Inspecting for better lives Key inspection report
Care homes for older people
Name: Address: Heeley Bank Heeley Bank Road Sheffield S2 3GL The quality rating for this care home is:
two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Ivan Barker
Date: 0 8 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area.
Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection.
This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home
Name of care home: Address: Heeley Bank Heeley Bank Road Sheffield S2 3GL 01142557567 01142555803 heeleybank@schealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): CC Care Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 64 Number of places (if applicable): Under 65 Over 65 0 46 dementia old age, not falling within any other category Additional conditions: 18 0 The maximum number of service users who can be accommodated is: 64 The registered person may provid the following category of service only: Care Home with Nursing, Code N. To service users of the following category: Either. Whose primary care needs on admission to the home are within the following catgories: Old age, not falling within any other category, Code OP, maximum number of places 46 Demntia, Code DE, maximum number of places 18 Date of last inspection Brief description of the care home Heeley Bank is a purpose built two storey building in the Heeley area of Sheffield. The home is divided into three units. Each unit had facilities for a designated category of people. There are a total of sixty-four bedrooms, all en-suite consisting of toilet and washbasin. There is a large car park to one side of the building and there is a large garden area. The weekly charges ranged between 329.00 pounds and 513 pounds. Care Homes for Older People
Page 4 of 28 Brief description of the care home There were additional charges for hairdressing, newspapers and chiropody. There were copies of the statement of purpose and service user guide available. Care Homes for Older People Page 5 of 28 Summary
This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: We have reviewed our practice when making requirements, to improve national consistency. Some requirements from a previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use the service are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Only a limited number of the National Minimum Standards were examined at this inspection (with emphasis on the key standards) and the previous requirements. The person present at the inspection was B Furniss manager. Care Homes for Older People
Page 6 of 28 Within this site visit, which occurred over a five and a half-hour period, we toured the building, examined requirements relating to the previous inspection, case tracked three people (case tracked means looking at the care and service provided to specific people living at the home; checking records relating to the health and welfare, care plans and other records; by talking to the specific people; viewing the personal accommodation as well as communal living areas). Spoke with other people, relatives and also three staff and examined assessments, care plans, risk assessments, menus, complaint files, staff files and quality assurance at motoring documents. The history of the service was examined prior to the site visit. This included the AQAA (Annual Quality Assurance Assessment) a self assessment document, telephone contact, letters and notifications. People who use the service will be refered to within this report as people. The last inspection was the 30th November 2007 What the care home does well: Peoples needs were known to the service prior to admission. The two assessments ensure that the service has sufficient information to assess if the service was able to meet their needs. Accurate care plans, and the introduction of new technology will contribute to the delivery of care. People and relatives were satisfied with the care. People and relatives expressed their views, during the inspection and within the surveys. The opinions were. They look after me very well. The nursing staff look after her extremely well and the other carers are also kind and thoughtful. We were shown around the home and introduced to all the staff who fully answered our questions about mums care. Yes Im very happy here. They always listen to us and always try to make dad comfortable. Whilst touring the building it was observed that several people were in a frail condition and in bed. All the people who were observed to be in bed appeared to be comfortable and well cared for. Activities were organised and people were able to exercise their right of choice within the service, therefore this provided stimulation and enhanced their quality of life. On discussing the activities with the people and their relatives and from the information from the surveys, the opinions were: She doesnt like to get involved in activities she says shes here to relax and is happy to stay in their room. The activities lady arranged a party for mum and dad on hearing that they had a 70th wedding anniversary. Mum had only been in the care home for a month so the family thought this was extremely kind and thoughtful. We do all sorts of things. The comments received regarding the meals were: The meals are very good and we get a choice. Care Homes for Older People Page 8 of 28 Mum hardly eats anything but the staff try to encourage her and also gives her protein drinks. They let us have a choice at breakfast. I have my meals in my room, they are always very nice. The service had a complaints procedure and it was operating according to the company policy. This should provide confidence that complaints were taken seriously and acted upon to address any shortfalls in care or service provision. People lived in an environment that was maintained to a good standard to provide a safe, well maintained, homely environment. Comments which were received from the people and relatives regarding the environment during the inspection and from the surveys were: My room is kept nice and clean. Whenever we find that something needs to be fixed in my dads room, we asked the staff and it is sorted straight away. Its very nice here. The manager was able to provide evidence that staff had received all the necessary training except for one individual. The training reflected on the quality of care being delivered to the people. The staff recruitment process provided protection for the people. The comments from the people and relatives during the inspection and in the surveys were: The staff on my fathers unit are very good, they always listen to us and always try to make dad comfortable. Very helpful staff. They always phone the family if mum needs a doctor and advise us of the results of the doctors visit. The nursing staff look after her extremely well and the other carers also kind and thoughtful. The majority of staff are pretty good, some are very good. The laundry workers do a good job. There is a quick return of laundry. The nurses do an excellent job. An experienced manager was in post. This contributed to the effective organisation and operation of the service. A comment within a survey stated: Care Homes for Older People Page 9 of 28 The new manager is helpful and has improved the running of the home. What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 10 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 11 of 28 Choice of home
