Inspection on 03/10/05 for Heathside

This inspection was carried out on 3rd October 2005.

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

Heathside 10/01/07

Heathside 30/01/06

Heathside 24/02/05

Heathside 17/08/04

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

CARE HOMES FOR OLDER PEOPLE Heathside Plank Lane Leigh Greater Manchester WN7 4ND Lead Inspector Julie Conrad Unannounced Inspection 3rd October 2005 10:00 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 Heathside DS0000005739.V254339.R01.S.doc Version 5.0 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. Heathside DS0000005739.V254339.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Heathside Address Plank Lane Leigh Greater Manchester WN7 4ND 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) 01942 602328 01942 682937 Wigan Social Services Department Mrs Carole Evans Care Home 32 Category(ies) of Dementia (2), Dementia - over 65 years of age registration, with number (32) of places Heathside DS0000005739.V254339.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Within the maximum registered number (32), there can be up to 2 service users aged between 60 and 65 in the category of DE. The service should at all times employ a suitable qualified and experienced manager who is registered with the CSCI. Staffing levels are to be calculated in accordance with the Residential Forum Guidance (Older People) by April 2004. 24th February 2005 Date of last inspection Brief Description of the Service: Heathside is a purpose built Local Authority residential care home, supporting thirty-two older people with dementia, who do not need nursing care. Two residents can be admitted between the ages of sixty and sixty five years. The home is situated near Leigh town centre, close to local shops and public transport. There are thirty-two bedrooms some have en-suite facilities. All rooms have an address and visual cues which are used throughout the home. Communal space within the home includes, a dining room, a dining room and lounge area, two lounge areas a garden room and a conservatory and a snoozelen room. The layout of the building allows residents to walk freely and securely around the home. Specific colours have been used in different parts of the home’s walking area, which helps to orientate the residents. Heathside DS0000005739.V254339.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection of Heathside care home took place on 3rd October 2005, from 10.05am until 12.50pm. The manager was present for part of the inspection. The inspector had a discussion with two staff, the assistant manager and the registered manager, whose comments have been included in the report. The inspector was able to talk with one resident and observed other residents. Records, resident’s files and staff files were seen. The premises was checked and was found to be in good condition. What the service does well: What has improved since the last inspection? Since the last inspection, staff have attended a manual handling course. A new care plan format has been introduced. Heathside DS0000005739.V254339.R01.S.doc Version 5.0 Page 6 The small dining room and corridor has been redecorated. Formal staff supervisions are taking place. A member of staff is providing activities twice a week. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Heathside DS0000005739.V254339.R01.S.doc Version 5.0 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 Heathside DS0000005739.V254339.R01.S.doc Version 5.0 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): 1, 3 The service user guide is not user friendly and needs to be updated, to ensure prospective residents and their representatives have the correct information in a user-friendly format. EVIDENCE: A service user guide pack, ‘Dementia care services at Heathside residential home’, is available to prospective residents and their representatives. The guide is informative it contains a summary of the homes statement of purpose, activity plan, staffing structure, links with other organisations, carers course information, carers support group, dementia and Alzheimer’s care and support group, support available in the voluntary sector and information on complaints. The information provided in the guide is very good, however, the guide needs to be presented and written in a user friendly way. The guide also needs to be up-dated, the section on complaints needs to change the name of the National Care Standards Commission to the Commission for Social Care Inspection. Heathside DS0000005739.V254339.R01.S.doc Version 5.0 Page 9 Residents are admitted to the home following an assessment by a social worker and an assessment by the managers at the home. After a four week stay at the home, a review is carried out, the review includes the social worker, manager from the home, relatives and resident, to determine if the placement is suitable long term. At present there are two residents at the home, who will be moving to a different home more suitable to their needs. The inspector met one of these residents, whose dementia is not severe and therefore will benefit from a living in a home where residents are more able to communicate with her. Heathside DS0000005739.V254339.R01.S.doc Version 5.0 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 the following standard(s): 7,8,10 The new care plan format will benefit the residents, by including more detail of the needs and how the needs should be met. EVIDENCE: Since the last inspection, the home has introduced a new care plan format, which is in an easy to read format and is more detailed and states how the needs should be met. The new care plan includes personal care, physical well-being, communication, mobility and dexterity, personal safety, risk assessment, medical history and medication, mental health and cognition, diet and weight, food and mealtimes, dental and foot