Inspection on 12/12/08 for Heatherwood Nursing Home

This inspection was carried out on 12th December 2008.

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

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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: Heatherwood Nursing Home 47 Foxley Lane Purley Surrey CR8 3EH     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: Janet Pitt     Date: 1 2 1 2 2 0 0 8 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. the things that people have said are important to them: They reflect 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: Heatherwood Nursing Home 47 Foxley Lane Purley Surrey CR8 3EH 02086606646 02086606646 info@heatherwood.org www.heatherwood.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Heatherwood Nursing Home Ltd care home 22 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The Registered Person may provide the following categories of service only: Care home with Nursing - Code N 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 - Code OP The maximum number of service users who can be accommodated is: 22 Date of last inspection Brief description of the care home 0 Over 65 22 Care Homes for Older People Page 4 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 peterchart Environment Staffing Management and administration Poor Adequate Good Excellent How we did our inspection: The Quality Rating for this service is two star. This means that the people who use this service experience good quality outcomes. One inspector undertook this unannounced in section. The home provided us with an Annual Quality Assurance Assessment [AQAA]. Information from this document has been used to inform the report. A site visit was made which lasted two and three quarter hours. During the visit records relating to care, staffing and training were inspected. Care Homes for Older People Page 5 of 25 People and staff who use the service were spoken with. What the care home does well: What has improved since the last inspection? What they could do better: 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 7 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 8 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that their needs will be assessed prior to them moving into the home. Information on personal interests and health needs are detailed. There are regular reviews of assessments this makes sure that changing needs are addressed. Individuals are informed what services are included in the weekly fee in their contract. Evidence: We examined the revised Statement of Purpose during our site visit. This document has been updated to reflect new ownership of the home. There is information within the Statement of Purpose on how equality and diversity will be promoted at Heatherwood, such as how a person will be able to practice their religion. Work is in progress on the service user guide to make sure it is revised and updated. The manager reported that the Statement of Purpose is available in large print or as a compact disc, to aid accessibility. Care Homes for Older People Page 9 of 25 Evidence: The manager reported that the new owner is reviewing contracts given to privately funded individuals. People place by local authorities have a standard contracts in place, that details terms and conditions. People are assessed prior to moving into the home by the manager and assessments include information on relationships and personal interests. A Standex systems is used which allows for a good assessment of health need. We noted that information received by placing authorities was included in the assessments. Individuals are involved in the assessment process and reviews of information held. Care Homes for Older People Page 10 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. People are supported to maintain independent skills. Their privacy and dignity is respected and end of life care is dealt with sensitively. Care plans are person centred and regularly reviewed with the involvement of the person. Individuals can be confident that medication is handled safely and records are accurate. This makes sure that they are protected from harm. Evidence: The homes AQAA indicated that people are encouraged to make their own decisions in all aspects of their daily care and life. Heatherwood also has a stringent privacy policy to make sure that individuals are respected. We found care plans to be person centred such as; offer [the person] water,soap, flannel and ask [them] to wash area [they] can. Care was generally taken with the language used;occasional forgetful episodes, but staff must avoid the use of the word refused as individuals are under no obligation to do things they do not want to do. Care Homes for Older People Page 11 of 25 Evidence: Individuals dietary preferences were noted and also clothing choices ie likes to wear trousers and blouse. We found evidence of people being treated with dignity in the plans. Entries included obtaining a persons consent prior to a need being met. Staff were observed to interact well with people. We saw staff talking politely with individuals and making sure they listened to what the person had to say. Care plans lead from assessments and were routinely reviewed. There was evidence of other health professionals involvement, such as the general practitioner and physiotherapist. Monthly risk assessments were in place and covered areas such as moving and handling, skin integrity and nutrition. Permissions for the use of bed rails were in place, but there needs to be a clear indication of why the rails are necessary. We noted that medications are stored safely and securely and accurate records maintained. The majority of medications are provided in blister packs, this assists with making sure there is a clear audit trail. End of life care is approached sensitively. The care plans indicates that individuals are ask about any specific wishes. If they do not want to discuss death and dying this is noted. Representatives of the person are also involved if needed. One person who lives in the home has suffered a bereavement in the past year. They said that staff had been supportive in helping them grieve for their loved one. Care Homes for Older People Page 12 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 who chose to live at Heatherwood can be confident that they will be able to continue with their interests. Contact with family and friends is maintained. There are suitable private and communal areas in which visitors can be received. Mealtimes are a social occasion and assistance is given when needed. People are consulted on the variety of food available and care is taken to make sure that alternatives are available. Evidence: Heatherwoods AQAA states that they have strong outreach links where [people] have a choice of outdoor visits, into the community, and their previous home environment. The home also recognises the importance of personal and social relationships. People who live in the home are able to participate in a variety of activities. Minutes of meetings with them evidence that they are involved in choosing what social events occur in the home. Records showed that the home has visiting entertainers, such as classical groups and entertainers. Plans were in place for those people who wished to celebrate Christmas and individuals were able to visit their families and friends. Care Homes for Older People Page 13 of 25 Evidence: Relatives spoken with had high praise for the home and said that they were able to visit freely and were informed of any incidents which affected their relation. they were also looking forward to spending family time with their relation over the Christmas Holiday. We found that if an individual wanted to have a daily paper this was facilitated, to enable them to maintain individual interests. Staff must do some further work on making sure that individuals life stories are documented, as this will assist in planning of activities. The home has links with a local church and we found that visits were made monthly by members of the church for a service in the home. Also