Inspection on 11/07/05 for Heatherdene

This inspection was carried out on 11th July 2005.

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

The inspector 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

Heatherdene 09/02/09

Heatherdene 21/02/07

Heatherdene 06/02/06

Heatherdene 26/01/05

Heatherdene 10/06/04

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Heatherdene 13 - 14 Southfields Road Eastbourne East Sussex BN21 1BU Lead Inspector Jon Wheeler Announced 11 July 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Heatherdene H59 H10 S21132 Heatherdene V227355 110705 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Heatherdene Address 13 -14 Southfields Road Eastbourne East Sussex BN21 1BU 01323 642715 01323 647377 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) Mrs Janet Matthews Mrs Terry Blandford Care Home 23 Category(ies) of Mental disorder, excluding disability or dementia registration, with number (MD) 23 of places Mental disorder, excluding learning disabilty or dementia over sixty-five (65) years of age (MD(E)) Heatherdene H59 H10 S21132 Heatherdene V227355 110705 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 The maximum number of residents to be accommodated is twenty three (23). Date of last inspection 26 January 2005 Brief Description of the Service: Heatherdene is registered to provide residential care to twenty-three people who have mental health problems. People are admitted to the home aged eighteen and above, with no upper age limit on admission. Most of the current residents are under sixty five and therefore within the younger adult category. The home is a three-storey detached property in an attractive residential area close to Eastbourne town centre. The home is close to local transport links, shops and the town’s facilities. There are twenty three single bedrooms in the home, eight of which have ensuite facilities. There are a number of communal areas, some of which provide areas to smoke in. The home is well-maintained throughout. There is a large secluded garden at the rear of the property. There is parking at the front of the building and a ramp to enable disabled access. Heatherdene H59 H10 S21132 Heatherdene V227355 110705 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place in July 2005, started at 9.30 am and lasted for about five hours. The inspection involved talking to seventeen service users, four staff and the manager and deputy manager. The inspection was also based on observation of staff working with service users, a tour of the environment, reading care plans, policies and records and looking at the storage, administration and recording of medication. What the service does well: What has improved since the last inspection? Heatherdene H59 H10 S21132 Heatherdene V227355 110705 stage 4.doc Version 1.40 Page 6 The home has worked hard to continue to provide a good quality service. There is a new procedure to ensure the safe storage, administration and recording of medication. Staff have continued to do NVQ and other training courses to ensure they have the skills to meet the needs of service users. 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. Heatherdene H59 H10 S21132 Heatherdene V227355 110705 stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Heatherdene H59 H10 S21132 Heatherdene V227355 110705 stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3, 4, 5. A thorough and comprehensive statement of purpose and service user guide enable prospective service users to make informed decisions about the home. The home undertakes comprehensive pre-admission assessments, and enables visits to the home prior to admission to ensure it can meet the needs of prospective service users. Service users are fully informed about the range of services provided, which are included in a written contract. EVIDENCE: A comprehensive statement of purpose and service user guide were available to prospective service users, which described in detail the range of services provided by the home. Individual service users’ care plans contained comprehensive pre-admission assessments to ensure their needs could be met by the home. There is a thorough pre-admission process. Service users spoken with confirmed that they had been able to visit the home before moving in, where they meet other service users and the staff. Care plans indicated that there is a three month trial period for each service user once they have moved in. By talking to service users, reading care plans, policies and records, there was a wide range of evidence to demonstrate that the home is able to meet the needs of all the service users. Heatherdene H59 H10 S21132 Heatherdene V227355 110705 stage 4.doc Version 1.40 Page 9 There was documentary evidence that each service user has a contract, which they sign to demonstrate their agreement with the services provided by the home. Heatherdene H59 H10 S21132 Heatherdene V227355 110705 stage 4.doc Version 1.40 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8, 9, 10. Individual care plans clearly reflect the needs of the service users and the support needed to enable them to have their needs met. A clear ethos of the home is based on enabling service users to make decisions about all aspects of their lives, including the running of the home. The service has a range of risk assessments to enable service users to take reasonable and managed risks in their lives. Information about service users is handled in confidence by an aware and professional staff team. EVIDENCE: Care plans had been regularly reviewed and were updated as necessary, to identify changing needs. The care plans included pre-admission assessments, background information, risk assessments and support guidelines. Care plans indicated specific care