Inspection on 17/07/08 for Heathfield

This inspection was carried out on 17th July 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

Heathfield 04/12/06

Heathfield 12/09/05

Heathfield 05/05/05

Heathfield 02/12/04

Heathfield 13/05/04

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 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Heathfield 88 Hurst Road Horsham West Sussex RH12 2DX Lead Inspector Liz Palmer Unannounced Inspection 17th July 2008 10:00 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 DS0000014558.V367494.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 DS0000014558.V367494.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Heathfield Address 88 Hurst Road Horsham West Sussex RH12 2DX 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) 01403 254055 sue@heathfieldrch.co.uk Heathfield (Horsham) Limited Mrs Jennifer Mary Backelandt Care Home 36 Category(ies) of Old age, not falling within any other category registration, with number (0) of places Heathfield DS0000014558.V367494.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: 2. Old age, not falling within any other category - OP The maximum number of service users who can be accommodated is: 36 4th December 2006 Date of last inspection Brief Description of the Service: Heathfield is a care home providing personal care and accommodation for up to 36 older people. Heathfield Horsham Ltd., a charitable organisation, owns it. The home is located on the outskirts of Horsham, close to shops and other local amenities and consists of a two-storey building with well-maintained gardens. Both floors are served by a passenger lift. There are 36 single bedrooms 13 of which offer en-suite facilities. Communal areas consist of a large sunroom, comfortable lounge and dining areas. The fees for the home are from £350 per week. Heathfield DS0000014558.V367494.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. The inspection included a site visit to the home over a period of 3 hours. During this time three staff were interviewed and a senior carer and responsible individual (RI) assisted with the inspection. Three service users were met and spoken to privately, others were observed and spoken to during the inspection. A visiting community nurse was also spoken to about her opinion of the home. Care plans, medication records, policies and staff records were sampled. Other information used to make judgements about the standard of care in the home included the home’s Annual Quality Assurance Assessment (AQAA) that they completed and returned to us. We also looked at three surveys that residents returned to us, the last inspection report and other information received by us since the last inspection including notifications of any events in the home. What the service does well: The home is very clean and maintained to a high standard. It is well run and staff and residents are happy here. There is a relaxed atmosphere and a friendly rapport was noted between staff and residents. Care plans are clear and residents say their care needs are met at all times. They feel well looked after and safe in the home. Staff are well trained and work as a team. They are enjoy their work and turnover is low. There is plenty to do and the food is good. Heathfield DS0000014558.V367494.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Heathfield DS0000014558.V367494.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 DS0000014558.V367494.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 and 6 People who use the service experience good quality outcomes in this area. People who use the service are assessed to ensure that only those whose needs can be met are admitted to the home. Standard 6 does not apply. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The AQAA states that a comprehensive pre-admission assessment is undertaken before each admission. A two-week assessment period is then continued once someone moves in. Heathfield DS0000014558.V367494.R01.S.doc Version 5.2 Page 9 Considerable time is spent with prospective residents and their representatives to ensure all aspects of an admission are considered. Three pre-admission assessments were sampled. They all included full details of care needs and other relevant information about the person including their medical history, mental health needs, care needs, religious preferences, hobbies and interests, next of kin and the general practitioners (GPs) name and address. Heathfield DS0000014558.V367494.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 and 10. People who use the service experience good quality outcomes in this area. People who use the service have their health and personal care needs met. Arrangements are in place for the safe handling of medication. