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Inspection on 11/11/05 for Heathercroft Care Home

Also see our care home review for Heathercroft Care Home for more information

This inspection was carried out on 11th 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

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

Medicines are well managed. A programme of social activities is provided for residents. Staff are provided in sufficient numbers to meet the needs of residents. The home has a good core of staff of all grades who are committed to the welfare of the residents. The home is working towards the Investors in People award, and as part of this process a programme of training and development for all staff has been developed.

What has improved since the last inspection?

There have been some improvements to care plans. Some bedrooms have been redecorated and re-carpeted. The home has a new maintenance person and gardener. Window restrictors have been fitted in some bedrooms and security lighting has been improved. Overgrown trees and shrubs have been cut back. There are new blinds in the dining room. A new nurse call system is to be installed later this month.

What the care home could do better:

The daily entries made in care plans should be meaningful and should refer to the areas of need that have been identified for each resident. The assessments in the care plans should be kept up to date. The physical environment, including bedrooms, corridors, lounges, bathrooms and dining room, must be improved. Comfortable armchairs must be provided for all residents.

CARE HOMES FOR OLDER PEOPLE Heathercroft Care Home Heathercroft Care Home Longbarn Lane Woolston Warrington Cheshire WA1 4QB Lead Inspector Wendy Smith Unannounced Inspection 11th November 2005 09:45 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 Heathercroft Care Home DS0000059297.V263610.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. Heathercroft Care Home DS0000059297.V263610.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Heathercroft Care Home Address Heathercroft Care Home Longbarn Lane Woolston Warrington Cheshire WA1 4QB 01925 813330 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) Ashberry Healthcare Limited Mrs Janet Southwood Care Home 63 Category(ies) of Old age, not falling within any other category registration, with number (63) of places Heathercroft Care Home DS0000059297.V263610.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. No more than 63 Service Users, within the category of old age (OP) may be accommodated The attached schedule of requirements must be met within the stated timescale 21st April 2005 Date of last inspection Brief Description of the Service: Heathercroft is a purpose built care home set in its own grounds in the Woolston area of Warrington. The home provides nursing and personal care for up to 63 older people. It is on a main bus route and has easy access to local shops, churches and a library. The home has 61 single bedrooms and one double bedroom, all on the ground floor. There is a large main lounge, an activities lounge, a smoking room, and recessed seating areas in some corridors. There is a large dining room and a hairdressing salon. Heathercroft Care Home DS0000059297.V263610.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by two inspectors on 11th November 2005 as part of the Commission for Social Care Inspection annual inspection programme. Most of the key standards had been inspected on 21st April 2005 and found to be met. Time was spent in conversation with the home manager. A tour of the building was conducted, including all communal areas and some bedrooms. A number of residents and members of staff were spoken with. Arrangements for the handling of medicines were inspected and a sample of care plans was looked at. Some of the information contained in the report is taken from the preinspection questionnaire completed by the home manager. What the service does well: What has improved since the last inspection? There have been some improvements to care plans. Some bedrooms have been redecorated and re-carpeted. The home has a new maintenance person and gardener. Window restrictors have been fitted in some bedrooms and security lighting has been improved. Overgrown trees and shrubs have been cut back. There are new blinds in the dining room. Heathercroft Care Home DS0000059297.V263610.R01.S.doc Version 5.0 Page 6 A new nurse call system is to be installed later this month. 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. Heathercroft Care Home DS0000059297.V263610.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 Heathercroft Care Home DS0000059297.V263610.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): Not inspected on this visit. EVIDENCE: Heathercroft Care Home DS0000059297.V263610.R01.S.doc Version 5.0 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 the following standard(s): 7 and 9. Each resident has a care plan, and some improvements to care plans are still needed. Medicines are well managed. EVIDENCE: Each service user has a care plan in a Standex format. Care plans for residents receiving nursing care are filled in by the qualified nurses, and care plans for residents receiving personal care are completed by senior care staff. The care plans contain assessments, plans, and daily continuation sheets. A sample of four care plans was looked at and the quality of recording varied. Some of the assessments at the front of the care plans had been in place since the resident was admitted and had not been updated. Monthly reviews often took the form of ‘care plan reviewed and ‘remains effective’, however the daily reports made in the care plans did not always provide evidence to support this. The majority of entries in the daily continuation sheets were ‘settled day’, ‘no problems’ etc. and the word ‘settled’ continued to be overused. Heathercroft Care Home DS0000059297.V263610.R01.S.doc Version 5.0 Page 10 In one care plan looked at there had been no meaningful entry for several weeks. The resident had been identified as needing assistance with personal hygiene, and having needs relating to mobility and continence. None of the daily entries in her care plan referred to any of these needs. However another resident, who had a chest infection, had a very well-written care plan and daily entries recorded her condition and progress. A recently admitted resident is diabetic. The care plan did not make clear how often his blood sugar should be tested. He had been assessed by the continence advisor, but his continence needs were not detailed and there was no record of what the continence advisor had prescribed. This resident’s medicines had not been entered