Inspection on 26/06/06 for Heffle Court

This inspection was carried out on 26th June 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Heffle Court 30/07/08

Heffle Court 03/09/07

Heffle Court 03/03/06

Heffle Court 03/01/06

Heffle Court 07/12/04

Heffle Court 29/06/04

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

CARE HOMES FOR OLDER PEOPLE Heffle Court Station Road Heathfield East Sussex TN21 8DR Lead Inspector Alexis Reilly Unannounced Inspection 26th June 2006 11:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Heffle Court DS0000021402.V295240.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. Heffle Court DS0000021402.V295240.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Heffle Court Address Station Road Heathfield East Sussex TN21 8DR 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) 01435 864101 01435 868046 The Harebeating Care Company Mr James Sales Care Home 34 Category(ies) of Dementia (34) registration, with number of places Heffle Court DS0000021402.V295240.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of service users to be accommodated is thirtyfour (34). Service users must be older people aged sixty-five (65) years or over on admission. Service users with a dementia type illness only to be accommodated. Date of last inspection 3rd March 2006 Brief Description of the Service: Heffle Court is a large, purpose built home providing residential care and support for 34 older people with a dementia type illness. The manager and dedicated staff team have created a relaxed, welcoming and homely environment. The registered owners are the Harebeating Care Company. The premises are well maintained, safe and accessible and comprise of service user accommodation on two floors, in single rooms. All rooms are fitted with an alarm call system and all but four have en-suite facilities. The rooms have been individually decorated and furnished. Many have been personalised with the service user’s own furniture and other possessions. Communal areas on both floors include comfortable lounges, spacious dining areas, bathrooms and toilets. Outside, there are safe and secluded courtyard gardens where residents may sit and relax. The home is located close to the centre of town and is close to local shops and a public house. The service currently charges between £366.00 – £800.00 per week. There are additional charges for chiropody at £9.00, hairdressing between £5.00 £30.00, and newspapers at cost from the local shop. Heffle Court DS0000021402.V295240.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection began at 12.30pm and lasted until 4pm. During the inspection the inspector examined care plans, risk assessments, health and safety documents, menus, supervision records, sheets which record the administration of medication, a selection of policies and procedures and staff recruitment files. Additional time was taken in the preparation and writing of the report. Residents were seen in the home and the inspector spoke with three residents, interviewed two staff members and spoke with the Registered Manager. Views of residents, relatives and health professional were gained via the Commission for Social Care Inspection Surveys the comments of which are included in this report. What the service does well: What has improved since the last inspection? All staff have completed a 1 day course in dementia care. Weight charts are in place and the Registered Manager has good links with the local doctor if a residents weight or nutritional intake was of concern. The medicine cupboard was secure on the day of the inspection. The service now operates a improved recruitment procedure that ensures the safety of residents. The Registered Manager has introduced a formal process of documented supervision for staff and is in the process of implementing this. Staff have now been provided with a copy of the General Social Care Council Code of Conduct. Heffle Court DS0000021402.V295240.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. Heffle Court DS0000021402.V295240.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 Heffle Court DS0000021402.V295240.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): 3,4 & 6 Quality in this outcome area is good. This judgement has been made using available evidence including a site visit to this service. The service ensures it has gained the relevant background information for a resident prior to offering them a place in the service. The service does not offer intermediate care. EVIDENCE: The manager carries out an assessment of prospective new residents care needs. This includes an assessment of general overall physical health, a life history which is completed by the family, and up to date information and assessments from the General Practitioner and Community Psychiatric Nurse. All residents admitted are on a 1 months trial. The Registered Manager will go and assess the resident at the hospital if appropriate or the resident will come to Heffle court for one day’s assessment. The service does not provide intermediate care. Heffle Court DS0000021402.V295240.R01.S.doc Version 5.2 Page 9 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 & 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a site visit to this service. Residents have plans of care however further improvements need to be made to provide a clear record of care and clear relevant risk assessments. Residents are not fully protected by the homes policies and procedures with regard to medication. EVIDENCE: Care plans are reviewed every two weeks. Invited to the