need to be ambulant and able to manage the stairs. Care Homes for Adults (18-65 years) Page 5 of 30 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 Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: Before the visit: We looked at: Information we have received since the how was re registered. How the service deals with any complaints and concerns. Any changes to how the home is run. The providers view of how well they care for people. The views of people who use the service,their relatives,staff and other professionals. We checked the fee rates which vary accoding to individual need. The basic fee rate is 630 pounds per week.Person items such as clothing,toiletries,papers,and some outings are not included in the fee rate. We have reviewed our practice when making requirements,to improve national consistency. Care Homes for Adults (18-65 years) Page 6 of 30 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. The visit: An unannounced visit was made on the 8 October 2008.This visit started at 12:00 and was completed on the 10 October 2008 at 15:00.The visit was carried out by one inspector and took seven hours to complete. During the visit we: Talked with people who use the service,staff,the manager and regional manager. Looked at information about the people who use the service and how well their needs are met. Looked at other records which must be kept. Checked that staff had the knowledge,skills and training to meet the needs of the people they care for. Looked around the building to make sure it was safe,clean and comfortable. We told the manager and regional manager what we found. What the care home does well: What has improved since the last inspection? What they could do better: Care Homes for Adults (18-65 years) Page 8 of 30 The Statement of Purpose and Service User Guide need to be in different ways so that people can understand what is going to be provided. The care plans should be in a simpler style that they are easier to understand. The home should now provide holidays and short breaks for people as part of the contract. Further refurbishment is needed.The dining room chairs need replacing,flooring in one en suite is needed,one wardrobe must be bought and the lighting in two bedrooms must be improved. The manager should progress with completing Registered Mangers Award and NVQ 4. Building work needs to be completed as soon as possible and application to register the bungalow progressed. 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 30 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 30 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Although detailed information is gathered before people move into the home people are not given enough easy to understand information to help them make an informed choice about moving in. Evidence: The Statement of Purpose and Service User Guide has been reviewed and updated as a bungalow has been built in the grounds and this is to provide specialist care for two people.The bungalow has not yet been completed nor registered. Although there is a lot of detail in the Service User Guide it is not in large print,audio or picture style.This means people who have difficulty understanding the written word and complex information may not always know that the home will meet their needs. There is information about how peoples preferences and choices will be supported.This includes personal beliefs,religious preferences,equal opportunities and disability discrimination. Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: The care plans show that detailed assessments have been undertaken by the home and care managers.Where possible the person and their family have been involved in preparing the care plan. Care Homes for Adults (18-65 years) Page 12 of 30 Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. 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 have good opportunities to take part in life risks and choose how to make decisions in their everyday lives.This means people are well supported and actively involved in their chosen lifestyle. Evidence: Each person has a care plan which covers all aspects of personal,social and health care needs.Since the last visit to the home the staff,the person using the service and their advocate and or relatives have worked hard to improve the care plans. There are detailed assessments in place.These include pressure ulcer risk,moving and handling,nutritional assessments,continence and risk managements for behaviours that may challenge.Each person also has individual risk assessments in place so that they can meet their own goals. For example people case tracked like to go to church each week and the care plans are Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: very clear about how this is to be achieved.There is also good information about how people are to be supported with bathing and dressing.For example one person just needs help with fastenings and may forget to use the toilet.The care plan clearly shows what prompts are needed so that this persons dignity and independence is maintained. Care plans have a self advocacy part.These are completed with the person and detail what each individual can do for themselves,what support they would need and what help they need.For example one person can tell staff if there is something they want,would like support from family in making requests or a complaint and making more choices and needs help talking to other professionals. All of the people are consulted about life in the home.They are involved in meetings and supported to take risks and lead independent lives as far as they are able. Care Homes for Adults (18-65 years) Page 14 of 30 Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. 