Inspection on 13/02/07 for Heathfield

This inspection was carried out on 13th February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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.

Other inspections for this house

Heathfield 18/06/09

Heathfield 19/10/05

Heathfield 04/05/05

Heathfield 14/03/05

Heathfield 20/09/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Heathfield Canterbury Road Ashford Kent TN24 8QG Lead Inspector Mrs Sue Gaskell Unannounced Inspection 13th February 2007 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Heathfield DS0000023432.V326782.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Heathfield DS0000023432.V326782.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Heathfield Address Canterbury Road Ashford Kent TN24 8QG Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01233 610010 01233 623560 Mr Jason Prior Mrs Bonita Jayne Davis-Prior Mrs Shelagh Lewis Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (29), Physical disability (1) of places Heathfield DS0000023432.V326782.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Residents under the age of 65 to be restricted to (1) one with physical disabilities 19th October 2005 Date of last inspection Brief Description of the Service: Heathfield provides long term and respite accommodation, care and support to up to 29 older people and 1 person with a physical disability. The fees are in the range of £316-£415. Residents pay for hairdressing and papers, magazines etc. The Home comprises detached premises located in a residential area of Ashford within level walking distance of shops, medical centres, churches, a library and other local amenities. Further facilities are within a short drive. There are bedroom facilities on the ground floor as well as the first floor. Some bedrooms have en-suite facilities. The Home, which is accessed from within a housing development, has a well maintained garden available for residents use, and adequate car parking space within the grounds. Staffing comprises a registered manager, care manager, care, catering and domestic staff. Heathfield DS0000023432.V326782.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 13th February 2007, between 10.00am and 3.30pm. There were 28 people living at the home. I met five residents, one resident’s relative, the registered manager, care manager, and two care staff. I toured the building and looked at all communal areas. The residents said that they were happy for me to look in their rooms. The inspection process also consisted of information collected before and during the visit to the home, and feedback from a Care Manager after the site visit finished. Other information seen included general assessments, risk assessments and care plans, medication records, the duty rota and staff recruitment, training and supervision records. There were no outstanding requirements from the previous inspection and no requirements made following this inspection. What the service does well: What has improved since the last inspection? A walk in bath has been installed and 3 more bedrooms have been provided with en-suite facilities. Heathfield DS0000023432.V326782.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Heathfield DS0000023432.V326782.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Heathfield DS0000023432.V326782.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents know what services can be offered and can be confident that their needs can be met. EVIDENCE: The files of residents admitted since the last inspection include an assessment of their needs on admission. These assessments are carried out prior to admission, either in the residents’ previous home or when they had come to visit the home. There is also a range of supporting information from care managers. Heathfield DS0000023432.V326782.R01.S.doc Version 5.2 Page 9 All residents are issued with terms and conditions of residence and a service user guide. The service user guide also includes useful information on facilities in the area, eg accommodation and shops. Heathfield DS0000023432.V326782.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 & 10 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents’ care plans are reviewed and their health care needs are met. Residents are protected by the home’s policies and procedures for dealing with their medication. Residents are able to make choices and are treated with respect. EVIDENCE: Heathfield DS0000023432.V326782.R01.S.doc Version 5.2 Page 11 All residents have care plans. Four care plans were inspected in detail. They include assessments on various aspects of daily living including mobility, nutrition, and personal care needs. The files also include as much of the resident’s life history as possible, together with details about their medical needs, interests and likes and dislikes. The files are clearly set out and easily accessible to staff. Some residents have signed their care plan to acknowledge that it has been prepared according to their wishes. The care plans are reviewed regularly or as and when residents’ needs have changed. Although there are risk assessments and guidelines on how best to assist residents, they would benefit from more detail. Five residents and one resident’s visitor praised the staff and said that they are kind and helpful. One newer member of staff said that she asks residents how they prefer to be assisted. Two residents said that the staff are sensitive when assisting with personal care and that the staff are “smashing”. Medication administration records are clear and current, and there are sound systems in place for the receipt and disposal of medication. The home has a current copy of the medication guidelines and there are medication procedures at the front of the administration record file. Two members of staff confirmed that they have undergone recent and regular training. There is a notice in the kitchen to remind staff of the importance of ensuring that residents are not given food or drink which conflicts with their medication. The medication is stored securely in an appropriate place and is checked regularly by the pharmacist. Heathfield DS0000023432.V326782.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 & 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Daily life meets the residents’ lifestyle preferences and expectations. Residents have regular contact with their families and friends. Residents receive a nourishing and balanced diet. EVIDENCE: Heathfield DS0000023432.V326782.R01.S.doc Version 5.2 Page 13 Two residents said that they may come and go as they please. Another resident said that “it’s a home from home”. She also said that the staff are kind, helpful and respectful. Residents’ bedrooms are regarded as their own. Staff knock on bedroom doors and wait for permission before entering. Residents said that they enjoy a range of activities such as arts and crafts, sing songs, visiting entertainers and occasional outings to places of interest. There are also regular events such as coffee mornings and parties, such as the “valentine’s evening”. The staff keep a record of who has joined in each activity. One resident and another resident’s relative said that visitors always made welcome and offered refreshments or lunch. The food served on the day of the inspection appeared appetising and nutritious. There are two well decorated dining rooms and the tables were laid in an attractive manner. One member of staff made sure that residents were seated comfortably. There is a wide range of fresh fruit and vegetables in the food store, together with good quality food products. Residents and a visitor said that the food is always good and that tastes and choices are well catered for. There is a varied selection of food and hot and cold drinks available during the day and evening. One resident said that she often asks for something other than that on the menu and this is never a problem. Heathfield DS0000023432.V326782.