CARE HOMES FOR OLDER PEOPLE
Heathfield 88 Hurst Road Horsham West Sussex RH12 2DX Lead Inspector
Jennifer Wright Announced 5 May 2005, 10:00 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 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 H60_S000014558_Heathfield_V220185_060505 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION
Name of service Heathfield Address 88 Hurst Road, Horsham, West Sussex, RH12 2DX Telephone number Fax number Email 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 Limited (Horsham) Ms Jennifer Mary Moone Care Home (CRH) 36 Category(ies) of Old age, not falling within any other category registration, with number (OP) of places Heathfield H60_S000014558_Heathfield_V220185_060505 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 2 December 2004 Brief Description of the Service: Heathfield is a care home providing personal care and accommodation for up to 36 older people, and is owned by Heathfield Horsham Ltd., a Charitable organisation The home is located in the outskirts of Horsham, close to shops and other local amenities. The home was opened in 1986 and consists of a two-storey building with well-maintained gardens. The home has 36 single bedrooms 12 of which offer ensuite facilities. There is a passenger lift, a large sun room, plus comfortable lounge and dining areas. Heathfield H60_S000014558_Heathfield_V220185_060505 Stage 4.doc Version 1.20 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was the first of a minimum of two statutory visits that an inspector must make to each care home during the course of a year. This was an announced inspection, made at 10am. which covered the morning, and afternoon shifts. A second inspection, which will be unannounced, will be undertaken later in the year. During this inspection the Inspector toured the building, visited every room, and joined the residents for lunch. As well as talking to the Manager and four of the staff members, the Inspector spoke at length to 17 of the 24 residents plus a District Nurse. Four visitors were also spoken to on the day of inspection about how they find Heathfield. The Inspector examined records about care being provided to residents; as well as records of any accidents, or concerns or complaints, to make sure that the residents at Heathfield are being taken care of. Prior to this inspection “comment cards” were circulated in order that people could make their views known to the Commission for Social Care Inspection. The comments made will be incorporated in this report. During the course of the day the Inspector was very ably assisted by the Manager Mrs. Moone, and the Administer Mrs. Worsell, and the inspector would like to thank both them, and everyone else who cooperated with her at this inspection. What the service does well:
Heathfield offers the residents who live there, good care, good food and the opportunity for some activities. The majority of the residents were spoken to or written to at the time of this inspection, and everybody who responded to the Inspector spoke very highly of the care on offer at Heathfield. The building is maintained safely, and is well decorated, with all relevant records in place to ensure the safety of the people living there. The inspector was assured by the Manager that staff training was very important at Heathfield, and it was seen that many of the staff members have worked at the home for many years. A District Nurse told the Inspector that she had no concerns with regard to the care being provided at Heathfield House. Heathfield H60_S000014558_Heathfield_V220185_060505 Stage 4.doc Version 1.20 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 full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Heathfield H60_S000014558_Heathfield_V220185_060505 Stage 4.doc Version 1.20 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 Standards Statutory Requirements Identified During the Inspection Heathfield H60_S000014558_Heathfield_V220185_060505 Stage 4.doc Version 1.20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,3,5 and 6 Prior to moving into Heathfield people were given sufficient information about what the home offers, to enable them to make a choice as to whether or not they want to live there. In addition before moving into the home, people are assessed, by a member of staff, in their own home or hospital whenever possible, to make sure they are suitable, and invited for a trial period. People know exactly what they can expect from Heathfield and what is expected from them. EVIDENCE: Some of the residents spoken to on the day of inspection confirmed that they had been given information all about Heathfield, and that they had been invited to visit the home before they came to stay. Some residents could not remember, but said that they were “very pleased they were here”. Residents told the Inspector that they would go to the Manager or the Administer if they had any queries, and had no complaints whatsoever about the way they were being looked after. The Inspector met with a District Nurse who said that she
Heathfield H60_S000014558_Heathfield_V220185_060505 Stage 4.doc Version 1.20 Page 9 had found the staff to be efficient and friendly. The Inspector looked at the care records of the residents, and found them all to be satisfactory. Heathfield H60_S000014558_Heathfield_V220185_060505 Stage 4.doc Version 1.20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10and 11 Where possible residents are involved with the drawing up of their care plans. All residents are informed of all services available under the National Health Service, and specialist equipment is provided where necessary. Correct medication procedures were seen to be in place, to protect the people living at Heathfield from harm, and from the comments made by many residents and a District Nurse, it would appear that the staff members respect the privacy and dignity of the people living at Heathfield. EVIDENCE: Where resident are not able to be involved with the drawing up of their care plans, then the residents relative or advocate is involved. This was confirmed by many of the residents who the Inspector spoke to on the day of inspection, one of whom said they “couldn’t fault anything”. A new bath has recently been installed, and a resident told the Inspector that she was” over the moon that she was able to take a bath herself”. Records of drug administration and maintained, and the correct procedures, relating to medication, were being adhered to. Mrs. Worsell confirmed to the Inspector that staff members administering medication had all received the appropriate training.
