Inspection on 02/08/05 for Heathfield Gardens

This inspection was carried out on 2nd August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 Gardens 11/06/08

Heathfield Gardens 25/06/07

Heathfield Gardens 12/12/05

Heathfield Gardens 17/01/05

Heathfield Gardens 06/09/04

Heathfield Gardens 17/09/02

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Heathfield Gardens 163-165 High Street Tibshelf Chesterfield Derbyshire, DE55 5NN Lead Inspector Ivan Barker Unannounced 2 August 2005 nd 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 Gardens C02 C52 Heathfield S2058 V242673 020805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Heatfield Gardens Address 163-165 High Street Tibshelf Chesterfield Derbyshire DE55 5NN 01773 872229 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) MGB Care Services David Ridley Care Home 10 Category(ies) of LD - Learning Disability - 10 registration, with number of places Heathfield Gardens C02 C52 Heathfield S2058 V242673 020805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: none Date of last inspection 17/01/05 Brief Description of the Service: The home is situated within the rural community of Tibshelf, Derbyshire, which provides many local facilities. Many of the service users access these local facilities within the village. The home consists of two converted adjoining houses to provide one registered home, which provides nursing care for 10 service users with learning disabilities. There are two lounge/ dining rooms and bedrooms are situated on the ground and first floor. There is the provision of a minibus and local transport. Heathfield Gardens C02 C52 Heathfield S2058 V242673 020805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The person present at the inspection was: Miss Alison Stafford, deputy manager. Within this inspection, which occurred over a three and half hour, the inspector toured the building, spoke to service users, and staff and examined the care plans and other documentation. He spoke with 9 service users during the inspection. What the service does well: What has improved since the last inspection? What they could do better: The registered person must comply with the requirements relating to the furnishings, record keeping and provision of a risk assessment, within the specified timescales. Heathfield Gardens C02 C52 Heathfield S2058 V242673 020805 Stage 4.doc Version 1.40 Page 6 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. Heathfield Gardens C02 C52 Heathfield S2058 V242673 020805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Heathfield Gardens C02 C52 Heathfield S2058 V242673 020805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2, 5 Full assessments should mean that the home is aware and able to meet the needs of the service users. EVIDENCE: On examination of the assessment process, the inspector established that full needs assessment were undertaken by the home and the contracting unit, prior to admission and that individual contracts were drawn up by Health and Social Services were based upon these assessments. The inspector recognised that the service users had resided within the home for some time, because of this fact new assessments were not undertaken. Heathfield Gardens C02 C52 Heathfield S2058 V242673 020805 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 Accurate care plans will contribute to the delivery of care. Regular reviews on the methodology used will assist in enhancing the quality of care and service provision. EVIDENCE: The deputy manager showed the inspector the new care plan documents that had been developed. She identified that the care plan review had taken place as the staff were of the opinion that the documents could be more service user centred. The new documentation contained several pictorial symbols to assist the service users, when their care plan was being discussed with them. The documentation was extensive, it covered the service users activities of daily living, the specific needs of the individual, how these identified needs were to be met, and an evaluation of the action / intervention. The plans were reviewed on a monthly basis. The deputy manager identified that there was still some work to be done to fully complete the document. As the document meets the expected standard a score of 3 was awarded, if the document had been completed then a score of 4 would have been warranted. Heathfield Gardens C02 C52 Heathfield S2058 V242673 020805 Stage 4.doc Version 1.40 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,17 The quality of the service users lives will be enhanced by the opportunities to maintain contact with the community, and participate in their hobbies and interests. Dietary needs of the service users are well catered for with the service users having the opportunity to make their own choice of meal. EVIDENCE: There was evidence that the service users’ regularly visited the facilities in the local community, for example workshops, training centres, colleges, clubs etc. The placement of the service user, to such facilities, is co-ordinated through the social worker or contracting unit. The inspector obtained the service users’ view on these