Inspection on 29/06/05 for Heathside Rest Home

This inspection was carried out on 29th June 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 Rest Home 13/08/07

Heathside Rest Home 24/05/06

Heathside Rest Home 21/12/05

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Heathside Rest Home 74 Barrington Road Altrincham Cheshire WA14 1JB Lead Inspector Val Bell Unannounced 29 June 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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 Rest Home F55 F05 s63746 Heathside v236463 290605 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Heathside Rest Home Address 74 Barrington Road Altrincham Cheshire WA14 1JB 0161 941 3622 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Miss Alicia McDonnell Miss Frances Anne McDonell Miss Alicia McDonnell CRH PC 16 Old age 16 Care home Care home only Category(ies) of OP registration, with number of places Heathside Rest Home F55 F05 s63746 Heathside v236463 290605 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: The maximum number of service users requiring personal care shall be sixteen (16) over the age of 65. Care staffing levels will not fall below the minimum levels set out in the Residential Forum Guidance `Care Staffing in Care Homes for Older People`. The registered persons must undertake training in the protection of vulnerable adults from abuse by 31 July 2005. Date of last inspection n/a Brief Description of the Service: Heathside provides residential accomodation and personal care for up to sixteen residents within the category of old age. However, any of the residents could additionally have a physical disability. Heathside is a large property, which is set in pleasant grounds. The home is situated on Barrington Road in Altrincham, close to the town centre. Service users bedrooms were personalised with furniture, photographs and possessions from home. Fourteen single bedrooms and one double bedroom are located on two floors. All rooms are fitted with washbasins and vanity mirrors. A small car parking area is available at the front of the building. There are gardens to the rear of the property. This area includes a patio/barbecue area, with garden furniture, where residents can sit in the summer months. Since the last inspection the home had been sold and the new owners had implemented a programme of redecoration, renewal and refurbishment. Heathside Rest Home F55 F05 s63746 Heathside v236463 290605 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection, the first under new ownership, was conducted during daytime hours on 29 June 2005 and was followed up with several monitoring visits due to a variety of issues experienced by the new owners. Throughout the inspection and additional visits the inspector had conversations with residents, relatives, staff and a visiting hairdresser. What the service does well: What has improved since the last inspection? This was the registered persons’ first inspection. Most of the areas covered under the above section had seen considerable development and improvement. Heathside Rest Home F55 F05 s63746 Heathside v236463 290605 stage 4.doc Version 1.30 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 Rest Home F55 F05 s63746 Heathside v236463 290605 stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Heathside Rest Home F55 F05 s63746 Heathside v236463 290605 stage 4.doc Version 1.30 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 standard(s) 3 and 6 A robust system for pre-admission and ongoing assessment, monitoring and review of needs ensured that residents were confident that their needs would be met. The ongoing practice of enabling residents to fully participate in decisions that affected their lives was commendable. EVIDENCE: The homes new owners had given priority to the pre-admission assessment of needs since acquiring ownership of the home. Prospective residents were visited in hospital or in their own homes prior to admission to undertake a thorough assessment of needs. This covered all the required areas outlined in Standard 3. Following admission, each individuals needs were continually assessed and care plans updated as required. From conversations with residents it was evident that they were being fully involved in decisions that affected their lives. A welfare officer had been appointed and her role was to sit and talk to individual residents every day to ensure that there were no unidentified needs and also to build up a pen picture and life history. Residents told the inspector that they valued these sessions. Heathside Rest Home F55 F05 s63746 Heathside v236463 290605 stage 4.doc Version 1.30 Page 9 Residents also said that it was a good opportunity to air any concerns that they might have. The inspector conducted several visits to the home following the unannounced inspection and this practice was in evidence on each occasion. This was commended as an area of best practice. The home did not offer an intermediate care service. Heathside Rest Home F55 F05 s63746 Heathside v236463 290605 stage 4.doc Version 1.30 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 standard(s) 7, 8, 9 and 10 The absence of completed care plans places the residents at risk of not having all their assessed needs met. Enabling residents to fully participate in decision-making in a dignified and respectful environment had improved their self-confidence and selfdetermination. EVIDENCE: The registered persons had determined that the existing care plans did not adequately reflect the assessed needs of residents living in the home. Consequently they had begun a system of re-assessment of all the residents care needs. This was in evidence as detailed in records. At the point of inspection all the residents’ optical and dental needs had been reassessed. One resident had recently been diagnosed as diabetic and appropriate foodstuffs had been obtained. Care plans were in the early stage of development and the inspector was shown the format that would be used. This was found to be suitable. This must be given priority and completed care plans will be fully assessed at the next inspection. Heathside Rest Home F55 F05 s63746 Heathside v236463 290605 stage 4.doc Version 1.30 Page 11 Keyworkers had been appointed for individual residents. The keyworkers had been delegated responsibility for ensuring that care plans were being followed and that residents had all the requisites that they needed, such as toiletries. This was highlighted as an area of good practice. In conversation with the inspector residents said they were registered with local general practitioners and if they had any health concerns they were confident that staff would make the appropriate appointments or referrals