Inspection on 10/12/08 for Heatherdale Healthcare Ltd

This inspection was carried out on 10th December 2008.

CSCI found this care home to be providing an Good service.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Heatherdale Healthcare Ltd 19/01/07

Heatherdale Healthcare Ltd 09/01/06

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 27/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Heatherdale Healthcare Ltd 204 Hempstead Road Hempstead Gillingham Kent ME7 3QG     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sue McGrath     Date: 1 0 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Heatherdale Healthcare Ltd 204 Hempstead Road Hempstead Gillingham Kent ME7 3QG 01634260075 01634361123 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Margaret Ann Burgess Type of registration: Number of places registered: Heatherdale Healthcare Ltd care home 37 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Heatherdale Healthcare Limited occupies a purpose built detached premises, with accommodation for residents on two floors. The premises are registered as a care home with nursing for 37 service users. The Home has a shaft lift and other mobility aids that enable it to accommodate wheelchair users. There is allocated car parking to the front of the building and a pleasant garden to the rear. The Home is situated in a residential area, with local shops, public transport and other community facilities within the vicinity. The Manager employed at the Home has worked in the role of matron for a number of years. The proprietor, Mr Wills, is very much involved in the Home and works closely with the Matron in overseeing the daily running of the Home. The current the fees range from £557.00 to £603.25 per week. Further information can be given by the home. Care Homes for Older People Page 4 of 27 Over 65 37 0 Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was a Key Unannounced inspection that took place in accordance with the Inspecting for Better Lives (IBL) process. Key inspections are aimed at making sure that the individual services are meeting the standards and that the outcomes are promoting the best interests of the people living in the home. The IBL process for a Key inspection involves a pre-inspection assessment of service information obtained from a variety of sources including an annual self-assessment and surveys. Further information can be found on the CSCI website with regards to the IBL process including information on KLORAs and AQAAs. It is now a legal requirement for services to complete and return an Annual Quality Assurance Assessment (AQAA). This assessment is aimed at looking at how services are performing and achieving outcomes Care Homes for Older People Page 6 of 27 for people. At the site visit, service users and staff were spoken to, records were viewed and a tour of the environment was undertaken. Judgements have been made based on records viewed, observations and verbal responses given by those people who were spoken with. These judgements have been made using the Key Lines of Regulatory Assessment (KLORA), which are guidelines that enable the CSCI to be able to make an informed decision about outcome areas. Further information can be found on the CSCI website with regards to information on KLORA and AQAAs. At all times the manager and staff were helpful and demonstrated a pro-active approach to ensuring that service users were being supported to the best of their abilities and resources. This report contains evidence and judgements made from observation, conversation and records. Five of the six requirements made at the last inspection had been complied with. One had not been complied with. Overall this was a positive inspection with generally good outcomes for service users. The inspector on leaving the home was satisfied that residents were both safe and well cared for and wishes to thank the manager and her staff for their assistance and hospitality. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. What the care home does well: What has improved since the last inspection? What they could do better: The home did not meet the requirement regarding the supervision of staff and the enforcement pathway may now be followed and further action may be taken as this requirement has been carried over from previous reports. The provider must review the management structure within the home and look to employ a deputy manager as part of the restructuring. Care Homes for Older People Page 8 of 27 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents are provided with the information they need to make an informed choice about where to live prior to admission and are provided with a statement of terms and condition of residency. People who live in the home benefit from a comprehensive assessment of their needs prior to moving into the home to ensure their assessed needs can be met. Residents and families also benefit from the opportunity to visit the home prior to admission to assess the quality, facilities and suitability of the service. Evidence: The statement of purpose had been updated and complied with the requirements of Schedule 1 of the Care Standards Act 2001, but was not used by the home. The only copy appeared to be kept on the managers computer. It was recommended that this required document be added to the homes pamphlet that it gives to prospective residents so to enable them to make an informed choice about what the home has to Care Homes for Older People Page 11 of 27 Evidence: offer. There was a robust admission procedure which ensured the home would be confident it could meet the needs of any resident before they were admitted to the home. Prospective residents and their relatives were encouraged to visit the home prior to admission and the home offered a trail period if necessary. The registered manager confirmed all residents were proved with a contract/statement of terms and conditions. Heatherdale offers services for residents with nursing needs. Residents and relatives spoken with said they felt well cared for and that their needs were well met. Evidence was also seen that good clinical guidelines were in place to ensure specialist medical care was delivered appropriately. Intermediate care is not provided at Heatherdale. