Inspection on 13/02/06 for Heather House Nursing Home

This inspection was carried out on 13th February 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Heather House Nursing Home 05/07/07

Heather House Nursing Home 08/08/06

Heather House Nursing Home 02/08/05

Heather House Nursing Home 15/12/04

Heather House Nursing Home 04/06/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Heather House Nursing Home Bannerdown Road Batheaston Bath Bath & N E Somerset BA1 7PL Lead Inspector Jill Cornelius Unannounced Inspection 13th February 2006 08:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Heather House Nursing Home DS0000020361.V282715.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Heather House Nursing Home DS0000020361.V282715.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Heather House Nursing Home Address Bannerdown Road Batheaston Bath Bath & N E Somerset BA1 7PL 08453 455741 01225 859210 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) Mrs Sally Roberts Ms Lorna Flick Care Home 36 Category(ies) of Old age, not falling within any other category registration, with number (36) of places Heather House Nursing Home DS0000020361.V282715.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. May accommodate 36 Persons aged 50 years and over Staffing Notice dated 10/10/2001 and as amended on 31/03/2003 applies. Manager must be a RN on parts 1 or 12 of the NMC register Date of last inspection 2nd August 2005 Brief Description of the Service: Heather House is registered as a care home with nursing for 36 older persons. The home has voluntarily capped its registered beds at present to 33.The home is situated in Batheaston, which facilitates ready access to Bath. The home itself can be accessed by car or bus. There is easy access to local shops and social venues. The home is a converted older property, providing a mix of single, companion and en-suite rooms. Care is offered over two floors, with communal space in three areas on the ground floor. There is a passenger lift providing access to all resident areas. Heather House is part of the Blanchworth Care group. Heather House Nursing Home DS0000020361.V282715.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day. The manager and deputy manager were present during the inspection. Records looked at included care plans, assessments and training. The arrangements for administering and managing of medication were also examined. A number of residents and visitors were also spoken with about the quality of care provided at the home. Discussion was held with the manager on progress that has been made with regards to meeting the requirements and recommendations made following the unannounced inspection of this home, which was conducted in August 2005. What the service does well: What has improved since the last inspection? Residents where positive about the activities on offer. Supervision and Appraisals of staff is being undertaken. Decoration and furnishings have been improved as required. For example, several bedrooms have been redecorated. Residents were pleased with the effect. Heather House Nursing Home DS0000020361.V282715.R01.S.doc Version 5.1 Page 6 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. Heather House Nursing Home DS0000020361.V282715.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Heather House Nursing Home DS0000020361.V282715.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 4 The home is committed to providing a good level of information and opportunities to visit for prospective residents. Resident care needs are properly assessed and well met. EVIDENCE: The Statement of Purpose has been reviewed and updated. Local Authority assessments are obtained as part of admission procedure. These outline the health and social care needs of perspective residents. The pre admission assessments were found to contain sufficient details. Conversations with the manager and care staff provided evidence that detailed assessments of the needs of each resident are undertaken and that the home is committed to provide a good standard of care. One new resident said that they received a warm welcome. Relatives said that they were informed of their loved one’s day to day progress in settling at the home by the manager. Heather House Nursing Home DS0000020361.V282715.R01.S.doc Version 5.1 Page 9 Heather House Nursing Home DS0000020361.V282715.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8, 9,10, 11 Individual care plans are satisfactorily completed and residents’ health needs are met. There is a safe system in place to administer medication. Residents are treated with respect and staff assist any resident who is approaching death with sympathy and sensitivity. EVIDENCE: It was evidenced that two new residents had complete holistic care plans generated from assessment details Care plans viewed showed full details about care needs, regularly reviewed. Risk assessments and manual handling assessments completed. Evidence through signature of resident involvement was not always observed. A recommendation is made in relation to this practice being undertaken. When speaking to residents they confirmed they were aware of care plans “saying what help I need”. Heather House Nursing Home DS0000020361.V282715.R01.S.doc Version 5.1 Page 11 Health services visit the home to support residents who require medical treatment. On the day of inspection an audiologist visited a resident. Appropriate wound evaluation undertaken which indicate the type, size, location and treatment of each wound. Action is included within their care plan and the timescales for the review process noted. Medication records accurately recorded the administering of medication where observed. The storage of medication including controlled drugs is satisfactory and secure. Return of medication is evidenced by pharmacist signature. The home makes every effort to care for residents who are approaching death with sensitivity and respect. Heather House has strong links with Dorothy House Hospice and family and friends are encouraged to spend as much time as they wish at the home if a resident is dying. Correspondence was seen from two families who expressed their “personal appreciation to the carers at Heather House for the care their loved ones had received”. Heather House Nursing Home DS0000020361.V282715.