to health professionals. This was confirmed from records held that detailed the outcome of health appointments. The registered manager and responsible individual were providing hands on care alongside the care assistants, enabling them to lead by example. From indirect observation the inspector noted that staff were being guided in paying attention to detail when delivering personal care to residents. This included areas such as ensuring that residents’ spectacles, fingernails and dentures were clean and generally encouraging residents to take pride in their appearance. The inspector had conversations with all the residents and relatives and other visitors to the home. Without exception, everyone spoken to praised the way staff treated residents with dignity and respect. This was also observed from the inspector’s observations of staff interacting with residents. The inspector noted that residents appeared to be much more outgoing and their self-confidence had improved. The inspector observed the lunchtime administration of medication. It was noted that significant progress had been made under the current leadership as there had been cause for concern at the previous inspection. The member of staff undertaking this task was given positive feedback from the inspector for operating a safe system of administration. This Standard could have been met if the member of staff administering medication had dispensed tablets from the blister packs into a container instead of her hand. The registered person took this on board and had obtained plastic medication pots by the time of the inspector’s next visit to the home. Heathside Rest Home F55 F05 s63746 Heathside v236463 290605 stage 4.doc Version 1.30 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 standard(s) 12, 13, 14 and 15 Social activities and meals were well managed, creative and varied and provided daily interest and stimulation for people living in the home. EVIDENCE: There had been a marked improvement in this area since the previous inspection. A dynamic daily activity programme had been implemented based on individual residents social, cultural and religious needs assessed by the welfare officer. Activities included an entertainer, exercise classes, dominoes, a visiting library service, manicures and one-to-one conversations. During one of the inspectors visits residents were enjoying a sing-along and ballroom dancing with the manager. On the day of inspection the visiting hairdresser stated that she had never seen the residents so relaxed and happy. This was also the view of visiting relatives. The welfare officer also arranged for residents to purchase a daily newspaper of their choice. The home received a commendation in this area for best practice. Flexible visiting was encouraged by the home. Visitors said they were made welcome and were always offered a drink. The welfare officer had responsibility for purchasing food stocks for the home. Fresh fruit and vegetables were available daily and speciality foods to tempt Heathside Rest Home F55 F05 s63746 Heathside v236463 290605 stage 4.doc Version 1.30 Page 13 residents who had poor appetites. The inspector joined residents for their lunchtime meal, which was appetising and nourishing. Residents told the inspector that they enjoyed the food provided by the home. Drinks and snacks were available at all times. During the meal staff maintained an unobtrusive presence and were available to provide assistance and encouragement to residents where needed. Heathside Rest Home F55 F05 s63746 Heathside v236463 290605 stage 4.doc Version 1.30 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 standard(s) 16 and 18 Although no complaints had been received, the home demonstrated that they were operating a responsive service and residents were confident that their concerns would be taken seriously and acted upon. Inadequate staff development in abuse awareness and policies or procedures for responding to suspicions or allegations of abuse placed the residents at risk. EVIDENCE: The home had an appropriate complaints log in place although no complaints had been received since the change of ownership. However, there was recorded evidence to demonstrate that the registered persons had responded to a suggestion for improvement made by a resident’s relative. Additionally, residents told the inspector that they were confident their concerns would be listened to and that the appropriate action would be taken. The inspector examined the homes policy on the protection of vulnerable adults from abuse (POVA). This advised the home to investigate allegations of abuse. This was not the correct procedure. All allegations of abuse must be reported to Trafford Metropolitan Borough Councils adult protection coordinator. The home was required to obtain a copy of the local authority’s multi-disciplinary policy on POVA and to review and update the in-house policy. Additionally, the registered persons and care staff must receive training in awareness of abuse. Heathside Rest Home F55 F05 s63746 Heathside v236463 290605 stage 4.doc Version 1.30 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 standard(s) 19, 24 and 26 The home was clean and hygienic and significant improvements had been made to the décor and fabric of the home to provide residents with comfortable surroundings. The registered persons demonstrated a commitment to improving the home’s environment so that residents’ health and safety could be maintained. EVIDENCE: The inspector undertook a tour of the premises and found the environment to be clean and hygienic. There were no unpleasant odours apart from one of the resident’s bedrooms where a strong urine odour was present. This was being addressed in consultation with the continence nurse. The new owners had undertaken an audit of the premises and a development and maintenance plan was in evidence. The registered persons had replaced laundry equipment, some carpets and had done some redecoration. Other equipment replaced included a carpet shampooer, office equipment and kitchen work surfaces had been replaced. Heathside Rest Home F55 F05 s63746 Heathside v236463 290605 stage 4.doc Version 1.30 Page 16 Some of the first floor bedroom windows did not have restricted openings and hot water temperatures in wash hand basins and baths were scalding. An immediate requirement was made to risk assess window openings and where the risk could not be minimised window restrictors limiting the opening to 100mm must be fitted. Additionally, hot water temperatures must also be risk assessed and the temperature controlled to around 43 degrees Celsius. By the time of the inspector’s second visit to the home first floor windows had been restricted to