Inspection on 28/06/06 for Heathercroft Care Home

This inspection was carried out on 28th June 2006.

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

Heathercroft Care Home 05/07/07

Heathercroft Care Home 11/11/05

Heathercroft Care Home 21/04/05

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 Care Home Heathercroft Care Home Longbarn Lane Woolston Warrington Cheshire WA1 4QB Lead Inspector John Mills Key Unannounced Inspection 28th June 2006 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 Heathercroft Care Home DS0000059297.V292456.R01.S.doc Version 5.1 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.V292456.R01.S.doc Version 5.1 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.V292456.R01.S.doc Version 5.1 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 11th November 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.V292456.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Two regulatory inspectors conducted this unannounced site visit on 28th June 2006 over a period of six and a half hours. Feedback was given to the newly appointed manager and the owner of the home the following week. Records were inspected and staff practice was observed. Discussion took place with residents, visitors and staff. A tour of the building was made during visit. The manager at the time of the inspection confirmed that the fees within this home are £401 pw for nursing service users and £309 pw for non-nursing. This information is made know to prospective clients on inquiry and confirmed within the formal contract of residency. Each of the four requirements made at the previous inspection have either been met or are in the process of being met. Additional requirements in relation to care planning, and the registration of a manager are made within this report. What the service does well: Service Users are treated in a manner that confirms the positive regard that staff have for them. The atmosphere at the home was warm and welcoming. The home was clean and hygienic. The home has a regular group of staff that have worked at the home for some time and they are aware of the needs of the residents. Staff were friendly and attentive to the residents and had a good knowledge of the residents needs and the character and history of the residents in their care. Heathercroft Care Home DS0000059297.V292456.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: The continued development in the structure and content of care plans must be sustained and carried forward. The completion of the redecoration of the home must proceed in a structured manner. The manager must proceed with her application to register and also commence her NVQ Level 4 award in management. Requirements and recommendations to address these matters are made within this report. Please contact the provider for advice of actions taken in response to this Heathercroft Care Home DS0000059297.V292456.R01.S.doc Version 5.1 Page 7 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.V292456.R01.S.doc Version 5.1 Page 8 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.V292456.R01.S.doc Version 5.1 Page 9 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): 1,2,3 & 5 The quality rating for this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has written information to enable prospective service users to make an informed choice about whether to take up residence, but not enough care is taken to ensure that the service users themselves have access to it. All prospective service users have their needs assessed prior to admission to ensure that the home can meet those needs EVIDENCE: Heathercroft does not provide intermediate care facilities and standard 6 is not applicable. Twelve service users were consulted regarding their admission to the home and six care files were reviewed. Most service users said they had been unable to visit the home prior to admission because they were in hospital, but their families had been on their behalf. Heathercroft Care Home DS0000059297.V292456.R01.S.doc Version 5.1 Page 10 One service user said they had visited the home prior to admission. All said that a senior member of staff from the home had visited them prior to admission, carried out an assessment of their needs and told them about the facilities and services provided. Care files contained evidence that these assessments had taken place. Service users are admitted to the home on a six week trial basis, prior to making a decision about permanent placement. The home had a satisfactory statement of purpose and service user guide and the manager said that relatives were given a copy when they came to view the home, but none of the service users interviewed had seen the service user guide. See Recommendation No 1. The local authority purchases the places in Heathercroft on behalf of service users and there was an individual contract in place for each of the service users. Heathercroft Care Home DS0000059297.V292456.R01.S.doc Version 5.1 Page 11 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): 7,8,9 &10 The quality rating for this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care that service users receive is based on their individual needs. The principles of respect, privacy and dignity are put into practice. Medication is managed according to the home’s policy and procedures for receipt, storage and administration EVIDENCE: Six service user plans were reviewed. All had plans of care in place to address health, personal and social care needs. They were reviewed regularly and contained evidence that service users and/or their relatives were consulted. Risk assessments were in place, but in two cases bed rails were fitted to the bed without a documented risk assessment. See Requirement No1. One service user had recently been reassessed by the speech and language therapist, who had provided detailed instructions on the consistency of food the service user would be able to tolerate orally. Heathercroft Care Home DS0000059297.V292456.R01.S.doc Version 5.1 Page 12 This information was recorded in the multidisciplinary record but the care plan for nutrition only stated can take small amounts of food orally. A new detailed care plan should have been written. See Requirement No 2. Another service user had two wounds that required dressings. One care plan had been written that covered both wounds. This can cause confusion in recording when one wound is improving or deteriorating at a different rate to the other. It is better to write an individual care plan for each wound. See Recommendation No 2. Discussion with service users and examination