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 The home is now making satisfactory provision for recreational activities for people living in the home. The manager and staff need to continue with this improvement for residents in a day-to-day meaningful way. Residents maintain contact with family/friends/ representatives and local community as they wish. EVIDENCE: Staff organise activities such as; Games, such as beetle drive; bingo; quizzes; making cards; flower decoration; cake baking. Opportunity to go out on visits are planned for this spring. Records are maintained for the monitoring of residents participation and enjoyment of activities. Some activity sessions are undertaken on a one-to-one, this ensures that people who do not join in a group activity session are still able to enjoy activities. One relative stated” that her/his loved one looked forward to the time spent with the carer for this time. However, they would welcome it more often”. A weekly programme is available in the hall and for residents. Staff remind residents each day what is on the programme and that they were encouraged to take part. A residents meeting was held on the 28th November 2005. Minutes of this meeting was observed. Residents’ views were sought in relation to the Heather House Nursing Home DS0000020361.V282715.R01.S.doc Version 5.1 Page 13 activities. Two residents’ reported their appreciation of the activities arranged and said “ I like the activities and am glad they have been restarted”. Another resident said that they felt that “the activities have been good and I would like the opportunity to do more of them during the day”. Another resident said that they felt ”it would be better that these be undertaken during the afternoon”. A request for a representative of Blanchworth Care was also noted. This had not been auctioned and an immediate requirement was made in relation to this. A religious service is held fortnightly. Many people have well-established links with their families. Heather House has an open policy with regard to visitors and this is clear in its statement of purpose and a notice in the home welcoming visitors with the agreement of the resident. This was also evidenced in the visitor’s book. Visitors on the day of inspection commented that their “loved ones enjoyed activities” and “food provided at the home”. Resident’s choices of rising and retiring are documented in care plans. Three residents confirmed that their choice was observed, however they could “change their mind and request an alternate time”. Choices to where individuals spend their day, was also supported by residents. The inspector joined residents’ at lunch in the dinning room. The meal was well presented and residents commented that it was very tasty”. Residents spoken with enjoyed their meals and felt they received a balanced diet. Staff members served, supervised and assisted residents discreetly in the dinning room; the meal was unhurried. The dinning table arrangements could be enhanced as one table was in the corner looking at an inside wall. The tables had individual place settings but the condiments required cleaning, as did the table clothes. The dinning room evidenced a lot of clutter and dead flower arrangements. One resident said that “this was unpleasant and it should be tidy” A month’s record of meals served is kept and showed a varied and balanced diet. The catering staffs are able to offer alternative choices. The kitchen was not inspected at this inspection. Heather House Nursing Home DS0000020361.V282715.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18. Staff have awareness of what abuse is and their role in reporting suspected or actual abuse and protecting residents. EVIDENCE: Evidence gathered during the inspection confirmed that any concerns raised by residents / advocates are acknowledged and actions taken where possible to resolve issues. The complaints log recorded a number of complaints or dissatisfactions: one about laundry items not being pressed correctly. This had been investigated and an action plan formulated by the manager in obtaining “views about your laundry” from residents and their relatives. When asked residents said they would “always” say something that staff “try and change it” “listen to what we have to say”. A resident said that they were able to speak to the manager or deputy if she wanted too or had concerns about anything. A complaint procedure including Commission for Social Care Inspection contact details has been supplied to each resident and displayed on the notice board. The home has an Adult Protection policy and procedure and staff have received training making sure as far as possible that residents live in a safe environment. Heather House Nursing Home DS0000020361.V282715.R01.S.doc Version 5.1 Page 15 Residents are able to participate in the political process, and are enabled to exercise their rights by voting during elections. The majority of residents tend to use their postal vote. Currently an advocacy service is not used, but the manager said that if residents required an advocate she would access a resource locally. Heather House Nursing Home DS0000020361.V282715.