CARE HOME ADULTS 18-65
Heatherstones 1a/1b Heatherstones Queensgate Halifax HX3 0DH Lead Inspector
Lynda Jones Unannounced 18 July 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Heatherstones J52J01_s1056_heatherstones_v239496_180705c.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Heatherstones Address 1a/1b Heatherstones Queensgate Halifax HX3 0DH 01422 369724 01422 369724 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) St Annes Mrs Julie Banks Care Home 7 Category(ies) of Learning and Physical Disability 7 registration, with number of places Heatherstones J52J01_s1056_heatherstones_v239496_180705c.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 5 October 2004 Brief Description of the Service: Heatherstones is a stone, purpose built bungalow, offering 24 hour nursing and social care to 7 service users with severe learning and physical disabilities.The interior of the building comprises; 7 single bedrooms, 2 bathrooms/ wcs. 2 separate wcs, 1 shower and toilet, 2 kitchen/ dining rooms, 2 lounges, 1 staff room and a laundry.The church and local shops are within walking distance and it takes approximately 5 minutes when travelling by car to the town of Halifax, and 10 to 15 minutes on foot. The home is also on a bus route. Heatherstones J52J01_s1056_heatherstones_v239496_180705c.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was carried out over a 4-hour period. The nurse on duty offered some background information about the service provided, as this was the inspector’s first visit to Heatherstones. Introductions were made to all of the residents who were at home and a sample of individual personal plans was examined. A tour of the building was undertaken and discussion took place with the service manager about the proposed building of a conservatory at the home. What the service does well:
The team of staff are dedicated to providing a high quality service to people with learning and physical disabilities. Assessments of prospective residents are detailed and time is taken to fully understand the needs of each individual. The prospective resident and their family determine the pace of introduction to the home. Detailed information is provided about the service that is available and when people move into the home they do so with a contract, which outlines what care and support will be provided. Healthcare needs are thoroughly assessed and evidence shows that the staff work alongside and take advice from a range of other healthcare providers with specialist skills. Care plans are detailed and the records show that these are reviewed regularly. The accommodation is pleasant and homely but at the same time it is equipped to meet individual moving and handling requirements. Every bedroom is different and people have lots of their own personal possessions around them. The participation of relatives in decisions about care and support, the way the home is run and in social activities is highly valued. The staff have a good understanding of each person living at the home and people are treated with dignity and respect. Staff are gentle in their approach and through their knowledge of individuals they are able to use their skills to communicate with residents and determine their immediate needs. Heatherstones J52J01_s1056_heatherstones_v239496_180705c.doc Version 1.40 Page 6 What has improved since the last inspection? 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. Heatherstones J52J01_s1056_heatherstones_v239496_180705c.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Heatherstones J52J01_s1056_heatherstones_v239496_180705c.doc Version 1.40 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4,5. Assessments are thorough and service users and their families have plenty of time to decide if the service suits their needs. EVIDENCE: From speaking to staff and from examining care plans it is clear that a lot of preparation takes place to help people decide whether they want to live at Heatherstones. There is evidence of some very detailed, good quality assessments being carried out. The records show that social workers and a range of health care providers are involved in the assembly of each person’s plan of care. Genuine efforts are made to get to know prospective residents and their families. The records demonstrate that care is taken to understand individual needs in detail and plans show that care is taken to help individuals continue with the lifestyle that they have already chosen for themselves. There is no prescribed timescale for the period in which people get to know the home, other residents and staff. The pace is entirely determined by each individual. Evidence shows that prospective residents visit the home frequently to test whether it is suitable for them. Individuals can increase the length of visits to the home to include an overnight stay to help increase their experience of the service. Heatherstones J52J01_s1056_heatherstones_v239496_180705c.doc Version 1.40 Page 9 Detailed information about the home and the service provided is made available to prospective residents and their families. Everyone has a contract, which gives details of the care, and support that will be provided. Heatherstones J52J01_s1056_heatherstones_v239496_180705c.doc