Inspection on 04/12/06 for Heathfield

This inspection was carried out on 4th December 2006.

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 17/07/08

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 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Heathfield 88 Hurst Road Horsham West Sussex RH12 2DX Lead Inspector Mrs K Allen Key Unannounced Inspection 4th December 2006 09:35 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.V316741.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.V316741.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 Heathfield (Horsham) Limited Ms Jennifer Mary Moone Care Home 36 Category(ies) of Old age, not falling within any other category registration, with number (36) of places Heathfield DS0000014558.V316741.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th September 2005 Brief Description of the Service: Heathfield is a care home providing personal care and accommodation for up to 36 older people. It is owned by Heathfield Horsham Ltd., a charitable organisation and celebrated its 50th birthday in October. 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 and a new replacement lift is currently being installed. There are 36 single bedrooms 12 of which offer en-suite facilities. Communal areas consist of a large sunroom, comfortable lounge and dining areas. The fees for the home are £311-£377 per week. Heathfield DS0000014558.V316741.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Prior to the inspection a review was made of the contact between the home and the Commission for Social Care Inspection (CSCI) since the last inspection. This included an analysis of incident reports and those of other statutory bodies such as the fire service. A pre-inspection questionnaire was completed and returned prior to the inspection which took place from 9.35am over six hours. During the inspection twelve residents were interviewed either in communal areas or in the privacy of their own rooms. Two visiting friends were also spoken to. Two care staff were interviewed as well as the manager. A discussion was held with the administrator and other staff were seen going about their duties. A meal was taken with residents and a number of records were seen. Residents said the home was “wonderful”, “I am perfectly happy”, “the staff are marvellous” and “food is very good with plenty of choice”. Three recommendations have been made. They are that the a record should be made of any restrictions placed on residents, risk assessments should be completed for all situations where individual residents are at risk and that the quality assurance system should be further developed. What the service does well: What has improved since the last inspection? The home continues to maintain a good level of service, which is appreciated by and is of benefit to all residents. A new lift is being installed. Heathfield DS0000014558.V316741.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 DS0000014558.V316741.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.V316741.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, 2, 3 & 6 Quality in this outcome area is good. Prospective residents have the information they need to make an informed choice about where to live. They have a written contract with the home. No one moves in without having their needs assessed. The home does not provide intermediate care. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a written Statement of Purpose and Service Users Guide, which is made available to all residents. A number of people said how helpful the Service Users Guide was in informing them of the homes routines and conditions of residence. Everyone has a written contract with the home, although in some cases this is held by a relative or other representative. Residents often come to the home for a short stay prior to deciding whether to move in or not. If they do move to the home then they are on a two-week trial and a full assessment is carried out over this period. Written records are kept Heathfield DS0000014558.V316741.R01.S.doc Version 5.2 Page 9 of this and they show that a comprehensive assessment is carried out taking account of physical needs as well as emotional and social needs. No one was at the home for intermediate care. The home does provide short stays and a room is dedicated for this purpose. Heathfield DS0000014558.V316741.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 good. Residents’ health, personal and social care needs are set out in an individual plan of care. They make decisions about their own lives with assistance as necessary and are protected by the homes medication procedure. Residents’ privacy and dignity are respected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A written care plan is available for all residents and it is updated every month. They participate in drawing up this document and are encouraged to sign to say they agree to it, which the majority do. One person had a particular interest in poetry and this was recorded and he was supported in this interests. Some residents were considered to be at risk of falls and one other to be at risk over consuming too much alcohol. However no individual written risk assessments were available or details of restrictions placed on residents. The manager confirmed that she considered everyone to be vulnerable and that the service operated with this in mind. None the less individual risk assessments should be carried out and recorded. Heathfield DS0000014558.V316741.R01.S.doc Version 5.2 Page 11 Most people are able to care for themselves with minimal input from staff. However, they confirmed that staff were available whenever they needed them. No one was suffering from pressure areas and precautions are taken to prevent these such as special cushions and encouraging residents to be active. Two people have a leg ulcer and these are being attended to by a community nurse. Access to routine health screening is available either at the home in the case of the chiropodist and dentist and via local services for the optician and hearing tests. Two people were in hospital and contact was being maintained by the home. The manager was due to attend a review of one person with a view to them returning to the home as soon as possible. The majority of residents have given their consent for the home to manage their medication although one person looks after their own. Good procedures are in place with regard to receipt, storage, administration and disposal of medication. A record is kept of all medication given to residents and this was up to date. Staff who administer medication are trained in safe practice. In conversation with residents they said that staff were careful to call them by their preferred name and that they maintained their privacy when they were helping them with personal care. One person said, “all the while I can bath myself they let me” and she evidently appreciated this. All residents have their own room and therefore a private place in which to see consultants, solicitors, family etc. Bathrooms and toilets are fitted with suitable locks. Residents have access to a telephone in private. Plans are in hand for Christmas celebrations and a Bazaar was held recently to raise money for the residents welfare fund. During this event staff ensured that residents’ rooms were secure. It was recognised, however that Christmas is not always a happy time for people and staff said that they tried to take individuals “sadness” into account over the festive period. Heathfield DS0000014558.V316741.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. Residents’ lifestyles match their expectations. They maintain contact with family, friends and the local community. They are helped to exercise choice and control over their lives and are provided with wholesome and appealing meals in pleasant surroundings. