Inspection on 30/05/07 for Heathwood Care Home

This inspection was carried out on 30th May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Heathwood Care Home 25/10/06

Heathwood Care Home 09/12/05

Heathwood Care Home 20/09/04

Heathwood Care Home 24/02/04

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

CARE HOMES FOR OLDER PEOPLE Heathwood Care Home 9 - 11 Trewartha Park Weston Super Mare North Somerset BS23 2RP Lead Inspector Juanita Glass Unannounced Inspection 30th May 2007 09:30 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 Heathwood Care Home DS0000040239.V335782.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. Heathwood Care Home DS0000040239.V335782.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Heathwood Care Home Address 9 - 11 Trewartha Park Weston Super Mare North Somerset BS23 2RP 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) 01934 627376 Mr Charles Larkin Mrs Teresa Simone Larkin Mrs Gillian Susan Page Care Home 24 Category(ies) of Dementia - over 65 years of age (24) registration, with number of places Heathwood Care Home DS0000040239.V335782.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 24 persons over the age of 65 years with dementia who require personal care only DE(E). 25th October and 22 November 2006 Date of last inspection Brief Description of the Service: Heathwood Care Home is registered with the CSCI to provide dementia care for up to 24 older people. The home is a converted property situated on the hillside of Weston-superMare approximately 1 mile from the town centre. There is a pleasant front garden and patio area to the rear of the building. Accommodation is offered over three floors. A stair lift provides access to the upper floors. It is a condition of registration that all service users admitted to the home must be ambulant Heathwood Care Home DS0000040239.V335782.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Current fees are: £413.02 to £550 This unannounced inspection took place in the presence of the manager Ms Gill Page over one day. A total of six hours were spent in the home. Evidence to support this inspection was gathered by talking to residents, staff and visitors. A review was also carried out of care records, staff personnel files, records maintained in the home and the environment. Comments made by residents were all in praise of the staff and management. One lady spoken to insisted on stating how well in her opinion Heathwood was run. Whilst a lady, who has commented in past inspections and lives at Heathwood under the impression she is staying at a boarding house in Westonsuper-Mare, said she was very impressed and would recommend Heathwood to her friends. Another lady said ‘they are so good really, nice young girls to look after me and my own room.’ One relative spoken to said that they always found the staff very helpful and the care to a high standard. They said they always found their mother well dressed and happy. The atmosphere in the home was relaxed and cheerful. Residents were observed exercising personal choice, all residents were well dressed and well groomed. During the morning residents were observed taking part in a reminiscence group where they were discussing their favourite holidays. One resident said she still did not like fussy entertainment but staff understood this and helped her to do something else. This was a very positive inspection and no requirements were made. What the service does well: What has improved since the last inspection? Since the last inspection the first stage of building and renovation work has been completed. All rooms are maintained to a high standard. Reminiscence therapy is provided regularly by an outside organisation. Residents past lives have been taken into consideration so the subjects covered are relevant to the groups. Heathwood Care Home DS0000040239.V335782.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. The summary of this inspection report can be made available in other formats on request. Heathwood Care Home DS0000040239.V335782.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 Heathwood Care Home DS0000040239.V335782.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3 and 5. 6 does not apply Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Admissions to the home are not made until a full needs assessment has been made. This assessment involves both the prospective resident and their family or advocate. Prospective residents have the opportunity to visit the home prior to admission. A contract or statement of terms and conditions clearly states the rights and obligations of the individual. EVIDENCE: The manager confirmed that following a referral or enquiry she will carry out a full assessment of the prospective resident’s needs. This can be carried out either in hospital or in the residents’ own home. The resident is fully involved in the assessment process with the support of family or advocate. The prospective resident can visit Heathwood during which time the assessment can be carried out if it is more convenient for them. Heathwood Care Home DS0000040239.V335782.R01.S.doc Version 5.2 Page 9 The preadmission assessment includes psychological needs. All care records reviewed contained clear and concise preadmission assessments. In most cases these were also supported by a full Social Services or hospital Care Plan. Care records also contained signed and dated contracts and statements of terms and conditions. Prospective residents are invited to visit the home prior to admission. A relative or representative usually carries this out on their behalf. Residents spoken to were unable to comment on the admission procedure. The relative spoken to said they were not involved but believed their brother/sister found the manager helpful and supportive through out the process. Heathwood Care Home DS0000040239.V335782.