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three care plans were sampled. These are drawn up from the initial assessments. The care plans contain detailed information and are kept under regular review and changes are made as necessary. There was written evidence that medical assistance is sought when needed and residents confirmed they can ask to see a doctor if the need to. They said they felt well cared for and in safe hands. A visiting community nurse was spoken to about her experience of visiting the home. She has been coming to the home for eight years and spoke highly of the standard of care given consistently over Heathfield DS0000014558.V367494.R01.S.doc Version 5.2 Page 11 the years. She said staff always ring the surgery if they are concerned about a resident’s health and always follow the advice given by them. She gave examples of this and how this has benefited individuals in the home. The administration, storage and recording of medication was observed during lunchtime. The medication cabinet was seen to be suitably secure, clean and organised. No errors or omissions were seen on the records. The home uses a monthly blister pack system delivered by a local pharmacy. The member of staff administering has completed a distance-learning course in safe handling of medicines and was knowledgeable and competent. The procedure for controlled drugs was seen to be suitable. Policies on self-administration and controlled drugs are in place and accessible to staff. Arrangements are in place for those residents who wish to look after and administer their own medication. Risk assessments are in place for this. The residents spoken to all said they are treated with respect by staff that are always ‘polite’ and ‘loving’. They felt their privacy is respected and their dignity upheld when receiving personal care. Staff were observed on the day speaking in a polite and friendly way to residents. Heathfield DS0000014558.V367494.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 and 15. People who use the service experience excellent quality outcomes in this area. People have a wide range of activities on offer in the home and they are happy with the choices. The home provides wholesome food to suit the needs and tastes of residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A wide range of activities is available in the home. A notice board in the home lets people know what’s on offer. There is usually as activity every afternoon. The AQAA states that they ask residents what they would like to have provided and arrange these whenever possible. Residents can air their views and requests about activities at their regular meetings or via the questionnaires given out by the home. Usual activities include outside entertainers, movement to music, bingo, quizzes and theatre trips and coach outings. Residents’ birthdays are celebrated by the home and those spoken to say they have Heathfield DS0000014558.V367494.R01.S.doc Version 5.2 Page 13 enough to do and they always have the choice whether to join in or not. People are also encouraged to pursue their own hobbies and remain independent as far as possible. For example, listen to their ‘talking books’. Residents said their visitors are welcome and some residents have their own telephones to enable them to keep in touch with friends and family. People with diverse needs are provided with the support and equipment they need. For example, talking books and large button telephones for those with sight problems. Lunchtime was observed to be calm and relaxed. Residents said they enjoyed the food and there was always two choices. They said it was all home cooked and always tasty and well presented. Heathfield DS0000014558.V367494.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 and 18. People who use the service experience good quality outcomes in this area. People who use the service are able to complain and are protected by the home’s policies for safeguarding them. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A complaints procedure is displayed in the home. Residents spoken to say they know how to make a complaint and feel that any concern they may have would be dealt with by the staff or the manager. Residents gave examples of minor ‘niggles’ that had been speedily resolved to their satisfaction. Residents were observed making requests and expressing their views during the inspection. There was an open and relaxed atmosphere and staff dealt promptly with requests. Staff were asked about the homes procedure for safeguarding adults. They have received training and were confident about their responsibilities if they suspected any abuse or were told of any. The AQAA states that the home has incorporated the ‘Mental Capacity Assessment Toolkit’ into their procedures to ensure that all residents have an advocate in the event that their own decision-making ability is negatively affected or deteriorates on a more permanent basis. Heathfield DS0000014558.V367494.R01.S.doc Version 5.2 Page 15 Heathfield DS0000014558.V367494.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 and 26. People who use the service experience excellent quality outcomes in this area. People who use the service benefit from a clean and homely environment, which is well maintained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inside and outside of the home are maintained to a high standard. The garden is accessible to all residents with handrails and seating provided where needed. There is a routine maintenance programme and one resident commented how quickly and efficiently maintenance matters are dealt with. Residents say their rooms are cleaned regularly and staff were seen to be Heathfield DS0000014558.V367494.R01.S.doc Version 5.2 Page 17 wearing suitable gloves and aprons. Risk assessments are in place to promote the health and safety of residents and staff are trained in issues relating to health and safety. A resident commented on the high standard of hygiene promoted in the home. Hand rails are provided in the corridors and one new resident who is registered blind commented how quickly and easily they found their way around the home The home provides assisted Parker jacuzzi/baths for all residents with assistance if they want it. The AQAA states that the residents lounge seating has been replaced and rearranged in groups to try to avoid an ‘institutionalised ‘ atmosphere. This was seen on the day and residents were seen sat in small groups chatting to each other and staff in a very relaxed manner. The AQAA states that policies and procedures are in place in relation to infection control, clinical waste, fire safety and environmental health. The most recent report from the environmental health officer stated that “good standards of hygiene and food safety” were maintained. The home has a designated environmental health officer who regular undertakes assessments. Heathfield DS0000014558.V367494.