Inspection on 03/05/07 for Heathfield

This inspection was carried out on 3rd May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 27/04/09

Heathfield 10/05/06

Heathfield 13/12/05

Heathfield 21/06/05

Heathfield 02/02/05

Heathfield 07/06/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Heathfield Cannell Green Norwich Norfolk NR3 1TT Lead Inspector Mr Pearson Clarke Key Unannounced 3rd May 2007 10:15 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 DS0000035281.V339630.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 DS0000035281.V339630.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Heathfield Address Cannell Green Norwich Norfolk NR3 1TT 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) 01603 612768 01603 614765 heathfield@norfolk.gov.uk Norfolk County Council Mrs Karen Sell Care Home 37 Category(ies) of Dementia - over 65 years of age (5), Old age, registration, with number not falling within any other category (32) of places Heathfield DS0000035281.V339630.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th May 2006 Brief Description of the Service: Heathfield is situated near to the centre of Norwich, in a quiet residential location close to Mousehold Heath. The service is operated by Norfolk County Council, providing residential accommodation for a maximum of 37 older people. Registration conditions stipulate that nursing care is not available and that of the 37 places, 5 may be offered to older persons suffering from dementia. Accommodation is on 2 floors in single rooms. The upper floor is served by a shaft lift and staircase. Service users have access to a pleasant, enclosed garden area. A day centre, providing specialist care for people suffering from dementia is attached to the care home. This centre has its own manager and staff, working there each week-day. The Heathfield service users and staff can make use of the centres facilities when the day centre is not operational. Those service users with dementia who are resident at Heathfield have a daily place at the centre where they take part in recreational and therapeutic activities designed to meet their particular needs. Local bus services pass in the vicinity of Heathfield and the railway station lies within walking distance. the current weekly fee level is individually assessed with a maximum of £368.72. Heathfield DS0000035281.V339630.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Care services are judged against outcome groups which assess how well a provider delivers outcomes for people using the service. The key inspection of this service has been carried out by using information from previous inspections, information from the providers ,the residents and their relatives, as well as others who work in the agency. This has included a recent unannounced visit to the agency and this report gives a brief overview of the service and current judgements for each outcome. What the service does well: What has improved since the last inspection? The service has continued to provide effective care and increased staffing now offers more opportunity to deliver good outcomes for all of those cared for. The development of a timed plan of improvement for the environment will soon lead to beneficial improvements in this area. Heathfield DS0000035281.V339630.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 DS0000035281.V339630.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 DS0000035281.V339630.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): 1 and 3 Quality in this outcome area is good. People living at the home benefit from a good pre admission assessment which helps reassure them that their needs will be satisfactorily met. The management needs to ensure that its systems for providing information about the home are robust and that everyone has the information needed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the site visit the inspector tracked two recent admissions to the home. From the paperwork concerned, views of staff, the manager and people living at the home, it was apparent that appropriate admissions are being made. The service management are carrying out pre admission assessments in addition to assessments made by social workers and the home encourages visits to the service as part of the admission process. It was apparent from some of the written comment received by the commission that some people felt that they Heathfield DS0000035281.V339630.R01.S.doc Version 5.2 Page 9 did not receive sufficient information as part of the admission process. The service ,manager confirmed that all of those living at the home had been provided with a service user guide and whilst it is likely that people have forgotten this, it is recommended that the manager considers ways to raise awareness of the guide within the home. Heathfield DS0000035281.V339630.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 Quality in this outcome area is good. The service has an effective care planning and medication management system which helps people receive the social , emotional and health care they need and wish for. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Prior to the site visit the inspector analysed the results of the providers visiting reports and these indicated that people living in the home have an awareness of their care plans and have been part of the care planning process. Tracking of a selection of plans by the inspector showed them to be well maintained with evidence of review and appropriate risk assessment in place. Written comment from residents showed appreciation of the care provided and people spoken to told the inspector they received very good care from kind and hard working staff. Health care professionals commented on the good standard of care provided at the home and from care records and discussion with residents Heathfield DS0000035281.V339630.R01.S.doc Version 5.2 Page 11 and staff it could be seen that health care needs are being effectively met. Everyone talked to was aware of the importance of privacy and dignity and felt this was effectively protected by staff. The arrangements for the management of medication were inspected and storage and records seen were satisfactory. The manager confirmed that there is an internal audit process carried out by her team which helps identify errors and issues. It was apparent that a recent practice issue had been quickly identified and effective action had been taken to resolve this. Heathfield DS0000035281.V339630.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 Quality in this outcome area is good. The home offers residents a relaxed atmosphere , good food and a reasonable range of activity. Contact with family and friends is successfully supported by staff and management. