CARE HOMES FOR OLDER PEOPLE
Heather Vale Heathervale Road Hasland Chesterfield S41 0HZ Lead Inspector
Rose Veale Unannounced Inspection 26th August 2005 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 Vale C02 C52 Heather Vale S20009 V244650 260805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Heather Vale Address Heathervale Road Hasland Chesterfield S41 0HZ 01246 221569 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) Anchor Trust Anne Brooke Care Home 39 Category(ies) of Older People registration, with number of places Heather Vale C02 C52 Heather Vale S20009 V244650 260805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 04/02/2005 Brief Description of the Service: Heather Vale is a purpose built care home which opened in 1989. The home provides personal care and accommodation for 39 older people in thirty-seven single rooms and one double room, all with en-suite facilities. The home has two communal lounges and four dining rooms and is set in pleasant accessible gardens. Heather Vale is situated on the outskirts of the village of Hasland which has a range of shops, pubs, churches, a public park and access to public transport. Heather Vale C02 C52 Heather Vale S20009 V244650 260805 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over 3½ hours on one day. There were 38 residents accommodated in the home on the day of the inspection. Residents, staff and visitors were spoken with during the inspection. The care records of two residents were examined, plus other records relating to the staffing and management of the home. Although a full tour of the home was not undertaken, communal areas of the home were seen. The manager and deputy manager were available and very helpful throughout the inspection. What the service does well: What has improved since the last inspection?
All the requirements made at the last inspection had been carried out, resulting in improvements to the administration of medication in the home. The providers, (Anchor Trust), had set up a work committee for representatives of staff working in their homes to meet with senior
Heather Vale C02 C52 Heather Vale S20009 V244650 260805 Stage 4.doc Version 1.40 Page 6 management to discuss the views and ideas of staff. Staff at Heather Vale were positive about this initiative and felt it would help to improve the service for residents. 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 Vale C02 C52 Heather Vale S20009 V244650 260805 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 Vale C02 C52 Heather Vale S20009 V244650 260805 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) 2 and 3 The home’s assessment process and the information provided to residents ensured that they could make an informed decision about living in the home. EVIDENCE: The home provided each resident with a copy of the terms and conditions of living in the home. The statement of terms and conditions included all the required information. It was well written and had received the ‘Crystal Mark’ from the Plain English Campaign. The care records of two residents were examined, one of a recently admitted resident. Both contained detailed and comprehensive assessment information. Individual care plans had been produced from the assessment information. Heather Vale C02 C52 Heather Vale S20009 V244650 260805 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 and 8 Residents’ health and personal care needs appeared to be fully met, with residents involved in the planning of care and good liaison with other healthcare professionals. EVIDENCE: The care plans of two residents were examined. Each resident had a Lifestyle Agreement which detailed all aspects of their daily lives and the action required by staff to ensure their needs were met. One of the Lifestyle Agreements had been signed by the resident. Risk assessments were included appropriate to the needs of each resident, such as falls and bathing. All assessments and the Lifestyle Agreements had been regularly reviewed up to date. There was also a six monthly review of the Lifestyle Agreement with the resident and their keyworker which had been signed by the resident. The resident’s preferred name was not recorded in the care notes. Mobility, nutritional and tissue viability assessments were included in the care records seen. These assessments had all been regularly updated. The nutritional and tissue viability assessments seen had not been signed by the member of staff who completed them. Residents were registered with local GPs. One resident spoken with confirmed that access was arranged to other services, such as chiropodist, dentist and optician.