care, religious observation, daily life and social activity and resident profile. Three residents files were seen, these demonstrated that not all files have the new care plan format, these need to be introduced as soon as possible. Reviews have been talking place on a monthly basis, up until September, which has not been done yet. Heathside DS0000005739.V254339.R01.S.doc Version 5.0 Page 11 Risk assessments focus on the preventative and protective measures to be taken, the risk assessments were good and are reviewed on a monthly basis. A nutritional risk assessment is completed on all resident’s, these assessments also record the weight of the resident and are reviewed monthly. Other assessments include, fluid intake charts and manual handling assessments. A personal care chart records bath times and water temperatures. A member of staff was asked about meeting and knowing each residents needs. The member of staff said that having worked at the home for many years, she knew the needs of the residents. This member of staff was seen to assist two residents with mobility problems back onto their chairs, this was done in a skilled way. Heathside DS0000005739.V254339.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15 Residents would benefit from an activities co-ordinator, to ensure residents receive appropriate activity and stimulation throughout the week. The menus demonstrate that good food is served at the home, with alternatives available to the set menu. EVIDENCE: Since the last inspection, a member of staff has been arranging activities two afternoons a week. The current activities taking place include, painting, singing, drawing, use of a sensory table, music, one to one chats and walks. Although this is an improvement, it is not sufficient. To ensure the residents have a full a life as possible, the home should consider employing an activities co-ordinator, who can provide activities on a daily basis, appropriate to the needs of the resident group. There are a number of courses available on activities for people with dementia, which an activities coordinators could attend. A member of staff said that there was a need for visitors and families to beable to make them-selves at home when visiting residents at Heathside. In order to meet this need, the staff room is currently undergoing changes; the Heathside DS0000005739.V254339.R01.S.doc Version 5.0 Page 13 staff room will be made available to visitors at certain times of the day to enable them to make a drink. Staff breaks will still be taken in the staff room at set times. A priest visits the home to give communion, whilst some residents watch religious services on television. The menus are set on a four-week rotational basis, these demonstrated that the meals served at the home are nutritious and varied and that there is always an alternative to the set menu. There is a resident’s list, which states each residents preferences, allergies and preferred use of cutlery, used by kitchen staff and care staff. Heathside DS0000005739.V254339.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 The home has a complaints procedure that is accessible to visitors and their relatives and representatives. The home operates Wigan local authority’s Protection of Vulnerable Adults policy and procedure, to ensure residents are protected. EVIDENCE: The home has a complaints and comments book displayed in reception, with a written request, asking visitors to write down their concerns or comments. An assistant service manager checks the book each month and deals with any issues raised and then signs the book. There had been no comments or concerns recorded recently. There is a formal complaints procedure, where complaints can go directly to Wigan Local Authority’s Customer Relation team. The complaints procedure is explained in the service user guide. All staff receive training in the protection of vulnerable adults at induction and as part of the NVQ level 2 qualification. The inspector interviewed a member of staff and asked her about the protection of vulnerable adults procedure. The member of staff was fully aware of what to do if she suspected a resident was being abused and knew the different types of abuse that can occur. Heathside DS0000005739.V254339.R01.S.doc Version 5.0 Page 15 All staff attends a refresher course on the protection of vulnerable adults every two years. Wigan Local Authority is to launch its revised Protection of Vulnerable Adults policy and procedure during October 2005. Heathside DS0000005739.V254339.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 25, 26 The home appeared to be safe and well maintained. The communal areas are nicely decorated and furnished, ensuring comfort and homeliness for the residents. EVIDENCE: The premises were checked and everything appeared safe and wellmaintained. There is a choice of lounge areas and sitting areas throughout the home, these are nicely decorated and furnished. The window ledge in Lavender Walk needs to be repainted. Two cushions were missing from two chairs in the small lounge, the manager said a particular resident is in the habit of removing them. There is an enclosed garden area, called the ‘friendship garden,’ which has a plant and flower display and plants in pots and ornaments, the garden can be viewed and accessed from the conservatory. Heathside DS0000005739.V254339.R01.S.doc Version 5.0 Page 17 Residents appeared content, some residents were resting in the lounge, others in the conservatory, whilst some residents enjoy talking to staff by the office, were there are seats and lots of activity. All bedrooms are numbered in large print and also have the name of the resident on the door. The corridors throughout the building have pictures and paintings on the wall. There are prints of old film stars on one wall, Humphrey Bogart, Clark Gable and Marilyn Monroe. The day and date is written in large print on a blackboard near the reception area, to help orientate residents. The manager said that there are a number of bedrooms, which have part carpet and part floor covering, due to many residents urinating on the carpets in their rooms. The manager said that although the carpets in the corridors throughout the home appear clean, some residents often urinate on them. The manager suggested a non porous floor covering would be beneficial to residents, staff and visitors, as bacteria might be clinging to the carpet and may be causing a form of sick building syndrome. On the day of the inspection there was no odour from the carpets in the corridors, however, the registered provider responsible for the home may wish to consider non porous floor covering as an option. Heathside DS0000005739.V254339.