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents interests are recorded and the homes programme of activities reflect them. Each afternoon there are activities provided either by staff or external providers. They include music sessions, magician, bingo, board games, exercises and quizzes. One resident used the suggestion box to ask for art classes and this is now provided every two weeks. In addition, regular outings are arranged to places of interest or the theatre. Staff have time set aside each day for individual activities such as trips to the local shop and nearby park. There is a residents notice board which keeps everyone informed of events in the home for example building work, new residents and outings. Communion is held at the home regularly and some people attend local churches. Heathfield DS0000014558.V316741.R01.S.doc Version 5.2 Page 13 One resident said how much she appreciated having a vase of flowers on her breakfast tray when it was her birthday as well as a cake at teatime. Two visitors confirmed that they were always welcome at the home and that they can stay for a meal if they need to. One person said that the person she was visiting always liked to have a sherry before lunch and this has continued since she moved into the home. The home does not manage any residents’ financial affairs although some people do deposit small sums for safekeeping. It is stored safely and clear accounts are kept of all transactions. Residents and their representatives are provided with receipts as necessary. Residents were unanimous in their praise for the food. They were shown the menu in advance, were able to make choices and said that it was very well cooked and plentiful. Meals are served in the dining room, which is pleasantly decorated and spacious. It is a social occasion with staff waiting on residents. Special diets are catered for, as are those who need their food liquidised. Heathfield DS0000014558.V316741.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 good. Residents are confident that their complaints will be listened to and acted upon. They are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a written complaints policy and procedure which is made available to all residents. Comprehensive details are kept of all complaints, which are referred to the homes’ committee and resolved promptly. Action taken following a complaint is also recorded and followed up through the homes’ monitoring system. There is a written adult protection policy. Staff, including ancillary staff, receive training in the protection of vulnerable adults and they were able to describe the action they would take should they receive any such allegation. They were also clear about the signs and symptoms, which may indicate someone was being mistreated in some way. As previously stated the home has no dealings with residents financial affairs. Heathfield DS0000014558.V316741.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 & 26 Quality in this outcome area is excellent. Residents live in a safe and well-maintained environment which is clean and hygienic. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a routine maintenance programme and it was evident that the home is well maintained. It was light and bright with the whole environment being enhanced by pictures, ornaments and other artefacts. The grounds are well kept and enjoyed by residents. One person had just returned from the garden and said that she went out there each day, weather permitting. There is a well-equipped laundry situated away from food preparation areas. It has facilities for the washing of soiled linen and a wash hand basin in located nearby to prevent cross infection. The most recent report from the environmental health officer stated that “good standards of hygiene and food safety” were maintained. Heathfield DS0000014558.V316741.R01.S.doc Version 5.2 Page 16 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 good. The numbers and skill mix of the staff meets residents’ needs. They are in safe hands at all times and protected by the homes recruitment procedures. Staff are trained and competent. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a recorded rota showing which staff are on duty at any time during the day and night. This includes a full team of ancillary staff to support care staff. Residents said there was “always someone there if you needed them”. Staff considered that there were enough of them to do the job including spending social time with residents which was much appreciated. Over 50 of staff have a National Vocational Qualification (NVQ) thereby meeting the required standard. There is an ongoing NVQ training programme so that more staff may gain this qualification. In addition, the training programme provides for one off training in such areas as infection control, first aid and adult protection. The majority of staff have been at the home for some years however a thorough recruitment procedure is followed for new staff. This includes two references and a Criminal Records Bureau (CRB) check. Staff are employed on a trial basis following which they have an appraisal. They are issued with an employment contract. Heathfield DS0000014558.V316741.R01.S.doc Version 5.2 Page 17 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 & 38 Quality in this outcome area is good. The home is run and managed by a person who is fit to do so and in residents’ best interests. Their financial interests are safeguarded as is their health and safety. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager is suitably experienced and is currently studying for the Registered Managers Award (RMA). She has been at the home for five years and has support from an administrator and her assistant. Everyone is clear about the lines of accountability, which are clearly given in job descriptions. There is an annual development plan for the home, which includes all areas for example, meals, complaints, relative’s views, equal opportunities, ‘key working’ and the premises. This is reviewed regularly with tasks achieved being recorded. As previously stated the planned installation of a new lift is Heathfield DS0000014558.V316741.R01.S.doc Version 5.2 Page 18 going ahead and it is hoped that further en-suite facilities will be installed. Members of the committee monitor the home on a monthly basis and a survey of residents is done periodically. Following the last survey one person said “the staff are perfect –family not as good”. The manager responds promptly to recommendations made by the Commission for Social Care Inspection (CSCI) and agreed that the quality assurance system could be strengthened. The views of other interested parties such as visiting professionals and volunteers would enhance the information received and ensure that the home continues to operate in the best interests of residents. As previously stated, the management of the home is not involved in residents’ financial affairs. Any money deposited for safekeeping is managed by the administrator and is properly accounted for. Residents and their relatives receive regular statements from information kept on the homes computer system. Regular training is provided in safe working practices such as lifting, medication, first aid, food hygiene and infection control. Water temperatures are regulated and radiators covered. Regular checks are made on boilers and central heating as well as water temperatures and the risk of legionella. Fire fighting equipment is checked at the frequencies recommended by the fire service and a contract is in place for annual maintenance. There is an up to date fire risk assessment. All accidents are recorded. Heathfield DS0000014558.V316741.R01.S.doc Version 5.2 Page 19 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 3 3 3 X X N/A 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 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 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 4 X X 4 Heathfield DS0000014558.V316741.R01.S.doc Version 5.2 Page 20 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 3 Refer to Standard OP7 OP7 OP33 Good Practice Recommendations Risk assessments should be written up for all areas of risk, including falls. Any restrictions placed on residents should be agreed and recorded. The quality assurance system should be further developed. Heathfield DS0000014558.V316741.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 DS0000014558.V316741.R01.S.doc Version 5.2 Page 22 - 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. 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