Inspection on 02/08/05 for Heather House Nursing Home

This inspection was carried out on 2nd August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Heather House Nursing Home 05/07/07

Heather House Nursing Home 08/08/06

Heather House Nursing Home 13/02/06

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 BA1 7PL Lead Inspector Jill Cornelius Unannounced 1 & 2 August 2005 st nd 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 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 D56_20361_Heather House_241812_010805_Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Heather House Address Bannerdown Road, Batheaston, Bath, Bath & N E Somerset, BA1 7PL Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01225 858810 01225 895210 Mrs Sally Roberts Ms Lorna Flick Care Home with nursing 36 Category(ies) of Older People aged 65 or over registration, with number of places Heather House Nursing Home D56_20361_Heather House_241812_010805_Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th & 17th December 2004 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 D56_20361_Heather House_241812_010805_Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over two days. Opportunity was taken to tour the premises, examine records and talk to residents and staff, primarily in relation to the staffing levels and resident’s daily living activities. Most of the residents were seen during the inspection and several were spoken with. Four of the residents had visitors who gave their views of the service to the inspector. What the service does well: What has improved since the last inspection? What they could do better: Staff morale at the time of inspection is low. This has an effect on the wellbeing of residents. Heather House Nursing Home D56_20361_Heather House_241812_010805_Stage 4.doc Version 1.40 Page 6 The deployment and number of staff available in the early morning is not sufficient to respond promptly to the needs of the current residents. The home is not making satisfactory provision for recreational activities for people living in the home. The manager needs to improve the provision of activities for residents in a day-to-day meaningful way. The standard of deep cleaning must be improved to provide a hygienically safe environment. The manager has a good understanding of the areas in which the home needs to improve. Planning is underway indicating how this improvement was going to be resourced and managed but this needs to be turned into effective and sustained action that results in improved outcomes for residents. The organisation needs to play its part in ensuring that these improvements happen. Enforcement notices will be served if these improvements do not occur. 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 D56_20361_Heather House_241812_010805_Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Heather House Nursing Home D56_20361_Heather House_241812_010805_Stage 4.doc Version 1.40 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 standard(s) 1 The admission process is well managed and residents are given clear information regarding the service. EVIDENCE: New residents said that they received a warm welcome from staff and were given clear information about the home before and after their arrival. The Resident Guide mets legal requirements. Heather House Nursing Home D56_20361_Heather House_241812_010805_Stage 4.doc Version 1.40 Page 9 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 standard(s) 7, 8 and 11. The health needs of residents are well met with evidence of good multi disciplinary working taking place on a regular basis. Care plans give clear direction to staff as to what the care needs are and how these needs are to be met. Procedures and training mean that staff support residents and their relatives with respect at the time of the death of a resident. EVIDENCE: Heather House Nursing Home D56_20361_Heather House_241812_010805_Stage 4.doc Version 1.40 Page 10 The inspector viewed 6 resident care files. The home utilises a core care planning system based on Activities of Daily Living. Most of the documentation viewed identified a range of holistic needs. The plans of care prescribed in a clear way the interventions required to meet these identified needs. Sampled care records evidenced regular contact with GPs and other health professionals in order to maintain health care needs. The home has policies on managing the terminal stages of care, expected and unexpected deaths, which were viewed by the inspector and were comprehensive documents. Resident’s wishes when offered are recorded in their care file; the inspector visually evidenced this during the inspection. There is access to local ministers who will attend the home at any time. Hospitality would be offered to relatives if need be where residents are being cared for in the terminal stages of illness. Training records evidenced staff training in palliative / terminal care. Heather House Nursing Home D56_20361_Heather House_241812_010805_Stage 4.doc Version 1.40 Page 11 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 standard(s) 12 and 13 The home is not making satisfactory provision for recreational activities for people living in the home. The manager needs to improve the provision of activities for residents in a day-to-day meaningful way. Residents maintain contact with family/friends/ representatives and local community as they wish. EVIDENCE: The previous Activities Co-ordinator left in January 2005. For most of the time since then, two staff members have taken responsibility for arranging activities on a weekly programme basis. Following a complaint, the organisation was required to monitor the quality and consistency of this programme and to provide evidence of this monitoring to the Commission. The organisation was also required to provide evidence of the attempts made to recruit to this post but has only provided verbal evidence to date. The approach of designating staff members is no longer happening and has recently stopped. At the time of this inspection, no activities initiated by staff were happening whilst the whole area of activities is reviewed. Heather House Nursing Home D56_20361_Heather House_241812_010805_Stage 4.doc Version 1.40 Page 12 Residents’ views were sought in relation to the lack of activities. One resident reported their appreciation of the activities arranged and said “ I liked the activities and would like for them to be restarted”. Another resident said that they felt that “the day was very long without the activities and I would like them to start again”. Another resident said that they felt ”it would be better that these be undertaken during the afternoon”. Minutes were observed relating to the residents meeting held on the 31st July 2005. These had entries from residents and staff members in relation to the activities which had occurred and their ideas for future activities. The inspector and the manager discussed the planning of a resident/relative forum as such a forum had not been held this year. The manager advised the inspector again that this was to be planned and that