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, and 10 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Residents at Heathwood receive effective personal healthcare support provided by staff who have an understanding of the importance of person centred care. Care plans give concise guidance for staff who promote residents individual preferences. Staff respond appropriately and sensitively to personal needs ensuring they are conducted in privacy. The home has developed an efficient medication policy to which staff adhere. EVIDENCE: The care records for five residents were reviewed during this inspection. The records contained very clear guidance for staff. They showed evidence of Person centred care, emphasising where necessary residents’ personal needs and preferences. Staff spoken to showed a clear awareness of individual resident’s needs, as well as the diverse needs of people with dementia or other disabilities. It was noted the care records also contained information about specific health conditions for residents. These were researched from the Heathwood Care Home DS0000040239.V335782.R01.S.doc Version 5.2 Page 11 Internet or received from hospital. This demonstrates good practice and provides staff with clear information. Enabling them to meet the personal needs of individual residents with a better level of understanding. Residents spoken to confirm that staff are eager to assist them in maintaining personal choice. One lady who sometimes does not like the busy times in the home said I only have to ask and they will help me up to my room for some quiet time. Care plan reviews were recorded monthly. Relatives are also involved in regular reviews when their opinion and support is sort. Concise life histories were evident enabling staff to have an understanding of personal preferences. Care records also show that residents were supported in attending health-care appointments. They evidenced appointments with chiropodist, dentist and optician as well as appointments at various clinics. A review of medication records revealed no errors and staff were observed to administer medication within current guidelines. All staff administering medication have received appropriate training. Heathwood Care Home DS0000040239.V335782.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported in maintaining meaningful and important relationships with family and friends. There are appropriate daytime activities which residents are encouraged to become involved with. These include maintaining contact with the local community. A healthy and balanced choice of meals is provided. Care staff are sensitive to the needs of residents who require help at mealtimes. EVIDENCE: Residents take part in a varied programme of activities; these are assessed as suitable to their personal abilities. Residents stated that there was always something to do, whilst two ladies agreed that there was no need to get bored. During the inspection a group of residents were observed taking part in a reminiscence group. This is run by an outside agency on a regular basis. Residents were discussing their favourite holidays and they were so engrossed in the session that lunch was delayed until they could finish. A full life history is sort by the staff at Heathwood enabling them to understand specific likes and dislikes. When setting up the reminiscence groups specific attention was Heathwood Care Home DS0000040239.V335782.R01.S.doc Version 5.2 Page 13 paid to traumatic memories residents may have. So the therapist was aware of subjects that may not be suitable for individuals. Records maintained by the home showed that residents took part in regular activities and trips out. Care plans identified personal preferences; these showed that the home enabled residents to maintain contact with their church or peer group. There are no restrictions on visiting within the home and residents can entertain guests in one of the lounges or the privacy of their own room. One lady stated that she looked forward to taking her visitors up to her room where she could indulge in some private ‘gossip.’ Meals are prepared in Heathwoods own kitchen, residents commented on the standard of meals provided. They all said that mealtimes were a pleasant experience and the meals were excellent and well prepared. Lunch was observed to be relaxed and unhurried. The meals were well presented and a variety of fresh vegetables available. Staff took time to be sensitive of the needs of residents who needed assistance during lunch, although residents were also observed to be supportive of each other. Heathwood Care Home DS0000040239.V335782.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a clear complaints procedure; which is available within the home. Policies and procedures regarding protection of residents are satisfactory and are reviewed and updated. All staff demonstrate an awareness of the content of the policy. EVIDENCE: The home has a clear and robust complaints policy and procedure, which gives timescales and directs relatives and residents to the Commission for Social Care Inspection. No complaints have been received since the last inspection; the complaints folder was available to read. Residents spoken to said if they wanted to raise concerns they could go to the manager. The policies and procedures for the Protection of Vulnerable Adults and Whistleblowing were very clear and concise. Staff spoken to were aware of the issues surrounding adult protection and knew where they could find guidance in the office. The home also had a copy of the North Somerset inter agency policy and procedure. Heathwood Care Home DS0000040239.V335782.