Inspection on 21/04/05 for Heathercroft Care Home

This inspection was carried out on 21st April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Heathercroft Care Home 05/07/07

Heathercroft Care Home 28/06/06

Heathercroft Care Home 11/11/05

Heathercroft Care Home 07/10/04

Heathercroft Care Home 29/04/04

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 Heathercroft Longbarn Lane Woolston Warrington WA1 4QB Lead Inspector John Mills Unannounced 21 April 2005 08.50 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. Heathercroft F51 F01 S59297 Heathercroft V222109 210405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Heathercroft Care Home Address Longbarn Lane Woolston Warrington Cheshire WA1 4QB 01925 813330 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) Ashberry Healthcare Limited Mrs Janet Southwood Care Home 63 Category(ies) of Care Home with Nursing (N) (63) registration, with number of places Heathercroft F51 F01 S59297 Heathercroft V222109 210405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. No more than 63 Service Users, within the category of old age (OP) may be accommodated 2. The attached schedule of requirements must be met within the stated timescale Date of last inspection 07/04/04 Brief Description of the Service: Heathercroft Care Home is a purpose built home providing nursing and personal care for up to 63 older people. The home is situated in the Woolston area of Warrington. It is on a main bus route with easy access to local shops, churches and a library. Accommodation is provided on the ground floor, with 61 single bedrooms and one double bedroom. Shared accommodation comprises three lounges, seating in bays on corridors, a large dining room, a conservatory and a hairdressing salon. Registered General Nurses are on duty at all times to care for service users requiring nursing care. A team of care assistants provides personal care for residents and ancillary staff are employed for administration, catering, housekeeping and maintenance duties. Heathercroft F51 F01 S59297 Heathercroft V222109 210405 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Two inspectors carried out this inspection over 7 hours on 21st April 2005. During this inspection the inspectors spoke with residents, nursing staff care staff, housekeeping staff and visiting relatives. The inspection was carried out with the support of the manager. The inspection included the reading of six care plans, the examination of records relating to health and safety and a tour of the home. At this inspection 18 of the 20 core standards were assessed together with an additional 15 of the remaining 18 standards. There is presently an ongoing investigation being undertaken by the owner of the home into how a previous complaint was investigated. What the service does well: What has improved since the last inspection? NVQ training is being provided to 22 care staff. Access to this training improves the ability of staff to provide appropriate care to service users. The service is working towards introducing an external audit system, Investors in People (IPP). When this starts to operate this will allow residents, staff and relatives to be involved in assessing the quality of the service provided. There has been an improvement in the way the staff team work together and they know what plans the manager has for the home. Heathercroft F51 F01 S59297 Heathercroft V222109 210405 Stage 4.doc Version 1.30 Page 6 There has been a reduction in the use of agency staff, this has resulted in greater continuity of care for service users. Some redecoration of shared living areas and bedrooms has taken place. 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 F51 F01 S59297 Heathercroft V222109 210405 Stage 4.doc Version 1.30 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 Heathercroft F51 F01 S59297 Heathercroft V222109 210405 Stage 4.doc Version 1.30 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) 3, 4. 5 & 6 Assessment procedures before residents move into the home are thorough and allow family members to be part of the process of assessing needs. The home only admits those people whose needs are in keeping with the skills and knowledge of staff working within the home. EVIDENCE: The care plans belonging to two recently admitted residents contained detailed pre-admission assessments. These had been undertaken by the manager of the service and a standard social services assessment where necessary had been provided to the manager. Visiting relatives confirmed that they had been given an opportunity to visit the service before their relative move into the home, they had been asked about the persons needs and what the service could provide to meet those needs. This service does not provide intermediate care. Heathercroft F51 F01 S59297 Heathercroft V222109 210405 Stage 4.doc Version 1.30 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 & 10 Care plans are not maintained to a uniform standard, there is inconsistency in the dating of assessments and the carrying out of regular reviews. The complex and various needs of residents are not always or fully identified within the care plans, without this information those needs may not be properly met. EVIDENCE: Each resident has a care plan in a ‘Standex’ format. The care plans contained assessments, plans, and daily continuation sheets. In one care plan, needs had been identified up to two years earlier and had not been fully reviewed since. Monthly reviews were regularly recorded and usually took the form of ‘care plan reviewed and remains effective’, however this was not always accurate. For example, two years ago a service user had been identified as being considerably overweight and needing to lose weight. He had not lost weight and the manager said that it had been decided that he should have what he wished to eat. However the care plan had not been revised and monthly reviews read ‘care plan reviewed and remains effective’. Heathercroft F51 F01 S59297 Heathercroft V222109 210405 Stage 4.doc Version 1.30 Page 10 The majority of entries in the daily continuation sheets were ‘settled day’ ‘no problems’. In one care plan looked at there had been no meaningful entry for three weeks. The word ‘settled’ was frequently used. Care plans did not include reference