Version 1.40 Page 10 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Not assessed in detail on this inspection. EVIDENCE: Heatherstones J52J01_s1056_heatherstones_v239496_180705c.doc Version 1.40 Page 11 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Not assessed on this inspection EVIDENCE: Heatherstones J52J01_s1056_heatherstones_v239496_180705c.doc Version 1.40 Page 12 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19,21. Personal support is delivered in private and in a way, which suits each individual. Individual wishes regarding illness and death are respected and people are treated with sensitivity and respect. EVIDENCE: From speaking to staff it is clear that personal care and support is provided sensitively and privately. Details of individual needs are documented in personal plans and staff try to ensure care is delivered with consistency in a way that is preferred by each individual. The staff know people very well and have a good understanding of the sort of routine that individuals like to observe. As such, individuals are supported to maintain the sort of daily routine that suits them. Continuity of support is also provided through the use of a key worker and named nurse system. Everyone living at the home is enabled to choose their own clothes, appearance and individual style that is in keeping with their personality and to make decisions about their lives. The staff team are experienced in working with individuals who have complex healthcare needs. From talking to staff it is evident that the team continually strive to update their knowledge and understanding of the health issues that
Heatherstones J52J01_s1056_heatherstones_v239496_180705c.doc Version 1.40 Page 13 arise. Evidence shows that extensive work is undertaken with a wide range of specialist healthcare providers to meet the needs of each individual. The records demonstrate that residents health is monitored regularly and that potential problems and complications are identified and dealt with promptly. The team have cared for a resident who recently passed away at Heatherstones. They have been highly commended by one of the health care providers who worked with the team for the care, commitment and compassion that they provided. Heatherstones J52J01_s1056_heatherstones_v239496_180705c.doc Version 1.40 Page 14 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Not assessed on this inspection. EVIDENCE: Heatherstones J52J01_s1056_heatherstones_v239496_180705c.doc Version 1.40 Page 15 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,27,28,29,30. The standard of the environment is good, providing residents with an attractive, well equipped and homely place to live. EVIDENCE: All of the bedrooms are single. Each one is pleasantly decorated and furnished to reflect the tastes of each individual. In some cases, relatives have been involved in helping to decide on the colour schemes and this involvement is welcomed by staff. In every room there is evidence that people are surrounded by their own personal possessions, many people have their own state of art music systems, TVs and DVDs. Residents have the specialist equipment they require to maximise their independence. Overhead tracking is fitted in a number of service users bedrooms and in communal areas, and the tracking meets the movement and handling needs of each person. The toilet and bathroom facilities meet the needs of the service users and offer personal privacy. Heatherstones J52J01_s1056_heatherstones_v239496_180705c.doc Version 1.40 Page 16 There are well-kept gardens to the front and rear of the building. Furniture that is appropriate for wheelchair users and other outdoor equipment is available for people to make use of in the good weather. Consideration is being given to providing an eighth place at the home, this will require some minor alterations within the building. A new conservatory is proposed which will give some extra communal space. The planning for this has been thoughtfully addressed to ensure that it can be fully used by all residents. Heatherstones J52J01_s1056_heatherstones_v239496_180705c.doc Version 1.40 Page 17 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Not assessed on this inspection. EVIDENCE: Heatherstones J52J01_s1056_heatherstones_v239496_180705c.doc Version 1.40 Page 18 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Not assessed on this inspection. EVIDENCE: Heatherstones J52J01_s1056_heatherstones_v239496_180705c.doc Version 1.40 Page 19 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23
ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score x x x x x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 x x x x x x x Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Heatherstones Score 3 3 x 3 Standard No 37 38 39 40 41 42 43 Score x x x x x x x Version 1.40 J52J01_s1056_heatherstones_v239496_180705c.doc Page 20 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 Heatherstones J52J01_s1056_heatherstones_v239496_180705c.doc Version 1.40 Page 21 Commission for Social Care Inspection Park View House Woodvale Office Park Brighouse HD6 4AB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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