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs were known to the service prior to admission. The two assessments ensure that the service has sufficient information to assess if the service was able to meet their needs. Evidence: On examination of the care management assessment within three care plans, it was established that there were assessments from the care management team. On discussing the assessments with the manager, she advised that the service received all the assessments prior to admission. The manager advised that she visited the potential person and undertook an extensive assessment prior to their admission. The information, within both these assessments assisted in providing sufficient
Care Homes for Older People Page 12 of 28 Evidence: information for the staff to decide if the service could meet the persons needs. It also provided sufficient information for care plans to be drawn up. The service provided intermediate care. The manager advised that the service did not employ the specialist staff for the service. However the specialist staff were provided by the contracting service. Care Homes for Older People Page 13 of 28 Health and personal care
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Accurate care plans, and the introduction of new technology will contribute to the delivery of care. People and relatives were satisfied with the care. Evidence: The care plan documentation was found to be comprehensive. On examination of the care plans, from three people, it was established that all the care plans were up-todate and had been evaluated on a monthly basis. There were daily entries within the care plans and these entries recorded the care delivered on a daily basis. Comprehensive risk assessments were included within the documentation and included moving and handling, nutrition, skin integrity, and other risk factors specific to individual. However within the documentation, there was no record of the person or his/her
Care Homes for Older People Page 14 of 28 Evidence: relatives signing the record. Also several documents completed by the staff did not have signatures. The manager advised that they had purchased an electronic recording system called Checkit. The manager advised that every member on the night shift was given a device. She then demonstrated the use of one of the electronic devices. She identified that each member of staff had a pin number. Then using the device, the member of staff visited the room and scanned the room code into the device. The member of staff then entered the information regarding the care that was given to that person. Examples of the care that could be recorded were, if the person was awake or asleep, turned or not turned and on which side they were turned, and also the amount of fluid the person had taken. At the completion of the shift the staff placed the devices into a docking station which downloads the date into a computer. This allowed monitoring and analysis by the manager. The manager advised that she was of the opinion that the introduction of these devices had had a positive effect on the care and service provided. It was discussed that it may be more difficult introducing the device onto the day shift, but it may be useful when people are receiving palliative care. People and relatives expressed their views, during the inspection and within the surveys. The opinions were: They look after me very well. The nursing staff look after her extremely well and the other carers are also kind and thoughtful. We were shown around the home and introduced to all the staff who fully answered our questions about mums care. Yes Im very happy here. They always listen to us and always try to make dad comfortable. Whilst touring the building it was observed that several people were in a frail condition and in bed. All people who were observed to be in bed appeared to be comfortable and well cared for. However 2 people had 2 drinks left on their tables. On discussing the care allocation with the care staff we were advised that, we care for everyone. It was discussed with the manager that this care practice was open to question as care staff may assume that another member of staff has given the care. The introduction of individualised allocation was discussed with the manager. She
Care Homes for Older People Page 15 of 28 Evidence: agreed to speak to her staff and implement the individualised care practices. The storage, ordering, administration and disposable of medication procedures were discussed with the manager. The procedures explained by the manager were satisfactory. On examination of the medication administration records, these were found to be satisfactory. Care Homes for Older People Page 16 of 28 Daily life and social activities
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Activities were organised and people were able to exercise their right of choice within the service, therefore this provided stimulation and enhanced their quality of life. Evidence: The manager advised that there were 2 Activities Co-ordinators. There was an activities programme displayed within the home. Also special events were organised. There was a pub quiz organised for that evening. Also entertainers came into the home on a monthly basis. On examination of the activities co-ordinated records it was established that she did keep records but it was discussed that the activities and who participated, could be recorded in a more efficient way. On discussing the activities with the people and their relatives and from the information from the surveys, the opinions were: She doesnt like to get involved in activities she says shes here to relax and is happy to stay in their room. The activities lady arranged a party for mum and dad on hearing that they had a 70th