to any social assessment or life history and therefore did not give a complete view abut the resident. A number of assessments (e.g. handling assessment) were undated so it was not possible to say whether they were current. Care plans provided evidence of visits from optician, chiropodist, GP, infection control nurse, occupational therapist. The manager said that GP’s do not provide routine admission visits for new residents. Heathercroft F51 F01 S59297 Heathercroft V222109 210405 Stage 4.doc Version 1.30 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 & 15 Social activities and meals are both well managed, creating and providing daily variation and stimulation for people living within the home. EVIDENCE: The home employs an activities coordinator for 30 hours per week. She organises chair based exercises in the mornings and group activities including bingo and quizzes in the afternoons. On a Friday the activities coordinator spends time talking with residents who are not able to, or do not wish to, join in group activities. An art group is held weekly for those residents who wish to take part. The home’s care plans do not contain any assessment of residents’ social interests and the activities coordinator does not keep a written record of those service users who have taken part in activities. Musical entertainment is provided for residents on a regular basis, and two residents said that they enjoy this very much. One resident said that he often goes out with his family. Residents were observed to be assisted getting up at different times throughout the morning and the manager said that no-one got up before 8am. Heathercroft F51 F01 S59297 Heathercroft V222109 210405 Stage 4.doc Version 1.30 Page 12 Menus on display showed that there was only one main course available at lunchtime. Soup was offered as an alternative. This was discussed with the chef. He said that the home no longer provided two main courses, as this had proved wasteful. The soup is homemade and a service user told the inspector how much she enjoyed this. At teatime residents had a choice of a cooked meal or sandwiches. The chef said that night staff have access to food supplies should they be needed by residents. Heathercroft F51 F01 S59297 Heathercroft V222109 210405 Stage 4.doc Version 1.30 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 & 18 The and and and majority of complaints made to the manager have been taken seriously handled objectively. With the exception of one dissatisfied family, families service users are satisfied with the support and attitude of the manager staff. EVIDENCE: Visiting relatives stated that they had a got on well with the manager and other staff within the home and were of the opinion that if necessary their concerns would be taken seriously. An investigation is being undertaken by the owner of the home into how a previous complaint was dealt with following dissatisfaction expressed by family members. Two staff spoken with had received recent training from the manager in Adult Protection and they could tell the inspectors how they would respond to a variety of abusive situations. The home’s administrator had applied for postal votes for all residents, so that they could take part in the forthcoming general election. Heathercroft F51 F01 S59297 Heathercroft V222109 210405 Stage 4.doc Version 1.30 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, 20, 21, 22, 23, 24, 25, & 26. Some improvements have been to the décor and furnishings have been made. The provision of new equipment in the kitchen and laundry has improved these facilities. Residents live within a safe and well maintained home. EVIDENCE: The requirements made at the last inspection specific to these standards and the benefits for residents were assessed. Provision of a maintenance programme or a programme of redecoration for the home remains outstanding as does the need to provide an effective call bell system within the lounge. Heathercroft F51 F01 S59297 Heathercroft V222109 210405 Stage 4.doc Version 1.30 Page 15 Residents continued to say that it was often difficult to contact staff whilst sitting in the lounge. What redecoration that has taken place has been on an ad hoc basis and has not been planned. Lighting within the home has improved since the removal of trees that were close to the building. A gardener has been employed for 20 hours per week and the gardens were much tidier than at the last inspection. Old furniture and other rubbish had been left outside the home waiting to be disposed of, this is both unsightly and a potential health hazard. Recommendations made at the previous inspection were followed up. A bath panel that required repair had been attended to. There were no locks on individual bedroom doors. The ground floor windows remain without safety catches. Service users and their bedrooms are potentially vulnerable to intruders. All shared living areas and a number of bedrooms were visited. The lounge used for activities had been decorated and re-carpeted but there was no new furniture and some windowpanes were ‘blown’ and need replacing. This had been identified at the last inspection. Furniture in the dining room was showing signs of wear and tear. The window blinds in the dining room were stained in places and appeared dirty. The manager said that the blinds had been cleaned but marks could not be removed. The carpet in the corridor between the dining room and kitchen is very badly marked and gives the appearance of being dirty. The corridor in this area is also in need of decoration. The main lounge is a large room but residents were only using one part of it. Seating in the other parts of the lounge consisted of low, soft-upholstered chairs and settee that were not suitable for frail older people. Water was leaking into one area of the lounge and was dripping from the ceiling. A bucket had been placed to catch dripping water. The manager’s attention was brought to this and a roofing contractor visited during the inspection. He identified work required to the roof of the home. Bedroom areas are divided into two sections. ‘A’ unit has two shower rooms and one bathroom. The bathroom floor was damaged and needs repair/replacement. The hot water temperature was 41 degrees. There is a bidet in the bathroom which