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are encouraged to treat Heathwood as their own home. Heathwood provides a very well maintained, safe comfortable and attractive home. EVIDENCE: Heathwood is a well decorated and well maintained home. The décor, lighting and furnishing is all to a high standard. Since the last inspection the first stage of the building work has been completed. The new rooms are all decorated to the high standard observed throughout the home. Residents have a choice of communal areas and private rooms meet the floor space requirements stipulated in the National Minimum Standards. Residents spoken to said they had nice rooms and could bring in anything they wished. Rooms contained plenty of personal possessions. One lady said she ‘could not fault the hard Heathwood Care Home DS0000040239.V335782.R01.S.doc Version 5.2 Page 16 work put in to keep the home so clean.’ It was observed that staff continue to maintain a high standard of cleanliness. The home was free of offensive odours on the day of the inspection. Staff are aware of infection control guidelines and of the homes policies and procedures. The manager has contact details to obtain any specialist advice should it be required. Heathwood Care Home DS0000040239.V335782.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 and 29 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is consistently enough staff available to meet the needs of the residents. Staff have all received training relevant to Dementia Care and the resident group within the home. The service has a robust recruitment procedure; which supports the protection of vulnerable adults. EVIDENCE: Staffing rotas for the weeks prior to the inspection showed that sufficient numbers of staff were on duty to meet the needs of the current resident group. Residents spoken to said there were always enough staff. Staff confirmed that they did not feel pressurised through staff shortage or lack of knowledge when caring for the resident group in the home. The manager and owners encourage staff to obtain an NVQ and support them in the process. Of eleven care staff only 3 have completed their NVQ level 2 or above. However other care staff are in the process of obtaining the training. Recruitment records show that all the required checks were being carried out prior to new staff commencing work in the home. Staff spoken to understood their roles and responsibilities within the team. All mandatory training was up-to-date. Advertisements were displayed for training events available for staff. Records show that staff had also received training in Dementia Care, Adult Protection and Administration of Medication. Staff are also provided with training in Heathwood Care Home DS0000040239.V335782.R01.S.doc Version 5.2 Page 18 managing the diverse needs of residents with particular disabilities such as diabetes, sight or hearing impairment. Heathwood Care Home DS0000040239.V335782.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager has the required qualifications and is competent to run the home. She adopts an open and approachable style of management. She ensures that the homes quality assurance system is used to its best effect. The manager oversees an efficient system of staff supervision. Safeguarding resident’s health and safety is given a high priority; this is underpinned by robust policies and procedures. EVIDENCE: Staff and residents spoken to said they felt they could approach the manager at any time. The manager was observed to have an open and approachable manner towards both residents and staff throughout the inspection. Surveys Heathwood Care Home DS0000040239.V335782.R01.S.doc Version 5.2 Page 20 received from relatives through the homes quality assurance supported this observation. Responses said they always felt welcomed in the home. The manager carries out an annual quality assurance questionnaire with relatives and those residents able to express an opinion. Relatives are also invited to care reviews and their comments and opinions acted upon. The home does not handle residents’ personal finances. Health and safety in the home was satisfactory. The fire log was reviewed and showed that staff had received fire training updates throughout the year. Fire drills involve both day and night star. All checks had been carried out in line with current guidelines. A full fire risk assessment has been carried out and is available in the fire log file. Service records were all up-to-date and available for inspection. Insurance details were displayed in the home. Generic and working risk assessments continue to be reviewed. Heathwood Care Home DS0000040239.V335782.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 X 3 4 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 4 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 X 3 X 3 Heathwood Care Home DS0000040239.V335782.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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 Heathwood Care Home DS0000040239.V335782.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Taunton Local Office Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Heathwood Care Home DS0000040239.V335782.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. 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