Inspection on 31/01/07 for Heathfield Residential Home

This inspection was carried out on 31st January 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 Residential Home 24/11/08

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

CARE HOMES FOR OLDER PEOPLE Heathfield Residential Home 20/22 Alexandra Road Grappenhall Warrington Cheshire WA4 2EL Lead Inspector Paul Ramsden Unannounced Inspection 31st January 2007 09:55 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 Residential Home DS0000067817.V322523.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 Residential Home DS0000067817.V322523.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Heathfield Residential Home Address 20/22 Alexandra Road Grappenhall Warrington Cheshire WA4 2EL 01925 602195 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) Heathfield Residential Home Limited Vanessa Laurelle Johnson Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places Heathfield Residential Home DS0000067817.V322523.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. This home is registered for a maximum of 25 service users in the category OP (Old age, not falling within any other category) Staffing must be provided to meet the dependency needs of service users at all times and will comply with any guidance that may be issued through the Commission for Social Care Inspection 2nd August 2006 Date of last inspection Brief Description of the Service: Heathfield is a large Victorian three-storey privately owned care home. Access between floors is via a shaft lift or the stairs. Residents are accommodated on all floors. The home is located in the Warrington suburb of Grappenhall and is close to a variety of shops, churches and other community facilities. Heathfield is registered to provide personal care for up to twenty-five older people. It is the home’s policy to only provide accommodation to female residents. Residents’ accommodation consists of fifteen single and five double rooms. All of the bedrooms, with the exception of one double bedroom that has an ensuite facility, are fitted with wash hand basins. There are three separate day lounges and a separate dining room available for residents’ use. Heathfield has an adequate number of toilets and a variety of bathrooms available. Aids to facilitate independence are in evidence throughout the home; these include bath hoists, grab rails and an emergency call bell system. The current fees for the home are £350 - £450 per week. Further details regarding fees are available from the proprietor or the manager. Heathfield Residential Home DS0000067817.V322523.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced visit took place on the 31 January 2007 and lasted 7 hours. Paul Ramsden, Inspector, undertook the visit. All of the key standards for older people were looked at. This visit was just one part of the inspection. Before the visit the home manager was also asked to complete a questionnaire to provide up to date information about services in the home. Questionnaires were also made available for residents and families to find out their views. Other information received since the last key inspection was also reviewed. Six resident and two relative forms have been returned. During the visit various records and the premises were looked at. A number of residents, relatives and staff members were spoken with; they gave their views about the home and the service provided. Since the previous key inspection visit the home’s owner has changed; this is therefore the second key inspection that has been undertaken since April 2006. What the service does well: What has improved since the last inspection? What they could do better: Heathfield Residential Home DS0000067817.V322523.R01.S.doc Version 5.2 Page 6 According to a number of residents at the home the quality of the food provided to them could be improved. This issue could be addressed by the introduction of an appropriate quality assurance system. 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 Residential Home DS0000067817.V322523.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 Residential Home DS0000067817.V322523.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. This judgement has been made using available evidence including a visit to this service. Information and opportunities to visit before choosing to move in are available and residents are assessed prior to admission to ensure that their needs can be met at the home. EVIDENCE: The statement of purpose and service user guide was provided when the home’s owner changed in August 2006. These contained all of the information required under the Care Homes Regulations 2001 and Standard 1 of the National Minimum Standards for Older People. During the visit two residents confirmed that they had visited the home prior to making the decision to move in. One of them said, “First impressions are excellent”. As part of the inspection process the care files of two people living at the home were looked at. Pre-admission assessments demonstrating that a resident’s individual needs were being assessed in an accurate and consistent way had Heathfield Residential Home DS0000067817.V322523.R01.S.doc Version 5.2 Page 9 been carried out. The manager, with a considerable amount of input from the resident [where possible] and family members undertake the assessments in order to identify specific individual needs before a service is provided. One of the newly admitted residents confirmed that the home manager had visited her in hospital and had asked various questions about her needs and likes/dislikes. Copies of information provided by the placing authority were also seen on the files. Intermediate care is not provided at Heathfield. Heathfield Residential Home DS0000067817.V322523.