Inspection on 15/02/06 for Heathland Court

This inspection was carried out on 15th February 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Heathland Court 14/12/06

Heathland Court 01/06/05

Heathland Court 22/12/04

Heathland Court 05/07/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Heathland Court 56 Parkside Wimbledon London SW19 5NJ Lead Inspector Janet Pitt Unannounced Inspection 15th February 2006 07:15 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Heathland Court DS0000019098.V283854.R01.S.doc Version 5.1 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. Heathland Court DS0000019098.V283854.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Heathland Court Address 56 Parkside Wimbledon London SW19 5NJ 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) 020 8944 9488 020 8944 1820 BUPA Care Homes (AKW) Ltd Mrs Avril Jones Care Home 82 Category(ies) of Old age, not falling within any other category registration, with number (45), Physical disability over 65 years of age of places (37) Heathland Court DS0000019098.V283854.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Home can admit up to 3 named service users under the age of 65 years for respite care within the Nursing and Residential Units. Date of last inspection Brief Description of the Service: Heathland Court is registered to provide personal and nursing care for up to eighty-two residents. Accommodation is provided over five floors, with the nursing units on the lower floors of the home. There is a passenger lift to all floors. The home benefits from a well-maintained garden, which is accessible for residents. Heathland Court has communal areas comprising of lounges and dining areas on each floor. The home is situated close to the main A3 road and is on local bus routes to Wimbledon and Putney. There is limited parking available on site. The home is within a short walking distance of Wimbledon Common. Heathland Court DS0000019098.V283854.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was undertaken unannounced by two inspector and lasted a total of six hours. A tour of the premises was undertaken. The inspectors spoke with eleven residents, six members of staff and one visitor. Care documentation and staff files were examined. What the service does well: What has improved since the last inspection? What they could do better: The home have a comprehensive assessment and care planning system, however care needs to be taken to ensure all sections are fully completed, in order that all care needs are identified and appropriate action taken. Daily records of care must reflect the actual care given and detail appropriate interventions if care needs change. This will evidence that residents’ care needs are appropriately identified and met. There must be evidence of resident/ representative involvement in the assessment process. Areas of the home smelt strongly of urine, appropriate action had not been taken to eliminate these odours. Some areas of the home were ‘tired and scruffy’ looking and there was no fixed date for redecoration and refurbishment. Staff must be made aware that Heathland Court is the residents home and treat residents with respect. Heathland Court DS0000019098.V283854.R01.S.doc Version 5.1 Page 6 Staff must be aware that training they receive must be put into practice to make sure that residents needs are met appropriately and they are not placed at risk of harm. 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. Heathland Court DS0000019098.V283854.R01.S.doc Version 5.1 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 Heathland Court DS0000019098.V283854.R01.S.doc Version 5.1 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 the following standard(s): 3 Residents’ assessments need to be fully completed to ensure that care needs are identified. EVIDENCE: Assessments are undertaken prior to and on admission. When the assessment in the home is undertaken, care plans are triggered according to the information. The documentation meets the requirements of the Standard. There has been improvement in the completion of assessments since the previous inspection, but staff need to make sure that the life history section is fully completed. Involvement of the resident or their representative in the process has improved, as evidenced by their signatures within the document, but this must be consistent across all assessments. Some sections of the assessments were not completed at all. The staff need to ensure that the assessments are completed fully, in order that care needs are identified and a care plan is triggered. Heathland Court DS0000019098.V283854.R01.S.doc Version 5.1 Page 9 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 the following standard(s): 7,8, 10 and 11. Care documentation requires improvements to ensure that specific details are given on how care is to be carried out and how care has been given. EVIDENCE: Residents care plans varied within the separate units of the home, which does not indicate that care needs are appropriately met. On the residential units care plans were noted to lead from assessments and evidence of residents preferred daily routines. Individualised risk assessments relating to manual handling and skin care were in place where required and seen to give specific details. Residents’ wounds were accurately recorded and there was good evidence of wound progress. Care plans were noted to be reviewed monthly with records of involvement of other professionals as required. On the nursing units there were inconsistencies in the care plans, which were triggered by the assessment, for example one resident was seen to be on a food intake chart, but there was no care plan in place indicating why this was necessary. Another resident had a care plan for eyesight although they did not require