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People told the inspector that the home was a relaxed place to live and that they felt able to exercise choice and control over their day to day lives and this was supported by the providers visiting reports and observation on the day. A number of visitors were seen and all were positive about the home saying that they were always welcome and were kept informed about their relatives by helpful management and staff. Comment received about the food indicated that people are happy with the provision in this area and this concurs with the providers reports. There is a regular programme of activity , although in the inspectors opinion this is an area the service could strive for further improvement. Whilst people spoken to were happy with the levels of activity, Heathfield DS0000035281.V339630.R01.S.doc Version 5.2 Page 13 the inspector would encourage the consideration of ways to improve what is currently offered. Heathfield DS0000035281.V339630.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 Quality in this outcome area is good. People who live in the home are protected and feel able to raise complaints and concerns, knowing that any issues will be addressed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the site visit the inspector looked at the homes complaints record. This showed that there has been no extensive complaint activity and issues raised have been promptly addressed. People spoken to said that they felt no need to complain, however they were confident that should they need to do so their complaints would be properly addressed. The provider has a robust adult protection system with effective procedures supported by staff training. Heathfield DS0000035281.V339630.R01.S.doc Version 5.2 Page 15 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): 19,24 and 26 Quality in this outcome area is adequate . Residents live in a comfortable and clean home , which will be further improved when all aspects of the planned improvements are enacted. This judgement has been made using available evidence including a visit to this service. EVIDENCE: In many respects the environment was unchanged from that found at the last inspection. It continues to be clean with no odour and in general terms is comfortable and pleasant place to live. One significant issue arising from the last inspection was the inadequacy of the homes heating system and although this is unchanged an improvement plan has been submitted with work to replace the heating system due to commence in the near future. This plan also shows the intent to improve other areas of the home and facilities over the next few years some of which will relate to the plan to offer extended specialist Heathfield DS0000035281.V339630.R01.S.doc Version 5.2 Page 16 dementia care at the home. The majority of bedrooms are small when judged against current standards and whilst this did not provoke negative comment from people living at the home, staff acknowledged that safe moving and handling can be problematic . The service manager is aware of this and factors this into decisions about appropriate admissions. Heathfield DS0000035281.V339630.R01.S.doc Version 5.2 Page 17 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 Quality in this outcome area is good. People living at the home benefit from well trained staff, who have been safely recruited and are available in such numbers as to meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Discussions with staff, management and people living at Heathfield, showed that since the last inspection there have been improvements to staffing levels. As such there are now a regular number of staff on all shifts which enables more consistent cover of all areas of the home. It is clear that there still is a high level of dependency in the home and as a result the workload is heavy, however the inspector saw evidence of current recruitment which will ensure another member of staff on every night and a further person available between 9am and 5 pm. Taking all these factors in to account the inspector is satisfied that the home is staffed to meet need although the management needs to keep this issue under review. The provider continues to operate a robust staff recruitment system and sample employment records were inspected to evidence this. People living in the home clearly feel they receive very good care from good quality cares and this was supported by visitors to the home seen on the day. Staff records show the service has well trained staff and currently exceeds government targets in this area. Heathfield DS0000035281.V339630.R01.S.doc Version 5.2 Page 18 Heathfield DS0000035281.V339630.R01.S.doc Version 5.2 Page 19 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): 31,32,33,35 and 38 Quality in this outcome area is good. The home is well managed and residents benefit from an approach based on their needs and wishes in which their financial affairs and health and safety are appropriately protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Evidence from a variety of sources show the home to be well managed with strong and effective leadership. Written and verbal comment from residents, relatives and professionals indicate that the manage is effective and approachable. Staff spoken to stressed that the staff team are united and that they feel well managed and supported. The service has a quality system based Heathfield DS0000035281.V339630.R01.S.doc Version 5.2 Page 20 on survey and the inspector saw the action plan/analysis arising from this process. The plan does address issues arising, but in some areas it appeared that there was some drift and the management team need to revisit periodically to ensure that they are still on track. The provider continues to manage any financial matters relating to service users in a sound manner and sample records supported this. The provider has well established systems to promote and ensure health and safety and policies procedures and other records were seen and in conjunction with discussion with the manager demonstrated that this is a safe service. Heathfield DS0000035281.V339630.R01.S.doc Version 5.2 Page 21 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 2 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 x x x x 3 x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x 3 x x 3 Heathfield DS0000035281.V339630.R01.S.doc Version 5.2 Page 22 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 Refer to Standard OP1 Good Practice Recommendations That the management review ways in which it can be assured that all residents have available all of the information that they need about the services, both at the point of admission and on an on going basis. That consideration is given as to ways to further develop the activity and stimulation available in the home. 2 OP12 Heathfield DS0000035281.V339630.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 DS0000035281.V339630.R01.S.doc Version 5.2 Page 24 - 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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