required to meet the diverse needs of the service users, relating to their health, welfare, age, cultural and disability needs. Service users confirmed that they were supported by staff to make decisions in all aspects of their lives, which is a fundamental value of the service. There were risk assessments in place to address a wide range of issues affecting service users, both in the home and in the community. The risk assessments detailed the support required to enable the service to help the users manage acceptable risks and to develop their skills and quality of life. Service users Heatherdene H59 H10 S21132 Heatherdene V227355 110705 stage 4.doc Version 1.40 Page 11 spoken to said that they felt the information about them was discussed and handled sensitively and professionally by the staff. Staff were clear about the importance of confidentiality. Heatherdene H59 H10 S21132 Heatherdene V227355 110705 stage 4.doc Version 1.40 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14, 15, 16, 17. Service users are supported to take part in a wide range of activities to meet their needs and ensure their personal development. Service users are supported to access facilities in the local community. The ethos of the homes promotes the rights of service users and enables them to make choices in all aspects of their lives. The home provides a healthy and varied diet, which meets the individual needs and preferences of service users. EVIDENCE: There was documentary evidence of service users being supported to undertake a wide range of activities within the home and using facilities in the local community. Activities were tailored to the specific care needs and preferences of each individual service user. Service users said the activities they did included household tasks to help them develop their skills, leisure activities such as theatre trips, trips out, board games and cards in the home, and some service users attended a day centre. One service user said he was doing a college course in cookery. Service users confirmed that they were able to access a range of community facilities, either on their own or with support from the staff. Heatherdene H59 H10 S21132 Heatherdene V227355 110705 stage 4.doc Version 1.40 Page 13 It was reported by staff and service users that whilst most service users have little contact with their families, those that do are encouraged to develop and maintain positive relationships with family and friends. Visitors are welcomed in to the home. Service users spoken with said they felt valued and respected by the staff team. Staff were observed treating the service users with dignity and respect, in a friendly and courteous manner. The management and staff teams were clear about the rights of the service users and were able to describe the balance between helping service users develop their skills and responsibilities as well as providing them with dignified care. There is a varied menu providing good quality food, which offers choice and meets the dietary needs and preferences of the service users. Service users all said that the food is good. There were robust systems in place to ensure the provision of nutritious food and the cleanliness and safety of the equipment in the kitchen. Heatherdene H59 H10 S21132 Heatherdene V227355 110705 stage 4.doc Version 1.40 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19, 20. Service users receive sensitive and dignified support from staff, to meet their personal needs and preferences. Service users are supported to access a wide range of health services to meet their needs. Robust procedures for the administration and recording of medication ensure the health and safety of service users. EVIDENCE: Service users said that the staff team provides good quality care that meets their needs and helps them promote their rights, choices and independence. Staff were knowledgeable about the specific needs of each individual service user. There was documentary evidence of the service helping users access a wide range of health services to meet their physical and emotional needs. Medication is kept in a secure cupboard and all staff who administer have received appropriate training. On the day of the inspection, one error was found where one medication had been administered, but not signed for. However, the home has a robust system of checking, which picked up the error before further medication was administered. The error was identified and discussed with the staff member responsible. There was documentary evidence of robust policies and procedures in the storage, administration and recording of medication. Heatherdene H59 H10 S21132 Heatherdene V227355 110705 stage 4.doc Version 1.40 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22, 23. A transparent and robust complaints procedure enables service users to raise concerns and have them investigated thoroughly. The home’s policy and adult protection training for staff provide protection for the service users. EVIDENCE: There was a complaints procedure available, although the home had not received any complaints. Service users spoken with said they felt able to raise any issues or concerns they had either with the management team or staff. The service has an adult protection policy to address the safety of service users. There was documentary evidence that all staff had either completed adult protection training, or were about to attend a course. Staff spoken with were able to describe the adult protection procedure, and how they would raise any concerns they might have. Heatherdene H59 H10 S21132 Heatherdene V227355 110705 stage 4.