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 23, 24, 25 and 26. Residents have access to comfortable indoor and outdoor communal facilities. Attention is required to the monitoring of the clutter that builds up in areas around the home. EVIDENCE: There are two lounge areas, the smaller one with level access being a designated smoking / quiet area. The larger lounge is accessible via stairs for mobile service users or along the corridor, down the ramp into the dining area and then into the lounge area for wheelchair users. There is limited level access to the garden area. It is accessible to wheelchair users only with assistance via the dining room and down a ramp. Guardrails have been fitted at the end of this ramp to reduce the risk to wheelchair users. It was noted that a number of the flagstones were loose. A Requirement is made in relation to this. All rooms were naturally ventilated with most window heights affording sitting views outside the home. Central and domestic lighting was available, with Heather House Nursing Home DS0000020361.V282715.R01.S.doc Version 5.1 Page 17 most areas enjoying natural light. The lounge wall lights offered a mix match of some with shades on and others with just a bulb. This was highlighted to the manager and new candle bulbs domestic in character were put in by maintenance during the inspection. Residents commented that they were pleased with the outcome. Attention is required to the monitoring of the clutter that builds up in areas around the home. Some small side tables were showing signs of constant use and were becoming unsafe. A Requirement is made in relation to this. The inspector viewed a number of bedrooms in the home. All those seen were personalised and reflected individual tastes, indicating that choice and independence are promoted in this respect. One empty room required decorating and repairs to the wardrobe prior to its occupancy. A Recommendation is made in relation to this. Heather House Nursing Home DS0000020361.V282715.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 30 By undertaking an early morning inspection it was evident that enough staff are deployed to meet the current needs of the residents. Care staffs have a range of length of experience working at Heather House and a range of levels of previous relevant care experience. Although an ongoing programme of staff training is in place, the records of the training that is occurring do not clearly evidence this at present. EVIDENCE: The inspector randomly checked the staffing levels for the period of January 2006. The levels met the requirements. At 8:15 the beginning of the inspection one resident was dressed and in the lounge. Whilst touring the home other residents were eating their breakfast in their rooms. Call bells were in reach of residents. A number were starting to be assisted with their personal care. The home had a calm unhurried feel. Heather House Nursing Home DS0000020361.V282715.R01.S.doc Version 5.1 Page 19 RN’s spoken with, informed the inspector that they had attended clinical update training on such subjects as eg Palliative Care, Tissue Viability, Wound Management, Parkinson’s Disease, Pressure Area Care, Infection control, Bard Urology and Catheter Management. Carer’s spoken with informed the inspector of attendance in First Aid, Abuse and Challenging Behaviour, Dementia Care. Staff training records was not documented in the homes filing system. The evidence of these where gained by viewing entries in diaries certificates/photo copies, advertisements of training events. There was no evidence of individual signatures of attendance in records of training. These should be provided. There was no availability for the inspector to observe via the IT system, as the manager was not able to undertake this. A requirement is made in relation to this. Heather House Nursing Home DS0000020361.V282715.R01.S.doc Version 5.1 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 36 The views of family and friends are sought on how the home is achieving Staff training, the evidence of the level of staff supervision is not easily established through current records. This clarity needs to be gained. EVIDENCE: There were a number of examples in relation to mandatory training such as food hygiene, moving & handling and fire safety. Discussion with Ms. Flick, the home’s Manager about her ability to access Blanchworth head office to access the evidence of training was undertaken. This has been highlighted on a previous inspection in 2005. A Requirement is made in relation to this. Annual appraisal and supervision has occurred. The manager needs to maintain supervision sessions for care staff at least 6 times per year and maintain records of these in the staff files. Evidence was obtained by viewing four staff records. This was verbally confirmed as being undertaken by two Heather House Nursing Home DS0000020361.V282715.R01.S.doc Version 5.1 Page 21 staff members asked. Supervision and appraisal overview would assist with planning. This was discussed with the manager. Heather House Nursing Home DS0000020361.V282715.R01.S.doc Version 5.1 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 2 x x 3 3 2 2 STAFFING Standard No Score 27 3 28 x 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x x 3 x x Heather House Nursing Home DS0000020361.V282715.R01.S.doc Version 5.1 Page 23 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 OP12 Regulation 16(2)(m) (n) Requirement Arrange a date for residents to meet with operational director of Blanchworth as requested by residents in meeting held in November 05. Risk assess the security of the flag stones used as a path from the rear exit to the car park. Take actions to reduce those risks. Risk assess the small side tables in the lounge and renew as necessary. Avoid using bathrooms, toilets or sluice rooms as a general storing area. Clear all items out of toilets and bathrooms and remove shelving, which provide areas of “dumping” items. Decorate corridor and toilets close to lounge. Fit working blinds or equivalent to toilets providing privacy. Decorate empty room before offering to potential new resident Timescale for action 15/02/06 2. OP19 23(2)(o) 07/04/06 3. 4. OP20 OP 21 13(4)(a) (c) 23(2)(o) 13/04/06 13/04/06 5. 6. 7 OP 19 OP 19 OP19 23(2)(b) 23(2)(b) 23(2)(b) 28/04/06 28/04/06 28/04/06 Heather House Nursing Home DS0000020361.V282715.R01.S.doc Version 5.1 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3 Refer to Standard OP26 OP31 OP36 Good Practice Recommendations Complete previous findings in relation to maintenance and decoration. Gain ability to access through computer Blanchworth head office to access evidence of training for staff. Formulate an over view for supervision. Heather House Nursing Home DS0000020361.V282715.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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 Heather House Nursing Home DS0000020361.V282715.R01.S.doc Version 5.1 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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