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 and 30. People who use the service experience good quality outcomes in this area. The arrangements for recruiting staff protect the people who use the service. The training and support enables staff to carry out their roles confidently and competently. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the inspection there were suitable numbers of staff on duty to attend to the needs of service users and spend time with them socially. Residents spoken to said there were enough staff on duty during the day and night to meet their needs. They said call bells were answered promptly. Staff were observed interacting in a positive and respectful manner at all times. They responded to requests from service users and were caring and polite. The staff spoken to during the inspection were confident and competent at their jobs. They spoke confidently about the needs and preferences of service users. They said there is on going training provided including mandatory courses such as, first aid, food hygiene, infection control, health and safety, safeguarding adults and fire training which are provided to all staff. Comments such as ‘they are really good about training’ and ‘it’s fantastic, anything we need we Heathfield DS0000014558.V367494.R01.S.doc Version 5.2 Page 19 get’ were made. Staff turnover is low and moral is high at this home. The home has over 50 of its staff having or working towards NVQ level 2, or above. The home operates a robust recruitment procedure. The recruitment file of two new staff members was looked at. These contained the records required to meet the standards. For example; an application form two suitable references, a criminal record check and a protection of vulnerable adults check. A new member of staff was spoken to. They have undergone a three-month induction programme and have just started their NVQ level 2. The home rarely employs agency staff. Heathfield DS0000014558.V367494.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 and 38. People who use the service experience good quality outcomes in this area. People who use the service benefit from the home being well managed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The AQAA states that the manager is qualified to NVQ level 4 and has completed her registered managers’ award. Residents spoke highly of the management of the home and said they felt it is well run and they are in safe hands. There is a clear line management structure and regular, Regulation 26 visits are carried out by the committee members. The AQAA has excellent Heathfield DS0000014558.V367494.R01.S.doc Version 5.2 Page 21 information and states clearly the improvements they would like to make and how they will be achieved. The home undertakes their own quality assurance and they act on the things that people tell them. There is a clear line management structure and record keeping is of a consistently high standard. The RI works in the home most days and runs the office in an efficient and organised manner. Regulation 37 notices are sent to the Commission with regard to significant events in the home and the policy for reporting safeguarding is in place and accessible to staff. Staff have practice handbooks and access to all relevant policies and procedures. The home keeps up to date with new legislation and acts accordingly, for example implementing changes in relation to the Mental Capacity Act 2005. People are supported to manage their own money where possible. The home holds cash for some residents who require assistance. The administrator is responsible for this and collates all the records. The money is stored in a safe and arrangements are in place to ensure that residents can have access to their money at any time. Two balances were checked against the records, these were accurate. The AQAA states that the home has a policy on regular supervision for staff, every two months as well as annual appraisals. Staff said they are well supported and attend regular staff meetings where they feel they can air their views and be listened to. Residents said regular testing of the fire alarms takes place on a weekly basis. The AQAA states all other fire procedures are followed. Regular safety checks are undertaken to minimise risks to residents and staff. Heathfield DS0000014558.V367494.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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 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 X X X 3 STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 4 3 X 4 Heathfield DS0000014558.V367494.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. Refer to Standard Good Practice Recommendations Heathfield DS0000014558.V367494.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone 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. 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