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29,30 The home has a long-standing staff team, with a mix of skill and experience, the homes staff recruitment policy ensures staff are cared for by competent staff. EVIDENCE: The home has a long-standing staff team, the inspector spoke with a number of staff, one member of staff has worked at the home for nineteen years. Staff were seen to know individual residents needs, when asked a member of staff said having worked at the home for so long, she is knows each residents needs. Staff were observed assisting two residents, using manual handling techniques in a skilled way. Since the last inspection, a number of staff have attended a manual handling course, on 5th October 2005, the remaining staff will attend manual handling training.. The assistant manager said that all staff attend a training course, ‘Yesterday, Today and Tomorrow’, which is for staff working with people with dementia. Staff attend this course every two years as refresher training. Staff and residents were seen to get along well, office staff also had a rapport with residents and talked to them in a friendly, affectionate way. Staff were observed as being very busy, there are five staff on morning duty, four on afternoon and evening duty and three staff on waking night duty. The inspector spoke with two staff about staffing levels. Both staff thought more staff was needed, due to long term sick leave and sick leave taken by staff in Heathside DS0000005739.V254339.R01.S.doc Version 5.0 Page 19 general, staff said that they frequently volunteered to do extra shifts to cover staff shortage, which did result in them feeling tired. The inspector discussed staffing levels and cover with the assistant manager. The manager said that a temporary member of staff had joined the team and that they were advertising for a care assistant. The manager said that the staff team preferred to have the opportunity to cover shifts, before asking for back up staff from other local authority homes. The inspector has made a requirement that a formal back up system be introduced which provides staff who are experienced in caring for people with dementia. Residents are protected by the homes recruitment policy and procedure. No one is allowed to work at the home unless satisfactory references and police checks (CRB) checks have been completed. Heathside DS0000005739.V254339.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 35, 36 Formal staff supervision must take place regularly, to ensure staff are supported in providing a good service to the residents. EVIDENCE: The manager is competent and has many years experience of providing a service for older people, in different sections of social care. The manager has completed the Registered Managers Award and NVQ level 4. Two assistant managers are undertaking NVQ level 4, one assistant manager is undertaking NVQ level 3 and a temporary assistant manager who has now been made a permanent member of staff, will soon commence NVQ level 4. Resident’s personal allowances are kept secure, all individual transactions are recorded in a finance file and receipts are kept. An overall balance sheet is also kept on file. Heathside DS0000005739.V254339.R01.S.doc Version 5.0 Page 21 At the last inspection in February 2005, a requirement was made that formal supervision take place at least six times a year. Two staff files were seen, both files had supervision records for August 2005, other records were from 2004 and 2003. Since the requirement made in February 2005, only one formal supervision has taken place in August 2005. Heathside DS0000005739.V254339.R01.S.doc Version 5.0 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 2 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 3 x x x x 3 3 STAFFING Standard No Score 27 2 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x x x 3 2 x x Heathside DS0000005739.V254339.R01.S.doc Version 5.0 Page 23 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 2 3 4 5 Standard OP1 OP7 OP19 OP27 OP36 Regulation 5 15 23 18 18 Requirement The service user guide needs to be updated and presented in a user-friendly format. Care plans must be reviewed on a monthly basis. The window ledge on Lavender Walk needs repainting. A formal backup system, for staff cover needs to be introduced. Staff supervision must take place at least six times a year. Timescale for action 01/03/06 31/10/05 31/10/05 31/12/05 31/10/05 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 2 Refer to Standard OP12 OP26 Good Practice Recommendations The residents would benefit from an Activities Coordinator, who could provide more and appropriate activities. The registered provider might wish to consider using non porous floor covering in corridors throughout the home. Heathside DS0000005739.V254339.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG 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 Heathside DS0000005739.V254339.R01.S.doc Version 5.0 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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