glasses, interventions were required, however the daily records indicated that their vision was good. Heathland Court DS0000019098.V283854.R01.S.doc Version 5.1 Page 10 Daily records varied in detailing care given and phrases such as: ‘received [the resident] on their bed asleep appears comfortable’ and ‘catheter draining well’ are not consistent with Nursing and Midwifery Council’s guidance on record keeping. Residents’ comments included: ‘It’s your choice, we are asked if we want to do it’ and ‘staff are attentive’. Another resident commented that they ‘were treated with respect overall and were quite well off living here’. However, the inspector witnessed one nurse delaying giving a resident their medicine, which made the resident anxious and worried. The nurse had to be directed to destroy the tablet the resident did not want to take and dispensed a fresh one; this was after the resident had waited over ten minutes. One resident commented that they ‘didn’t like staff walking in their room and standing there.’ Staff must ensure that residents are treated with respect and as individuals in their home. Residents’ wishes in relation to death and dying were noted to be sensitively documented, which enables staff to care appropriately for residents at the end of their life. Heathland Court DS0000019098.V283854.R01.S.doc Version 5.1 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 and 14 Residents are able to participate in activities of their choice and receive visitors. Residents can exercise control over how they spend their day. EVIDENCE: Residents are able to participate in a variety of activities offered by Heathland Court. These include coffee mornings, films, potting plants, music and visits by outside entertainers. On Fridays the home has a cinema club and a poetry circle has just started, with readings from residents works and published poets. The activities co-ordinator confirmed that there is an allocated budget, which enables him to plan activities and he hopes to organise a summer fete. One disadvantage to the activities programme being deveveloped further is the lack of suitable transport. The activities co-ordinator said that ‘dial a ride’ is not always available and currently only one resident benefits from external outings weekly as they are wheelchair dependant. One resident commented that they miss the coach the home had when owned by Ashbourne, as they missed going on outings. Another resident wished to have more outings, but was happy with activities within the home. It is recommended that consideration is given to a permanent form of transport to enable residents to once again participate in external outings and activities. Residents are able to exercise choice over their lives and this was confirmed when speaking with residents. One resident was noted to be awake at the Heathland Court DS0000019098.V283854.R01.S.doc Version 5.1 Page 12 start of the inspection, they explained this was their usual routine and they enjoyed having and early breakfast. Residents confirmed that they are able to maintain contact with their families and friends. Heathland Court DS0000019098.V283854.R01.S.doc Version 5.1 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 the following standard(s): 18 Residents are protected from abuse by the training provided. EVIDENCE: There have been no Protection of Vulnerable Adults investigations at the home. Staff receive training on preventing abuse. This was confirmed by members of staff spoken with and examination of the training files. Heathland Court DS0000019098.V283854.R01.S.doc Version 5.1 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 the following standard(s): 26 Residents live in a home, which meets their personal requirements, but attention must be given to ensuring the fabric of the home is adequately maintained. The home must be free from odours, to ensure it is a pleasant place to live. EVIDENCE: Residents live in a home, which is generally clean and tidy. One resident commented that they had a ‘nice room’ and another said the accommodation was ‘good’. However, it was noted that there was a strong smell of urine on the ground floor and a slight smell on the first and second floor. One of the bathrooms had a broken tile, which presents an infection risk, as cleaning cannot be thorough. Staff spoken with recognised the importance of keeping residents rooms tidy. The deputy manager informed the inspector that the first, second and third floor were due to be refurbished, but there is no fixed date for this. The providers must ensure that a plan is submitted to the CSCI, as parts of the home are ‘tired looking’ and ‘scruffy’. Heathland Court DS0000019098.V283854.R01.S.doc Version 5.1 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29 and 30 Residents are supported by adequate numbers of staff that are appropriately trained. However, care should be taken with deployment of staff. Staff must be made aware of their role and responsibilities to ensure all Standards are met. EVIDENCE: Staff spoken with thought that generally there were sufficient staff and arrangements are in place to cover shortages. One staff member commented that on the floor where they were based that ‘there was a good team’. One resident commented that staff were ‘reasonable’ and another said that ‘nursing staff answer the call bell promptly’. However, one member of staff considered the skill mix on the garden suite could be increased, particularly in the mornings, as there are dependent residents on that floor. The home has adequate numbers of staff, but consideration should be given to making sure that staff are deployed appropriately. There were no concerns from residents about there being a lack of staff. Residents are supported by staff that are appropriately trained. There are individual staff training files in