review, are relatives, the residents General Practitioner, the Community Psychiatric Nurse and relevant Social worker. Care plans identify need, risk, aims and objectives and action needing to be taken. Risk assessments are in the process of being revamped and need to be more individualized and relevant to the individual resident. Currently Risk assessments are reviewed monthly. The doctor and District Nurse offer continual contact and support to the home, the Community Psychiatric nurse is based in the unit and visits weekly. Dieticians, dentist, and audiologist are contacted as required. The optician visits each six months, and the physiotherapist visits the service as required. The chiropodist visits Heffle Court on a monthly basis. Heffle Court DS0000021402.V295240.R01.S.doc Version 5.2 Page 10 On the day of the inspection medicine was stored safely however there were gaps in the record of administration of medication. Heffle Court DS0000021402.V295240.R01.S.doc Version 5.2 Page 11 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 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a site visit to this service. Residents have opportunities for a variety of appropriate leisure activities, and able to access the wider community and maintain good links with friends and families. Daily routines are very flexible with residents able to exercise choice. Residents enjoy their meals. EVIDENCE: The activities and leisure activities on offer at Heffle court range from regular visiting clergy, musical events, themed parties, hand massage, reminiscence, board games, outings to places of local interest, shopping trips and visits to local public houses. Meal times are totally flexible, and families are strongly encouraged to come into the service and are welcome to stay for meals. Staff where observed treating residents with respect and in discussion demonstrated how residents were offered choice. Heffle Court DS0000021402.V295240.R01.S.doc Version 5.2 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a site visit to this service. The service has an accessible complaints procedure in place, and service users feel their complaints are taken seriously and acted upon. Service users are protected from abuse by the policies in the service and by suitably trained and supervised staff. However further works needs to be completed on the Adult Protection policy. EVIDENCE: The service has had no complaints since the last inspection. Surveys received from residents, relatives and health professionals showed that people knew who to talk to if they were unhappy and knew how to make a complaint. The service has now sourced the Adult Protection Guidelines from East Sussex County Council obtained in Respect of the Protection of Vulnerable Adults. However further works need to be carried out to create a flow chart for the Adult Protection Guidelines to ensure it is easy and quick for staff to follow. Heffle Court DS0000021402.V295240.R01.S.doc Version 5.2 Page 13 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 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a site visit to this service. Residents live in a comfortable, homely and well-maintained environment. EVIDENCE: The premises are well maintained, safe and accessible and comprise of service user accommodation on two floors, in single rooms. All rooms are fitted with an alarm call system and all but two have en-suite facilities. The rooms have been individually decorated. Many have been personalised with the service user’s own furniture and other possessions. Communal areas on both floors include comfortable lounges. The service also has three dining areas. Outside, there are safe and secluded courtyard gardens where residents may sit and relax. Infection control procedures are in place and staff training is planned. Heffle Court DS0000021402.V295240.R01.S.doc Version 5.2 Page 14 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 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a site visit to this service. Residents’ needs are meet by suitably experienced and supervised staff. However the service must ensure they receive two written references prior to employing people in the home, and that 50 of staff are qualified to the required NVQ level 2 qualification. EVIDENCE: The service employees thirty five care staff in total. The ancillary staff number eleven. The total of care staff holding NVQ 2 or currently studying towards the qualification is eleven. Sixteen staff hold a current first aid certificate. Staff have competed the following training in the last 12 months; dementia, identifying abuse, infection control, manual handling, challenging behaviour, food hygiene, medication management, first aid and NVQ certificates. Four staff files were examined. Recruitment policies and staff files have been revised. The service has employed two new staff since the last inspection. There is new application for employment forms and health questionnaires. In place were two written references, photo identification, Protection of Vulnerable Adults checks, and details of when Criminal Record Bureau checks were obtained. One staff member has not had a Criminal Record Bureau Check returned and this is currently being processed, however they are working with a Protection of Vulnerable Adults check are additional to the shift and supervised at all times. New staff complete TOPPS induction training and the required, manual handling, dementia training, food hygiene, first aid, Heffle Court DS0000021402.V295240.R01.S.doc Version 5.2 Page 15 infection