placements, all identified that they enjoyed the placements. Each service user had an individualised programme for their social activities, which planned out the service user’s activities for each week. Several service users were members of local leisure clubs, for example motorboat club. Some service users attended the local leisure centre for swimming. Heathfield Gardens C02 C52 Heathfield S2058 V242673 020805 Stage 4.doc Version 1.40 Page 11 Several service users took the opportunity to go on holiday. The deputy manager informed the inspector that some of the service users had made friends at the colleges or clubs that they attend, and visitors were welcome to the home. The service users had access to a minibus, however the use of public transport was promoted so as to encourage a more independent lifestyle, for the service users. The inspector discussed the provision of meals with the cook and deputy manager. The inspector was shown evidence of the menu planned for the day of the inspection. The choice of meals was discussed with the service users. They informed the inspector that they had been asked that morning what they would like for dinner and that their requests would be provided. The inspector discussed the service users’ comments with the cook, who informed the inspector that the service users could have any meal in the freezer, or if she had enough notice her or a member of staff would purchase it from the nearly shop. An endearing phrase that the inspector heard throughout the inspection referred to the service users as ‘The Lads’. (The service user group is of 10 younger men). Heathfield Gardens C02 C52 Heathfield S2058 V242673 020805 Stage 4.doc Version 1.40 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19, 20 The staff gave the service users plenty of opportunity to express their own individual choices. The systems for the administration of medications are poor in the areas relating to the accountability of staff signing documents. EVIDENCE: The information within care plans indicated the service users preferences and specific care needs, both physical and emotional. At the time of inspection, four service users were ‘getting ready’ to go on an outing to the Sherwood Visitors Centre, in Nottinghamshire, which was having a festival. Two service users were particularly excited to go and see the archery. During this process of ‘getting ready’ the inspector heard the care staff offer the service users the choice of wearing their sunglasses and baseball caps. Three service users expressed a choice of wearing both items, and one just chose his cap. The inspector would commend the action of the staff as clearly there was dialogue with the service users, giving them the opportunity to express their choices. Heathfield Gardens C02 C52 Heathfield S2058 V242673 020805 Stage 4.doc Version 1.40 Page 13 On discussing this with the deputy manager, she produced the minutes of the previous service user meetings. Within these minutes it was clearly documented that the service users had had the opportunity to express their opinions including their likes and dislikes. At the last meeting the minutes indicated that they had discussed Christmas and Christmas day, and what activities ‘the lads’ would prefer and whether they would prefer a traditional Christmas dinner and buffet. The deputy manager informed the inspector that although it was not pertinent at the moment, the staff had attended a Palliative care course, which all staff had found it very interesting, and staff were of the opinion that they had learned another skill to assist them in providing good care to the service users. Regarding medications, there was no signature (ownership) of some of the hand written medication entries. Should an error occur it would be difficult to establish the individual who recorded the unsigned entries. All hand written entries should be signed. Heathfield Gardens C02 C52 Heathfield S2058 V242673 020805 Stage 4.doc Version 1.40 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 0 These standards were not assessed, at this inspection. EVIDENCE: Heathfield Gardens C02 C52 Heathfield S2058 V242673 020805 Stage 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,30 The environment, monitored at this inspection, had not been maintained to the required standard to provide a safe, well-maintained environment for services users. EVIDENCE: On touring the building the following was found: Within room 5, the carpet had a hole in approximately 5 cms in diameter. A rug had previously hid the worn area of the carpet, unfortunately at the time of inspection the rug had been moved to expose the worn area. The option of fitting a small insert of carpet was discussed. The inspector recommended that the manager consult with a carpet fitting company. Within room 8, there were several areas where the carpet had frayed. On discussing this with the service user, he indicated that he would like a new carpet, and asked if it could be ‘a red one’. The information was passed onto the deputy manager. Within the ‘quiet room / handover room’ the carpet was excessively stained. The deputy manager identified that there had been a number of spillages