place and the training programme has been restarted to make sure that all staff receive mandatory training and other training relevant to their identified needs. The deputy manager said that wound training had been undertaken two weeks prior to the inspection and a study day on tissue viability is planned. Medication training has been carried out for nursing staff and carers responsible for medication, this includes a written assessment for staff to complete. However, there are concerns that Heathland Court DS0000019098.V283854.R01.S.doc Version 5.1 Page 16 staff do not always take responsibility for medicines within the home and errors are not identified or corrected by staff. Residents can be confident that staff are recruited appropriately and relevant checks are carried out. Staff files examined contained the necessary information on staff, but consideration must be given to making sure that references are genuine, by use of company stamps or other identification. . Heathland Court DS0000019098.V283854.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 35 and 38 Residents’ views are sought and acted upon. Care must be taken to make sure that health and safety of the environment in the home is maintained. EVIDENCE: Staff and residents said that the management team are responsive to ideas and are approachable. A customer satisfaction survey has recently been sent out. Details of financial arrangements are recorded on admission and the home maintains personal allowances for residents in a satisfactory manner. There were two significant issues in relation to health and safety, which could compromise residents safety, these were cleaning materials being accessible, as the cupboard used to store them had been left unlocked and fridge temperatures in the ground floor kitchen/dining area consistently exceeding safe limits with no action being taken. Heathland Court DS0000019098.V283854.R01.S.doc Version 5.1 Page 18 It was also noted that bathing records in one bathroom indicated that the temperature was 34°C, which may not be comfortable for residents. The home must ensure that cleaning materials are kept securely to prevent accidental ingestion by residents. Fridge temperatures must be maintained between 5° and 8°C. Staff must ensure that the baths are at a suitable temperature to make sure that residents do not become cold. Heathland Court DS0000019098.V283854.R01.S.doc Version 5.1 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 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 2 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 X X X X X X X 1 STAFFING Standard No Score 27 3 28 X 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X 1 Heathland Court DS0000019098.V283854.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? yes 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 OP3 Regulation 14 (1) (a) & (2) Requirement Timescale for action 30/05/06 2. OP3 3. OP7 4. OP7 5 OP10 The registered person must ensure that assessments are completed fully in order that care needs are identified and all relevant information is gathered on residents.(previous timescale of 30/08/05 not met) 14 (1) (c) The registered person must ensure that there is resident/representative involvement in the assessment process and assessments are dated and signed by staff members. (previous timescale of 30/08/05 not met) 15 Sched3 The registered person must (3) (k) ensure that care plans provide specific details of care to be given and daily records must reflect the actual care given. (previous timescale of 30/08/05 not met) 15 (2) (c) The registered person must ensure that care plans are consistent with residents identified needs and are updated as necessary. 12 (4) (a) The registered person must ensure that staff treat residents DS0000019098.V283854.R01.S.doc 30/05/06 30/05/06 30/05/06 30/05/06 Heathland Court Version 5.1 Page 21 6 OP26 23 (2) (b) 7 OP26 23 (2) (b) 8 OP26 16 (2) (k) 9 OP30 18 (1) (a) 10 11 OP38 OP38 13 (4) (a) 12 (3) 12 OP38 13 (4) (c) with respect and as individuals. The registered person must ensure that minor repairs are carried out in a timely manner to ensure that there are no infection risks and cleaning can be thorough. The registered person must ensure that a full redecoration programme for the home is submitted to the CSCI, with dates for commencement of the work. The registered person must ensure that the home is free from offensive odours and take the necessary steps to eliminate odour. The registered person must ensure that staff take responsibility for their actions in accordance with the training they have received to carry out their role. The registered person must ensure that cleaning fluids and kept securely. The registered person must ensure that residents are able to bath in water that is a comfortable temperature for them. The registered person must ensure that all fridge temperatures are maintained within safe limits. 30/05/06 30/05/06 30/05/06 30/05/06 30/05/06 30/05/06 30/05/06 Heathland Court DS0000019098.V283854.R01.S.doc Version 5.1 Page 22 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 12 Good Practice Recommendations It is recommended that consideration is given to increasing activity hours, to develop the service and there is provision of permanent transport, to meet residents needs. It is recommended that deployment of staff within the home be reviewed routinely to make sure there is adequate staff on each floor to meet residents needs. It is recommended that references are verified. 2 3 27 29 Heathland Court DS0000019098.V283854.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG 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 Heathland Court DS0000019098.V283854.R01.S.doc Version 5.1 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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