Inspection on 07/11/05 for Heathercliffe Residential Home

This inspection was carried out on 7th November 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.

Other inspections for this house

Heathercliffe Residential Home 07/09/09

Heathercliffe Residential Home 23/04/07

Heathercliffe Residential Home 19/04/05

Heathercliffe Residential Home 01/11/04

Heathercliffe Residential Home 26/05/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Heathercliffe Residential Home Old Chester Road Helsby Via Warrington Cheshire WA6 9NP Lead Inspector Sue Dolley Unannounced Inspection 7th November 2005 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Heathercliffe Residential Home DS0000006660.V261818.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Heathercliffe Residential Home DS0000006660.V261818.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Heathercliffe Residential Home Address Old Chester Road Helsby Via Warrington Cheshire WA6 9NP 01928 723639 01928 724128 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) Pinestone Limited Mrs Sarah Jane Turner Care Home 22 Category(ies) of Dementia - over 65 years of age (4), Old age, registration, with number not falling within any other category (22) of places Heathercliffe Residential Home DS0000006660.V261818.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of twenty two service users to include: * Up to 22 service users in the category of OP (old age not falling within any other category) * Up to 4 service users in the category of DE(E) (Dementia, over the age of 65) The care plans and placements of service users in the category of DE(E) must be subject to at least quarterly review The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidance which may be issued through the Commission for Social Care Inspection 19th April 2005 2. 3. 4. Date of last inspection Brief Description of the Service: Heathercliffe is an older style property that has been adapted to provide comfortable, homely accommodation for service users. All 21 bedrooms have en-suite facilities and bedrooms are fitted with a call system. The majority of bedrooms have television and telephone 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 Home DS0000006660.V261818.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 7th November 2005 over a period of 6 hours to assess if the residents’ needs were being met at the home. A tour of the premises took place and included all shared areas such as lounges and the dining room, shared bathrooms and toilets, the kitchen and residents bedrooms. The proprietor and deputy manager contributed to the inspection of the home and 4 residents were spoken to during the inspection. What the service does well: What has improved since the last inspection? A new fire alarm panel has been installed and the fire alarm system now extends to include an adjacent building which houses the laundry facilities. The laundry has been fitted with new washing machine facilities to promote hygiene. There are now two sittings at lunchtime. The first sitting enables staff members to spend dedicated time with those residents who need help to eat. This makes lunchtime a more relaxed and sociable time. Staff members continue to undertake appropriate training and in September 2005 it was confirmed that the home had achieved an Investors in People Award. Heathercliffe Residential Home DS0000006660.V261818.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Heathercliffe Residential Home DS0000006660.V261818.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Heathercliffe Residential Home DS0000006660.V261818.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1and 4 The home provides useful written information to enable prospective residents to make an informed choice about the home The manager meets prospective residents, their families and others to assess whether identified care needs can be met at the home. EVIDENCE: A statement of purpose, a service user guide and copies of the last inspection reports are readily available within a folder within the reception area of the home. The statement of purpose was reviewed in October 2004. This provides comprehensive information regarding the aims, objectives and philosophy of care and describes the services and facilities available at Heathercliffe. Advice was given at feedback to the inspection, as the statement of purpose needs to be updated to reflect that the home is now registered to provide care for up to four residents who are over the age of sixty- five years and with dementia care needs. The statement of purpose also needs to be updated to refer to the Commission for Social Care Inspection. Heathercliffe Residential Home DS0000006660.V261818.R01.S.doc Version 5.0 Page 9 The service user guide provides useful, clear information about life within the home. The terms and conditions of residence are provided along with information about quality assurance and details of how to make a complaint. The manager meets prospective residents, their families and others to assess whether their needs can be met at the home. Three care files were checked. They were clearly presented, well organised, and provided evidence of assessments before service users moved into the home. One file awaited details from the residents next of kin regarding arrangements after death and one file did not have a photograph of the resident although a photograph had been taken and needed to be affixed. Two care files included full social history information to enable care staff to familiarise themselves with service users, their past and current circumstances and present range of care needs. A section relating to a brief social and psychological history had not been completed in one file. Risk assessments were completed as necessary and referrals to specialist health care services were made as appropriate. The aims of each care plan and expected outcomes were clearly stated and reviewed. During the inspection, the inspector observed staff promptly offer care when a need was anticipated and staff members demonstrated that they had the skills and experience to deliver the services the home offers to provide. Heathercliffe Residential Home DS0000006660.V261818.