Inspection on 24/03/09 for Heatherdene

This inspection was carried out on 24th March 2009.

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

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 01/05/08

Heatherdene 18/05/06

Similar services:

Ashcroft Hollow Nursing Home

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Heatherdene 3 Upper Brook Street Oswestry Shropshire SY11 2TB     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: Pat Scott     Date: 2 4 0 3 2 0 0 9 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. that people have said are important to them: They reflect the things 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 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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 25 Information about the care home Name of care home: Address: Heatherdene 3 Upper Brook Street Oswestry Shropshire SY11 2TB 01691670268 01691662073 mnusrat786@hotmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Primecare Homes Britannia Limited care home 18 Number of places (if applicable): Under 65 Over 65 18 old age, not falling within any other category Additional conditions: 0 The maximum number of service users who can be accommodated is: 18 The registered person may provide the following category of service only: Care Home Only (Code PC) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) 18 Date of last inspection Brief description of the care home Heatherdene is a care home for older people situated in the centre of Oswestry, close to all amenities. The home is registered to provide care for a maximum of 18 service users. The home offers respite and permanent care to male and females over the age of sixty-five. It is a large adapted family house and the first floor is accessed by a shaft lift. The front door to this home is kept locked but the key is easily available. The home is owned by Primecare Homes Britannia Limited. The home makes their services known to prospective service users in: The Statement of Purpose, Brochure, Welcome pack and web site which also contain their contact e mail address. Care Homes for Older People Page 4 of 25 Brief description of the care home The inspection report is mentioned in the statement of purpose and is given out on request. Fees are reviewed annually and range from £337.95-£380. The only additional charges to service users are for toiletries, hairdressing, newspapers and escorting to hospital for routine appointments. Care Homes for Older People Page 5 of 25 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: We, the commission, looked at all the information that we have received, or asked for, since the last key inspection or annual service review. This included: The annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. Surveys returned to us by people using the service and from other people with an interest in the service. Information we have about how the service has managed any complaints. What the service has told us about things that have happened in the service, these are called notifications and are a legal requirement. Care Homes for Older People Page 6 of 25 The previous key inspection and the results of any other visits that we have made to the service in the last 12 months. Relevant information from other organisations. What other people have told us about the service. What the care home does well: What has improved since the last inspection? What they could do better: People should be provided with a statememt of purpose that is more user friendly so that they have enough information in a suitable format to enable them to make a decision whether to move into the home. People should have an asssessment of need carried out prior to them coming to live at the home so that they can be assured that their needs will be met. People who are funded by a third party should have a statement of the terms and conditions of residency including the fees to be paid and by whom. People should be able to choose from at least two options from the menu each day. People who live in the home should not have unsuitable or stained flooring in their bedrooms. The flooring in rooms 6,8 and 10 are in urgent need of replacement. People should not be exposed to the hazard of wheelchairs being left in corridors. The service should provide storage for wheelchairs. Staff should not be disinfecting commode pots by hand in the laundry room. The provider should give consideration to providing suitable sluicing facilities to clean commode pots and urinals. The provider should give consideration to an increase in domestic hours, including cleaning and laundry duties, provided by dedicated staff to keep the home clean and free from odours. Staff do not have an area where they can take breaks and change from outdoor clothes into their uniform. Care Homes for Older People Page 8 of 25 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 25 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 25 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home needs to understand the importance of having information about their service so that people can choose a home that will meet their needs and preferences. The assessment process is not thorough enough so that not all people are given consideration to their individual needs, concerns and anxieties before moving into care. Evidence: The service has a statement of purpose which provides basic information about the home. The guide is in a standard format and the content is clear. The new manager is working on a more suitable format and better presentation. The files of two people recently admitted were viewed. They did not have a thorough assessment of need by the home prior to admission. One person, admitted through funding arrangements, had a poor assessment by the placing authority which did not give the manager enough information to decide whether that persons needs could be Care Homes for Older People Page 11 of 25 Evidence: met before she made the decision to accept the application for admission and offer a place. A person also was transferred from the hospital without prior agreement by the home as to the date and time. However, admission assessments upon arrival to the home are good and person centred with attention given to preference and choice. The manager stated that in future, no person will be admitted without being seen by the home beforehand. An individual currently in hospital did have an assessment by the home to ascertain whether discharge back to the service was appropriate. This assessment identified that the needs had changed and that the home was no longer a suitable placement for this individual. Individuals are provided with a contract on admission. One funded by the local authority had a contract from that authority but the home had not provided them with a statement of terms and conditions. The manager agreed to address these omissions. Care Homes for Older People Page 12 of 25 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. Peoples care needs and risk assessments are set out in their individual plans of care which ensures that all care needs have been addressed and will be fully met. The manager understands the need to comply with safe medication systems and staff training ensures that the homes procedures are complied with and that residents health matters are safely addressed. The actions of staff and their approach to care ensures that people are treated with respect and their right to privacy is upheld. Evidence: Each person has an improved care plan. This is person centred detailing preferences and wishes on how they liked to be helped and how they like to spend their day. It gives a comprehensive overview of health and social needs and how the home will address them in relation to any risks this may pose. The plans have been completed with the individual or their family and signatures obtained to verify this. Bed rail risk assessments are complete as well as other generic risk assessments for the home and staff practice. Care Homes for Older People Page 13 of 25 Evidence: Staff administering medication have been trained to do so. Systems are in place to audit staff compliance with policy and procedure. One of the team leaders is responsible for dealing with medication records and checks. Each person in the home will have their medication reviewed every 6 months. Care Homes for Older People Page 14 of 25 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 are provided with social activity and can