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Inspection on 17/01/06 for Heather House Nursing Home

Also see our care home review for Heather House Nursing Home for more information

This inspection was carried out on 17th January 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Following the loss of one of the young residents, the staff working in the home are providing support for the remaining residents some of whom have been deeply affected by the loss of their friend. His close friends are being encouraged to add their own personal tributes to a memorial poster in the entrance hall of the home. The home is well maintained and systems and equipment is provided to meet the specific needs of the residents. The manager supports all the staff in the home to provide a continuing high standard of care in the home. Systems of care within the home are regularly reviewed and the staff are consulted about any changes to be made in the home. The home operates a "key worker" system that provides both staff and residents with continuity in the provision of care.

What has improved since the last inspection?

New members of staff have been recruited who are providing addition support and care for the residents in the home.

What the care home could do better:

The home is constantly reviewing standards in the home and will look to maintain these standards.

CARE HOME ADULTS 18-65 Heather House Nursing Home Heather Drive Tadley Basingstoke Hampshire RG26 4QR Lead Inspector Sue Maynard Unannounced Inspection 17th January 2006 09:30 Heather House Nursing Home DS0000011653.V278121.R01.S.doc Version 5.1 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 DS0000011653.V278121.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 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. Heather House Nursing Home DS0000011653.V278121.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Heather House Nursing Home Address Heather Drive Tadley Basingstoke Hampshire RG26 4QR 0118 981 7772 0118 981 7757 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) SeeAbility Miss Sarah Jane Kenrick Care Home 16 Category(ies) of Sensory impairment (16) registration, with number of places Heather House Nursing Home DS0000011653.V278121.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Young people with a visual impairment from 16 years upwards Young people with degenerative diseases Date of last inspection 16th September 2005 Brief Description of the Service: Heather House is one of the services provided by SeeAbility, a registered charity. The Home provides residential and nursing care for 16 young adults aged from 16 years upwards who have a visual impairment and additional physical disabilities. This is a purpose built nursing home on ground level, set in a wooded site on the outskirts of Tadley. The building is spacious and of a very high decorative standard. The varied facilities within the Home provide the young people with the opportunities to develop their level of independence and enhance their quality of life. Heather House Nursing Home DS0000011653.V278121.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and was the second of two statutory inspections for the year 2005/2006. The inspection was conducted by one inspector and lasted three hours. The inspector observed staff interacting with the young residents. Records were examined and a tour of the building was made. What the service does well: What has improved since the last inspection? What they could do better: The home is constantly reviewing standards in the home and will look to maintain these standards. Heather House Nursing Home DS0000011653.V278121.R01.S.doc Version 5.1 Page 6 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 DS0000011653.V278121.R01.S.doc Version 5.1 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 Heather House Nursing Home DS0000011653.V278121.R01.S.doc Version 5.1 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): Standard 2 was assessed at the inspection in September 2005 EVIDENCE: Heather House Nursing Home DS0000011653.V278121.R01.S.doc Version 5.1 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): Standards 6,7 and 9 were assessed during the inspection undertaken in September 2005. EVIDENCE: Heather House Nursing Home DS0000011653.V278121.R01.S.doc Version 5.1 Page 10 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): 16 and 17 The young people in the home are supported by the staff to make decisions that affect their daily lives, ensuring that their rights are respected and their quality of life is maintained at all times. The regular monitoring and provision of a diet appropriate to their needs ensures that all the young people in the home receive a healthy and well balanced diet. EVIDENCE: Staff working in the home are very aware that some of the young residents are not able to verbalise their likes and dislikes. The home operates a “key worker” system and each of these members of staff working with the residents becomes very aware of changes in mood and body language. Facial expressions from the young person may be an indication of their like or dislike of a certain situation, proximity of another resident or member of staff. The key worker is then able to act accordingly and possibly remove the resident from a situation that they are not comfortable in. The staff, being aware of these triggers, enables them to ensure that the rights of the young people are respected and that they are supported to make decisions about how they live their daily lives. Heather House Nursing Home DS0000011653.V278121.R01.S.doc Version 5.1 Page 11 The manager of the home has introduced monthly meetings with every resident on an individual basis. The key worker is present to support the resident, together with the manager or her deputy. These meetings have been established with the young person to enable them to, possibly through their key worker, look at specific health and social needs problems. One month it may be mobility, the next dietary needs etc. All of the young residents in the home have regular multi-disciplinary meetings that includes their family, doctor, social worker, dietician and physiotherapist and possibly a representative from the funding authority. The manager in consultation with the key workers has decided that many of the young residents are overwhelmed at these meetings and do not always participate as fully as possible, hence the introduction of the monthly meetings. The home ensures that all the residents are provided with a healthy and well balanced diet. Meal times in the home are made to be social occasions when all the young people come together in the dining rooms of their house. This