of care files gave ample evidence that service users health care needs were addressed. All had risk assessments for pressure sores and malnutrition. Service users were weighed monthly or more often if at risk. All those reviewed had gained weight since admission to the home. Service users had been referred to, and had consultations with, a range of health care professionals including GPs, district nurses, continence adviser, optician, dietitian and physiotherapist. The treatment room/pharmacy was inspected inspected in the company of the senior nurse. Oxygen & suction equipment was signed as being checked weeky.There was a lsit of nurses names and signitures. There was equipment to be used for the safe disposal of medicine in line with current health & safety guidelines. The storeage of controlled medicines (Fentanol patches) was checked and found to in order. In addition to the legal records there was a separate weekly recording of stock levels witnessed by two nurses. The storage of prescription medicines was checked and was generally found to be in order. The exception being two medicines Otosporin and Latanoprise were in use but did not have the date of opening recorded on them. Cross referencing to the MAR sheets confirmed that they had been dispensed within the last 7 days. Should they continue to be used there was no certainty that they would be discarded within 28 days of opening. See Recommendation No 3 The MAR sheets were examined and confirmed that all medicines were checked on arrival by a nurse and the date of recipt together with the numbers were recorded. There is a robust process of stock control within this srervice. Particular medicines were duiscussed with the senior nurse and a good knowledge of these drugs, their use, contra indications and side effects was evidenced. TP stated that there were British National Formularies available in the home (office) but not kept in the pharmacy. See Recommendation No 4. Heathercroft Care Home DS0000059297.V292456.R01.S.doc Version 5.1 Page 13 All of the service users spoken with said that staff treated them with respect and were mindful of their privacy and dignity. Observation of staff practices confirmed this. Heathercroft Care Home DS0000059297.V292456.R01.S.doc Version 5.1 Page 14 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): 12,13,14 & 15 The quality rating for this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are able to choose their lifestyle, social activity and keep in contact with family and friends. They receive a healthy, varied diet according to their assessed requirement and choice. EVIDENCE: Service users said they could choose when to get up and go to bed, whether they stayed in their bedrooms or went to the communal rooms and whether they joined in communal activities or not. The home had a weekly activity programme and most service users said they joined in some of the activities. Several said they enjoyed the twice weekly prize bingo. Other activities included gentle exercises twice a week, arts and crafts, skittles, karaoke and table games. Entertainers visited the home and one service user said he had been on a couple of trips to Chester zoo and was hoping to go on a trip to Blackpool that the home was planning. Another service user said the home had provided her with a bigger TV because she loved to watch the snooker. A service user who was bedbound said that staff did come in and chat to him at times other than when they were attending to his physical needs. Heathercroft Care Home DS0000059297.V292456.R01.S.doc Version 5.1 Page 15 A service user who was blind said the home had arranged for her to have a weekly audiotape magazine delivered. A hairdresser was available in the home on the day of inspection and several ladies were having their hair done. The home had an open visiting policy and service users confirmed that they could receive visitors in private whenever they wished. One service user said staff sometimes took him out in the local community. Service users confirmed that they were able to bring personal possessions into the home with them, including small items of furniture. All the bedrooms were well personalised. Service users had access to the written information concerning them held by the home. In the main, service users were complimentary about the food and said that it had improved since the appointment of a new chef. They confirmed that they were offered choices at every mealtime and several said they enjoyed having a cooked breakfast. One service user said there are always nice puddings. Heathercroft Care Home DS0000059297.V292456.R01.S.doc Version 5.1 Page 16 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): 16 & 18 The quality rating for this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The policies, procedures and management at the home protect the residents from abuse. Complaints at the home are dealt with in accordance with the company’s complaints policy and residents and relatives know who to raise concerns with. Not all residents believe that they have seen a copy of the complaints procedure. EVIDENCE: Service users spoken with knew who they would speak to if they had any concerns, usually the nurse in charge or the manager, but none had seen a copy of the complaints procedure See Standard 1 & Recommendation No 1 re:Statement of Purpose & Service User Guide). The record of complaints was examined and both recorded complaints had been resolved to the complainants satisfaction within an acceptable time scale. Staff training records evidenced that 11 staff had recently undertaken specific training on Adult Protection and there is an identified programme for the remaining staff team. This subject is also included within staff induction training. Heathercroft Care Home DS0000059297.V292456.R01.S.doc Version 5.1 Page 17 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): 19,22 & 26 The quality rating for this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The physical design and layout of the home enables service users to live in a safe and comfortable environment, which encourages independence. There is an improvement plan in progress to upgrade the decor. EVIDENCE: At the time of the inspection maintenance staff were decorating and laying new flooring in B area. This area had been almost completely refurbished in accordancwith the improvement plan submitted by the registered provider after the last inspection. Bedrooms had been redecorated, recarpeted and fitted with new furniture. New laminate flooring was being fitted in the corridors. The green carpet in the