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. Opportunities to take part in meaningful activities and keep control of everyday decisions are good and the content and mealtimes are well organized.This means people can lead full and active lives. Evidence: The people living in the home can attend a day centre or college for five days a week.Some people are now making decisions about what days they go as they are getting older.They are preferring to stay at home sometimes and do other things. The care plans and daily records show people going out for for meals ,shopping for personal items,going bowling,to the theatre,cinema and disco evenings.Other activities include a visit to Beamish,church for weekly communion and regular visits with families.They also show daily routines in the home,for example assisting to make Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: meals and packed lunches. One person is currently on holiday with her sister and another regularly goes away with family.Increased staffing levels this year have given more flexibility about outings and this means someone can go out at short notice and not leave the home without enough staff. The manager has confirmed that they are now looking at planning holidays and short breaks for next year. Many of the staff have worked at the home for some considerable time and have formed good relationships with the people who live there.The daily routines are as flexible as possible and staff support peoples rights to choose how they live their lives within a risk assessment framework. Both the staff and people living in the home choose suitable menus.Records of what is provided is recorded in individual food diarys and staff guide and support individuals to eat a well balanced diet. Generally people have a packed or light lunch with the main meal in the evening.Records show choices such as beef casserole with two vegetables, dumplings and potatoes,chicken kievs, peas and chips and various choices for desserts.Fresh fruit ,yoghurts and ice cream are always available. Should anyone be hungry the staff have full access to the kitchen to prepare snacks. Care Homes for Adults (18-65 years) Page 16 of 30 Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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. Access to health care is good and care planning demonstrates that peoples needs are being fully met. Evidence: Three care plans showed how people are being supported regarding personal care.Care plans also show risk assessments and a person centred approach to daily living.For example, getting up ,bedtimes, evening outings and how individuals are supported at weekends. Clear information about how to assist people with personal hygiene and dressing is available in care plans.For example ,needs help with fasteners,likes hair gel, does not like wool as it itches, likes to be clean shaven and although likes casual clothing prefers trousers and ties when going out. Another plan shows how staff support someone who has communication problems and how they are to observe facial expression and body language. Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: Care plans show that people have full access to all NHS services and facilities.There is information to show that Speech and Language Therapists,Continence nurse, district nursing services and dentists,chiropodists and GPs are regularly involved in peoples care. There are detailed medication policies and procedures for staff to follow.All staff who administer medication have completed a Safe Handling of Medication course. The Medicine Administration Records(MAR)showed no gaps and handwritten directions had two signatures. Medication is recorded when received and disposed of, staff have sight of the prescription and keep a photocopy so that errors can be avoided. Care Homes for Adults (18-65 years) Page 18 of 30 Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. 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. Complaints and safeguarding issues are well managed and people feel they are valued and listened to.This means they are protected from harm. Evidence: The Company have clear accessible complaints policies and procedures.This is available in a picture style and is available in each persons care plan.How people are able to complain and what support they would need is also recorded in the advocacy part of the care plan. At the entrance to the home is a comments book where people can record any complaints or compliments they have about the service. There have been two recorded complaints since the last visit to the home.One was about the building work and access to natural lighting to bedrooms on the ground floor.The Company are currently looking at ways these complaints can be put right. There are also detailed procedures for staff to use should there be any allegation of abuse in the home.These policies include Whistle Blowing and Safeguarding procedures which link into the Local Authority Guidance. Staff have received training through their National Vocational training and Learning Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: Disability Award training. Money belonging to people living in the home is kept safely and all expenditure is recorded with dates and two signatures.Receipts are also available and records regularly audited. There have been no complaints or safeguarding incidents reported to the Commission during the last year. Care Homes for Adults (18-65 years) Page 20 of 30 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. 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. Although there has been considerable investment in recent months further work is needed to make sure it is a pleasing,comfortable and homely place for people to live and visit. Evidence: This home was going to close earlier in the year but has received increased funding which has made sure it remains open.During this time plans were approved for building work to start at the side of the home.The Company did not contest the plans at the time and the building has been completed.This has resulted in two bedrooms on the gable end of the home having reduced natural lighting.The Company are aware of the problem and are looking at ways to improve the lighting in these two bedrooms. In the grounds of the home the Company have built a two bedroomed bungalow which is not yet completed or registered with the Commission.This has taken quite a lot of the garden area although people have been able to access the front garden which does have some privacy screening. The people living in the home also have access to a pleasant conservatory which leads to the garden.Currently the garden cannot be used due to building works being Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: completed on the bungalow. During this year the home has had a full refurbishment including redecoration and new carpets. Bathrooms