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26, 27, 28, 29, 30. Service users live in a clean and tidy home which provides a friendly and relaxed environment. The home offers a comfortable and relaxed environment that is kept in good decorative order and offers sufficient communal space. There are sufficient en-suite, bathroom and toilet facilities that meet the needs of the service users. EVIDENCE: Service users live in a tidy, clean environment that offers a range of comfortable communal rooms, including a large dining room, lounge and smoking room. Service users bedrooms provide a comfortable and homely environment, which they are able to personalise to meet their needs and preferences. There are a range of appropriate bathroom facilities, with some bedrooms having en-suite facilities. The service has three house vehicles to enable staff to take service users out in to the community and to other services and appointments. There was evidence of an on-going maintenance plan to ensure the home is safe and attractively decorated. Heatherdene H59 H10 S21132 Heatherdene V227355 110705 stage 4.doc Version 1.40 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 34, 35, 36. There is a knowledgeable, skilled and well-trained staff team who are clear about their own roles and responsibilities and those of their colleagues. Staff work well together and are well supported to enable them to provide consistent, good quality care. The home has robust employment procedures to ensure the provision of good quality staff to meet the needs of the service users. EVIDENCE: Staff were able to describe in detail their own roles and responsibilities, and those of their colleagues. Staff demonstrated a clear knowledge and understanding of the specific needs of the service users, and how those needs are met. Service users reported that the staff are competent and caring. Staff were observed providing skilled and professional care to the service users. Staff reported that there was an excellent team spirit, where colleagues work well together and support each other effectively. There was evidence of sufficient staff on duty on all shifts, which enable service users to have their needs met and receive appropriate and dignified care. There was documentary evidence to support reports from staff that they receive regular supervision and support to enable them to develop their skills and carry out their roles effectively. Heatherdene H59 H10 S21132 Heatherdene V227355 110705 stage 4.doc Version 1.40 Page 18 There was documentary evidence in all staff files viewed of robust employment procedures to ensure the safety of service users. Staff files included evidence of application forms, job interviews, CRB and references checks and forms of identification. There is a well-trained staff team, with nine members of the team with relevant NVQs and eight more staff members currently doing NVQ courses. There was documentary evidence of staff undertaking a range of other courses to enable them to effectively carry out their jobs. Heatherdene H59 H10 S21132 Heatherdene V227355 110705 stage 4.doc Version 1.40 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 40, 41, 42. The home is well run by a skilled, experienced and professional management team. The ethos of the home promotes the rights, choices and interests of the service users. The home has up to date policies, procedures and records to ensure the effective running of the home. A range of regular health and safety checks ensures the protection of service users and staff. EVIDENCE: The manager and deputy manager are knowledgeable, skilled and experienced practitioners who work well as a team to provide clear direction, support and leadership to the staff team and service users. The managers ensure the home continues to provide a good quality service, which respects the rights, choices and independence of the service users whilst providing them with dedicated and sensitive support. All the service users and staff spoken with praised the skills and leadership of the managers, who they also described as approachable and supportive. Heatherdene H59 H10 S21132 Heatherdene V227355 110705 stage 4.doc Version 1.40 Page 20 Service users reported that they felt able to raise any concerns with the managers and believed their views were respected and taken into account. There was documentary evidence of a range of robust and effective policies, underpinning the procedures in the home. The policies had been regularly reviewed and updated. Staff were able to describe how the policies worked in practice. The records kept in relation to the running of the home were all up to date and accurate. The service has a range of checks to ensure the health and safety of the service users and staff. These included daily checks of the temperatures of the fridges and freezers; weekly checks of the water temperatures, the fire alarms and the emergency lighting. The fire equipment had been checked within the previous twelve months and there was documentary evidence of regular fire drills. There was also evidence of an on-going maintenance plan to ensure the safety of the building. Heatherdene H59 H10 S21132 Heatherdene V227355 110705 stage 4.doc Version 1.40 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 4 3 4 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 2 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Heatherdene Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 3 3 x H59 H10 S21132 Heatherdene V227355 110705 stage 4.doc Version 1.40 Page 22 No 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 Regulation Requirement Timescale for action 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 Good Practice Recommendations Heatherdene H59 H10 S21132 Heatherdene V227355 110705 stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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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