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Inspection on 19/04/05 for Heathercliffe Residential Home

Also see our care home review for Heathercliffe Residential Home for more information

This inspection was carried out on 19th April 2005.

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

The assessments of residents` needs and care plans are thorough and well written so it is clear how needs can be met and what staff have to do to meet them. The home is very well kept, clean and hygienic. Staffing levels are generous and extra staff are on duty at peak times during the day. Staff training is given high priority to ensure that staff are able to carry out their work well. The home is well managed, with good communication between management and staff. The owner of the home is closely involved with running it to make sure that it continues to be run in the best interests of the residents.

What has improved since the last inspection?

Staff members have welcomed the opportunity to undertake additional training, to improve their understanding and knowledge and to obtain appropriate qualifications.

What the care home could do better:

Greater care could be taken with recording the administration of residents` medication and to explain any changes, for example when medication is no longer needed.

CARE HOMES FOR OLDER PEOPLE HEATHERCLIFFE RESIDENTIAL CARE HOME Old Chester Road Helsby Via Warrington WA6 9NP Lead Inspector Sue Dolley Unannounced 19 April 2005 10:00 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. HEATHERCLIFFE RESIDENTIAL CARE HOME F51-F01 S6660 Heathercliffe V221784 190405 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Heathecliffe Residential Care Home Address Old Chester Road Helsby Via Warrington Cheshire WA6 9NP 01928 723639 01928 724128 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) Pinestone Limited Mrs Sarah Jane Turner Care Home 22 Category(ies) of OP (old age) 22 registration, with number of places HEATHERCLIFFE RESIDENTIAL CARE HOME F51-F01 S6660 Heathercliffe V221784 190405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: Heathercliffe is registered to provide care to a maximum of 22 service users within the category (OP) old age. Date of last inspection 1st November 2004 Brief Description of the Service: Heathercliffe is an older style property that has been adapted to provide comfortable, homely accomodation for service users. All 21 bedrooms have ensuite facilities and bedrooms are fitted with a call system. The majority of bedrooms have television and telphone points and a payphone is available in the foyer. A five-person passenger lift provides access to the upstairs bedrooms. There are two bathrooms, there is one large and one walk-in bath. Heathercliffe is situated in a quiet residential location, it has pleasant gardens and is within close proximity to Helsby and Frodsham HEATHERCLIFFE RESIDENTIAL CARE HOME F51-F01 S6660 Heathercliffe V221784 190405 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 19th April 2005 over a period of 6 hours to assess if the residents’ needs were being met at the home. A partial tour of the premises took place and included all shared areas such as lounges and dining rooms, shared bathrooms and toilets and the kitchen. Several members of management staff on duty, and 3 residents and were spoken to during the inspection. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. HEATHERCLIFFE RESIDENTIAL CARE HOME F51-F01 S6660 Heathercliffe V221784 190405 Stage 4.doc Version 1.20 Page 6 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 HEATHERCLIFFE RESIDENTIAL CARE HOME F51-F01 S6660 Heathercliffe V221784 190405 Stage 4.doc Version 1.20 Page 7 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, 3, 5 and 6 The process of moving new residents into the home is very well managed to ensure that people moving in, and their relatives, know what to expect and that their needs will be met at the home. EVIDENCE: Prospective residents are encouraged to visit the home with their relatives before they move in. They usually move in for a trial period before making the decision to stay. Unplanned admissions are avoided and intermediate care is not provided. Each service user is given a contract or statement of terms and conditions when they move into the home so they know what room they will be in, what services are covered by the fee, and their rights and obligations as well as those of the registered provider. HEATHERCLIFFE RESIDENTIAL CARE HOME F51-F01 S6660 Heathercliffe V221784 190405 Stage 4.doc Version 1.20 Page 8 The three care files that were examined contained assessments that had been completed before the resident moved into the home, as well as ones done just after they moved in. These were very thorough and included information about the resident’s life history and care needs. All care needs were identified, fully recorded and explained to ensure care staff had