CARE HOMES FOR OLDER PEOPLE
Heathside Mews Honiton Way Penketh Warrington Cheshire WA5 2EY Lead Inspector
Paul Ramsden Unannounced Inspection 2nd November 2006 11.50 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 Mews DS0000067907.V314705.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. Heathside Mews DS0000067907.V314705.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Heathside Mews Address Honiton Way Penketh Warrington Cheshire WA5 2EY 01925 722109 01925 721664 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) Warrington Community Living Ms Benita Hardman Care Home 25 Category(ies) of Dementia (4), Dementia - over 65 years of age registration, with number (21) of places Heathside Mews DS0000067907.V314705.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. This home is registered for a maximum of 25 service users to include: * Up to 21 service users in the category DE(E) (Dementia over 65 years of age) * Up to 4 service users in the category DE (Dementia under 65 years of age) N/A Date of last inspection Brief Description of the Service: Heathside Mews is a single-storey care home standing in its own grounds. The home is operated and managed by Warrington Community Living, a registered charity and non-profit making organisation. Heathside Mews is located in the Warrington suburb of Penketh and is close to the Honiton Way shopping precinct and other local amenities, including a health centre. There are adequate car parking facilities available. The home provides care for up to twenty-one older people and four adults with dementia. Residents accommodation consists of 25 large single bedrooms, all of which have kitchen and en-suite shower facilities. A variety of lounge and dining spaces are provided for residents. There are also an adequate number of toilets and a variety of bathrooms available. Aids to help maintain independence are in evidence throughout the home; these include bath hoists, grab rails and an emergency call bell system. The current fee for the home is £358. Heathside Mews DS0000067907.V314705.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 2 November 2006 and lasted 5 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 five relative forms have been returned. During the visit various records and the premises were looked at. A number of residents, one relative and two visiting Social Workers were spoken with and they gave their views about the home and the service provided. What the service does well: What has improved since the last inspection?
This is the first inspection of the home since it opened. Heathside Mews DS0000067907.V314705.R01.S.doc Version 5.2 Page 6 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 Mews DS0000067907.V314705.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 Heathside Mews DS0000067907.V314705.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 6 The quality rating for 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 moving in are available and residents are assessed before moving in to ensure that their needs can be met at the home. EVIDENCE: The home provides a range of information to residents; these include the statement of purpose, the service user guide and the procedures to be followed in the event of a complaint. Relatives have written on survey forms; “brochure received with all relevant information”, the information both written and personal was excellent”. As part of the inspection process the care files of three 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 been carried out. The home manager or senior staff members, with a considerable amount of input from the resident [where possible] and family members undertake the assessments in order to identify specific individual
Heathside Mews DS0000067907.V314705.R01.S.doc Version 5.2 Page 9 needs before a service is provided. Copies of information provided by the placing authority were also seen on the files. Intermediate care is not provided at Heathside Mews. Heathside Mews DS0000067907.V314705.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 The quality rating for 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 and where necessary re-written on a regular basis. Residents or their families/advocates are involved in the care planning process. The visiting relative confirmed this during the visit. A survey form states, “the family are keen to participate in the care of our relative, this has been welcomed by the staff”. Risk assessments are being carried out as and when a need is identified. The visiting Social Workers explained that they were there to carry out a review in order to check that the recent admission of a resident was working well. They said that in their opinion the atmosphere within the home was very supportive and that the manager and staff members,“ supported independence rather than dependence”.
Heathside Mews DS0000067907.V314705.R01.S.doc Version 5.2 Page 11 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. The staff members at the care home continually monitor the residents’ health needs and there was evidence to show that they were receiving appropriate support from health care professionals. This included GPs, community nurses, optician, dentist and chiropodist. All personal care is carried out in the privacy of a resident’s bedroom or one of the bathrooms. Residents spoken with confirmed that they had been able to express their opinions and wishes about their daily routines. It was 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. No obvious issues concerning the medication system were seen during the inspection visit. Heathside Mews DS0000067907.V314705.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 at least once during a 12 month period. 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 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. One of the residents said, “more like a five-star hotel”. Staff members were seen to knock on doors and to await permission before entering residents’ bedrooms. Due to the fact that the home has only opened recently and admissions are being made on a planned basis the staff members are currently organising social and other activities. The manager explained that it was her intention to appoint an activities co-ordinator in the near future. Whilst no negative comments were made during the visit some people have indicated on the survey forms that more activities would be welcome. Links with the local community, for example the local church are maintained.
