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Inspection on 20/04/05 for Heatherlea Residential Home

Also see our care home review for Heatherlea Residential Home for more information

This inspection was carried out on 20th April 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 residents were very positive about the staff and the care they give. One resident said ` The staff are really lovely, they are all kind and they always help me, in the day or at night.` Heatherlea offers a home where the preferences and wishes of each person are taken into account and respected. Residents are encouraged to make choices and they said they feel valued as individuals. The residents were very complimentary about the way the staff care for them and one person said `You couldn`t wish for any better home, in all areas, food, staff, rooms and care. The managers have a detailed knowledge about each resident and what they prefer and this information is effectively passed to the staff. The home is well managed and supervised and the records are clearly written and stored.

What has improved since the last inspection?

There were no outstanding requirements from the last inspection. The owners have improved the environment by decorating several of the communal areas and the residents are pleased with the results. The assistant manager has gained an N.V.Q level 4 managers award and learned a great deal from the experience. The interview process for prospective staff has changed by asking more questions and therefore offering better protection for the residents, and managers at the home. All of the homes policies and procedures and risk assessments have been reviewed and changed, if this was needed.

What the care home could do better:

The home needs to improve their systems for administering and recording medication. Records must be developed that give details of all residents allergies.

CARE HOMES FOR OLDER PEOPLE Heatherlea Residential Home Heatherlea House 109 Tor-o-Moor Road Woodhall Spa, Lincs LN10 6SD Lead Inspector Kima Sutherland-Dee Unannounced 20 April 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. Heatherlea Residential Home C53 C04 S2371 Heatherlea V222490 200504 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Heatherlea Residential Home Address Heatherlea House 109 Tor-o-Moor Road Woodhall Spa Lincolnshire LN10 6SD 01526 353394 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 Lesley Anne Sutherland Mrs Lesley Anne Sutherland PC Care Home 17 Category(ies) of Old Age (OP) - 17 registration, with number Dementia over 65 (DE(E)) - 5 of places Heatherlea Residential Home C53 C04 S2371 Heatherlea V222490 200504 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18.8.04 Brief Description of the Service: Heatherlea is a large converted house in the village of Woodhall Spa. Woodhall Spa offers local shops and other facilities and it is on a bus route for Lincoln and Horncastle. There is a local G.P surgery and the majority of residents do register with them. The home can care for up to 17 residents over 65 years old, who need help with their personal care, this can include up to 5 residents who have dementia. There are 2 double rooms that are currently only used by 1 resident in each, and the other rooms are singles. None of the rooms offer ensuite facilities, but there are bathrooms and toilets within easy reach of the private and communal rooms. The home is on two floors and there is a stair lift, there are both dining and lounge araes on each floor. The home has a statement of purpose which descibes the facilities and care that can be offered. Heatherlea Residential Home C53 C04 S2371 Heatherlea V222490 200504 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and during the visit the inspector spoke with 7 residents, 2 members of staff, the assistant manager and the manager who also owns the home. Three care plans were inspected and these gave the inspector information that was used to gather further evidence about the home and the care that is offered. A sample of other documents were seen where these were useful to give the inspector further information about how the home is managed. What the service does well: What has improved since the last inspection? Heatherlea Residential Home C53 C04 S2371 Heatherlea V222490 200504 Stage 4.doc Version 1.30 Page 6 There were no outstanding requirements from the last inspection. The owners have improved the environment by decorating several of the communal areas and the residents are pleased with the results. The assistant manager has gained an N.V.Q level 4 managers award and learned a great deal from the experience. The interview process for prospective staff has changed by asking more questions and therefore offering better protection for the residents, and managers at the home. All of the homes policies and procedures and risk assessments have been reviewed and changed, if this was needed. 