dining room and several carpets in A area were badly stained, also several rooms and corridors in A area needed redecorating. The improvement plan included refurbishment of A area and progress will be monitored on future visits. Heathercroft Care Home DS0000059297.V292456.R01.S.doc Version 5.1 Page 18 Adequate equipment was provided to meet the assessed needs of the service users. The home was clean and tidy at the time of the inspection and all service users spoken with said it was always kept clean. However, during the tour of the premises the inspector noted that staff had left used continence pads and soiled bedding on the floor in bedrooms after attending to service users. They did go back and tidy the room, but these items should not be placed on the floor. They should be placed in the appropriate receptacle straight away in accordance with the correct infection control procedures. The inspector also noted that bed rail padding was frequently stored under the bed on the floor. See Requirement No 3 Heathercroft Care Home DS0000059297.V292456.R01.S.doc Version 5.1 Page 19 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): 27,28,29 & 30 The quality rating for this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users in this home benefit from a service that is provided through a team of care & nursing staff that is knowledgeable, motivated and that have access to a range of appropriate training opportunities. EVIDENCE: All the service users spoken with said that the staff were very good, helpful and friendly. Examination of the staffing rota confirmed that minimum staffing levels of two nurses and seven care staff are maintained from 8.00 to 14.00 and three nurses and eight care staff from 14.00 to 16.00. and one nurse and six carers from 16.00 to 20.00. By night there is 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. In addition to the manager and the senior nurse four staff were interviewed and confirmed their knowledge of the needs of service users, safe working practices, positive management and supervision and a commitment to ongoing training and development. Heathercroft Care Home DS0000059297.V292456.R01.S.doc Version 5.1 Page 20 A training record for 2006 and a training programme for the next year was provided by the manager to support this commitment. Examination of staff records evidenced a robust and proper recruitment process, new members of staff are only appointed after a formal application has being received, two written references are obtained together with an enhanced disclosure from the Criminal Records Bureau. Heathercroft Care Home DS0000059297.V292456.R01.S.doc Version 5.1 Page 21 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): 31,32,33,34,35,36,37 & 38 The quality rating for this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a well managed service providing them with a good degree of safety and security EVIDENCE: Service users said they rarely saw the manager. One service user resident since March said he had seen her once, and another who came into the home in April said she had never seen her. See Recommendation No 5. The management of this home is going through a period of change, the present registered manager has been identified by the owner to take on senior managent responsibilities within the company. The future managent of the Heathercroft Care Home DS0000059297.V292456.R01.S.doc Version 5.1 Page 22 home will be undertaken by her deputy, who is a qualified general nurse and has worked in the home as a senior nurse for more that 2 years. There is a stated commitment from the new manager to commence her NVQ Level 4 in management in July 2006. The new manager has also started the process of registration with CSCI. See Requirement No 5. Throughout the day residents and staff were observed to be interacting in a positive and open way. The relationship between staff both between peers and those of different grades was positive, respectful and supportive. The manager has continued to develop a Quality Assurance system using a Satisfaction Survey. The records of finances belonging to service users held by the home were viewed and found to be correct and in order. There is a structured process of formal supervision in place for all staff working within the home. Records relating to safe working practices, maintenance of equipment and the recoding of all accidents are properly maintained. As identified previously staff had been observed to lacking in their management of soiled linen. See Standard 26 & Requirement No 3. Heathercroft Care Home DS0000059297.V292456.R01.S.doc Version 5.1 Page 23 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 3 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 X X 3 X X X 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 3 3 3 X 3 3 3 2 Heathercroft Care Home DS0000059297.V292456.R01.S.doc Version 5.1 Page 24 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 OP7 Regulation 12 Requirement Residents’ care plans must include specific Risk Assessments for the use of bed rails when used. When new areas of need are assessed they must be recorded in a new and specific care plan The progress achieved in the redecoration and refurbishment of the home must be maintained The manager must ensure that robust practices regarding the management of soiled linen are maintained The registered person must ensure that the manager makes an application to register with CSCI Timescale for action 01/08/06 2 3 4 OP7 OP19 OP26 12 23 13 01/08/06 31/12/06 01/08/06 5 OP31 8 01/12/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Heathercroft Care Home DS0000059297.V292456.R01.S.doc Version 5.1 Page 25 No. 1 2 3 4 5 Refer to Standard OP1 OP7 OP10 OP10 OP32 Good Practice Recommendations The registered person should insure that an up to date Statement of Purpose & Service User Guide is made available to all service users. The management of multiple wounds should be identified in separate and individual care plans. Staff responsible for the administration of medicines should date the opening of medicines, such as eye drops, that have a limited shelf life A copy of a British National Formulary should be kept in the home’s pharmacy. The new manager should develop a style of management that is inclusive and open Heathercroft Care Home DS0000059297.V292456.R01.S.doc Version 5.1 Page 26 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. Extracts may not be used or reproduced without the express permission of CSCI Heathercroft Care Home DS0000059297.V292456.R01.S.doc Version 5.1 Page 27 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!