control, identification of abuse Protection of Vulnerable Adult training, challenging behaviour, and health and safety training. Personal development plans and ongoing training records, as well as supervision notes are recorded in individual staff files. On the day of the inspection one recruitment file had one written reference and one telephone reference. The service must ensure that as well as the other documentation required they must obtain two written references prior to employment within the service. Heffle Court DS0000021402.V295240.R01.S.doc Version 5.2 Page 16 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): 31,33,35,36,37 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a site visit to this service. The service is run and managed sufficiently and run in the best interests of the service users with their rights and best interests protected. EVIDENCE: The Registered Manager has been in post for 5 years, and has the Registered Manager Award, and is a qualified nurse. The Registered Manager is supported and assisted by two unit managers and two assistant managers. A catering manager oversees all catering matters and manages all ancillary and domestic staff. No residents monies are kept in the building, Heffle court uses its own money, gains receipts and invoices families at the end of each month. Surveys received from residents and relatives confirmed that residents had Heffle Court DS0000021402.V295240.R01.S.doc Version 5.2 Page 17 received a contract, and had enough information about the home to enable them to make a decision with regard to moving in. The surveys also highlighted that residents felt they usually received the care and support they needed, that staff listen to them and were available. Residents knew who to talk to if they were unhappy and that they usually enjoyed the meals in the home. Some further comments received were ‘the staff are always very welcoming and friendly when friends and family visit’. Some residents mentioned the meals can be a bit boring and that there is not enough choice. A comment was received with regard to the laundry in the home, stating that clothes have been damaged in the washing process. This was discussed with the Registered Manager who confirmed that any damaged clothing would be reimbursed. Staff confirmed that families are encouraged into the home and that the management are very approachable. The service has policies in place with regard to, equal opportunities/ethnic minorities, racial harassment occurring between service users, between staff by staff or by service users on staff. Sexuality and relationships, Values of privacy, dignity, choice, fulfilment, rights and independence. The service has reviewed the following policies and procedures Medical Accident, Emergency or Crisis, Non Medical Emergency or Crisis, Anti bullying and Harassment, Complaints, Equal opportunities, Whistle Blowing, Sexual Relations Between Residents, Continence Management, Dealing with Residents Money, Valuables and Financial Affairs, Referral and Admission of Residents Health and Safety, Infection Control including HIV/AIDS, Manual Handling, Waste Substances, Recruitment and Selection. The fire officer last visited the service on the 6th October 2005, the fire equipment manufactures last check was on 10th march 2006. The date of the most recent fire drill was recorded as the 5th May 2006. Fire alarms are tested weekly. The environmental health officer last visited the service on 5th July 2005, the requirements from this inspection have been met. The Approved gas installation engineer certificate is dated 22nd June 2005, and the central heating system was checked on the same date. Water temperatures are checked weekly. Portable appliance testing was carried out on electrical goods on 4th January 2006. The lift was last inspected on the 8th May 2006. Hoists and lifts are inspected three monthly. The service has an Electrical wiring certificate in place dated 21st Jan 2003. Heffle Court DS0000021402.V295240.R01.S.doc Version 5.2 Page 18 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 X 3 3 X 3 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X 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 2 X 3 3 2 2 Heffle Court DS0000021402.V295240.R01.S.doc Version 5.2 Page 19 Are there any outstanding requirements from the last inspection? Yes 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 Timescale for action 01/10/06 2. 3. 4. OP9 OP37 OP38 13(2) 24 23 That the plans of care provided give clear guidance to care staff on how to meet the needs of residents with reference to individual risk assessments. That the Manager continues to be aware of the nutritional needs of the residents and refer for additional screening if necessary. That all medicines are 26/06/06 administered following the correct guidelines. That all the homes policies and 01/10/06 procedures are updated and reviewed regularly. That appropriate risk 01/10/06 assessments are completed in relation of health and safety issues and responded to as necessary. Heffle Court DS0000021402.V295240.R01.S.doc Version 5.2 Page 20 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 OP18 OP33 Good Practice Recommendations That the adult protection procedure is improved with a clear flowchart with relevant contact numbers. That the CSCI is provided with a report in respect of quality monitoring review. Heffle Court DS0000021402.V295240.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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. 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