CARE HOMES FOR OLDER PEOPLE
Heatherdale Residential Home South Broomhill Morpeth Northumberland NE65 9RT Lead Inspector
Deborah Haugh Unannounced 06 May 2005 09:30. 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. Heatherdale Residential Home B53_B03_S532_HeatherdaleResHome_V220604_060505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Heatherdale Residential Home Address South Broomhill Morpeth Northumberland NE65 9RT 01670 760796 01670 760796 N/A Wellburn Care Homes Limited 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) Vacant CRH 36 Category(ies) of DE(E) Dementia over 65 (12) registration, with number OP Old age (24) of places Heatherdale Residential Home B53_B03_S532_HeatherdaleResHome_V220604_060505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 24/11/04 Heatherdale Residential Home B53_B03_S532_HeatherdaleResHome_V220604_060505 Stage 4.doc Version 1.30 Page 5 Brief Description of the Service: Heatherdale is registered to provide residential care for 36 older people, 12 of who may have dementia. The home cannot provide nursing care. The home has 27 bedrooms with ensuites. Access in the home is level and a lift takes residents to and from both floors.The gardens are well maintained and residents who wish to can have access to them.Heatherdale is located within easy reach of local shops and amenities. Heatherdale Residential Home B53_B03_S532_HeatherdaleResHome_V220604_060505 Stage 4.doc Version 1.30 Page 6 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place on 6/5/05 at 9.30am and lasted until 3pm. At the time of this inspection there is no Registered Manager. But a manager has been recruited and at the time of writing is going through the process of registration. The new manager Cath Goode was on duty throughout the visit. There were 24 residents at the time of the visit and staffing levels were appropriate to meet the needs of the residents. Time was spent looking around the home to check the cleanliness, maintenance and decoration. Residents and visitors shared their views about the home. Time was also spent observing the contact between residents and staff. Three Care Plans for residents care were examined. The home’s Accident Book, Fire Log, staff and residents meetings were checked. Arrangements for the administration and management of medication were audited. What the service does well:
All of the residents and visitors spoken with spoke highly of the care which they receive at Heatherdale. Comments covered the positive relationships which residents and visitors have with staff in the home eg - ‘They treat people with dignity’ - ‘The cleaners are lovely, I mean really with the people, not just cleaning rooms but talking to them.’ - ‘Staff really care.’ Positives were shared about the catering in the home and the laundry arrangements eg - ‘ The food is great, good portions, high standard.’ - ‘Laundry is good, take care.’ People said they had confidence in the manager and said, - ‘I would tell the manager if I was unhappy.’ - ‘ We have confidence in the manager if we had any concerns.’ Staff respected resident’s dignity by asking them quietly and privately if they needed help. The resident’s comments were heard by staff and acted upon. Residents were appropriately dressed with make-up and jewellery, clean and
Heatherdale Residential Home B53_B03_S532_HeatherdaleResHome_V220604_060505 Stage 4.doc Version 1.30 Page 7 ironed clothes. The atmosphere in the home was cheerful and relaxed. One person became ill during the inspection and immediate care and observation was given discreetly and sensitively. The manager was attentive during the inspection and put things right straightaway if needed or reported that action would be taken. The bedroom vanity units are being updated and new lights and mirrors put in place. The bedrooms are personal and very cosy. The home was clean, well maintained and decorated. The new kitchen will be fitted in 2 months time. What has improved since the last inspection? 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. Heatherdale Residential Home B53_B03_S532_HeatherdaleResHome_V220604_060505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Heatherdale Residential Home B53_B03_S532_HeatherdaleResHome_V220604_060505 Stage 4.doc Version 1.30 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 standard(s) 3 Residents who move into the home have their needs assessed by a care manager and the home. EVIDENCE: Three residents records were inspected and 1 person had been recently admitted. There was evidence of assessments of the person’s needs. The resident confirmed their and their relatives involvement in the assessments. Heatherdale Residential Home B53_B03_S532_HeatherdaleResHome_V220604_060505 Stage 4.doc Version 1.30 Page 10 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7-10 There are care planning systems in place, which provide staff with the information they need to satisfactorily meet resident’s needs. However care plans need to reflect the personal preferences of residents. Staff demonstrated that they know the resident’s needs and wishes and have good relationships. Residents privacy is respected with the exception of hosiery which is mixed if not labelled. The health needs of residents are well met with multi disciplinary working taking place on a regular basis. The systems for the administration of medication require improvements. EVIDENCE: Three care plans were examined and the views of residents and staff were asked for. The documentation regarding the care of residents is positive and the staff know the residents well. One of the care plans examined is one which
Heatherdale Residential Home B53_B03_S532_HeatherdaleResHome_V220604_060505 Stage 4.doc Version 1.30 Page 11 the demonstrates the move towards personal preferences being recorded in such tasks as bathing and social activities. Each section of care is reviewed and there is evidence of other professionals being consulted and this was evident in practice on the day when a resident became ill. Personal care and sensitive conversations with residents were conducted with respect. The home agreed to provide delicate bags for hosiery at the last inspection in November so residents did not communally share clothing. However no delicate bags have been purchased. The manager agreed to provide these. An audit of the medication arrangements was undertaken in the presence of the manager and 3 areas require addressing see Requirements. Heatherdale Residential Home B53_B03_S532_HeatherdaleResHome_V220604_060505 Stage 4.doc Version 1.30 Page 12 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,15 The home is working hard to develop meaningful occupation for residents. Dietary needs of residents are well catered for with a balanced and varied selection of food available that meets resident’s tastes and choices