Heather Vale C02 C52 Heather Vale S20009 V244650 260805 Stage 4.doc Version 1.40 Page 10 Although Standard 9 was not specifically assessed at this inspection, the home’s medication policy was seen and the medication administration records, (MARs), were examined in relation to requirements made at the last inspection. All the requirements and recommendations made had been met. Heather Vale C02 C52 Heather Vale S20009 V244650 260805 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, 13 and 14 The home had a good programme of activities for residents, ensuring that their social and recreational needs were met. Routines at the home were flexible and varied so that residents were able to exercise choice and control in their lives. EVIDENCE: Residents’ preferred routines, likes and dislikes regarding food, spiritual needs, and choice of leisure activities were all detailed in their care records. Residents spoken with confirmed that routines at the home were reasonably flexible. One resident was pleased with the activities offered, but felt limited in group activities and would have liked more one to one activities offered. The activities coordinator at the home was enthusiastic about the role and recognised the need for more one to one activities. The activities coordinator had recently become involved with a work group aiming to bring the ideas and views of staff to the senior management of Anchor. The activities coordinator felt this was a really positive initiative. There was an open visiting policy at the home. Residents and visitors spoken with confirmed that visitors were made welcome in the home. Visitors spoken with felt they were kept informed about relatives at the home and involved in their care as appropriate. Heather Vale C02 C52 Heather Vale S20009 V244650 260805 Stage 4.doc Version 1.40 Page 12 The home displayed information about advocacy services. All prospective residents, or their representatives, were given information about advocacy services and supported to seek help if required. Residents were encouraged to bring personal possessions in to the home. Residents were given information on admission about handling financial affairs and access to personal records. Heather Vale C02 C52 Heather Vale S20009 V244650 260805 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 The information and support provided by the home ensured that residents’ rights were protected. EVIDENCE: The home provided information about an independent advice and advocacy service for residents, including a referral questionnaire if required. The manager said that all residents were included on the electoral register and were supported to vote if they chose to. One resident spoken with confirmed that they had voted by post in the last election. Heather Vale C02 C52 Heather Vale S20009 V244650 260805 Stage 4.doc Version 1.40 Page 14 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) 19 and 24 The home was very clean, fresh, bright and comfortable, providing a pleasant environment for residents. EVIDENCE: On the day of the inspection, the home was very clean and free from offensive odours. Residents, visitors and staff spoken with said that the home was always clean and fresh. The communal areas were well decorated and comfortably furnished. The home had recently been inspected by the fire service and records were seen to show that the one recommendation made had been carried out. Residents’ bedrooms all had en-suite toilets. One resident spoken with had brought some of their own furniture into the home and was pleased with the room. Residents are all provided with a key to their room which also fitted the front door of the home. Heather Vale C02 C52 Heather Vale S20009 V244650 260805 Stage 4.doc Version 1.40 Page 15 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, 28 and 30 There were sufficient staff to meet the needs of residents and there was a good programme of staff training to enable them to carry out their roles effectively. EVIDENCE: Staffing levels observed were appropriate for the number of residents in the home. Residents and visitors spoken with felt that although staff were busy, they were usually available when needed. Staff felt that there were times when they felt overstretched, particularly when there were residents in the home with higher care needs. Staff training was a high priority at the home. Staff spoken with were positive about the training offered to them. They were pleased that training was offered to all members of staff, not just the care staff. The staff training plan and records were seen and showed that 53 of staff had achieved NVQ Level 2 or above, and a further 29 of staff were currently working towards NVQ level 2 or 3. Heather Vale C02 C52 Heather Vale S20009 V244650 260805 Stage 4.doc Version 1.40 Page 16 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) 32, 33, 35, 37 and 38 The home was well run with the best interests of residents in mind, with good leadership for staff, as demonstrated by the home’s quality assurance programme. EVIDENCE: The home had a calm, relaxed atmosphere, and felt well organised. Staff spoken with felt that the manager was open and approachable. They commented that they felt the manager would listen to their views and ideas, and that necessary action would be taken. The home had regular residents’ meetings and also sought the views of residents at care reviews. There was an annual quality assurance audit carried out by the home with the results displayed for residents, visitors and staff to see. The report was seen of a customer satisfaction survey carried out by an external organisation, Laing and Buisson. This included positive comments from residents and visitors and comments on where the home could improve.
Heather Vale C02 C52 Heather Vale S20009 V244650 260805 Stage 4.doc Version 1.40 Page 17 The home was measured against all the homes surveyed by Laing and Buisson and scored above the mean for all homes. The survey report commented that “Heather Vale should be seen as a best practice home within the Anchor portfolio”. Also, “The home excels in many areas most notable care standards, food, birthdays, health care, keeping people informed, resident presentation, meeting personal needs, staff attentiveness and complaints handling”. The home held personal money for residents, if they chose to use this service. Residents were provided with information on or before admission about how the home dealt with personal money. Records were seen of the personal money held and these were satisfactory. Records held in the home were well organised and securely kept. Residents were given information about access to their records on admission. Records relating to health and safety were examined and were all satisfactory. These included records such as: maintenance of the gas central heating system; checking and maintenance of the emergency lighting; checking and maintenance of the water systems; records of accidents and incidents in the home. Heather Vale C02 C52 Heather Vale S20009 V244650 260805 Stage 4.doc Version 1.40 Page 18 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 x 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x
COMPLAINTS AND PROTECTION 4 x x x x 3 x x STAFFING Standard No Score 27 3 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x 3 x x 3 3 x 3 x 3 3 Heather Vale C02 C52 Heather Vale S20009 V244650 260805 Stage 4.doc Version 1.40 Page 19 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 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. 1. Refer to Standard 2 Good Practice Recommendations The statement of terms and conditions for residents should be amended at paragraph 4 to refer to the Commission for Social Care Inspection, (rather than the National Care Standards Commission) The preferred name or form of address of residents should be recorded in their Lifestyle Agreement Nutrional and tissue viability assessments should be signed by the member of staff completing them Further development and resourcing of the activies programme should be considered to include more one to one activities offered to residents The staffing levels should be kept under review, in consultation with staff, to ensure current good standards of care are always maintained. 2. 3. 4. 5. 7 7 12 27 Heather Vale C02 C52 Heather Vale S20009 V244650 260805 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection South Point Cardinal Square Nottingham Road, Derby DE1 3QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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