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. Heatherlea Residential Home C53 C04 S2371 Heatherlea V222490 200504 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Heatherlea Residential Home C53 C04 S2371 Heatherlea V222490 200504 Stage 4.doc Version 1.30 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 standard(s) 2. Each resident is given an opportunity to discuss their terms and conditions with the manager and to sign a copy so they are fully aware of their rights and responsibilities. EVIDENCE: Copies of the terms and conditions were seen on 3 residents file and they had been signed. A resident said they had seen a copy and they did understand the content. Where a resident would not be able to understand their terms and conditions then a legal representative or a family member is asked to read and sign a copy. Heatherlea Residential Home C53 C04 S2371 Heatherlea V222490 200504 Stage 4.doc Version 1.30 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 standard(s) 7,8,9,10. The care plans offer the staff good information on which to base their daily care, and the residents health needs, privacy and dignity are met. The medication procedures need to change to ensure they are safe and clearly recorded. EVIDENCE: Each resident has a care plan which is holistic and detailed this informs the way the staff should care for each of them. The plans are used on a daily basis particularly when staff start at the home and they were getting to know each resident. Any changes to a persons care is recorded in the daily records,and this also includes the monthly reviews. The three care plans seen did include signatures, which show that the service users have been consulted. The residents said the staff help them to get the health care they need and the care plans did show that the staff record when someone is poorly,then seek medical attention and follow the advice or treatment. The home keeps some tablets that are not part of the main monitored dosage system. The recording charts state that these are ‘given as required medication’ but they are actually regularly prescribed. This could lead to dosages being missed and it is not a clear procedure. This has been the case for a long period of time and it reflects where these tablets are kept in the Heatherlea Residential Home C53 C04 S2371 Heatherlea V222490 200504 Stage 4.doc Version 1.30 Page 10 drug cupboard, rather than the times it should be given. One service user has a medication allergy which is recorded on the medication chart. This was not noted on the care plan although there is space provided for this. The residents said that their privacy is maintained when the staff assist them with personal care, and they were positive about the care the staff offer. The staff do knock on doors and they ensure that the door is always closed before helping someone with personal care, therefore privacy is maintained. Heatherlea Residential Home C53 C04 S2371 Heatherlea V222490 200504 Stage 4.doc Version 1.30 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 standard(s) 12,14,15. A variety of activities are available and residents are able to make choices about their participation. The food and drink offered is plentiful, of good quality and provided to suit the residents individual preferences. The residents have the opportunity to express their views in groups and privately. EVIDENCE: The residents preferences are written in the care plans and their views are respected. They said they enjoyed the activities that are on offer and they can choose whether to join in. One resident pointed out the activities list that is put up on the lounge doors and they described the activities that had taken place recently. Each resident is consulted about their likes and dislikes and they have the opportunity to express their views and offer ideas at the residents meetings. During lunch the staff were kind and caring, they displayed patience and an understanding of the communication needs of each person. The meal was home cooked, tasty and of good quality. The residents all said they like the food every day and they have choices. There is variety, a good quantity and it is well presented. The residents are offered snacks and drinks during the day and it was observed that a poorly resident was encouraged to drink enough fluids. Heatherlea Residential Home C53 C04 S2371 Heatherlea V222490 200504 Stage 4.doc Version 1.30 Page 12 The managers have recently made efforts to assist a resident to make a choice about staying at the home or moving and they have contacted the relevant professionals for advice and support. The residents said the staff and the managers spend time talking with them and they are very kind. Heatherlea Residential Home C53 C04 S2371 Heatherlea V222490 200504 Stage 4.doc Version 1.30 Page 13 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 An open approach to receiving complaints means that the residents are comfortable discussing any concerns with the managers or staff. The procedures are in place to deal with complaints effectively. EVIDENCE: The complaints book records any complaints and how these were responded to, the managers have taken appropriate action and no new complaints have been received in the last 12 months. The residents stated that they have no cause for complaint, but they said if they did they would be happy to talk to the manager. The staff were aware of how to respond to any complaints and the manager said they are happy to receive complaints if this lead to improvements in the service. Heatherlea Residential Home C53 C04 S2371 Heatherlea V222490 200504 Stage 4.doc Version 1.30 Page 14 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) 