sufficient information to provide the level of care necessary. The pen pictures of each resident were positive and accurately reflected their individual needs and abilities. Each service user had a plan of care for daily living and longer term outcomes were identified. Risk assessments had been completed as necessary, referrals to specialist health care services were recorded and reviews of care were completed regularly. HEATHERCLIFFE RESIDENTIAL CARE HOME F51-F01 S6660 Heathercliffe V221784 190405 Stage 4.doc Version 1.20 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) 7,8,9, and 10 Service users are looked after very well in respect of their health and personal care needs. Their welfare is closely monitored and their health needs are promptly met. Minor improvements are needed to the records of administration of medication to ensure that service users receive the correct medication at all times. EVIDENCE: Two of the three plans of care seen contained all the information, including medical details and personal preferences, necessary to ensure that the residents’ needs were met. The third care plan was for a person who had moved in recently and was nearing completion. Care instructions were comprehensive and covered the full range of needs. Any changes in care needs and well being since moving into the home were fully described. Daily records are made of residents’ care which enable staff to monitor any changes in their health. Residents are able to register with a GP of their choice. Detailed records are kept of all health care visits made, including dental treatment. Specialist advice is sought for service users as necessary and their nutrition is monitored to ensure that they keep as healthy as possible. HEATHERCLIFFE RESIDENTIAL CARE HOME F51-F01 S6660 Heathercliffe V221784 190405 Stage 4.doc Version 1.20 Page 10 The medication procedures are comprehensive and generally the medication is well managed. Six staff are trained to give medication, most of which is given from a monitored dosage system. Although the medication administration records were mostly well maintained, there were a few errors which could have created problems in accounting for what medication each service user had actually received. Greater care is needed to ensure that records are accurate at all times and instructions to staff need to be explicit and clearly recorded. See Recommendation 1. Staff members were seen to be respectful and to take care to ensure the privacy and dignity of service users. They receive guidance on how to treat residents with respect during induction and through staff training and supervision. Service users can spend time alone as they wish and staff get permission before entering service users’ rooms. Residents’ mail is given to them unopened and they are all able to make phone calls in private, although staff do help them, if needed, to keep in touch relatives and friends. Each service user has a designated experienced staff member who attends on a more personal and individual basis to the needs of the service user. During the inspection many of service users attended a clothing party at the home and staff helped them to choose clothes in the right sizes. HEATHERCLIFFE RESIDENTIAL CARE HOME F51-F01 S6660 Heathercliffe V221784 190405 Stage 4.doc Version 1.20 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) 12,13,14,and 15 Social activities and meals are well managed to provide variety, choice and interest for people living in the home. EVIDENCE: Staff members organise and undertake a variety of activities with service users, including card and board games, music and dancing, watching films, puzzles and quizzes, craft work, baking, reminiscence, hairdressing, manicures, walking and shopping in the local community. A show had been arranged and there had been a number of birthday celebrations. Representatives of three local churches visit regularly and a mobile library also visits the home. Service users had been consulted about various events to be arranged and could choose to take part in them if they wanted. Their relatives and friends had also been invited to attend some of the events. Visitors are welcomed and service users are able to see their visitors in private if they wish to. Service users are consulted and are encouraged to make choices and maintain autonomy. They and/or their family members handle their financial affairs. They can bring personal possessions with them into the home, the extent of which is agreed before they move in. HEATHERCLIFFE RESIDENTIAL CARE HOME F51-F01 S6660 Heathercliffe V221784 190405 Stage 4.doc Version 1.20 Page 12 On the day of the inspection several staff members were helping a service user to move to another room and were making sure their furniture and belongings were arranged to suit them. Menus showed a variety of traditional meals are provided. Lunch is the main meal of the day with a lighter meal served at