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home benefit from having clear and in-depth care plans that identify their individual needs and give clear guidance to staff. Care plans are regularly updated to ensure changes are recorded and acted upon. Health needs are met and residents benefit from having full access to all professional health care services as required. People who live in the home are protected by the homes policies and procedures for dealing with medicines. Evidence: Since the last inspection where the care plans were inconsistent and unclear, work had been undertaken and the contents and structure of the care plans had improved. The care plans were now easier to follow and much more structured and informative. One concern was the standard of daily recording where it was very difficult to read the contents due to poor hand writing. This needs to be addressed as some where very difficult to read and understand. Not all of the care plans were reviewed monthly. Care Homes for Older People Page 13 of 27 Evidence: Evidence was seen in the care plans that residents health care and nursing needs were well met. Medication administration was viewed and was seen to be well managed with no errors found on the day. The home had a medication policy which protected residents. Only the qualified nurses administered medication and it was advised on the day that they undertake a more in depth training course to ensure their skills were kept up to date. The registered manager evidenced she completed regular audits to ensure the administration of medication was sound and safe. Several residents were spoken with and all commented that the staff were kind to them and they felt their privacy was respected at all times. Relatives spoken with raised no concerns over privacy and dignity of the residents. Examples of good practice by staff was seen throughout the day. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home have their social and recreational interest and needs very well provided for with a wide range of activities organised. People who live in the home are supported to maintain contact with family and friends, which ensures they continue to receive stimulation and emotional support. Residents receive a wholesome appealing balanced diet in pleasing surroundings. Evidence: The vast majority of the residents said they were happy with the lifestyle offered at the home. They commented that there was a range of activities and entertainments they could be involved with if they wished and praised the efforts of the coordinator. All said the food was good and they were offered a choice. The home had a dedicated activities co ordinator who organised a wide range of activities including craft work, games and quizzes and bingo to mention a few. Outside entertainers including a violinist, a choir and a country and western singer, visit the home approximately every three to six weeks. The local church was going to the home Care Homes for Older People Page 15 of 27 Evidence: for a carol concert the following week. A recent Christmas party had been held for the residents and their relatives. Regular church services were arranged for those who wished to participate. The home had very pleasant gardens which several residents said they used in the summer. Residents families confirmed they could visit at any reasonable time and were always made welcomed by the staff. They also confirmed they were kept well informed of any changes in their relatives conditions etc. The kitchen was seen to be clean and tidy and the cleaning schedule was viewed. The records of the food provided were seen, together with the menus for the home. These confirmed that a varied and nutritious diet was offered.On the day of the inspection it was seen that drinks were encouraged and one relative commented that she has seen staff promote drinks at every visit. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. he home has a robust complaints system and people who live in the home and their relatives feel their views are listened to and acted upon. The home has adult protection policies and procedures in place to ensure that people who live in the home are protected from abuse. Evidence: The registered manager confirmed the home had a robust complaints procedure in place with designated timescales for resolutions and included details of how to complain. Individual records were kept, as advised at the last inspection. Relatives spoken with confirmed they were aware of the procedure but of those spoken with nobody had needed to use it. All confirmed the management team were proactive in dealing with minor issues in a quick and efficient manner.The AQAA confirmed the home had received seven minor complaints in the last twelve months and that they had all been resolved. The home had adopted Kent and Medways Adult Protection Policy and Procedures. The registered manager reacted appropriately to one Adult Protection alert and followed the correct procedure and achieved the required outcomes.The majority of staff had recently completed a training course on Adult Protection and the remaining staff were booked to go on another course in the very near future. Care Homes for Older People Page 17 of 27 Evidence: Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home benefit from living in a clean, safe, well maintained environment and have safe access to comfortable indoor and outdoor communal areas. People who live in the home are encouraged to maximise their independence by having access to a range of specialist equipment supplied by the home. Evidence: The home was well maintained and very clean. Severals residents said the home was a comfortable place in which to live and they liked their own bedrooms. Several residents confirmed they had been able to bring some small personal items, which had helped them to settle in . All of the rooms viewed had access to the call system. Some work had been completed on the toilets, as required in the last report, and the registered manager confirmed the broken bath panel had been replaced. The laundry continued to use the Otex system and ensured hygienic cleaning of clothing etc, there was a dedicated laundry person to complete this duty. Sluicing facilities, both thermal and chemical, were used. The home also had two sluice disinfectors to dispose of waste and a macerator was also used. Sound infection Care Homes for Older People Page 19 of 27 Evidence: control procedures were followed. The home had a range of specialist equipment to maximise comfort and independence. Grab rails and other aids were provided in the corridors, bedrooms, bathrooms, toilets and communal rooms where necessary and according to need. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home have their needs mainly met by the number and skills range of the staff. People who live in the home are protected by the homes robust recruitment procedures. Evidence: The staff rotas were viewed and indicated that there were sufficient staff on duty at all times to meet the current needs of the residents. The registered manager stated new staff were currently being employed and the use of agency staff had decreased in the past year.The post of deputy manager has still not been filled and this has impacted on some of the management tasks such as supervision. Staff training was ongoing but the training matrix viewed indicated that only seven of the twenty one care staff had completed a National Vocational Qualification (NVQ) to level two or above. The required level is 50 . The registered manager did confirm that seven more staff had applied to start their award. The registered manager confirmed that a TOPPS induction programme was in place and one new member of staff confirmed she was currently working towards its Care Homes for Older People Page 21 of 27 Evidence: completion. Several staff files were viewed and indicated that a sound recruitment procedure was in place. All staff held a current Criminal Records Bureau (CRB) disclosure. A law mentor had been employed by the home to assist with policies and procedures. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home benefit from a registered manager who is competent and experienced with the care of older people who require nursing care. People who live in the home are protected by the homes sound financial procedures. The care of the people who live in the home may be compromised because staff continue not to be appropriately supervised. Current arrangements were sufficient to protect the health, safety and welfare of residents and staff. Evidence: As in all previous inspections the manager was open, honest and helpful throughout the inspection and had the necessary qualifications and experience to manage the home. Although there were clear lines of accountability within the home and with the Care Homes for Older People Page 23 of 27 Evidence: owner, the vacant deputy managers post was having a major impact on the general management of the home. The registered manager was having to complete all of the management tasks with little support and this needs to be addressed as urgently soon as possible. Both relatives and residents spoken with confirmed that all staff were approachable and communicated well with them. The registered manager had started a quality assurance survey but not all of the questionnaires had been returned and the final report had not been complied. This was the same situation at all of the recent inspections and the manager is advised to focus on a final outcome and produce a report as required by Standard 33 of the Care Standards Act 2001. The home held some small amounts of monies on behalf of some of the residents and these were kept secure with accurate records maintained. Supervision remains an issue, as it has from several of the last inspections. The staff are not being appropriately supervised and the registered manager stated she does not have the time to supervise all staff. Some staff appraisals had been completed but staff did confirm that they do not receive regular and structured supervision. The registered manager did say say that she observes work practices on a regular basis but does not record this. She also stated that staff meetings occur on a regular basis but again this is not recorded. This is an area where the manager could be assisted by having a deputy manager. As this requirement has not been met for the last two inspections, CSCIs enforcement pathways will now be followed. Information given in the AQAA confirmed the home manages the health and safety of the home well and all required maintenance and equipment checks were being completed. The AQAA confirmed the premises electrical wiring was inspected in July last year following the last report. The registered manager confirmed the fire risk assessment had been reviewed and amended as required from the last inspection. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action 1 36 18 The Registered Person shall ensure that all staff receive formal supervision at least six times a year. Previous timescale 20/02/06 31/01/2007 Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 27 18 Staffing numbers and skill 31/03/2009 mix of qualified/unqualified staff are appropriate to meet the assessed needs of the service users, layout and purpose of the home at all times. In that the management structure needs to be strengthened with the position of deputy manager. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 7 9 it is recommeded that care plans are reviewed and adjusted as necessary on a monthly basis. It is recommended that nursing staff undertake a more in depth medication training to ensure their skills are updated and maintained. It is recommended that the level of staff working in the kitchen is reviewed 3 27 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 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!