the local Beavers group of children visited the home for events such as barbecues and carol singing. One person spoken with said that they were having their room redecorated and a sitting area being made in the room so they could see their visitors in comfort. This person also said that they go to worship at a local church. The manager reported that the conservatory is available for private visits or celebrations and improvements are to be made to the heating of this area, to enable it to be used more widely. The Statement of Purpose indicates that there are two main choices for lunch and alternatives are available. This was also noted from minutes of meetings where a discussion had been held with people in the home on food and some people commented that the alternative of an omelette was very welcome and enjoyed. We observed some people have a pre lunch Martini or sherry. People are able to chose where they take their lunch. Some people ate in the dining room, others in their rooms or the lounge. Staff were seen to be seated to assist those who needed help with their meals. Lunch was an unhurried and sociable occasion. Pureed food was well presented and all meals were of a suitable portion size. The home plans to buy a Nintendo Wii, as an aid to stimulate not only mental agility, but physical as well. This will broaden the range of activities on offer. Care Homes for Older People Page 14 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. People who live in Heatherwood can be confident that if they have any concerns these will be listened to and acted upon. People are protected from harm by Safeguarding policies and procedures. there have been no Safeguarding investigations. Staff are provided with up to date information on how to handled Safeguarding incidents. Evidence: The home states in its AQAA that the complaints policy is accessible and details timescale of when concerns will be responded to. Individuals are deemed able to make decisions unless proved otherwise. Examination of training records indicated that staff have received training on Safeguarding Adults. The manager reported that they are waiting to access local authority training for which there is a waiting list. We found that in the interim training had been achieved via use of DVDs and discussion with staff. Safeguarding had also been discussed at staff meetings, evidenced by the minutes. The manager said the policy had been reviewed in line with the local authoritys guidance and the paper Hidden Voices. This is in the process of being provided to all staff members. Care Homes for Older People Page 15 of 25 Evidence: Relatives spoken with said they had no concerns about Heatherwood and were confident that staff would address any issues they had. We have not received any concerns or complaints about the service. There have been no Safeguarding incidents reported to CSCI. Throughout the site visit staff were visible within the home and people spoken with said they had no concerns and found staff responsive. The manager reported that they have not received any complaints. Care Homes for Older People Page 16 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in an environment that is clean and tidy. They are able to personalise their rooms and are consulted on changes to the home. There is sufficient indoor and outdoor space for individuals to make use of, which is accessible and free from hazards. Evidence: During the site visit we made a tour of the premises. The home was clean and tidy on this day and free from unpleasant odours. Each persons room was personalised and had differing decor themes, reflecting their individual taste. The dining room had recently been redecorated and people who live in the home were consulted on the colour scheme, as evidenced in minutes of their meetings. There is suitable communal and private space. The garden is accessible and a new patio area has been laid. The manager reported that redecoration is ongoing and the new owner hopes one day to provide en suite facilities for people. Care Homes for Older People Page 17 of 25 Evidence: She also stated that work will be done on the conservatory to make it warmer and more user friendly, as it is not used much during the colder months. Suitable equipment was noted to be in place for moving and handling and pressure relief. No issues relating to health and safety were identified on the day of the site visit. The AQAA shows that necessary checks are made on the water, gas, electrical and lift provision within Heatherwood. There are plans for the Internet to be made accessible to people who wish to use it. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that their individual needs will be met by trained and competent members of staff. Appropriate recruitment procedures make sure that people are not placed at risk of harm. Evidence: We inspected staff files of people who had recently been recruited. All files were seen to contain the required information. Criminal records bureau checks, references and the persons employment history was on file. Previous convictions had been asked for on the application form and it is recommended that prospective employees are asked about any cautions they may have, as this will appear on enhanced disclosures. We discussed with the manager supervision of staff and clarified what elements can be discussed, for example personal issues which may affect the persons ability to work. This will help make sure that staff are supported appropriately in their role. We noted that there is an induction and training programme in place and staff are updated on areas such as first aid and moving and handling. Staff were easily identifiable on the site visit as they were smartly dressed in clean uniforms and had name badges. Care Homes for Older People Page 19 of 25 Evidence: The duty rota showed that the home has male and female care staff, two chefs and a housekeeper, as well as the manager. Sufficient numbers of staff were available to meet the needs of the individuals living in Heatherwood. The manager reported that the gardener also had responsibility as a fire marshall. 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. People who live in the home are listened to and actions taken if required. Plans are in place to make sure that quality assurance systems are accessible for everyone. Individuals live in a home that is free from hazards and well maintained. Evidence: There has been no change in the manager since the new owner bought the home five months ago. The transition has been smooth and people who live in the home have been consulted on future changes via their regular meetings. The manager is proactive in making sure that all peoples views are heard either through meetings or on an ad hoc basis. Minutes of both staff and residents meetings showed that adequate time was allowed for individuals to put their points of views across for consideration and discussion. Care Homes for Older People Page 21 of 25 Evidence: The manager reported that the new owner will be working on reviewing the Quality Assurance System that the home has and plans to redesign surveys as response has not always been good. As previously mentioned no issues relating to health and safety were identified. The manager reported that individuals maintain their own finances when able or representatives assist. The AQAA received clearly detailed the service provision and how improvements will be made over the next twelve months. 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 10 It is recommended that care is taken over the use of language used within care plans to make sure that people are able to have a choice in what they do. It is recommended that individuals life stories are detailed fully to make sure that they staff are able to know more about the person and plan activities accordingly. It is recommended that prospective employees are asked about any cautions when applying for a position. 2 12 3 29 Care Homes for Older People Page 24 of 25 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. 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