keep in contact with family and friends. Social, cultural and recreational activities meet peoples expectations through assessment, consultation and choice. Residents receive a healthy diet according to their assessed requirement and preference. Evidence: The service has held resident meetings and conducted satisfaction surveys. Minutes of these meetings are available in large print and are well attended. Changes to the service have been made as a result of these meetings, such as, improvements to the resources used for activities and revision of the menus. People tell us that they welcome the chance to be involved in the running of the home. A newsletter is produced. Activities recently enjoyed include: coffee morning, birthday celebrations, quiz, mobile library, underwear party. Residents have also expressed a preference for trips out when the weather improves. Two new cooks are in post who will be undergoing food hygiene training. The lunch for the day is displayed on a board in the lounge. It does not state an option to the main choice. The manager stated this will change as people should be offered a choice even if the staff are aware of individual likes and dislikes for food. Care Homes for Older People Page 15 of 25 Care Homes for Older People Page 16 of 25 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. The service has a complaint procedure which is accessible so that people who use the service have information of how to make complaints about the home. Training is provided so that service users are protected from abuse and have their legal rights protected. Evidence: People surveyed state that they would go to the manager or one of the staff if they had a problem. All expressed confidence that issues would be dealt with. The person centred approach by the manager and staff have given people the confidence to air their concerns. The use of bed rails is a form of restraint and staff have worked hard to involve people in the decision making process to use them. Full individual risk assessments were seen to be in the care plans. Care Homes for Older People Page 17 of 25 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The physical design and layout of the home should improve so that people live in a safe, better-maintained and comfortable environment. Evidence: Some aspects of the premises have improved and cleanliness is better. The service has obtained a grant to improve the bathrooms and toilets. However rooms 6.8 and 10 are in need of a new carpet. There is no storage for wheelchairs as several were seen left around the corridors which is a hazard and also obstructing fire extinguishers. The commode pots are cleaned in the laundry as the home does not have a sluicing facility which is not good hygiene practice. Domestic hours are vacant and are being filled by care staff. The domestic hours of 6 per week have been increased for a spring clean of the home. Odours were present at various points around the home. Care staff also do the laundry duties. Care Homes for Older People Page 18 of 25 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff care roles and responsibilities have changed so that they provide more personalised care with improved communication. The boundaries of these roles are not clear so that people who use the service may not be aware of when a member of staff is engaged in caring, domestic or laundry duties. Evidence: Staffing rotas are in place and assistance to achieve National Vocational Qualifications (NVQ) is provided with all staff now registered on a course. Staff files kept in the home evidence the induction process provided for new starters. Initial training such as infection control, manual handling, first aid and medication are provided. After induction, candidates are assessed for suitability to move onto NVQ training. Staff in the home have clear roles with team leaders in post. The keyworker role has been introduced and a relative commented that they appreciated having a named carer as communication is better. The residents know the staff very well and observation showed that they provide a personal and professional service. Staff are seen to attend to people discreetly. Visitors are welcomed into the home. Comments from surveys relayed satisfaction with the care from all staff. The owner should be sensitive to the fact that staff do not have an area where they can take breaks or get changed when they come on duty. They come to and from the home in their uniforms which is not hygienic. Care Homes for Older People Page 19 of 25 Evidence: Care staff carry out the domestic duties of the home as the current post is vacant. The manager stated this is an interim measure until the vacancy is filled. The team leader was seen hoovering after lunch and the manager had been cleaning a bath during the morning. Care staff also do the laundry which is off site. Care staff should not carry out ancillary duties and only be involved in direct care. A comment in a survey states the home is clean but the bedroom is less clean when carers are busy as they do the cleaning. Care Homes for Older People Page 20 of 25 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. The new management of the home is based on openness and respect. The service has quality assurance surveys in place so that people are assured that the overall conduct of the home is taking into account their views. Peoples opinions are more central to how the home develops and reviews its practice, and the service is developing appropriate ways of making sure they get things right. So, people have confidence in the care home because it is run and managed well. Evidence: The service has a new manager in post since 5/1/09. She has experience and is confident to manage the service. She understands the need to have a plan for the business and to monitor the quality of care provision. She finds out what people like by talking to them, involving them in their care and holding resident meetings so that any issues can be discussed. The manager is aware of the importance of making people safe and has improved the assessments for use of bed rails. Care Homes for Older People Page 21 of 25 Evidence: The AQAA contains clear information that is supported by evidence and informs us of changes needed to make improvements. The organisation monitors itself through monthly visits by the owner, quality audits and surveys to relatives and residents. People are supported to manage their own money and records are kept. People who use the service say that they trust the staff and feel safe in the home. Comments from surveys include I am with friends. Manager finds time to listen, I do not know how to complain but would know who to talk to if I am concerned about anything, Willing to discuss problems. The manager has introduced the concept of person centred thinking and including residents to shape the delivery of the service. The AQAA gave us clear relevant information supported by evidence which let us know about the changes they have made and where they still need to make improvements. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R 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 Care Homes for Older People Page 23 of 25 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 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 1 The service should provide a statememt of purpose that is more user friendly so that people have enough information in a suitable format to enable them to make a decision whether to move into the home. People who are funded by a third party should have a statement of the terms and conditions of residency including he fees to be paid and by whom. Assessment of need should be carried out prior to a person coming to live at the home. People should be able to make their choice of meal from a menu that displays a variety of options. The provider should review the flooring in peoples bedrooms and replace where stained and worn. Provide storage for wheelchairs so that they do not pose a hazard to residents. Provide suitable sluicing facilities to clean commode pots and urinals. The provider should increase domestic hours provided by dedicated staff to keep the home clean and free from odours and provide dedicated laundry staff. Page 24 of 25 2 2 3 4 5 6 7 8 3 15 19 19 26 26 Care Homes for Older People 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 © (2009) 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 25 of 25 - 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!