minutes will be taken. These will be viewed at the next inspection. Heather House Nursing Home D56_20361_Heather House_241812_010805_Stage 4.doc Version 1.40 Page 13 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 standard(s) 17, 18 and 19 Arrangements for responding to complaints are not wholly satisfactory. Staff have awareness of what abuse is and their role in reporting suspected or actual abuse and protecting residents. Residents’ legal rights are protected. EVIDENCE: Residents’, visitors and staff comments received during this inspection showed that people feel comfortable discussing any concerns with senior staff or management. Issues arising from a previous complaint have yet to be adequately addressed by the organisation. Training records sampled by the inspector evidenced that staff have received Adult protection training in that they have attended the ‘Alerters’ level courses provided by the local authority. The manager informed the inspector that CRB checks have been completed for all staff. The inspector was unable to verify this, as records are not held within the home. 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 Heather House Nursing Home D56_20361_Heather House_241812_010805_Stage 4.doc Version 1.40 Page 14 manager said that if residents required an advocate she would access a resource locally. Heather House Nursing Home D56_20361_Heather House_241812_010805_Stage 4.doc Version 1.40 Page 15 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 standard(s) 21, 22 and 26. The overall quality of the equipment used is satisfactory although one of the toilet frames was a risk to residents. An immediate requirement was issued to replace this. The overall standard of the cleaning is adequate but there were specific areas which required additional attention in terms of deep cleaning. An immediate requirement was made to action this. EVIDENCE: There is adequate provision of communal toilet and bathrooms close to all resident areas; these are clearly marked. However, on observation there was evidence of clutter or items of equipment and unwanted furniture stored in toilets, bathrooms, small lounge and corridors. One toilet frame was found to be in need of urgent repair. An immediate requirement was issued to action this. Heather House Nursing Home D56_20361_Heather House_241812_010805_Stage 4.doc Version 1.40 Page 16 There are sufficient facilities for people with physical disability, which include ramps, rails, hoists and slings to assist with bathing. Sluices were provided separately on both floors. Discussion took place regarding the sluice on the ground floor. This was being used as a general storage area, which means it is non-useable by care staff for its intended purpose. The home was generally clean but would benefit from deep cleaning in several areas. There are some areas which are in need of redecorating. The home was found to be generally free from offensive odours. There is an infection control policy in place, which covers food hygiene, laundry and specific diseases. Heather House Nursing Home D56_20361_Heather House_241812_010805_Stage 4.doc Version 1.40 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 The deployment and number of staff available in the early morning is not sufficient to respond promptly to the needs of the current residents. Staff morale at the time of inspection is low. This has an effect on the wellbeing of residents. EVIDENCE: Residents spoken to said that staff at the home were kind and caring but that they were very busy and sometimes took a long time to answer call bells in the morning when they wanted to get up. Two visitors in the home reported the same concerns. During the visit one alarm call bell was tested and it took staff five minutes to respond to it. The staff member responding to the alarm said that during the morning when residents needed the most assistance it was sometimes difficult to answer alarm calls quickly with the staff available. Comments from other staff confirmed the high levels of need and the stresses of responding to this on current staffing levels. Records evidenced 3 staff members’ had left in the past 6 months. Heather House Nursing Home D56_20361_Heather House_241812_010805_Stage 4.doc Version 1.40 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 and 36 The manager has a good understanding of the areas in which the home needs to improve. Planning is underway indicating how this improvement was going to be resourced and managed but this needs to be turned into effective and sustained action that results in improved outcomes for residents. The recent implementation of staff supervision in a structured and formal way is welcome but will need to be sustained. EVIDENCE: Residents, their visitors and staff made positive and negative comments about the management of the home. Examples were given to the ways they have been involved and consulted. However, it was generally felt that the manager was unable to fully action some areas. Supervision notes were observed for 5 staff members. Heather House Nursing Home D56_20361_Heather House_241812_010805_Stage 4.doc Version 1.40 Page 19 Heather House Nursing Home D56_20361_Heather House_241812_010805_Stage 4.doc Version 1.40 Page 20 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 x 14 2 15 x COMPLAINTS AND PROTECTION x x 2 2 x x x 2 STAFFING Standard No Score 27 2 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x 3 3 2 x x x x 2 x x Heather House Nursing Home D56_20361_Heather House_241812_010805_Stage 4.doc Version 1.40 Page 21 yes 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 12 Regulation 12(1)(a) 12(3) 16(2)(m) 16(2)(n) 23(2)(l) Requirement Provide activities in relation to the needs of service users. Provide sufficient storage space for the purposes of the care home so as to avoid using bathrooms, toilets or sluice rooms for this purpose.. Review the deployment and number of staff available in the early morning so that it is sufficient to respond promptly to the needs of the current residents. ensure recorded and structured staff supervision is maintained on a regular basis. Ensure all areas of the home are kept clean. Timescale for action by 30/9/05 2. 21 by 31/10/05 3. 27 18(1)(a) from 2/8/05 4. 5. 36 26 18(2) 13(3) 23(2)(d) from 2/8/05 from 2/8/05 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. Refer to Standard 26 Good Practice Recommendations undertake a visual monitoring assessment of all bedrooms D56_20361_Heather House_241812_010805_Stage 4.doc Version 1.40 Page 22 Heather House Nursing Home 2. 12 and ensuites. Action any findings in relation to decoration. hold a relative & resident forum particularly in relation the provision of activities. Heather House Nursing Home D56_20361_Heather House_241812_010805_Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection 300 Aztec West Almondsbury South Gloucestershire 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 D56_20361_Heather House_241812_010805_Stage 4.doc Version 1.40 Page 24 - 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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