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. This judgement has been made using available evidence including a visit to this service. The clients care plans seen provided sufficient information for staff members to be able to take appropriate action to meet an individuals needs. EVIDENCE: The care plans seen as part of the case tracking process provided staff members with the necessary information for them to look after a person’s needs. The health and well being of residents was being monitored and an appropriate record of development and actions taken was being kept. Care plans were being reviewed monthly and where necessary re-written on a regular basis. Residents or their families/advocates are involved in the care planning process. The staff members at the care home continually monitor the residents’ health needs and there was evidence to show that they were receiving appropriate Heathfield Residential Home DS0000067817.V322523.R01.S.doc Version 5.2 Page 11 support from health care professionals. This included GPs, community nurses, optician, dentist and chiropodist. Staff members spoken to have a good understanding of the people they were supporting and were able to meet their diverse needs. The changing needs of individuals are discussed as and when required; the inspector was able to see this in practice during the visit. All personal care is carried out in the privacy of a resident’s bedroom or one of the bathrooms. The residents spoken with during the inspection all said that the standards of care provided were very good and that they had been able to express their opinions and wishes about their daily routines. It was also seen throughout the visit that residents were being treated with courtesy, respect and good humour by staff. The home uses a blister pack system dispensed by a local pharmacist. An inspection of the medication system within the home demonstrated that it was being well managed and there were no obvious issues seen during the visit. The pre-inspection questionnaire gives the names of those staff members who administer medication. Heathfield Residential Home DS0000067817.V322523.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. This judgement has been made using available evidence including a visit to this service. Residents spoken with were positive about the home and the support they received so they could maintain contact with friends and family and make choices about their daily lives. EVIDENCE: Residents were able to move around freely within the home and a choice of sitting areas was available. They confirmed that routines within the home were flexible and that they were able to make choices in many areas of daily living; for example times of rising and retiring, participation in planned activities and where to spend time and with whom. The residents and visiting relatives spoken with during the visit made a number of positive comments during the inspection. One of the relatives stated, “I have no issues at all”. It was seen throughout the visit that residents were being treated with courtesy, respect and good humour by staff. The relatives spoken with confirmed that they were free to visit the home at any reasonable time and links with the local community were maintained. Personal mail was delivered unopened, or given to relatives if appropriate. Heathfield Residential Home DS0000067817.V322523.R01.S.doc Version 5.2 Page 13 Meals can be taken in the dining room or in the privacy of residents’ own rooms. There is a menu that has the flexibility to meet individual needs and choices. Breakfast is served at 8.00am and residents can select a cooked breakfast if they wish. They can also have breakfast in bed. Lunch, the main meal of the day, is served at 12.00 noon and tea at 4.00pm. Hot drinks and snacks are served in the evening. The majority of the residents spoken with said that whilst the food was generally good they thought there were some problems regarding the food quality. One of the relatives had also mentioned this on a survey form. In addition to the above a good practice recommendation that was specific to one of the residents was identified. Both of these issues were passed to the manager at the end of the inspection. She agreed to address the good practice recommendation and explained that she was aware of the comments regarding the food and was in the process of trying to address the problem. Heathfield Residential Home DS0000067817.V322523.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. This judgement has been made using available evidence including a visit to this service. Residents and relatives are able to complain and action is taken to respond to their concerns. Adult protection training for staff is available to ensure the continued safety of residents. EVIDENCE: There is a clear complaints procedure for the home; this is included in the Statement of Purpose and Service User Guide. The pre-inspection questionnaire indicates that one complaint has been received during the previous 12 months; this was responded to within the agreed timescale. The residents and relatives spoken with during the visit confirmed that they knew what to do if they were unhappy or wanted to make a complaint. The survey forms received confirmed this opinion. The home has an Adult Protection procedure (including Whistle Blowing), which complies with the Public Disclosure Act 1998 and the Department of Health Guidance ‘No Secrets’. The manager is aware of the appropriate procedures to follow should an incident arise. The home enrols staff members on the training courses run by Warrington Borough Council and some of them, including the manager have recently attended an adult protection course. More staff members are due to undertake this course in the near future. A copy of the training schedule for staff was given to the inspector during the visit. Heathfield Residential Home DS0000067817.V322523.R01.S.doc Version 5.2 Page 15 Heathfield Residential Home DS0000067817.V322523.