Inspection on 03/01/06 for Heffle Court

This inspection was carried out on 3rd January 2006.

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

Heffle Court 30/07/08

Heffle Court 03/09/07

Heffle Court 26/06/06

Heffle Court 03/03/06

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 Melanie Freeman Unannounced Inspection 3rd January 2006 13:30 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 Heffle Court DS0000021402.V276524.R01.S.doc Version 5.1 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.V276524.R01.S.doc Version 5.1 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 32 Category(ies) of Dementia (32) registration, with number of places Heffle Court DS0000021402.V276524.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The number of residents accommodated must not exceed thirty two (32). The people accommodated will be aged sixty five years or over on admission Only residents with a dementia type illness will be accommodated Date of last inspection 7th December 2004 Brief Description of the Service: Heffle Court is a large, purpose built home providing residential care and support for 32 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 to a high specification. 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 service users may sit and relax. The home is located close to the centre of town and is close to local shops and a public house. Heffle Court DS0000021402.V276524.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001 often use the term ‘service user’ to describe those living in care home settings. For the purpose of this report those living at Heffle Court will be referred to as ‘residents’. This was an unannounced inspection carried out on a weekday between the hours of 13.30 and 16.45 by two inspectors. The registered manager was in the home for part of the inspection and contributed to the inspection process and received the inspector’s feedback. The final feedback was given to the deputy manager at the end of the inspection. The inspectors spent time with residents and one visitor and were able to review the homes facilities and environment. Staff were spoken to and observed whilst working. The care documentation for 4 residents was reviewed in depth. Other records reviewed included the homes statement of purpose, service users guide, preadmission assessment documentation and some of the homes policies and procedures. What the service does well: What has improved since the last inspection? There was no requirements or recommendations made following the last inspection. The manager continues to respond to changes in any regulations that impact on the care home industry and keeps himself up to date. Heffle Court DS0000021402.V276524.R01.S.doc Version 5.1 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.V276524.R01.S.doc Version 5.1 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.V276524.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3 and 6 Heffle Court provides appropriate information about the home and the services it offers however this needs to be reviewed regularly and kept up to date. Residents are fully assessed prior to admission to ensure appropriate placement. EVIDENCE: During the inspection the statement of purpose was reviewed and it was noted that although this provides good information it was not fully accurate. The statement of purpose is available in the main office. A copy of the homes service users guide was not readily available however the inspector was able to confirm that each new resident is given a copy of this, and that it includes the terms and conditions of residency and a copy of the last inspection report. All prospective admissions to the home are assessed by the home manager who visits them and their families if possible. The assessment completed on two recently admitted residents were reviewed as part of the inspection and confirmed that these are completed to a satisfactory level. Heffle Court DS0000021402.V276524.R01.S.doc Version 5.1 Page 9 Intermediate or rehabilitative care is not provided at Heffle Court. Heffle Court DS0000021402.V276524.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 and 8 Although the arrangements for meeting resident’s needs are good staff are not provided with clear guidance on how to meet the resident’s health personal or social care needs. The lack of risk assessment and planning of care could lead to the health and welfare needs of residents not being met. EVIDENCE: The care documentation of four residents was reviewed in depth and identified a number of shortfalls that were confirmed to the deputy manager at the end of the inspection. One resident was found not to have any plans of care at all and other residents were found not to have plans of care that cover all their care needs. For example two of the residents clearly had challenging behaviour and this was not recorded in a plan of care. Therefore guidance was not being provided to staff on how to provide the best care for residents to ensure their and other residents safety and comfort. Heffle Court DS0000021402.V276524.R01.S.doc Version 5.1 Page 11 Risk assessments were not being used to inform the care provided for example one resident wanted to go out of the home on his own and there was no evidence to suggest that this activity had been risk assessed in any way. An immediate requirement form was left with the deputy manager at the end of the inspection and this required that individual risk assessments are completed and that clear guidance is provided to staff. On the ground floor care plans were stored in an unlocked cupboard in the dining room; this was not satisfactory as the documents contain personal details. Heffle Court DS0000021402.V276524.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 and 14 Current arrangements for activities and entertainment in the home need further development to ensure residents individual needs are met. Resident’s choices and wishes are respected. EVIDENCE: Discussion with the newly appointed Occupational Therapist, and management confirmed that improvements to the activities and entertainment are planned which will include some specific training for the new OT which will provide her with skills to engage more constructively individually and in groups with the residents and further structure to the activities programme. Staff were seen to be spending time with the residents and engaging them in conversation. One resident has been able to bring her small dog to live in the home giving her a focus and ongoing enjoyment from her pet. During the inspection it was noted that choices are given to residents and that these are responded to with resident’s wishes being respected. Residents are encouraged to be independent whenever possible and this should be further supported by individual risk assessments to ensure appropriate supervision and parameters are maintained. Heffle Court DS0000021402.V276524.R01.S.doc Version 5.1 Page 13 Heffle Court DS0000021402.V276524.