CARE HOMES FOR OLDER PEOPLE
Heathermount Mount Avenue Heswall Wirral CH60 4RH Lead Inspector
Inger Moynihan Announced 05 May 2005 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. Heathermount F52 F02 S0000018893 Heathermount V221363 050505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Heathermount Address Mount Avenue Heswall Wirral CH 0151 342 2175 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) Category(ies) of registration, with number of places Mr Robert Allan Mrs Lorraine Quinn PC Care Home 12 Heathermount F52 F02 S0000018893 Heathermount V221363 050505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: There are no conditions attached to the registration of this service. Date of last inspection 30/11/2004 Brief Description of the Service: Heathermount is registered to provide accommodation for twelve older people. The home is a detached three storey house set in its own grounds. The gardens are mature with a level footing which provides a safe environment for the service users. Patio furniture is also provided. There is a small car park with parking space for four cars at the front of the building. Accommodation for service users is provided on three floors with a passenger lift to all floors. Service users bedrooms have en-suite facilities which comprise of a toilet and washbasin. Specialised bathing facilities are provided on each floor. The communal facilities comprise of a lounge / dining room which has access to a small patio area and the garden. The standard of decoration throughout the home is very high. Heathermount is within walking distance of Heswall town centre which has a selection of shops, banks and restaurants. The town also has a bus station which gives easy access to Liverpool and other parts of the Wirral. Heathermount F52 F02 S0000018893 Heathermount V221363 050505 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place over four hours and was the statutory announced inspection for this service. A tour of the premises took place and service users’ records were inspected. A range of staff, six service users and three visitors (one relative and two friends of a service users) were spoken to during the inspection. What the service does well: What has improved since the last inspection?
The last inspection took place on 30 November 2004. No recommendations or requirements were made at this inspection. The registered manager and staff continue to provide a high standard of care for the service users with good quality assurance systems being in place.
Heathermount F52 F02 S0000018893 Heathermount V221363 050505 Stage 4.doc Version 1.30 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. Heathermount F52 F02 S0000018893 Heathermount V221363 050505 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 Heathermount F52 F02 S0000018893 Heathermount V221363 050505 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) 3,4 and 5. Service users are only admitted into the home on the basis of a full assessment which ensures staff can provide the appropriate package of care. EVIDENCE: An assessment of service users individual care needs is carried out prior to any service user being admitted into the home. This ensures the registered manager and staff team are able to meet the service users’ specific care requirements. Through discussion with the service users it was evident that their care needs were being met in every way. The service users spoken to confirmed they were completely satisfied with the standard of care they received and commented on the kind and caring nature of the staff group. Heathermount F52 F02 S0000018893 Heathermount V221363 050505 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 and 10. Service users health care needs are met through the care planning process. Appropriate facilities are in place the storage of service users medication which ensure service user safety. Service users privity and dignity is upheld is all times. EVIDENCE: Service users’ health, personal and social care needs are set out in an individual plan of care. This is in line with good practice and ensures staff know how to care for the service users in accordance with their particular needs. Service users confirmed they have access to their GP, chiropodist and district nurse to ensure their physical and mental well being. A record of this information is also kept so staff can monitor service users’ general welfare. This is further supported by a system whereby staff spend time each day discussing any issues or concerns that have arisen over the past 24 hours. All of these factors contribute to providing a safe environment for service users to live.