and kitchens have all been renewed with new tilings and fittings. One person now requires some specialist aids and these have been provided. The flooring in one en-suite shower room is marked and lifting at the edges. People have been encouraged to personalize their bedrooms.These now reflect individual likes and preferences.One persons bedroom does not have a wardrobe and the manager confirmed that one would be provided as soon as possible. The lounge and dining room are large and homely but the dining chairs which have previously painted again have the varnish flaking off. Everyone living and working in the home has some responsibilities to make sure it remains clean,organised and free from odours.On both days of the site visit the home was warm and comfortable. Care Homes for Adults (18-65 years) Page 22 of 30 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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. Staffing levels and systems around recruitment,selection and training of staff are good and meet the range of need of the people using the service and protect them from harm. Evidence: The home was due to close earlier this year but they have received extra funding from the Local Authority which has meant it can remain open.It has also meant the the home has been able to increase the staffing levels throughout the day so that peoples individual needs and choices about daily living can be met. The manager is supernumerary and there are plans to have a deputy manager in the near future.During the day when people are at the day centre the manager,deputy and a domestic are in house. The staffing levels change according to what is happening on daily basis.For example in the evening or at weekends there are sometimes between four and six staff on duty so that individual needs can be met. Four files showed that all staff complete an application form,medical Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: questionnaire,have an interview,complete Criminal Record Bureau checks,supply two references and proof of identity.They also receive a contract of employment which covers equality and diversity issues such as race,gender,religion,sexuality and disability. New staff have a twelve week induction which follows the Common Induction standards. All staff have training file and they have completed mandatory training,conflict and resolution,safe handling of medication and training following the Learning Disability Framework. Care Homes for Adults (18-65 years) Page 24 of 30 Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. 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 home is run by a manager who makes sure that good quality assurance and safety systems are in place.This means people receive a good quality care. Evidence: The manager is registered with the Commission and is in the process of completing the Registered Managers Award and National Vocational Qualification level four. He been been managing the home for some time and receives support from the operations manager. During the visit to the home it was evident that the staff have formed a good team and work hard to promote individuals lifestyles. There is a quality assurance system in place.This included regular audits and visits at least monthly from the operations manager.These audits include checks on health and safety, care practises,record keeping and talking to the people who visit and use the service. Questionnaires are sent out and the replys show that everyone is generally Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: satisfied with the service provided.There were some comments about lack of holidays and the decorations in the home which have largely been put right. The people living in the home have regular meetings and they set the agenda.Families are also involved and there is a Friends of Heather House forum which works with the home to improve all aspects of the service. Staff confirmed that their views are listened to and they also have regular meetings and they said they can approach management at any time. The AQQA was returned and gave a reasonale picture of how the home is to develop over the next year. Accidents are recorded and analysed to track trends so that staff can as far as possible prevent the same incidents happening. Internal maintenance records and external contracts are available and up to date. Care Homes for Adults (18-65 years) Page 26 of 30 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 Adults (18-65 years) Page 27 of 30 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 1 26 16 The registered persons must 07/11/2011 ensure that the identified bedroom is fitted with a suitable wardrobe. This will give this person a proper place to store their own clothing 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 2 4 The registered persons must 30/01/2009 ensure that the Service User Guide is available in alternative formats such as pictures,large print and audio. This will make sure people have clear information about the home so that they can be sure it will meet their needs. 2 24 16 The registered persons must 05/01/2009 ensure that the dining room chairs are replaced. This will make sure that the home remains a pleasant place to live. Care Homes for Adults (18-65 years) Page 28 of 30 3 26 23 The registered persons must 21/11/2008 ensure that a suitable wardrobe is provided in the identified bedroom. This will make sure that the person has somewhere to store personal items of clothing 4 26 23 The registered persons must 05/01/2009 ensure that the lighting in the two downstairs bedrooms meets the recognised standard of 150lux. This will mean the the peoples bedrooms are bright and a pleasant place to be and their safety will not be compromised. 5 27 16 The registered persons must 05/01/2009 ensure that the flooring in the identified en-suite is replaced. This will make sure that the facility is pleasant and clean to use on a daily basis. 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 37 The registered manager should continue to complete the Registered Managers Awards and NVQ level 4. Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: 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 We want people to be able to access this information. 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