teatime. Individual nutritional needs were recorded and specialist diets and alternative meals are always available. Service users made positive comments regarding the food provided. Drinks, biscuits and fruit were readily available and a water cooler has been provided in the entrance hall. Breakfasts are mainly served on trays in service users’ bedrooms at the time they choose, and supper and evening drinks are served from 8.30pm onwards. Service users can choose to eat in a pleasant dining room or in their own rooms if they wish. HEATHERCLIFFE RESIDENTIAL CARE HOME F51-F01 S6660 Heathercliffe V221784 190405 Stage 4.doc Version 1.20 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) 16,17 and 18 Arrangements for protecting service users and for responding to their concerns are in place to ensure they remain safe and are satisfied with the care they receive. EVIDENCE: There is a detailed complaints procedure displayed throughout the home, with appropriate records kept. The procedure was reviewed in October 2004 and contains information that a response to a complaint will be made within 28 days. No complaints have been reported or received since the last inspection. Service users are enabled to take part in elections by postal voting. Where a service user lacks capacity the staff team refer the service user and their representatives for independent advice and support. The local authority’s guidance on inter-agency procedures for dealing with allegations of abuse is available in the home for staff to refer to. The home’s own Abuse Guidance Policy (Protection of Vulnerable Adults) provides a definition of abuse, information on types of abuse, possible signs that abuse is occurring and guidance about monitoring and prevention. Well-trained highly motivated staff are employed at the home and they are all aware of the policy about reporting poor practice and possible abuse. This encourages them to be vigilant and to raise concerns to ensure continuing good care practice in the home. Advice was given about forthcoming training courses on the protection of vulnerable adults and the manager undertook to release staff so they could take part in this training. HEATHERCLIFFE RESIDENTIAL CARE HOME F51-F01 S6660 Heathercliffe V221784 190405 Stage 4.doc Version 1.20 Page 14 There is a policy on ‘Gratuities and Bequests to Staff’ to ensure that service users’ financial interests are protected. HEATHERCLIFFE RESIDENTIAL CARE HOME F51-F01 S6660 Heathercliffe V221784 190405 Stage 4.doc Version 1.20 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) 19 and 26 The home is very well maintained, clean and hygienic. It is decorated and furnished to a high standard and this helps to create a comfortable and homely environment for service users. EVIDENCE: The home is very well maintained, furnished and equipped to suit service users’ needs. It is attractively decorated and carpeted to a high standard to provide a comfortable environment. As on previous inspections, the home was cleaned to a high standard and was welcoming, pleasant and hygienic. Service users confirmed that the home was always very clean and that everyone takes a pride in the environment. There is a pleasant conservatory which increases the amount of shared space (lounge and dining room space) available for service users. The grounds are kept tidy and are accessible to service users. HEATHERCLIFFE RESIDENTIAL CARE HOME F51-F01 S6660 Heathercliffe V221784 190405 Stage 4.doc Version 1.20 Page 16 The kitchen was orderly and clean. Protective clothing was available for visitors to the kitchen and fridge and freezer temperatures checks had been recorded daily. The laundry is in an outbuilding and soiled laundry is washed at appropriate temperatures to thoroughly clean linen and to control the risk of infection. HEATHERCLIFFE RESIDENTIAL CARE HOME F51-F01 S6660 Heathercliffe V221784 190405 Stage 4.doc Version 1.20 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) 27,29 and 30 The staffing levels are generous to ensure service users’ needs are met promptly and staff members have time to spend with individual service users. Appropriate training is given high priority to ensure staff members are trained and competent to do their jobs. EVIDENCE: At the time of the inspection there was a full complement of staff, including domestic, laundry and catering staff to make sure the home is kept clean and to provide food for service users. There is a loyal, flexible and committed staff team and turnover is low so service users have continuity of care from staff they have got to know. The rota showed that the staffing levels for the home were generous and additional staff are provided at peak times during the day. The manager is on duty each weekday and is supported by a deputy, who works some weekday and weekend shifts. Two new staff members had been appointed since the last inspection. Both recruitment files were seen and contained all