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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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14 and 15 People living at Heathfield are able to make the day-to-day decisions about how they want to live their life. There is a range of activities for those who wish to participate, and residents are encouraged to maintain contact with all their old friends and family wherever possible. The food is of an extremely high standard, and offers a choice of menu, with people able to eat either with other residents or in their own room should they prefer. EVIDENCE: Heathfield H60_S000014558_Heathfield_V220185_060505 Stage 4.doc Version 1.20 Page 12 There were a variety of activities on offer at Heathfield, and the majority of people told the Inspector that they felt that there was enough to do, should they wish it. One resident told the Inspector that the Manager took her to the local supermarket on occasions “just to have a look around”. On the day of inspection a young pianist from Christ’s Hospital School was playing the piano, which the residents were enjoying immensely. The Manager informed the Inspector that this was a regular occurrence. On the day of inspection the Inspector shared a meal with the residents, which was very tasty, attractive in appearance, plentiful, and clearly enjoyed by all. The inspector noted that the meal was served on hot plates, and in a way to encourage appetites. One resident told the Inspector that “the cook was really good” and another said that she “had no complaints whatever”. From direct observation, the Inspector noted that the mealtime appeared to be unhurried, with residents being afforded sufficient time to eat their meal. Where it was necessary staff members were seen to help residents in a sensitive and unobtrusive manner. Heathfield H60_S000014558_Heathfield_V220185_060505 Stage 4.doc Version 1.20 Page 13 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,17 and 18 Regular training sessions for staff, a complaints book, plus policies and procedures regarding abuse, ensure that, as far as is possible, the people who live at Heathfield are protected from bad practice. EVIDENCE: Not all complaints were recorded in the complaint’s book, although they had been recorded elsewhere, and were seen to have been addressed satisfactorily by Heathfield. Residents told the Inspector that should they have any concerns at all, then they would have no hesitation in going to any staff member, and know that they would be listened to. The Manager informed the Inspector that she operated an “open door policy, and residents are aware that they can always come to me whenever they want to.” Heathfield H60_S000014558_Heathfield_V220185_060505 Stage 4.doc Version 1.20 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 22, 23, 24 and 26 On the day of inspection Heathfield appeared clean and well maintained, and the location of the home is suitable for the residents who live there. Heathfield House was seen to provide a lift, aids, ramps and assisted bathing facilities. EVIDENCE: During the course of the inspection all of the rooms were visited to ensure that the environment was safe and comfortable for people who live there, and it was noted that many residents had brought personal possessions into the home, including small items of furniture, ornaments and photographs. Records were available to show that hot water from the taps of sinks, used by residents, is tested at appropriate intervals to ensure that people are not put at risk from scalding. On the day of inspection, Heathfield was seen to be clean, and free from offensive odours. Policies and procedures were available for staff regarding control of infection, and the safe disposal of clinical waste. Residents told the inspection how much they liked their bedrooms, and one said that their room “was the best bedroom I have ever had”, whilst another
Heathfield H60_S000014558_Heathfield_V220185_060505 Stage 4.doc Version 1.20 Page 15 said that they “couldn’t fault anything”. There is a large sun lounge at Heathfield that opens onto a well-maintained garden, which residents were sitting in on the day of inspection. The Manager informed the Inspector that some members of the committee are very active in the running of Heathfield, and one was seen to be attending to the flowers on the day of inspection. Another member irregularly changes all the pictures in the corridors, to offer the residents a variety. Heathfield H60_S000014558_Heathfield_V220185_060505 Stage 4.doc Version 1.20 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30 Heathfield is adequately staffed with employees who appear competent to care for older people. National Vocational Qualification is on going and further development training is expected. All training is recorded on staff member’s files. . EVIDENCE: Mrs. Worsell informed the Inspector that Heathfield is very committed to the training of their staff members. Many of the staff have worked at Heathfield for a long time, and staff members spoken to on the day of inspection told the Inspector that they felt “well supported by” the Manager, enjoyed their work, and felt that “we all work well together as a team”. One staff member said “I have worked in a number of care homes in the past, and this one is the best”. Residents told the Inspector that there appeared to be enough people on duty to assist them when they needed it, and that their bell was always answered when they rang it. A visiting District Nurse confirmed this. Heathfield H60_S000014558_Heathfield_V220185_060505 Stage 4.doc Version 1.20 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31. 32, 33, 35 and 38 Mrs. Moone, the registered Manager, is experienced in working with older people. Records needed for the safe running of a care home are kept up to date. Policies and procedures are available for staff members to refer to, to ensure the safety of the people who live and work at Heathfield. EVIDENCE: All the residents confirmed to the Inspector, that Mrs. Moone is extremely approachable and supportive. The staff members that the Inspector spoke to echoed this. Residents told the Inspector that they liked the way Heathfield was run. Visitors commented to the Inspector that Heathfield is “a bright, warm cheerful home, with high standards for meals and cleanliness” and a resident said that they “full of praise for all the care and attention” received.
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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. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x 3 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 3 14 3 15 4
COMPLAINTS AND PROTECTION 3 x x 3 3 3 x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 3 3 3 3 3 x 3 x x 3 Heathfield H60_S000014558_Heathfield_V220185_060505 Stage 4.doc Version 1.20 Page 20 no Are there any outstanding requirements from the last inspection? 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. 1. 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 18 Good Practice Recommendations That all known concerns of residents be recorded, plus any action taken relating to them. Heathfield H60_S000014558_Heathfield_V220185_060505 Stage 4.doc Version 1.20 Page 21 Commission for Social Care Inspection 2nd Floor, Ridgeworth House, Liverpool Gardens Worthing West Sussex BN11 1RY National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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