includes residents who receive their nutrition in a liquid form via a gastroscopy tube. It is considered very important that these young people are exposed to the sounds and smells of cooked food and the sound of the interactions between the young people and members of staff. Where possible the young people are involved in the planning of the menus and are supported by their key workers to visit the local supermarket to purchase their favourite foods. A dietician reviews the dietary needs of all the residents each month and adjusts their dietary needs accordingly. Heather House Nursing Home DS0000011653.V278121.R01.S.doc Version 5.1 Page 12 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): Standards 18, 19 and 20 were assessed during the inspection undertaken in September 2005. EVIDENCE: Heather House Nursing Home DS0000011653.V278121.R01.S.doc Version 5.1 Page 13 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): Standards 22 and 23 were assessed during the inspection undertaken in September 2005. EVIDENCE: Heather House Nursing Home DS0000011653.V278121.R01.S.doc Version 5.1 Page 14 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 and 30 The ongoing review of services provided in the home ensures that all residents live in a clean, safe and comfortable environment. EVIDENCE: The home is a purpose built unit designed to meet the needs of the young people who live there. Every consideration has been given to provide equipment for them that address not only their physical needs but also their psychological needs. Each of the bedrooms are very individualised demonstrating the personal likes of each resident. Specialist activity areas are provided throughout the home. Communal areas are used for group activities, as was seen by the inspector on the day of the inspection. In a separate lounge area the inspector spoke to one resident who was alone with a care worker and was enjoying listening to his personal choice of music. There is a programme of regular maintenance and re-decoration for the home. When the residents’ bedrooms are re-decorated they are fully involved in the choice of colours for their rooms. The home has a large garden area behind the home. The manager informed the inspector that a local company has given sponsorship to the home to Heather House Nursing Home DS0000011653.V278121.R01.S.doc Version 5.1 Page 15 provide a sensory walk through the grounds, which will include the new residential unit being built in the grounds of Heather House. Not only are the sponsors providing the sensory equipment, such as lights and sounds in the form of running water and wind chimes and aromatic plants, they are also volunteering to do much of the manual work of clearing the ground and installing the equipment. Some of the work is already underway and ground has been cleared in some areas of the garden. On the day of the inspection the inspector noted that the home was clean and tidy and standards of hygiene had been maintained throughout the building. Heather House Nursing Home DS0000011653.V278121.R01.S.doc Version 5.1 Page 16 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 and 34 Comprehensive training undertaken by the staff enables them to be competent to do their jobs. The robust recruitment procedure for the home ensures the vulnerable people living in the home are protected. EVIDENCE: The manager reported that following advertisements placed in the nursing and local press the home has successfully recruited new members of staff, including trained nurses and care workers. All new members of staff undertake a period of supervised induction training. The home has a training programme for all staff that this co-ordinated by SeeAbility. The manager reported that 70 of the care staff have achieved NVQ level 2 or above. The inspector examined samples of four staff recruitment files. All of these were found to be in order. Evidence of completed application forms and written references was seen. All the files contained evidence of personal identification. Appropriate police checks had been undertaken prior to the staff member commencing employment. Heather House Nursing Home DS0000011653.V278121.R01.S.doc Version 5.1 Page 17 All new applicants have two interviews, one of which involves the residents in the home. All subjects discussed at the interviews are documented. Heather House Nursing Home DS0000011653.V278121.R01.S.doc Version 5.1 Page 18 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 and 39 The manager of the home is able to demonstrate that she is suitably qualified to ensure that the home is well run and that the needs of the residents are met. The manager provides strong leadership in the home providing guidance and direction to ensure that standards within the home are maintained at all times. EVIDENCE: The manager for the home has been in post since 1998. She is a Registered General Nurse Level 1 with specialist knowledge of the condition that affects many of the young people in the home who require very specialist care. Her deputy and other senior nurses working in the home support her in her role as manager. She ensures that communication between the staff is maintained and team meetings are held regularly. The manager ensures regular supervision is undertaken for all staff and any areas of concern in staff working practices or training needs are identified and addressed. Heather House Nursing Home DS0000011653.V278121.R01.S.doc Version 5.1 Page 19 Regular surveys are undertaken regularly with the families of the residents to monitor the level of service provided in the home. Family members are encouraged to maintain regular contact with the home by speaking with the manager or the key worker to ensure that the family are kept aware of any changes in the daily life of their son or daughter. The manager reported that the results of the surveys are generally very positive. Any suggestions that are made to possibly improve the quality of the residents lives are always considered and where possible implemented. Heather House Nursing Home DS0000011653.V278121.R01.S.doc Version 5.1 Page 20 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 X 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 X 23 X ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 X 34 3 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X X X 3 X 3 X X X X Heather House Nursing Home DS0000011653.V278121.R01.S.doc Version 5.1 Page 21 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Heather House Nursing Home DS0000011653.V278121.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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. 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