as well as special dietary needs. EVIDENCE: Heatherdale Residential Home B53_B03_S532_HeatherdaleResHome_V220604_060505 Stage 4.doc Version 1.30 Page 13 A generalised activities programme is in place and records are maintained. The Activities Book was examined and entries/photographs included board and floor games, sing-a-longs, entertainers such as a recent Easter party, keep fit, Angel feet (foot massage) and visits to Friendly café. The minutes of April Team meeting indicate the managers commitment to personalised activity care plans for residents. One photograph in the activities book is a resident helping dry dishes which she enjoys, this is meaningful and good practice. Wellburn Care Homes Ltd now have a Nutritionist to develop the menus of the residents. Menus were examined at the last inspection in November and these are being reviewed. However nutritional screening is in place in the 3 care plans examined. On the day of the inspection residents had a choice of battered, poached fish, fish cakes and chips with peas. A ham salad was also an alternative. The food looked appetising and residents said they enjoyed their lunch. Heatherdale Residential Home B53_B03_S532_HeatherdaleResHome_V220604_060505 Stage 4.doc Version 1.30 Page 14 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 The home has a satisfactory complaints system in place. EVIDENCE: There have been no complaints since the last inspection in November 2004. Residents and visitors spoke of their confidence in the home to deal with any complaints and know who they would speak to such as their family or the manager. Heatherdale Residential Home B53_B03_S532_HeatherdaleResHome_V220604_060505 Stage 4.doc Version 1.30 Page 15 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) 19-26 The standard of the environment within this home is good providing residents with an attractive, safe, clean and homely place to live. EVIDENCE: A tour of the home was completed and the home was clean, well maintained and decorated. Residents and visitors said that the home is always clean. The garden is well tended and an attractive place to spend time. Visitors spoke of a BBQ which they had enjoyed in the garden. The location and layout of the home are suitable for the residents. There is sufficient communal space for 36 service users. The home has one conservatory (used as a dining room), three lounges, a dining room and a pleasant entrance area. The home has adequate numbers of bathrooms and wc’s for the service users living in the home. Twenty-seven bedrooms are en-suite.
Heatherdale Residential Home B53_B03_S532_HeatherdaleResHome_V220604_060505 Stage 4.doc Version 1.30 Page 16 The bedroom vanity units are being updated and new lights and mirrors put in place. The bedrooms are personal and very cosy. The new kitchen will be fitted in 2 months time. Two recommendations were made to improve infection control and these are to provide paper towels and liquid soap for bedroom sinks where personal care is provided and plastic covered pull cords to be used in bathrooms and toilets for ease of cleaning. Heatherdale Residential Home B53_B03_S532_HeatherdaleResHome_V220604_060505 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 Staffing numbers are appropriate to the assessed needs of the residents, size and layout and purpose of the home at all times. EVIDENCE: The home maintains the level of staffing in accordance with previous agreements with the local authority and this reflects the size and layout of the building and the needs of the residents currently living in the home. The current levels of staffing are a minimum of 5 care staff on duty during the morning, 4 care staff on duty during the afternoon and early evening and 2 waking night staff. The home has its own laundry assistant. Heatherdale Residential Home B53_B03_S532_HeatherdaleResHome_V220604_060505 Stage 4.doc Version 1.30 Page 18 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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) 32 & 38 On the whole the home is well run with residents wishes and needs being met. There are some issues which need addressing concerning fire instruction to staff. EVIDENCE: The Fire Log book was examined and fire instruction to staff which should happen every 3 months for any staff who cover night shifts have not occurred since the last inspection in November 2004 until March 2005 when the new manager started. This was a requirement in November 2004. The fire alarm panel must be tested weekly but this was not found in the Log Book. The minutes from resident and staff meetings were read and there is evidence of consultation and action to improve and acknowledge good practice. The new manager is working hard to achieve better standards and progress will be
Heatherdale Residential Home B53_B03_S532_HeatherdaleResHome_V220604_060505 Stage 4.doc Version 1.30 Page 19 monitored at the next inspection. Residents and visitors were very complimentary about the management and staff of the home. Heatherdale Residential Home B53_B03_S532_HeatherdaleResHome_V220604_060505 Stage 4.doc Version 1.30 Page 20 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 3
COMPLAINTS AND PROTECTION 3 3 3 3 3 3 2 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 Standard No 16 17 18 Score 3 x x x 3 x x x x x 1 Heatherdale Residential Home B53_B03_S532_HeatherdaleResHome_V220604_060505 Stage 4.doc Version 1.30 Page 21 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 38 Regulation 23(4) Requirement Staff must receive fire instruction at the appropriate timescales. Outstanding 24/11/04 Weekly checks of the fire alarm panel must be made and recorded. Medication issues must be addressed ie -creams and ointments must be dated when opened, handwritten signatures must be countersigned, ensure allergies are recorded. Care plans must reflect the wishes and preferences of the residents ie bathing, social activities Timescale for action 6/5/05 2. 9 13(2) 6/5/05 3. 15 7 24/10/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 26 Good Practice Recommendations Consider providing paper towels and liquid soap for bedroom sinks where personal care is provided and plastic covered pull cords to be used in bathrooms and toilets for ease of cleaning. Provide delicate bags for hosiery.
B53_B03_S532_HeatherdaleResHome_V220604_060505 Stage 4.doc Version 1.30 Page 22 2. 10 Heatherdale Residential Home 3. 28 A minimum ration of 50 trained members of staff (NVQ 2 or equivalent) should be achieved by 2005, excluding the Registered Manager. Heatherdale Residential Home B53_B03_S532_HeatherdaleResHome_V220604_060505 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Northumbria House Manor Walks, Cramlington Northumberland NE23 6UR National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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