Inspection on 25/08/05 for Heightlea

This inspection was carried out on 25th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Heightlea 17/10/06

Heightlea 16/02/06

Heightlea 10/03/05

Heightlea 13/04/04

Heightlea 09/10/03

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Heightlea Old Falmouth Road Truro Cornwall TR1 2HN Lead Inspector Richard Coates Unannounced 25 August 2005 09:00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Heightlea D52-D04 S9113 Heightlea V245542 250805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Heightlea Address Old Falmouth Truro Cornwall TR1 2HN 01872 263344 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Spectrum Mr Giles Reynolds Docking Care Home 3 Category(ies) of Learning Disability (3) registration, with number of places Heightlea D52-D04 S9113 Heightlea V245542 250805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: No conditions have been set. Date of last inspection 10 March 2005 Brief Description of the Service: The registered provider for Heightlea is Spectrum. Spectrum is an organisation which provides services for people with autistic spectrum disorders. The home is registered to provide accommodation and care to up to three service users. There are four single bedrooms, two on the ground floor and two on the first floor. The shared space compises two sitting rooms, a conservatory, a spacious hallway and a kitchen-diner on the ground floor, and a large communal room on the first floor. There are two bathrooms, one on each floor. The home also offers a respite care and day care service. One service user currently has regular respite when one of the residents spends time with his family. Heightlea is a detached property situated on the edge of Truro and has pleasant rural views. The approach to the home is a fairly steep drive and the main access has a moderate threshold through the double glazed door and a substantial (approximately 9 inch) step at the inner door. The garden can be accessed down a step from the conservatory on to a patio. A path leads to a large sloping grassed area. Heightlea D52-D04 S9113 Heightlea V245542 250805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a planned unannounced inspection. The aims were to look at compliance with the requirements set in the last inspection report dated 10 March 2005 and to focus on key standards in the areas of care planning, lifestyle and the environment. The balance of the standards will be included in the announced inspection later in the year. The inspection took place during the 25 August 2005 and the inspector was at the home for 5 hours. The inspector spent time in discussion with the registered manager, staff and residents, toured the premises, inspected records and documents and had lunch with the residents. What the service does well: The residents have lived here for some years and are well settled. The house is spacious, comfortable and homely, with a large garden. The town centre of Truro is within easy walking distance. There are good public transport routes and the home has two cars to provide transport for residents. Care plans direct and inform staff clearly about the interventions and support required to meet the needs of each resident. Service users are encouraged to be independent in their personal care and in choosing what to wear. They enjoy going out shopping for their personal effects and clothes. Care staff record daily diaries – records of activities and outings for each resident and support residents to plan their activities and to complete their own diaries. The residents enjoy a wide range of activities inside and outside of the home, including attendance at the local college, social events and other activities in the community. They are encouraged to keep in touch with their families and meet with people from outside of the home. The residents said that they enjoyed the activities provided for them at the home. Residents also said that the home was well run. Service users go shopping for the household food and choose the menu with support from staff. They all said that they were satisfied with the food provided to them. They are encouraged to eat healthily and always have access to fresh fruit and healthy snacks. The home is clean, hygienic and well maintained. Heightlea D52-D04 S9113 Heightlea V245542 250805 Stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? 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. Heightlea D52-D04 S9113 Heightlea V245542 250805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Heightlea D52-D04 S9113 Heightlea V245542 250805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2 and 5 Residents and prospective residents receive appropriate information material in order to make an informed choice about the home. EVIDENCE: The service users guide now contains a summary of the fees and terms and conditions, and the accommodation provided for each individual. The registered manager reported that copies of this have been provided to families and social workers. Residents have read their guide through with support from staff. This was documented and signed on the example inspected. The registered manager said that he was intending to individualise the service users guides further and was reviewing the