Heathside Mews DS0000067907.V314705.R01.S.doc Version 5.2 Page 13 Meals can be eaten 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. All of the residents that commented said that the food was good and that choices were available. Special diets are prepared where necessary; some of the assessments and care plans seen confirmed that individual dietary needs are discussed and where necessary addressed. Heathside Mews DS0000067907.V314705.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 The quality rating for 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 written complaints procedure for the home. This is also included in the Statement of Purpose and Service User Guide. No complaints have been made since the home opened. 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 was able to demonstrate that she is fully aware of the appropriate procedures to follow should an incident arise. Some of the staff members have received training in this area; more are to attend in the immediate future. Heathside Mews DS0000067907.V314705.R01.S.doc Version 5.2 Page 15 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, 21, 23, 24 and 26 The quality rating for this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The accommodation is newly built with extremely good facilities; residents live in a safe, clean and comfortable home. EVIDENCE: A tour of the premises was undertaken; this included communal areas and a number of bedrooms. The home both externally and internally is maintained to a very good standard and standards of décor, furnishings and fittings were commendably high throughout the home, as were standards of hygiene and cleanliness. All bedrooms are large enough to accommodate both a sitting and sleeping area. They also have ample built-in wardrobe/storage space. Each room has a fully equipped bathroom fitted with a toilet, sink and walk-in shower. Bedrooms seen during the inspection were, homely, comfortable, well-furnished and contained personal items of furniture. .
Heathside Mews DS0000067907.V314705.R01.S.doc Version 5.2 Page 16 The home was found to be clean and tidy on the day of inspection. The laundry is appropriately equipped and good systems are in place for the care of peoples’ clothes. Heathside Mews DS0000067907.V314705.R01.S.doc Version 5.2 Page 17 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, 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, families and visiting professionals 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 was adequate to meet the needs of the residents within the home. Staff members were cheerful and friendly. The residents and visitors spoken with during the visit were complimentary about their attitude and competence. The manager explained that as well as admitting residents into the home in a planned and structured manner she has also adopted this approach to staff recruitment, preferring to appoint them for their aptitude and commitment to working with the resident group. The visiting relative confirmed this by saying, “the manager will not appoint just anyone, staff must be good and fit in”. According to the information provided in the pre-inspection questionnaire over 50 of senior and care staff members have either achieved an NVQ qualification or are undertaking one. . The files for three 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
Heathside Mews DS0000067907.V314705.R01.S.doc Version 5.2 Page 18 POVA list before employment commences and CRB disclosures are obtained. All applications are subject to equal opportunities monitoring. New staff members undertake an in-house induction and are then enrolled on a two-week induction-training programme that is run by Warrington Borough Council. Evidence of induction training was seen on the day of the visit. Warrington Community Living provides a range of training courses; these include, safer manual handling, first aid, adult protection and health and safety. The home manager keeps records of all of the training undertaken by staff members. Heathside Mews DS0000067907.V314705.R01.S.doc Version 5.2 Page 19 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, 33, 35 and 38 The quality rating for this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are appropriate procedures in place to make sure that residents are safe from possible harm. EVIDENCE: The home has an experienced and competent manager who is registered with the Commission for Social Care Inspection. She has attended courses/training in order to fulfil her management responsibilities and was able to demonstrate an awareness of the diverse needs of the resident group and how to manage the staff team. She is currently undertaking the registered managers award. Senior staff members and an administrator support the manager. The residents that commented said that the home’s management team were approachable and supportive. A comment on a resident’s survey form states; “The manager has given us great support”.
Heathside Mews DS0000067907.V314705.R01.S.doc Version 5.2 Page 20 Attempts are being made to seek the opinions of residents about the quality of service provided by the home. A quality assurance system to ascertain whether residents and families are happy with the standards of care being provided is in place. This is an on-going process. Residents’ personal allowances were inspected; those checked had correct balances and were being well managed. The systems for the recording of any monies or valuables held were good. All staff members are supervised on a continuous basis; this helps to ensure that the high quality of care provided to residents is maintained. All of the relevant maintenance certificates were provided upon registration of the home. The fire safety record was seen during the visit. This showed that the fire alarm and emergency lighting systems were being tested at the intervals recommended by Cheshire Fire Service. Fire drills and staff training were ongoing. These systems ensure that residents are protected form possible harm. Monthly visits to comply with regulation 26 of the Care Homes Regulations are being carried out. Heathside Mews DS0000067907.V314705.R01.S.doc Version 5.2 Page 21 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 4 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 4 4 4 X 4 4 X 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 3 X 3 X X 3 Heathside Mews DS0000067907.V314705.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? N/A 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Heathside Mews DS0000067907.V314705.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Mews DS0000067907.V314705.R01.S.doc Version 5.2 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!