Heathermount F52 F02 S0000018893 Heathermount V221363 050505 Stage 4.doc Version 1.30 Page 10 Efficient systems are in place for the safekeeping and handling of service users’ medication. To ensure the close monitoring of this medication, only trained senior staff are allowed to administer medication. Documentation was in place to demonstrate staff have undertaken appropriate training in this area. All of the service users spoken to during inspection confirmed the staff team were polite, caring and helpful. Comments included ‘I feel extremely well looked after’, ‘the staff and manager are excellent, they are very helpful and kind’ and ‘the staff are very discreet when they help me with my personal care’. Heathermount F52 F02 S0000018893 Heathermount V221363 050505 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 and 15.The daily routines within the unit are flexible and service users can come and go as they choose. A varied and nutritious diet is provided with service users medical needs being catered for. A range of social activities are provided which service users may participate in if they wish. This provides a forum for service users to mix as a group and maintain mental stimulation. Service users experience reflects their social, cultural, religious and recreational needs. EVIDENCE: A range of social activities are provided which the service users confirmed they were free to participate in if they wish. A number of the service users confirmed the activities were appropriate and enjoyable. During discussion they confirmed their friends and relatives could visit at any time and they were free to go about their routines as they wished. The menus demonstrated a varied and balanced diet is provided with service users’ medical needs being catered for. All of the service users commented on how much they enjoyed the food and confirmed a choice was always available. Heathermount F52 F02 S0000018893 Heathermount V221363 050505 Stage 4.doc Version 1.30 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 standard(s) 16 and 18. An efficient complaint and adult protection procedure is in place to ensure service users safety and welfare. EVIDENCE: The home has a detailed complaints procedure which staff can access when necessary. The CSCI has not received any complaints about this service. A copy of the Wirral adult protection procedure is in place and staff have received training on this issue. This training is supported with an in-house training manual which all of the staff will be expected to read. The service users spoke highly of staff team said they had no complaints to make about the standard of care they received. They all commented on the caring nature of the staff team and said ‘the staff go out of their way to attend to my needs’. Heathermount F52 F02 S0000018893 Heathermount V221363 050505 Stage 4.doc Version 1.30 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 standard(s) 19,21, 22,25 and 26.The standard of the decor remains very high and provides a comfortable and pleasant environment for service users to live. EVIDENCE: The standard of furnishings throughout the home is very high and the grounds are well kept. An efficient cleaning system has been set up and a member of the domestic staff stated they had enough equipment and materials to carry out their work. Sufficient laundry facilities are in place along with systems to ensure the prevention of cross infection. It is clear the domestic staff are working very hard to ensure a high standard of cleanliness is maintained throughout the home. All of the service users spoken to commented on the high standards of cleanliness throughout the building. Service users have sufficient, toilet and washing facilities and there are adaptations and equipment to assist service users with their bathing and mobility. Service users’ bedrooms are safe and comfortable. In order to make their environment more homely, service users have brought items of their own furniture into the home and have personalise their rooms with their own belongings.
Heathermount F52 F02 S0000018893 Heathermount V221363 050505 Stage 4.doc Version 1.30 Page 14 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, 29 and 30. There are sufficient trained and competent staff to meet the service users needs. Thorough recruitment and selection procedures are in place to ensure service users safety and welfare. EVIDENCE: The staff rota indicated the staff were evenly deployed across the week to ensure service users’ care needs are met at all times and to ensure their safety and well-being. The staff spoken to during the inspection confirmed that a range of relevant training was available and that the registered manager encouraged them to become involved in training. Through discussion it was evident that staff had completed training relevant to the care of elderly service users. The staff spoken to confirmed procedures were in place to ensure their continual development within their role. The Abbeyfield Society have a positive approach to training and development which is a positive aspect of the home as it ensures service users are being cared for properly and their needs are being met in accordance with current good practice. This also allows staff to continue with their learning and keep up to date with current good practice in relation to the care of older people. Thorough recruitment and selection procedures are in place which include carrying out the necessary CRB disclosure checks. This ensures suitably qualified and competent staff are employed in the home and that service users’ safety is promoted..
Heathermount F52 F02 S0000018893 Heathermount V221363 050505 Stage 4.doc Version 1.30 Page 15 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) 33 and 38. The manager offers clear leadership to staff to ensures service users receive a high standard of care. Efficient systems are in place to ensure the home is run for the best interests of the service users. The health, safety and welfare of the service users is well promoted. EVIDENCE: Through discussion, the registered manager demonstrated she was aware of her responsibilities with regard to the management of the home, supervision of staff and the care of service users. The staff spoken to during inspection spoke highly of the registered manager and senior staff and said they were supportive and approachable. Efficient communication systems within the staff team have been established for the smooth running of the home; staff confirmed the systems are effective for the purpose of their role. The staff spoken to commented they worked well as a team and enjoyed their work. Discussion with staff confirmed that safe working practices were promoted within the home and that they were provided with appropriate training for this
Heathermount F52 F02 S0000018893 Heathermount V221363 050505 Stage 4.doc Version 1.30 Page 16 purpose. All of these issues demonstrate that a high quality of care continues to be provided at Heathermount. Heathermount F52 F02 S0000018893 Heathermount V221363 050505 Stage 4.doc Version 1.30 Page 17 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 3 x x 4 4 x HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 4 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 x 14 x 15 4
COMPLAINTS AND PROTECTION 4 x 4 4 x x 4 x STAFFING Standard No Score 27 3 28 x 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 4 x 4 x x 4 x x x x 4 Heathermount F52 F02 S0000018893 Heathermount V221363 050505 Stage 4.doc Version 1.30 Page 18 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 Heathermount F52 F02 S0000018893 Heathermount V221363 050505 Stage 4.doc Version 1.30 Page 19 Commission for Social Care Inspection 3rd Floor 10 Duke Street Liverpool L1 5AS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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