is highly unlikely to be used by service users and could be removed to provide greater accessibility for staff when bathing service users. Heathercroft F51 F01 S59297 Heathercroft V222109 210405 Stage 4.doc Version 1.30 Page 16 A variety of hoists were available. Handrails are fitted in all corridors. There is a payphone in the corridor with an area of missing wallpaper around it. The carpet in the corridor around bedrooms A23 to 29 is badly stained. Some bedrooms had fire closer boxes fitted. The firebox had ripped the carpet in bedroom A32. The carpet in ‘B’ unit was very stained in places. The corridor between bedrooms B 25 to 32 was in need of decoration. The manager said that 20 bedrooms had been re-carpeted over the last year. Some bedrooms were in poor condition and the inspector noticed some badly stained carpets. A number of over-bed lights were without shades, or with shades that rested on light bulbs and presented a potential fire hazard. The built in furniture was also damaged in some rooms. Throughout the home there were no unpleasant smells 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 has been fitted with new washing machines and driers and the laundry staff said that they were now able to do their job much better. The inspectors observed that residents’ clothes were well cared for. Staff said that both care and laundry staff did small repairs and labelling of clothes. Heathercroft F51 F01 S59297 Heathercroft V222109 210405 Stage 4.doc Version 1.30 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, 28, 29 & 30 Staff are given a good range of training opportunities covering both mandatory areas and developmental subjects. Residents benefit from a service that provides adequate staffing levels and well informed and knowledgeable staff. EVIDENCE: Examination of the staffing rota confirmed that agreed minimum staffing levels of three nurses and ten care staff are maintained from 8.00 to 14.00, two nurses and seven care staff from 14.00 to 20.00. By night there are one nurse and six care staff on duty. In addition to these direct care staff there are housekeeping staff with specific responsibilities for, the laundry, the kitchen and general cleaning. All nurses within the home are undertaking ongoing professional development to satisfy the registration requirement of the Nursing & Midwifery Council. Seven care staff have achieved NVQ level 2 in care and a further 22 candidates will be undertaking this training. Additional training is provided by the manager or senior staff and by external training agencies. The records of two newly appointed care staff were examined and confirmed that written application had been made by them. Written references had been obtained to support their CV and checks with the Criminal Records Bureau had been taken up. Heathercroft F51 F01 S59297 Heathercroft V222109 210405 Stage 4.doc Version 1.30 Page 18 Several staff were spoken with throughout the inspection, including two nurses, a student nurse from John Moore’s university, laundry staff, housekeeping staff, kitchen staff and carers. These informal conversations provided evidence of a well informed and knowledgeable staff team. Two care staff were interviewed by both inspectors and gave good answers to a comprehensive range of questions. These included resident information, care practices, training adult protection and responding to complaints. Heathercroft F51 F01 S59297 Heathercroft V222109 210405 Stage 4.doc Version 1.30 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) 31, 32, 33, 35, 36 & 37 There has been an improvement in the relationships between senior staff, residents are cared for by a team of staff who work efficiently and effectively together. Residents live in a well managed service providing them with a good level of safety and security. EVIDENCE: The manager of this service is an experienced trained nurse with additional advanced management qualifications. The manager stated that a commitment to developing and implementing Investors in People is being made. This will allow staff, relatives and service users to contribute to a recognised quality assurance system. Heathercroft F51 F01 S59297 Heathercroft V222109 210405 Stage 4.doc Version 1.30 Page 20 The financial records of service users were examined and found to accurately record the monies held in trust for residents. The manager was routinely checking these records each month. Records relating to health a safety; fire log book, accident book, hot water temperatures, kitchen records and testing of electrical and mechanical equipment were checked and found to be in order. Heathercroft F51 F01 S59297 Heathercroft V222109 210405 Stage 4.doc Version 1.30 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. 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 x 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 2 3 3 3 2 2 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 3 3 3 2 3 x 3 3 3 3 Heathercroft F51 F01 S59297 Heathercroft V222109 210405 Stage 4.doc Version 1.30 Page 22 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 7 Regulation 12 Requirement The care plans of service users must be reviewed and updated on a regular and frequent timescale. The care plans of service users must include details of all the current needs of service users(timescale of 1/12/04 not met) A sustained and scheduled programme of redecoration and refurbishment must be undertaken. (timescale of31/12/04 not met Worn and damaged armchairs must be replaced. (timescale of 31/12/04 not met) A working and suitable callbell system must be provided within the main lounge (timescale of 1/12/04 not met) Timescale for action 1/6/05 2. 8 12 1/6/05 3. 19 23 1/6/05 4. 5. 20 22 16 23 1/6/05 1/6/05 6. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Good Practice Recommendations F51 F01 S59297 Heathercroft V222109 210405 Stage 4.doc Version 1.30 Page 23 Heathercroft 1. 2. 3. Standard 24 24 Overridable locks should be provided to all bedroom doors security locks should be provided to all ground floor windows Heathercroft F51 F01 S59297 Heathercroft V222109 210405 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Address 1 Address 2 Address 3 Address 4 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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