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents can be confident complaints will be listened to and dealt with appropriately and they will be protected from abuse. EVIDENCE: The service user guide is issued to each resident and includes the home’s complaints procedure. All of the residents spoken to, and one resident’s regular visitor, said that they would feel comfortable in mentioning any complaints to the managers or staff. Three residents said that they “couldn’t think of anything to complain about”. Approximately 50 of the staff team are trained in adult protection awareness. Heathfield DS0000023432.V326782.R01.S.doc Version 5.2 Page 15 Two staff members said that they were aware of the home’s adult abuse procedures as it is covered in staff induction and discussed at team meetings. The homes policies and procedures manual and staff handbook include sections on confidentiality and “whistle blowing”. Heathfield DS0000023432.V326782.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents live in a safe, clean environment. The bedrooms, communal areas and garden provide an attractive environment. EVIDENCE: All parts of the building are clean and there are no obvious health and safety issues or hazards to residents. Heathfield DS0000023432.V326782.R01.S.doc Version 5.2 Page 17 The home is very well maintained and there is an on-going programme of improvement and decoration. The manager now has a purpose built office in a conservatory type extension. The does affect the garden space but there are still seating areas for the residents. The garden is well maintained and generally available for the residents to use Bedrooms and communal areas are decorated and furnished to a very good standard. Residents said that they had been able to bring as many items of furniture or other possessions as possible as long as it fitted comfortably in their rooms. There are two bedrooms on the ground floor, either side of the main entrance, where visitors to the home can see into the resident’s rooms as there are no net curtains. The manager is considering the best way to address this issue. Since the last inspection a walk in bath has been installed and three more bedrooms have been provided with en-suite facilities. The home has two other assisted bathing facilities and there are adequate hoists and specialist equipment available. Both of the staff interviewed said that they have regular training in health and safety, fire safety, food hygiene and moving and handling. They showed a good awareness of general health and safety issues, eg the importance of using gloves, aprons and hand-washing to avoid cross infection. All certificates are current and there are no outstanding maintenance or safety issues. Heathfield DS0000023432.V326782.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staffing numbers are appropriate to meet the daily needs of the residents. Residents are protected and supported by the home’s recruitment and induction training procedures. EVIDENCE: The staffing levels are adequate and appropriate to meet residents’ needs. One resident said that staff come quickly if she requires assistance. There is a low turnover of staff which has had a beneficial effect on staff competency and consistency. Heathfield DS0000023432.V326782.R01.S.doc Version 5.2 Page 19 The four staff files examined included application forms, references, CRB checks, and evidence of identity. Although there is less than 50 of staff with NVQ training there is evidence to show that the staff group as a whole have received sufficient training to compensate for this. One established member of staff said that the training is excellent. A less experienced member of staff said that she had received induction training prior to actually starting work and then received on-going training. Staff were seen to be caring and competent in the way they carried out their tasks. They said that it is important for residents to be able to say how they want things done. Staff referred to the high level of support from the registered manager, and the excellent working atmosphere. Heathfield DS0000023432.V326782.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35, 36 & 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The current management arrangements ensure that the home is being run in a way that benefits residents and staff. The record keeping, and health and safety systems are generally sufficient to safeguard residents’ welfare, rights and best interests. EVIDENCE: Heathfield DS0000023432.V326782.R01.S.doc Version 5.2 Page 21 The manager is very experienced and has recognised care qualifications. The management of the home and completion of records are generally of a good standard with daily records regularly checked by the registered manager. There are further checks by the owners as part of the monthly regulation 26 reports. Staff said that the residents are regularly asked for their views and feelings about activities, meals and how things are done. This is either through residents’ meetings or through questionnaires for residents and/or their families. The results of surveys are provided to residents, families, staff etc. Residents confirmed that any suggestions or feedback are acted upon. Other quality assurance methods include an annual business plan and achievement of the “Investors in People” award. Staff said that the manager and senior staff are supportive and that staff morale is good. The manager was very ready to praise the staff team. The manager acknowledges that there has been a lack of formal recorded supervision. She said that there is a lot of informal discussion about any issues which arise and that staff are appraised regularly. There are no obvious hazards around the home and there is evidence to show that health and safety issues are taken seriously eg risk assessments are carried out; staff ensure that personal items are appropriately disposed of; and warning signs are in place for wet floors. The maintenance file contains current certificates to show that regular checks eg gas, electricity, are carried out and there are no outstanding health and safety issues. Heathfield DS0000023432.V326782.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 4 X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 4 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 4 4 X X X 3 4 X 4 STAFFING Standard No Score 27 4 28 4 29 4 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 4 3 X 4 Heathfield DS0000023432.V326782.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? no STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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 2 Refer to Standard OP23 OP36 Good Practice Recommendations Provide means of ensuring residents’ privacy in ground floor rooms. Provide and record regular staff supervision. Heathfield DS0000023432.V326782.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: 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 © 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 Heathfield DS0000023432.V326782.R01.S.doc Version 5.2 Page 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!