statement of purpose in order to update it. No new residents have been admitted since the last inspection so there were no examples to inspect for the assessment and introduction of a new resident to the home. Spectrum has detailed admission and assessment policies and procedures for prospective residents. Heightlea D52-D04 S9113 Heightlea V245542 250805 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 and 9 Care plans reflect the residents’ needs and personal goals. The risk assessments require development to fully support residents to take risks so that they can pursue an independent lifestyle. EVIDENCE: The records for one resident were case tracked. The care planning documentation comprised the risk assessment and safe working practice document, a care plan summary, and other elements of the care plan specific to the individual resident, for example the individual plan with goals and weekly activity plans. The care plan set clear objectives, gave staff directions and information on the care to be delivered, and provided a basic risk assessment. The key worker records regular monthly profiles. The individual plan was dated 26 April 2005 and the key worker was currently reviewing the care plan summary. The key worker should ensure that this resident signs the summary care plan when completed to evidence that he has been consulted. Care staff records a daily log of significant events and activities; the resident completes his own daily diary of activities. There is also a medical record which details basic medical information, allergies, a weight chart, and medication records. Heightlea D52-D04 S9113 Heightlea V245542 250805 Stage 4.doc Version 1.40 Page 10 Spectrum completes a detailed risk assessment and safe working practice document for each resident which sets out specific interventions for staff in managing risks. Where staff intervene in incidents, they complete an ‘antecedents, behaviour and consequences’ record. These were inspected during case tracking. Risk assessments for specific individual activities are not consistent or complete and are in the process of being drawn up. Heightlea D52-D04 S9113 Heightlea V245542 250805 Stage 4.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 15, 16 and 17 Service users enjoy a range of appropriate activities in and out of the home in accordance with their assessed needs, preferences and written care plans. They are supported to maintain contact with their families. EVIDENCE: Inspection of records and discussion with the residents showed that residents are engaged in a broad range of activities in accordance with their individual interests, abilities and needs, and as reflected in their care plans. This includes attending college for three of the residents. Care staff provide positive encouragement to develop their skills and range of activities. The home has sufficient staff and drivers to ensure that service users participate in activities individually as well as in small groups. During the unannounced inspection, they were all in and out of the house with staff, actively engaged in various activities during the day. Each resident draws up a weekly plan with support of proposed activities, outings and household tasks. The residents are supported to participate in a ‘Wednesday group’ with residents from other Spectrum homes to meet at local public houses and other social activities. Residents and staff walk into Truro for shopping and for visits to cafes. Information about Heightlea D52-D04 S9113 Heightlea V245542 250805 Stage 4.doc Version 1.40 Page 12 events is obtained from local newspapers and radio. There is evidence of a range of leisure activities in the home, including music systems, television, videos and DVDs, puzzles and games. Residents discussed their interest in sport with the inspector. There is a pool table and a table tennis table. Contact details for families and friends are in individual records. The registered manager discussed the family links maintained outside the home for each resident. Residents have freedom of movement around the home. The ‘COSHH’ cupboard and ‘sharps’ cupboards are locked. Residents, with one exception supported by a risk assessment, retain keys to their rooms. The registered manager reported that times for getting up and going to bed were flexible, but are sometimes linked to activities, for example, attendance at college. The variety of bed times was reflected in the night records. Residents participate in housekeeping tasks with support. Staff were noted to interact with residents appropriately and supportively. Service users are encouraged to eat healthily. They are involved in food preparation and are encouraged to develop their skills. They go shopping for household food, and plan menus together with staff. The menus evidence a varied and wholesome diet. There are usually two choices for main meals. Residents are able to access the kitchen at all times and have a ready supply of snacks, including fresh fruit. Care plans detail residents’ preferences and dislikes. No resident has a specific nutritional need at present. Main meals are a social occasion with residents and care staff sitting down together. The inspector had lunch with the residents. Residents stated that they were involved in