on the care plan and in another care plan, the list of medicines had been written a year and a half previously, with no indication of whether it is still current. See requirement. The home has a medicines room that is kept locked. There are separate drugs trolleys for nursing residents in A and B areas of the building, and a third trolley for personal care residents. Nurses administer medicines to the residents receiving nursing care, and senior care staff, who have received appropriate training, administer medicines to residents receiving personal care. There is a new drugs fridge. One of the registered nurses takes lead responsibility for the ordering, checking and storage of medicines. Repeat prescriptions are ordered monthly from ten different GP surgeries and are returned to the home to be checked before being sent to the pharmacy. A Boots monitored dosage system is used. All medicines were stored appropriately and there was no old stock. Administration records were completed to a good standard. A contract is in place for the disposal of unused medicines. It is recommended that a photograph of each resident is included in the medicine administration record folders. See recommendation. Heathercroft Care Home DS0000059297.V263610.R01.S.doc Version 5.0 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 the following standard(s): Not inspected on this visit. EVIDENCE: Heathercroft Care Home DS0000059297.V263610.R01.S.doc Version 5.0 Page 12 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): Not inspected on this visit. EVIDENCE: Heathercroft Care Home DS0000059297.V263610.R01.S.doc Version 5.0 Page 13 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): 19, 20, 21, 23, 24 and 26. Improvements must be made in bedrooms, communal areas and bathrooms. The home is clean and there were no unpleasant odours. EVIDENCE: The inspectors carried out a tour of the building with the home manager. The home has a new maintenance person and he has been able to make some improvements in the building. A number of bedrooms have been decorated and re-carpeted. The maintenance person has fitted window restrictors in some bedrooms and said that he intends to continue fitting these in the other rooms. Security lighting has been improved at the back of the building. New window blinds have been fitted in the dining room. The carpet in the corridor between the dining room and kitchen is very badly marked and gives the appearance of being dirty. There is a join between two Heathercroft Care Home DS0000059297.V263610.R01.S.doc Version 5.0 Page 14 carpets in the dining room that is a potential trip hazard. The dining room would benefit from redecoration. Carpets in some of the corridors and bedrooms are very badly stained. Carpets are secured in some doorways by wooden strips that can not be cleaned properly. Some of the corridors and bedrooms are in need of decoration. Furniture in some bedrooms is in poor condition and there are over-bed lights without shades. The flooring in several bathrooms, and in the laundry, requires repair or replacement. There is no redecoration and refurbishment programme to address issues that have been raised during previous inspections. See requirement. Armchairs in the lounges and bedrooms are old and in poor condition and need to be replaced. See requirement. The current nurse call system does not fully meet the needs of residents. The manager was pleased to report that a new system is to be installed later in November See requirement. On the day of the inspection the lounge door was being held open by an armchair. It is recommended that an automatic door closer be fitted to this door so that if residents wish to have the door open this can be done safely. See recommendation. Throughout the whole building there were no unpleasant odours and this is a credit to the cleaning staff. The home has two sluices that are well equipped and were clean and tidy. The laundry was fitted with new washing machines and driers earlier this year, and residents’ clothes are well cared for. Heathercroft Care Home DS0000059297.V263610.R01.S.doc Version 5.0 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 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): 27. The home provides an appropriate number and skill mix of staff to meet the needs of residents. EVIDENCE: The home employs ten registered nurses, 43 care staff and 16 ancillary staff. Staff rotas showed that there are always two nurses on duty between 8am and 8pm and one nurse at night. There is a senior care assistant on duty at all times. There are at least nine care staff on duty in a morning, seven in an afternoon/evening, and five during the night. In addition to this is the home manager and a full time activities organiser. There is minimal use of agency staff. Heathercroft Care Home DS0000059297.V263610.R01.S.doc Version 5.0 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 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): Not inspected on this visit. EVIDENCE: Heathercroft Care Home DS0000059297.V263610.R01.S.doc Version 5.0 Page 17 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 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 3 10 X 11 X 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 2 2 2 X 2 2 X 3 STAFFING Standard No Score 27 3 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X X Heathercroft Care Home DS0000059297.V263610.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? Yes 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 OP7 Regulation 12 Requirement Timescale for action Residents’ care plans should include an up to date 11/11/05 assessment of the resident’s needs, and daily entries made in the care plans should be relevant to these needs. A programme of redecoration and refurbishment must be produced to address all areas of the home where improvements are needed (timescale of 31/12/04 and 1/6/05 not met). Worn and damaged armchairs must be replaced (timescale of 31/12/04 and 1/6/05 not met). A working and suitable call bell system must be provided in the main lounge (timescale of 1/12/04 not met). 3. OP19 23 31/01/06 4. OP20 16 31/01/06 5. OP22 23 31/12/05 Heathercroft Care Home DS0000059297.V263610.R01.S.doc Version 5.0 Page 19 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 2 Refer to Standard OP9 OP19 Good Practice Recommendations A photograph of each resident should be available for staff administering medicines. The registered person should fit an automatic closing device to the lounge door so that it can be held open safely. Heathercroft Care Home DS0000059297.V263610.R01.S.doc Version 5.0 Page 20 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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