Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 27/09/05 for Heatherdene Nursing Home

Also see our care home review for Heatherdene Nursing Home for more information

This inspection was carried out on 27th September 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home provides full information on the services and facilities provided. Residents and visitors spoke highly of the home and care provided by the care staff who were said to be `friendly` and `kind`. Care documentation confirmed that the medical and health care needs of residents are fully assessed and responded to. Heatherdene Nursing Home is a converted premise that provides a home like environment that is pleasant and well decorated. The home manager has an approachable manner and is responsive to residents, visitors and staff views.

What has improved since the last inspection?

The home has made good progress towards meeting the requirements made at the last inspection. The care documentation now records individual care needs and residents and their representative`s involvement in the planning of care. Ongoing redecoration is evident and disabled access to the garden has now been provided. Staff training is being developed and quality assurance measures that involve residents and relative`s views have been established.

What the care home could do better:

Although the communal areas are attractive and well used they need to be enlarged to meet the needs of all the residents in the home. Recruitment practice was found to be poor and not protecting vulnerable adults as staff were working in the home without a current Criminal Records Bureau /Protection Of Vulnerable Adults check being completed. Although staff training is improving further training needs to be established to ensure staff have the skills to fully meet all the needs of the residents in the home. Risk assessment on the use of door wedges during the day need to be completed.