Care Homes for Older People Page 17 of 28 Evidence: wedding anniversary. Mum had only been in the care home for a month so the family thought this was extremely kind and thoughtful. We do all sorts of things. Regarding the meals, the manager advised that people were given a menu sheet to complete the day before the meal. This was confirmed by the people who we spoke with. The cook then received a list of the orders. The menu was displayed at the reception and on the dining tables. There was a cooked breakfast available. There were two choices of the main meal and two choices of the desert. Soup, light meals and sandwiches were available at tea. The comments received regarding the meals were: The meals are very good and we get a choice. Mum hardly eats anything but the staff try to encourage her and also gives her protein drinks. The soup and rice pudding are far too thick. There is gravy available when we have fish or cheese and onion fan?? I buy my some of my own food which my family bring in. They let us have a choice at breakfast. I have my meals in my room, they are always very nice. Care Homes for Older People Page 18 of 28 Complaints and protection
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service had a complaints procedure and it was operating according to the company policy. This should provide confidence that complaints were taken seriously and acted upon to address any shortfalls in care or service provision. Evidence: The complaints procedure was displayed in the reception. On discussing complaints with the manager, she produced a complaints file. Within the file it showed that the complaints and the action taken had been recorded. It indicated that the complaint had been resolved within a 28 day period. No complaints were raised during the inspection. Regarding Safeguarding Adults, the service had policies and procedures which were available to staff. Staff had undertaken Safeguarding Adults training and the manager was able to evidence this, by showing copies of training certificates. Care Homes for Older People Page 19 of 28 Environment
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People lived in an environment that was maintained to a good standard to provide a safe, well maintained, homely environment. Evidence: On touring the building it was found to be clean and well maintained. Within the dementia unit, areas of the unit were colour-coded or decorated according to specialist guidance relating to dementia care. There were minor repairs required. Rooms 31 and 54 had a minor damage to the walls which needed repair and repainting. Rooms 38 required a new lock to the door. Comments which were received from the people and relatives regarding the environment during the inspection and from the surveys were: My room is kept nice and clean. Whenever we find that something needs to be fixed in my dads room, we asked the staff and it is sorted straight away. Its very nice here.
Care Homes for Older People Page 20 of 28 Evidence: The peoples rooms had been personalised and many contain photographs, pictures, some personal belongings and items of furniture, which the individual or the family had provided. Care Homes for Older People Page 21 of 28 Staffing
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager was able to provide evidence that staff had received all the necessary training except for one individual. The training reflected on the quality of care being delivered to the people. The staff recruitment process provided protection for the people. Evidence: On examination of the staff rotas and the examination of the staff on duty, the following was established: A. M. shift, 2 qualified nurses, 1 senior carer and 9 care staff. P. M. shift, 2 qualified nurses, 1 senior carer and 9 care staff. Night shift, 1 qualified nurse, 1 senior care and 4 care staff. Plus a manager, an administrator, domestic, catering staff and laundry staff. A full assessment of the dependency needs of the people was not undertaken and compared with the indicated staffing levels.
Care Homes for Older People Page 22 of 28 Evidence: On examination of 3 staff files all contained the required documentation including the Criminal Records Bureau and POVA (protection of of vulnerable adults) checks. An examination of staff training records it was established that moving and handling, fire training and various training to meet the needs of the people had been undertaken. However one individual had not received fire training within a year. The manager advised that this individual had been asked on several occasions to attend the training. The manager supported this comment by producing copies of the letters that had been sent to the individual. We were informed that the individual would be attending the next training session which was on the 19th January 2009. The comments from the people and relatives during the inspection and in the surveys were: The staff on my fathers unit are very good, they always listen to us and always try to make dad comfortable. Very helpful staff. They always phone the family if mum needs a doctor and advise us of the results of the doctors visit. The nursing staff look after her extremely well and the other carers also kind and thoughtful. The majority of staff are pretty good, some are very good. Sometimes there is a shortage of staff. Some lack enthusiasm. The laundry workers do a good job. There is a quick return of laundry. The nurses do an excellent job. Care Homes for Older People Page 23 of 28 Management and administration
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. An experienced manager was in post. This contributed to the effective organisation and operation of the service. Evidence: There is not a registered manager in post. However the manager had received a date for her fit person interview. The manager advised that she had 30 years experience in care and 6 years experience in management. She had obtained her Registered Managers Award. A comment within a survey stated: The new manager is helpful and has improved the running of the home. Regarding the Quality Assurance, the manager undertakes quality monitoring and the operation manager reviews this monitoring and undertakes her own quality
Care Homes for Older People Page 24 of 28 Evidence: monitoring. The information provided from these indentifies any shortfall within the service and action plans are produced to address these shortfalls. The monitoring and the actions plans were observed at the inspection. Regulation 26 documentation, which are records of the registered persons monthly visits were up to date. Regulation 37 notices, which are documents that are sent to the Commission regarding untoward occurrences, including falls,acidents etc; have been received by the Commission. The information showed that appropriate action had been taken. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No. Refer to Standard Good Practice Recommendations 1 8 The care staff need to be given responsibility of individual people so that they are full aware of the care that should have been and has been given. The manager needs to continue with her application to become the registered manager 2 31 Care Homes for Older People Page 27 of 28 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - 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!