the required opening and hot water temperatures had been reduced. A temperature probe had been obtained for the purpose of testing the hot water temperatures on a weekly basis. A further requirement was made to mend a bath panel that had come lose. Heathside Rest Home F55 F05 s63746 Heathside v236463 290605 stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 and 30 The deployment of staff appeared to meet the assessed needs of service users. Pre-employment checks undertaken during the recruitment of staff provided safeguards to offer protection to people living in the home. EVIDENCE: The inspector examined the staff rotas. The home was being staffed by two carers and a senior member of staff between the hours of 8 a.m. and 10 p.m. and a waking carer was deployed to work between 10 p.m. and 8 a.m. with the manager on sleep-in duty. This staffing level complied with the guidelines of the previous registering authority. Since the recent change of ownership, almost two thirds of the care staff complement had left the home and a member of the care staff had been summarily dismissed for leaving the premises without permission. This had resulted in the registered persons covering long hours to make up the shortfall. The inspector undertook several additional visits to monitor the situation. By the time this report was prepared several care staff had been recruited and the staffing situation had eased. Appropriate pre-employment checks had been obtained for the staff recently employed. Two care staff and a senior member of staff were interviewed and asked about their experience of working with the new management. The staff valued the guidance, leadership and support provided by the management and generally felt that this had resulted in improvements to the care practices within the home. Development Heathside Rest Home F55 F05 s63746 Heathside v236463 290605 stage 4.doc Version 1.30 Page 18 opportunities in undertaking NVQ and other training courses had also been offered. The inspector was told that staff were being individually assessed for their training needs and that free training in NVQ levels two and three had been accessed for staff under the age of 25 years. Heathside Rest Home F55 F05 s63746 Heathside v236463 290605 stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 35, 38 Leadership, guidance and direction to staff was good and this ensured that residents received consistent quality care. From conversations with residents, staff and visitors to the home, it was apparent that staff were working hard to safeguard the health, safety and welfare of the people using the service. Failure to ensure that residents have access to their personal allowances places them at risk of having their financial independence and self-determination compromised. EVIDENCE: The registered manager and responsible individuals are both registered nurses and have many years experience of working with vulnerable people. The registered manager is qualified in teaching and assessing clinical practice and will be undertaking the Registered Managers Award to complete her home management qualification. Heathside Rest Home F55 F05 s63746 Heathside v236463 290605 stage 4.doc Version 1.30 Page 20 Standard 33, relating to quality assurance was not fully assessed as the registered persons had obvious priorities relating to their management of the home. However, it was clear that daily feedback was being sought from residents and their representatives. The inspector and the manager discussed how a quality assurance programme might be developed in the future and the manager showed a commitment to this. The manager’s father had been devolved the responsibility for administration duties, including accounting. He told the inspector that the home did not manage residents’ personal finances and that this was done by residents’ relatives or solicitors. However, it appeared that not all residents had access to their weekly allowances. This must be established to ensure that all residents have access to some capital for their daily living expenses. Residents told the inspector that the staff were very kind and caring and that staff responded quickly to calls for assistance. There were no other health and safety issues found during this inspection. Heathside Rest Home F55 F05 s63746 Heathside v236463 290605 stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 4 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 x x x x 3 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 Standard No 16 17 18 Score 3 x 3 3 x 3 x 2 x x 3 Heathside Rest Home F55 F05 s63746 Heathside v236463 290605 stage 4.doc Version 1.30 Page 22 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 Requirement Individual residents must have a plan of care that details how their needs in respect of their health and welfare are to be met Medication must be dispensed from blister packs into a container suitable for administration to residents The registered manager must obtain a copy of Trafford Metropolitan Borough Councils policy on the Protection of Vulnerable Adults from Abuse (POVA) and all staff working in the home must receive training in awareness of abuse Windows above ground floor must be risk assessed. Where the risk of residents falling cannot be managed the opening widths of the windows must be restricted to 100mm. Hot water temperatures must be subject to risk assessments. Where the risk of scalding to residents cannot be managed, hot water temperatures must be controlled at around 43 degrees Celsius. Timescale for action 29/08/05 2. OP9 13 (2) 29/08/05 3. OP18 13 (6) 29/10/05 4. OP19 13 (4) Immediate 5. OP19 13 (4) Immediate Heathside Rest Home F55 F05 s63746 Heathside v236463 290605 stage 4.doc Version 1.30 Page 23 6. OP19 13 (4) 7. 8. OP28 OP31 18 (1) c 9 (2) (b) (i) 17 (2) 9. OP35 The loose bath panel identified during the inspection must be mended to avoid the risk of injury to residents. 50 of care staff must be qualified to NVQ level 2 in care (or equivalent) by 2005 The registered manager must be qualified to NVQ level 4 in management (or equivalent) by 2005 Residents must have access to their personal allowances unless their risk assessment shows otherwise. 29/10/05 31/12/05 31/12/05 29/09/05 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 Good Practice Recommendations Heathside Rest Home F55 F05 s63746 Heathside v236463 290605 stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection 9th Floor Oakland House Talbot Road Manchester M16 0PQ 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 Rest Home F55 F05 s63746 Heathside v236463 290605 stage 4.doc Version 1.30 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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