CARE HOMES FOR OLDER PEOPLE Heatherdene Nursing Home The Highlands Bexhill on Sea East Sussex TN39 5HL Lead Inspector Melanie Freeman Unannounced Inspection 27th September 2005 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Heatherdene Nursing Home DS0000047280.V252239.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Heatherdene Nursing Home DS0000047280.V252239.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Heatherdene Nursing Home Address The Highlands Bexhill on Sea East Sussex TN39 5HL Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01424 224518 01424 212800 Mrs Zeenat Nanji Dr Tasneem Osman Stianand Baichoo Care Home 23 Category(ies) of Old age, not falling within any other category registration, with number (23) of places Heatherdene Nursing Home DS0000047280.V252239.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. The maximum number of service users to be accommodated is 23. That the care home provides general nursing care to older people over the age of 65. That rooms 5 and 15 are the only rooms used as shared rooms. That the communal space is improved to meet the pre commission Heath Authority standard by June 2005. That the bathing facilities are improved by June 2005. Date of last inspection 29th April 2005 Brief Description of the Service: Heatherdene is registered to provide nursing care for older people and accommodates both privately and those service users who are funded by social services.Heatherdene was originally a family home and has been greatly extended and adapted to its present use over the last 20 years.The home has 21 bedrooms 2 of which can be used for sharing and 6 of the single rooms have en-suite facilities. Heatherdene Nursing Home is situated on the outskirts of Bexhill on Sea, in a private residential road in an elevated position facing towards the sea, with attractive gardens on all sides.Heatherdene is owned by a family partnership that also owns and manages another care home in East Sussex. Heatherdene Nursing Home DS0000047280.V252239.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001 often use the term ‘service user’ to describe those living in care home settings. For the purpose of this report those living at Heatherdene Nursing Home will be referred to as ‘residents’. This report should be read in conjunction with the report of the inspection that took place on 29 April 2005 for an overview of the core standards inspected over the year. This was an unannounced inspection carried out on a weekday in September. The registered manager was on duty and was able to contribute to the inspection process and received the inspector’s feedback. The inspector spent most of her time with residents in the communal areas of the home and in individual rooms and spoke to 2 visitors who come to the home regularly. The inspector observed staff working and reviewed the recruitment files of 3 staff members. The care documentation pertaining to 3 residents were also reviewed in depth. The inspector toured the home and was able to review the facilities. What the service does well: What has improved since the last inspection? The home has made good progress towards meeting the requirements made at the last inspection. The care documentation now records individual care needs and residents and their representative’s involvement in the planning of care. Ongoing redecoration is evident and disabled access to the garden has now been provided. Staff training is being developed and quality assurance measures that involve residents and relative’s views have been established. Heatherdene Nursing Home DS0000047280.V252239.R01.S.doc Version 5.0 Page 6 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 Nursing Home DS0000047280.V252239.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Heatherdene Nursing Home DS0000047280.V252239.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 5 Heatherdene Nursing Home provides appropriate information about the home and the services it offers. Pre-admission procedures ensure residents can make an informed choice about the home. EVIDENCE: The home has a full and comprehensive statement of purpose and service users guide. This is available in the front entrance area. Further information including room sizes and resident’s views should also be included in this document. From discussions with residents and visitors it was clear that prospective residents are encouraged to visit the home prior to admission if at all possible. In reality it is often a relative who visits the home and the manager confirmed that this could be completed at any time. The most recently admitted resident conformed that the manager met with her before her admission and that her daughter visited the home. Heatherdene Nursing Home DS0000047280.V252239.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8 and 9 The home was found to be meeting service users health and general needs and accessed additional community support was being provided. Procedures and practice in the home allow for the safe administration of medicines. EVIDENCE: The care documentation of 3 residents were inspected in depth and these demonstrated that full assessments are completed and are used to inform the plans of care generated. The care documentation was found to be accurate, and to reflect the health care needs of residents, giving clear guidance to care and nursing staff. The care documentation reviewed confirmed regular review and that resident or their representatives are involved in this process. Risk assessments are being used to inform the care practice and are an integral part of the care documentation. The 2 visitors spoken to confirmed a high satisfaction with the care provided and residents spoken to were also happy with the care and staff in the home. Medicine administration charts were found to be accurate and signed, medicines were found to be stored appropriately and securely and practice seen at the time of this inspection was good. All unused medicines are collected and disposed of in accordance with new recommendations. Heatherdene Nursing Home DS0000047280.V252239.R01.S.doc Version 5.0 Page 10 During the inspection the inspector observed that staff were moving service users in a safe and competent manner with the use of appropriate equipment. Heatherdene Nursing Home DS0000047280.V252239.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13 and 14 Residents are enabled in maintaining links with people from outside the home. Resident’s choices are respected. EVIDENCE: Visitors spoken to during this inspection confirmed that they were always greeted and that they could visit the home at anytime. Links are maintained with local churches and schools who also visit the home. One resident confirmed that the home had arranged for him to continue his regular visits to a day centre. Resident’s rooms are personalised and are respected as their own space. Residents are encouraged to make choices and the inspector observed residents choices being respected and responded to. The home has a policy on advocacy and access to care notes. Heatherdene Nursing Home DS0000047280.V252239.R01.S.doc Version 5.0 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 Procedures in the home ensure that complaints made are managed appropriately. EVIDENCE: A clear complaints procedure is available in the home and a complaint form is used to record any complaint and the action taken in response. Visitors spoken to during the inspection confirmed that they felt comfortable to raise any issue or concern with the home manager or the administrator. They said that both responded to concerns immediately and positively. Heatherdene Nursing Home DS0000047280.V252239.R01.S.doc Version 5.0 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20 and 26 Heatherdene Nursing Home provides residents with a comfortable clean environment that is well decorated and home like. The communal space needs to be improved to promote resident choice. EVIDENCE: Heatherdene nursing home is a converted family home and has retained a homely looking environment. A tour of the home confirmed that a good standard of decoration is maintained throughout along with a good standard of cleanliness. The access to rear garden has been improved since the last inspection and one resident who uses a wheelchair confirmed that he was now able to enjoy the garden. The communal areas are well used and as identified at the last inspection these are to be improved in the near future as agreed with the new owners prior to their registration. During the inspection it was noted that the dining area were crowded at lunchtime, and did not allow for all residents to eat communally. Heatherdene Nursing Home DS0000047280.V252239.R01.S.doc Version 5.0 Page 14 All areas of the home were found to be clean and hygienic at the time of this inspection. Residents and visitors confirmed that cleaning is completed regularly and to a good standard. Heatherdene Nursing Home DS0000047280.V252239.R01.S.doc Version 5.0 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28 and 29 The homes recruitment procedures were found to be poor and did not ensure resident’s safety. Although staffing arrangements ensure appropriate numbers the number of hours worked needs reviewing along with staff training. EVIDENCE: At the time of this inspection 21 services users were living in the home. During the inspection the inspector reviewed the staffing rota and was concerned to note that some carers were working very long hours 1 carer working 72 hours in one week and another working 64 hours. During this inspection the recruitment files for 3 staff members were reviewed in depth. These indicated that 1 recently employed care staff had been working in the home without evidence that a CRB/POVA first check had been completed and without documentation confirming her identification. This was a serious shortfall and an immediate requirement form was left with the manager who was required to address this shortfall and to ensure that this care staff was fully supervised while working in the home until the necessary checks are completed. Residents and visitors complimented the staff saying they were ’kind’ and ‘friendly’. The home manager confirmed that no care staff currently have an NVQ at level to in care but staff are being facilitated in progressing NVQ training and are to start training in the near future. Induction training is completed and recorded. Heatherdene Nursing Home DS0000047280.V252239.R01.S.doc Version 5.0 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 and 35 The registered manager promotes a positive inclusive environment where staff residents and visitors are happy to consult with him and quality monitoring has been established. The homes procedures safeguard resident’s monies. EVIDENCE: It was clear when observing the manager’s interaction with residents that he is well known to them and that they responded very positively to him. Visitors spoken to also confirmed that they liked the manager and were able to discuss all matters with him. Quality assurance measures are being established and these include consultation with residents and responding to their comments. The manager confirmed that resident’s monies are not dealt with by the home and any extras are billed for directly on a monthly basis with receipts. Heatherdene Nursing Home DS0000047280.V252239.R01.S.doc Version 5.0 Page 17 During the inspection it was noted that some bedroom doors were being wedged open. Discussion with the home manager confirmed that all doors are closed at night in accordance with fire brigade recommendations. Heatherdene Nursing Home DS0000047280.V252239.R01.S.doc Version 5.0 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 x x x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 x 3 2 x x x x x 3 STAFFING Standard No Score 27 X 28 2 29 1 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 3 X X 3 X X 2 Heatherdene Nursing Home DS0000047280.V252239.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? no 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 OP20 Regulation 23(2) Requirement That the communal space is improved in accordance with agreement made with CSCI prior to registration That the staffing arrangements and the number of hours worked by carers is reviewed. That a thorough recruitment procedure is operated and includes securing a current CRB/POVA first check before allowing staff to work in the home. That training is established to meet the NTO work force training targets and that more care staff are trained to NVQ level 2. That risk assessments are completed on the use of door wedges. Timescale for action 01/12/05 2 3 OP27 OP29 18(1) 19(1) 01/11/05 01/11/05 4 OP30OP28 18(1)c) 01/02/06 5 OP38 13 01/11/05 Heatherdene Nursing Home DS0000047280.V252239.R01.S.doc Version 5.0 Page 20 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 OP1 Good Practice Recommendations That room sizes and residents views are included in the service users guide. Heatherdene Nursing Home DS0000047280.V252239.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection East Sussex Area Office 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. Extracts may not be used or reproduced without the express permission of CSCI Heatherdene Nursing Home DS0000047280.V252239.R01.S.doc Version 5.0 Page 22 - 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!