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,9 and 11 The health and changing personal care needs of residents are closely monitored and potential health difficulties promptly addressed by the appropriate health care services. The recording of medication could be improved to explain any changes and to ensure medication is administered as often as prescribed. Instructions to staff about recording medication to be given ‘as and when required’ should be clear and explicit to ensure consistency of recording. Care staff members make every effort to ensure they are aware of resident’s wishes concerning terminal care and arrangements after death so that residents’ wishes are respected. EVIDENCE: Residents care plans are devised from the information gathered from the assessment, which covers all aspects of health, personal and social care. Care plans are reviewed monthly, or more often as necessary, and are updated to reflect changing needs. Heathercliffe Residential Home DS0000006660.V261818.R01.S.doc Version 5.0 Page 11 Plans are developed with the involvement of the residents and their representatives. The care plans set out in great detail the action to be taken by care staff to ensure that all aspects of the health, personal and social care needs of each resident are met. The inspector checked three residents care plans as part of the inspection and each included very thorough care instructions. There was evidence that family members and relatives are encouraged to participate in the residents daily routine as far as is practicable. They are invited to monthly formal reviews or to discuss with staff if they have concerns. For ease of access staff members are provided with a copy of the medication procedure placed at the front of the medication administration record file. The medication procedures are comprehensive and generally the medication is well managed with the majority of medication given from a monitored dosage system. All medication administration records were checked dating back to 17th October 2005. Members of staff are recording medication to be given ‘as and when required’ in different ways and some staff had been using omission code ‘F’, without defining the reason why medication had not been given. The application of a prescribed cream had not been recorded and, one prescribed medication was given twice daily instead of three times daily as prescribed. The records contained a photograph of each resident to aid identification, all self- medication was indicated and any special directions were clearly marked onto the records. Greater care is needed to ensure that records are accurate at all times. See Recommendation 1. The service user guide provides a section on bereavement, which, gives assurance to residents and family members that every possible support will be given in the event of a bereavement. Care staff members make every effort to ensure they are aware of resident’s wishes concerning terminal care and arrangements after death so that residents’ wishes are recorded, respected and carried out. Heathercliffe Residential Home DS0000006660.V261818.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None National Minimum Standards 12,13,14 and 15 were assessed at the previous inspection on 19th April 2005. EVIDENCE: Heathercliffe Residential Home DS0000006660.V261818.R01.S.doc Version 5.0 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 the following standard(s): None National Minimum Standards 16,17 and 18 were assessed at the previous inspection on 19th April 2005. EVIDENCE: Heathercliffe Residential Home DS0000006660.V261818.R01.S.doc Version 5.0 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 the following standard(s): 20,21,22,23,24,and 25 Heathercliffe provides a welcoming environment in which to live. The premises are clean, well furnished and equipped for the comfort of residents. EVIDENCE: There is one large lounge with a quiet reading area, a conservatory area leading off the lounge, and a separate dining room. An inspection of the communal space, bedrooms, bathrooms, toilets and kitchen was undertaken and all areas were fresh and clean. All rooms are centrally heated. Service users are encouraged to use the communal lounge space but can also choose to stay in their own rooms when they prefer. All rooms are connected to the alarm call system for the benefit and safety of service users. All rooms have privacy locks on doors, which can be overridden in an emergency, and lockable facilities to secure valuables and personal items are available in service users’ rooms. Lighting and furnishings in communal rooms is domestic in character and of good quality. Heathercliffe Residential Home DS0000006660.V261818.R01.S.doc Version 5.0 Page 15 There are pleasant and well maintained gardens which are accessible to residents. All bedrooms have en-suite facilities. Toilets throughout the home are accessible, clearly marked and there are facilities close to the lounge and dining room. Residents are referred for individual occupational therapy assessments when necessary so they can be provided with aids or adaptations. There is a call system throughout the home. A number of aids to promote mobility were available including grab rails, hoists and other specialist moving and handling equipment, and specialist bathing equipment. Residents have access to all parts of residents’ communal and private space. There is a passenger lift for residents to use to move between floors. Lockable facilities are available in residents’ bedrooms unless their care plan/risk assessment indicates otherwise. The home has 20 single bedrooms and 1 twin bedded room. Eleven single and one twin bedded room are on the first floor of the premises. The service users in the shared room have made a positive choice to share with each other. All bedrooms have slightly different dimensions and are arranged, furnished and equipped to meet varying individual needs. All bedrooms except one were checked. There was a good standard of decoration and furnishing and rooms had been personalised with residents’ belongings. Two bedrooms had been scheduled for redecoration within the coming weeks. All rooms have windows with openings to allow natural ventilation and light. Rooms are centrally heated, radiators are covered and the heating may be controlled in the service user’s own rooms. Lighting is domestic in character and includes table-level lamps. Emergency lighting is installed throughout the home. Hot water temperatures throughout the home are regularly checked to ensure safety. Heathercliffe Residential Home DS0000006660.V261818.