20,21,23,24,25,26 Both private and communal space is suitable for the residents, homely and comfortable. The residents should be protected from the potential hazards and risks of cigarette smoke. EVIDENCE: The home has assessed the communal areas and the private rooms to ensure the residents are protected from risk wherever possible. The records show that where risks are identified they are minimised. Each radiator is covered to minimise the risk of burns. The bathrooms are well maintained and they are in suitable locations throughout the home to enable access for all the residents. When the staff need to assist the residents to bathe, they are trained to use the suitable equipment that is provided. One resident said that the staff are kind and considerate when they help them to have a bath. One resident showed the inspector their room ,they had their own furniture and personal items and the room was well decorated. Heatherlea Residential Home C53 C04 S2371 Heatherlea V222490 200504 Stage 4.doc Version 1.30 Page 15 The provider employs domestic staff and the home was clean and pleasant apart from the smell of smoke in one corridor coming from the staff room. None of the residents mentioned this as a problem. Heatherlea Residential Home C53 C04 S2371 Heatherlea V222490 200504 Stage 4.doc Version 1.30 Page 16 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) 27,28 There are sufficient staff to care for the residents, The staff are trained, competent and they undertake an induction when starting at the home. EVIDENCE: Two members of staff said that they received an induction and that they have the opportunity to attend regular training courses. The training record confirms that courses are booked and attended. One staff member said that they attended medication administration course in September 2004 and they were able to describe what medication the residents took and why. The staff do have time to look at the policies and procedures and to discuss how they should be used. The staff also said they have time to talk to the residents. During the discussion a member of staff left the room to help a resident who had become confused. It was observed that this was done with care and patience, and the resident was supported fully before the member of staff returned to the inspector. 2 Members of staff were on duty as well as the manager and domestic staff. The residents said that the staff had time to care for them and they never had to wait long for help. Heatherlea Residential Home C53 C04 S2371 Heatherlea V222490 200504 Stage 4.doc Version 1.30 Page 17 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) 31,32,33,36. The home is managed competently and the staff are supported and supervised to carry out their roles. The residents are involved in contributing to the running of the home. EVIDENCE: The manager and the assistant manager are competent through their experience and qualifications to run the home and they work closely as a team. The assistant manager has completed the N.V.Q managers award. Staff said they are well supported and they are confident to approach the managers with concerns or ideas. The minutes from the recent residents meeting show that residents do contribute and raise issues, and that action is taken to address these. The home conducts regular surveys to monitor quality and the results have been very positive. Heatherlea Residential Home C53 C04 S2371 Heatherlea V222490 200504 Stage 4.doc Version 1.30 Page 18 The assistant manager supervises the staff both formally and during every day observation. Annual appraisals take place and the format of these has recently been improved. Heatherlea Residential Home C53 C04 S2371 Heatherlea V222490 200504 Stage 4.doc Version 1.30 Page 19 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 3 x x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 3 COMPLAINTS AND PROTECTION x 3 3 x 3 3 3 2 STAFFING Standard No Score 27 3 28 3 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 3 3 3 x x 3 x x Heatherlea Residential Home C53 C04 S2371 Heatherlea V222490 200504 Stage 4.doc Version 1.30 Page 20 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 OP9 Regulation 13(2) Requirement The home must clearly define which medication is prescribed regularly and which is to be given as required (PRN) they must be kept in seperate areas of the medication cupboard, and clearly recorded on the administration sheets. When a medication is prescribed PRN there must be a protocol to descirbe when it should be given, under what circumstances and the dosage. The home must identify all the residents who have known allergies and these must be recorded in both the care plans and on medication charts. Timescale for action 30th May 2005. 2. OP7 13(4)(c) 30th May 2005. 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 OP26 Good Practice Recommendations The providers should eliminate cigarette smoke odour from the areas used by the residents, including the corridors. C53 C04 S2371 Heatherlea V222490 200504 Stage 4.doc Version 1.30 Page 21 Heatherlea Residential Home Commission for Social Care Inspection Unity House, The Point Weaver Road Lincoln LN6 3QN 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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