the necessary checks, showing that a thorough recruitment and selection process is used at the home. The manager was advised of the need to obtain Protection of Vulnerable Adults (POVA) First checks for all future employees. HEATHERCLIFFE RESIDENTIAL CARE HOME F51-F01 S6660 Heathercliffe V221784 190405 Stage 4.doc Version 1.20 Page 18 Each new member of staff receives a staff handbook and has an induction and training record. The records show the staff team is very well trained and competent. Appropriate training is given high priority and there is a training, development and supervision policy for the home. Staff files showed that the home operates a thorough staff appraisal process. All staff members have recently received training in oral hygiene and several staff members are due to attend a half-day training course on dementia and challenging behaviour. The registered manager confirmed that an ‘Investors In People’ assessment is ongoing at present and has not yet completed. HEATHERCLIFFE RESIDENTIAL CARE HOME F51-F01 S6660 Heathercliffe V221784 190405 Stage 4.doc Version 1.20 Page 19 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) 33,35,37 and 38 There are good organisation and recording systems in the home and clear lines of accountability which ensure the home is run in the best interests of service users and that they are safeguarded. EVIDENCE: The manager confirmed that quality assurance questionnaires had recently been circulated to service users and their relatives. The owner was in the process of analysing the results and acting upon the comments made. The results of the service user surveys will be made available in the near future. There was evidence to show that the owner continuously monitors the home so that it is maintained to a high standard and changes are made to bring about improvements. HEATHERCLIFFE RESIDENTIAL CARE HOME F51-F01 S6660 Heathercliffe V221784 190405 Stage 4.doc Version 1.20 Page 20 Where the money of individual service users is handled by staff of the home, the registered manager ensures that the personal allowance of these service users are not pooled, and appropriate records are kept. A random sample of 4 personal allowance balances and records were checked and were accurate with receipts available for all expenditure. Secure facilities are provided for keeping money and valuables on behalf of service users. The manager ensures a safe working environment for service users and staff by arranging relevant staff training including safe handling, fire safety, emergency aid, food hygiene and infection control. Cheshire Fire Brigade visited the home in March and made a small number of recommendations for improve fire safety. These have all been implemented satisfactorily. Records showed that fire safety precautions were checked regularly and that fire safety training for staff was up to date. There are infection control procedures that are clear and promote good, basic hygiene to guard against infection. There are procedures for handling and disposing of clinical and soiled waste and all new members of staff are encouraged to read the health and safety policies within the home. The kitchen was clean and orderly, and food storage was satisfactory. A Control of Substances Hazardous to Health (COSHH) file is kept and contains safety data sheets and guidance notes for all cleaning products used. There is a comprehensive health and safety manual as well as policies and procedures for safe working practices. Risk assessments were completed as appropriate and records of water temperature checks were seen. The accident records were appropriately completed. HEATHERCLIFFE RESIDENTIAL CARE HOME F51-F01 S6660 Heathercliffe V221784 190405 Stage 4.doc Version 1.20 Page 21 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. Where there is no score against a standard it has not been looked at during this inspection. 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 4 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 4 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 x x 3 x 3 x 3 3 HEATHERCLIFFE RESIDENTIAL CARE HOME F51-F01 S6660 Heathercliffe V221784 190405 Stage 4.doc Version 1.20 Page 22 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 9 Good Practice Recommendations Greater care should be taken to make sure that the recording and administration of medication is accurate at all times. Instructions to staff should be explicit and clearly recorded. HEATHERCLIFFE RESIDENTIAL CARE HOME F51-F01 S6660 Heathercliffe V221784 190405 Stage 4.doc Version 1.20 Page 23 Commission for Social Care Inspection Unit D, Off Rudheath Way Gadbrook Park Northwich Cheshire, CW9 7LT 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 HEATHERCLIFFE RESIDENTIAL CARE HOME F51-F01 S6660 Heathercliffe V221784 190405 Stage 4.doc Version 1.20 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. 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