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 25 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents live in a safe, homely, clean and comfortable home. EVIDENCE: Furnishings, fittings and lighting of the communal rooms are of a good quality and are domestic in character. Bedrooms were not seen during this inspection. The Inspector is aware following previous visits that four bedrooms are not individually and naturally ventilated by outside windows. There are window openings near to the ceiling in these rooms, the windows are on dividing walls and the rooms are dependent on shared ventilation and lighting from adjacent rooms, which have windows on outer walls. These are unusually appointed room arrangements that have been in existence prior to the Care Homes Regulations 2001. The new owners intend to carry out some building alterations in the near future and this issue will be addressed during the work Heathfield Residential Home DS0000067817.V322523.R01.S.doc Version 5.2 Page 17 Heathfield has a passenger lift available to allow access between floors. The home also provides adaptations for use by residents with mobility problems. These include bath and toilet aids. One of the resident’s relatives spoken with said that they had chosen Heathfield because of its homely atmosphere. The home was found to be clean and tidy on the day of the visit. The laundry is appropriately equipped and good systems are in place for the care of peoples’ clothes. Heathfield Residential Home DS0000067817.V322523.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff members work positively with residents and families to improve the quality of life of people living in the home. A robust staff recruitment process is in place in order to protect residents from possible harm. EVIDENCE: Staff on duty and rotas seen demonstrated that staffing levels and the skill mix of staff is adequate to meet the needs of the residents within the home. Staff members were cheerful and friendly. Residents and the visiting relatives were complimentary about staff attitude and competence. One of the residents said that, “the staff are very good and treat me with respect”. The home manager confirmed that 9 of the 20 care staff members are qualified to NVQ level 2 or above this is a recognised qualification for staff involved in delivering care. A further 7 staff members are currently working towards this qualification The files for two recently appointed members of staff seen contained all of the required information and a robust recruitment procedure was in place for the protection of residents. Prospective staff members are checked against the POVA list before employment commences and CRB disclosures are obtained. Heathfield Residential Home DS0000067817.V322523.R01.S.doc Version 5.2 Page 19 New staff members are routinely inducted through the home’s induction procedure to ensure that they are suitably trained when starting work. Staff members also enrol on the induction-training programme that is run by Warrington Borough Council. Heathfield Residential Home DS0000067817.V322523.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is being well run and managed on a day-to-day basis. There are appropriate procedures in place to make sure that residents are safe. EVIDENCE: The home has a competent manager who is registered with the Commission for Social Care Inspection. She has completed the registered managers award and has attended courses/training in order to fulfil her management responsibilities. She was able to demonstrate an awareness of the diverse needs of the client user group and how to manage the staff group. Residents Heathfield Residential Home DS0000067817.V322523.R01.S.doc Version 5.2 Page 21 and the visiting relatives spoken with made a number of positive comments about her and said they would raise any issues of concern with her. Although questionnaires in order to ascertain whether residents and families are happy with the standards of care being provided are sent out on a regular basis the home does not currently have a system of collating these and making the results available to residents, families and the Commission. The home does not hold personal spending money for residents; any money given to a resident is put into a bank account and a record of individual transactions and amounts held is maintained. The maintenance records demonstrated that the appropriate service contracts are in place. This includes the passenger lifts, hoists, gas safety certificate and the fire alarm system. The fire precautions record book demonstrated that checks of the alarm system, emergency lighting, fire drills and staff training were taking place at the recommended intervals. Heathfield Residential Home DS0000067817.V322523.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 3 X X X 3 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 2 X 3 X X 3 Heathfield Residential Home DS0000067817.V322523.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP33 Regulation 24 Requirement The registered person must ensure that an appropriate quality assurance system is implemented. Timescale for action 31/07/07 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 OP25 Good Practice Recommendations The registered person should consider how the identified room arrangements relating to this standard could be altered. Heathfield Residential Home DS0000067817.V322523.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Residential Home DS0000067817.V322523.R01.S.doc Version 5.2 Page 25 - 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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