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 Adult protection procedures in the home are not fully developed and therefore vulnerable adults may not be fully protected. EVIDENCE: The home has a policy and procedure for the protection of vulnerable adults. This needs to be updated to provide clear guidance to staff as to what action to take if there is an allegation or suspicion of abuse, with reference to the agency taking the lead on any adult protection issue and relevant contact numbers. When reviewing the care documentation the inspectors noted that two residents had been physically abusive to other residents. These incidents had not been reported in accordance with the Protection Of Vulnerable Adults guidelines to social services and there was no evidence to confirm that incident reports had been completed or that the plans of care had been reviewed and updated. An immediate requirement form was left with the deputy manager at the end of the inspection and this required that that the POVA guidelines policies and procedures are followed as necessary. Heffle Court DS0000021402.V276524.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24 and 26 Physical standards in the home are good ensuring that residents live in a well maintained, hygienic and generally safe environment. EVIDENCE: Heffle Court DS0000021402.V276524.R01.S.doc Version 5.1 Page 16 Heffle Court is a large, purpose built care home situated in a residential area of Heathfield, approximately half a mile from the town centre. Accommodation is provided on two floors and a shaft lift is fitted to assist those residents who may have mobility problems. The design and layout of the home is appropriate to meet the specific care needs of the residents admitted to the home and provides communal space to meet the individual and collective needs of the residents, including three spacious and comfortable lounges, two dining areas and an activities room. Toilet, washing and bathing facilities in the home are sufficient to meet the assessed needs of residents. The majority of bedrooms are fitted with en-suite toilet, washbasin and shower facilities. In addition there are also three assisted bathrooms, four toilets downstairs and three toilets on the upper floor. Residents rooms viewed were found to be attractive and very personalised providing adequate space and facilities. The home was found to have a high standard of cleanliness throughout and the laundry room was well equipped and was found to be locked for safety reasons. Heffle Court DS0000021402.V276524.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 and 28 Staffing arrangements ensure that residents are supported by a well-trained, motivated and caring staff group. EVIDENCE: At the time of this inspection 30 residents were living in the home. Staffing levels seen confirmed that they are good and appropriate to meet the specialist care needs of residents. Records confirmed that these levels are maintained and that care staff are supported by catering and domestic staff. Observations made during the inspection confirmed that staff have a good rapport with residents treating them with respect and managing difficult situations linked to residents mental health needs with calmness and professionalism. Residents and a visitor spoke well of staff, their comments included “staff are marvellous” and “I am very happy with the care and staff’’. Staff are encouraged and facilitated in undertaking NVQ training and many of the staff have or are completing their NVQ in care at level 2. Heffle Court DS0000021402.V276524.R01.S.doc Version 5.1 Page 18 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): 31,32,35 and 37 Heffle Court is well managed by a manager who has the skills and commitment to run the home in an open and positive way that promotes an inclusive atmosphere. Systems are in place to safeguard resident’s finances. EVIDENCE: Heffle Court DS0000021402.V276524.R01.S.doc Version 5.1 Page 19 The home manager is very experienced and is qualified both as a Registered General Nurse (RGN) and a Registered Mental Nurse (RMN). He has also recently completed the Registered Managers Award and is awaiting his certification. During the inspection the atmosphere in the home was found to be, relaxed, friendly and welcoming. Staff were found to be comfortable around the manager who had a good rapport with staff and residents. Discussions with the manager and staff confirmed an open management style in the home with regular staff meetings to allow for staff views to be heard and responded to. The home manager advised the inspector that the home do not have any involvement in resident’s monies. All activities or shopping is billed for in addition to the monthly fee with relevant receipts. An examination of the records retained within the CSCI office confirmed that the homeowner is not completing the required monthly regulation 26 reports despite the fact that she visits the home regularly. Heffle Court DS0000021402.V276524.R01.S.doc Version 5.1 Page 20 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 2 X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 1 3 3 3 3 3 3 X 3 STAFFING Standard No Score 27 3 28 3 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X 3 X 2 X Heffle Court DS0000021402.V276524.R01.S.doc Version 5.1 Page 21 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. 1 2 Standard OP1 OP7 Regulation 4 15 Requirement That the statement of purpose is kept up to date. That care plans are written for all residents to include full guidance regarding resident’s dementia, and how to manage challenging situations. To ensure confidentiality the plans should be stored securely. That risk assessments are used to inform the plans of care and ensure as far as possible residents safety. That the adult protection procedure is updated and provides clear guidance to staff following an allegation/suspicion of abuse. That this procedure is followed and clear records are maintained. That the required Regulation 26 visits by a representative of the owners are recorded with reports being forwarded to the Commission for Social Care Inspection. Timescale for action 01/02/06 01/02/06 3 OP8 13(4) 14/01/06 4 OP18 13(6) 01/02/06 5 OP37 26 01/02/06 Heffle Court DS0000021402.V276524.R01.S.doc Version 5.1 Page 22 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 OP1 OP12 Good Practice Recommendations That a copy of the service users guide is available in the home for any interested parties to view. That the planned improvements to the activities and entertainment in the home are implemented. Heffle Court DS0000021402.V276524.R01.S.doc Version 5.1 Page 23 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. Extracts may not be used or reproduced without the express permission of CSCI Heffle Court DS0000021402.V276524.R01.S.doc Version 5.1 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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