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28 and 29 NVQ training is continuing. Staff members receive support and encouragement, to achieve their training goals and to ensure they are competent and confident in their caring roles. The recruitment guidance regarding Criminal Records Bureau disclosures should be read and adhered to ensure the protection of residents. EVIDENCE: All new staff members complete thorough induction training and receive a staff handbook, which includes an induction and training record. The home ensures that as many care assistants as possible hold a minimum of NVQ level 2 in care and all new members of staff are encouraged to train to attain this level of care and competence. One member of staff has recently been promoted to senior carer. The home now has five senior carers. Currently ten members of staff hold NVQ level 2 and 5 staff members of staff have or are completing NVQ level 3. External training courses are arranged to ensure staff are aware and competent regarding food hygiene, lifting and handling, care of older people, first aid and drugs practice. Staff members continue to undertake appropriate training and in September 2005 it was confirmed that the home had achieved an Investors in People Award. Heathercliffe Residential Home DS0000006660.V261818.R01.S.doc Version 5.0 Page 17 All prospective members of staff complete pre employment questionnaires and any gaps in employment records are explored. The home’s recruitment guidelines include a policy on equal opportunities, and all staff members receive a statement of terms and conditions. Criminal Record Bureau checks are completed. Seven staff files were checked during the inspection. All contained two written references and there was evidence of a thorough recruitment and selection process except that one file contained an old enhanced criminal record bureau check which had been accepted in the mistaken belief that it was portable from one employment to another. See Recommendation 2. Heathercliffe Residential Home DS0000006660.V261818.R01.S.doc Version 5.0 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,34,36 and 38 The registered manager is experienced in the provision of care to older people and she continues to update her skills and knowledge. The residents and staff benefit from a clear leadership and management approach within the home, which promotes their health, safety, welfare and interests. EVIDENCE: The registered manager has over thirteen years experience in the care sector. She has been employed at Heathercliffe for nearly six years and has continued to update her skills and knowledge and hopes to complete the registered managers award. The registered manager communicates a clear sense of direction and leadership, which, staff and residents understand and are able to relate to the aims and purpose of the home. Heathercliffe Residential Home DS0000006660.V261818.R01.S.doc Version 5.0 Page 19 There was evidence of good organisation and recording systems in the home. The management and senior staff members are familiar with the conditions and diseases of old age. There are clear lines of accountability within the home. The proprietor has been employed in the care administration and finance sector since 1984 and took ownership of Heathercliffe in January 2000. She is closely involved in the running of the home and supports the manager. The processes of managing and running the home are open and transparent and residents benefit from a positive and inclusive atmosphere. The inspector was provided with a copy of the financial report and accounts for the year ended 31st December 2004. These provided evidence of financial viability and of effective and efficient management of the business. Appropriate insurance cover was also in place. All care staff and other staff members are supervised on a continuous daily basis and receive formal supervision approximately every three months. Staff appraisals take place and formal supervision covers all aspects of practice, the philosophy of care in the home and career development needs. See Recommendation 3. The registered manager ensures a safe working environment for residents and staff members by arranging relevant training including safe handling, fire safety, emergency aid, food hygiene and infection control. The fire precautions record book was satisfactorily completed and fire safety training for staff was up to date. A weekly fire safety exercise is carried out on each shift to ensure staff and residents have a comprehensive understanding of their responsibilities. A complete new fire alarm panel was installed and the fire alarm system has been extended to include the laundry which, is housed in an adjacent building. A new central heating boiler is to be installed in the coming weeks. The accident records were checked and all accidents had been fully recorded and there was evidence of appropriate action taken. There are infection control procedures that are clear and promote good, basic hygiene to guard against infection. New washing machine facilities had been installed to promote hygiene. 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. Heathercliffe Residential Home DS0000006660.V261818.R01.S.doc Version 5.0 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X X 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 X 9 2 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X 3 3 3 3 3 3 X STAFFING Standard No Score 27 X 28 3 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X 3 X 2 X 3 Heathercliffe Residential Home DS0000006660.V261818.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? No 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. 1. Refer to Standard OP9 Good Practice Recommendations Improve the recording of medication to explain any changes and to ensure medication is administered and applied as often as prescribed. Ensure that instructions to staff about recording medication to be given ‘as and when required’ are clear and explicit to ensure consistency of recording. (A similar recommendation was made at the last inspection on 19.04.05). Ensure that the recruitment procedure follows the latest guidance from the Criminal Records Bureau regarding obtaining an up to date POVA first check and an enhanced disclosure as disclosures are no longer portable in the majority of cases. Ensure care staff members receive formal supervision at least six times a year. 2 OP29 3 OP36 Heathercliffe Residential Home DS0000006660.V261818.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich 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. 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