on Heathfield Gardens C02 C52 Heathfield S2058 V242673 020805 Stage 4.doc Version 1.40 Page 16 the carpet, and there had been discussion with the manager regarding the replacement of this carpet. Despite the findings stated above, the inspector also found the bedrooms had been extensively personalised by each service user, and reflected the age group of the service user i.e. men in the approximate age range of 20-45. The service user had chosen the colour schemes of their bedrooms. The rooms contained posters of pop stars, football teams etc, and stereo systems, televisions etc. The service users were very proud to show the inspector their individual rooms. Heathfield Gardens C02 C52 Heathfield S2058 V242673 020805 Stage 4.doc Version 1.40 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 Current staffing levels in place would appear to meet the current dependency needs of service users, accommodated within the home. EVIDENCE: On examination of the duty rotas and discussion with the deputy manager the inspector established the following; On the am shifts, there were I qualified nurse and 3 care assistants, and a student nurse. On the pm shifts, there were I qualified nurse and 3 care assistants, and a student nurse. On the night shifts, there were I qualified nurse and 1 care assistants. The manager was part of the qualified cover. However once a month he was supernumerary. Caring for 10 service users receiving nursing care. Heathfield Gardens C02 C52 Heathfield S2058 V242673 020805 Stage 4.doc Version 1.40 Page 18 The registered person had obtained an agreement from the Commission for Social Care Inspection that 2 care staff, with the appropriate knowledge and qualification could cover the home at night, with a senior qualified nurse being on call. This agreement is to be reviewed at the end of September 2005. The deputy manager identified that the night cover had been on occasions, 2 care staff rather than 1 qualified nurse and 1 care staff. There had not been any problems and the person on call had not received any calls. However the manager was still recruiting for the calibre of staff expressed in the agreement, therefore the majority of night shifts was still covered by a qualified nurse. Heathfield Gardens C02 C52 Heathfield S2058 V242673 020805 Stage 4.doc Version 1.40 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 Necessary risk assessments had not been undertaken to monitor the possible risk to service users. EVIDENCE: Within the garden to the rear of the property, there was a very large inflatable ‘swimming pool’ with a depth of approximately 1 metre. At the time of inspection the pool was covered, however service users were in the garden without staff supervision. On discussing the pool with the deputy manager she informed the inspector that the service users had requested the pool, and during the two very hot weeks the service users had used the pool, under the supervision of the staff. The inspector asked to see the risk assessment that had been drawn up regarding the use of the pool. The deputy manager apologised and identified that a risk assessment had not been drawn up. However now it had been brought to her attention, she would complete one that afternoon, and involve the student nurse, as part of her learning process, within the home. Heathfield Gardens C02 C52 Heathfield S2058 V242673 020805 Stage 4.doc Version 1.40 Page 20 The inspector would commend the home, for acting upon service users wishes and providing the pool and the deputy manager for considering that this matter could be used as a learning exercise for the student nurse. Heathfield Gardens C02 C52 Heathfield S2058 V242673 020805 Stage 4.doc Version 1.40 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x 3 Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 x x x 3 Standard No 11 12 13 14 15 16 17 x 4 4 x x x 3 Standard No 31 32 33 34 35 36 Score x x x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Heathfield Gardens Score 4 3 2 x Standard No 37 38 39 40 41 42 43 Score x x x x x 2 x C02 C52 Heathfield S2058 V242673 020805 Stage 4.doc Version 1.40 Page 22 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 20 Regulation 13 Requirement The registered person must ensure that accurate records are provided relating to medication administration systems. The registered person must ensure that the furnishings are of good quality. Therefore the floor coverings identified needs to be repaired or replaced. The registered person must ensure that necessary risk assessments are carried out, and that significant findings are recorded. Timescale for action 2/9/05 2. 24 16 2/10/05 3. 42 12 9/8/05 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 Good Practice Recommendations Heathfield Gardens C02 C52 Heathfield S2058 V242673 020805 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection South Point Cardinal Square Nottingham Road, Derby DE1 3QT National Enquiry Line: 0845 015 0120 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 Gardens C02 C52 Heathfield S2058 V242673 020805 Stage 4.doc Version 1.40 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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