planning meals and shopping and liked the current meals. There was sufficient variety and they ate the things they liked. They discussed the activities that they enjoy. They felt that the home was well run and did not suggest any changes or improvements to the current arrangements. Heightlea D52-D04 S9113 Heightlea V245542 250805 Stage 4.doc Version 1.40 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards will be included in the announced inspection later in the year. EVIDENCE: Heightlea D52-D04 S9113 Heightlea V245542 250805 Stage 4.doc Version 1.40 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards will be included in the announced inspection later in the year. EVIDENCE: Heightlea D52-D04 S9113 Heightlea V245542 250805 Stage 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 26, 27, 28 and 30 The home provides residents with a homely, comfortable and safe environment. EVIDENCE: Heightlea is a spacious detached property on the edge of Truro. There are two cars for accessing local amenities. The town is within walking distance and the ‘bus to Falmouth stops nearby. The premises appeared to be safe, comfortable, airy and clean. The approach to the house is a fairly steep drive and the main access is over two steps; one of these is a substantial step. The grounds are accessed through sliding doors down a step on to a patio area. The home is on two floors with a single staircase. The furniture and fittings are of good quality, domestic in nature and suitable for their purpose. The registered manager has completed a fire risk assessment. The home is well maintained and in good order. The home provides four single bedrooms. The bedrooms reflect the individual preferences and lifestyles of the residents and provide suitable furniture and fittings. There is a bathroom and toilet on each floor, each providing a bath, Heightlea D52-D04 S9113 Heightlea V245542 250805 Stage 4.doc Version 1.40 Page 16 shower, hand basin and toilet. The ground floor bathroom has recently been refitted. The toilets, baths, showers and basins were all clean and hygienic. There is extensive communal space that exceeds the recommended floor area. The ground floor provides a large sitting room and a smaller sitting room, a kitchen/diner, a spacious hallway and a conservatory. There is a large shared room on the first floor that accommodates a pool table. Sliding doors lead to a paved patio and access to a large sloping grassy area to the side of the house. Lighting is domestic in style. An activity board in the hallway displays weekly plans written by residents and other notices. The communal areas are clean, suitably furnished and in good decorative order. The home was clean and hygienic. A plan and checklist for regular household tasks is kept in the kitchen. There were no untoward odours. The laundry is off the kitchen; the registered manager stated that laundry is always transferred to the laundry in baskets. The laundry floor is vinyl. There is a new washing machine, replacing one that had become unreliable, and a tumbler dryer. The registered manager reported that there are no issues of incontinence or soiled laundry. Hand washing facilities with antiseptic hand wash are provided in the laundry and the bathrooms. It would be good practice to provide paper towels rather than cotton hand towels. The kitchen has a dishwasher to support good hygiene practice. Heightlea D52-D04 S9113 Heightlea V245542 250805 Stage 4.doc Version 1.40 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards will be included in the announced inspection later in the year. EVIDENCE: Heightlea D52-D04 S9113 Heightlea V245542 250805 Stage 4.doc Version 1.40 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37 and 42 EVIDENCE: The registered manager is currently working on his NVQ 4 in management and plans, following this, to complete the registered managers award. He meets the requirement for experience. Standard 42 was not inspected in detail – this will be included in the announced inspection. The certificate for the safety of the home’s electrical wiring was inspected to evidence compliance with a requirement from the last inspection. The certificate was issued by Manderley Maintenance Services on 31 March 2005 and was carried out to BS 7671. It states that documentation of the company’s qualification to issue the certificate is available at their office. The registered manager stated that he had checked this through the internet. Heightlea D52-D04 S9113 Heightlea V245542 250805 Stage 4.doc Version 1.40 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 x x x 3 Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 3 3 x 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Heightlea Score x x x x Standard No 37 38 39 40 41 42 43 Score 3 x x x x x x D52-D04 S9113 Heightlea V245542 250805 Stage 4.doc Version 1.40 Page 20 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 9 Regulation 13(4) Requirement Risk assessments must be completed for each service user for activities with potential risks. Timescale for action 31.12.05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 30 Good Practice Recommendations Hand washing facilities for staff should be provided with paper towels. 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