Inspection on 19/05/06 for The Heights Care Centre

This inspection was carried out on 19th May 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 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

The Heights Care Centre 25/06/08

The Heights Care Centre 27/06/07

The Heights Care Centre 23/06/05

The Heights Care Centre 28/02/05

The Heights Care Centre 17/11/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Heights, The Care Centre Ankerbold Road Tupton Chesterfield Derbyshire S42 6BX Lead Inspector Ivan Barker Unannounced Inspection 19th May 2006 09:00 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 Heights, The Care Centre DS0000002085.V294586.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. Heights, The Care Centre DS0000002085.V294586.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Heights, The Care Centre Address Ankerbold Road Tupton Chesterfield Derbyshire S42 6BX 01246 250345 01246 250520 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) Southern Cross Care Homes Limited Mrs Sharon Rogers Care Home 36 Category(ies) of Dementia (6), Old age, not falling within any registration, with number other category (30) of places Heights, The Care Centre DS0000002085.V294586.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. That The Home Accommodates One Named Individual For Nursing Care Who Is 41 Years Old. The registered person will only admit service users, into the home who have Dementia, Alzheirmer`s Disease, Picks Disease, Huntington’s Chorea, Creutzfeldt Jakob Disease, Korsakoff’s Psychosis, ArtereoSclerotic Dementia conditions, who are in the latter stages of the illness, and present with similar clinical features, as Dementia. The unit must have at least one member of staff trained in Demential care on each shift. A Registered Mental Nurse must be available for advice and support for the service users, staff and the unit, 24 hours a day. 6 DE service users can only be accommodated in the specialist unit, which has keypad locks and is located to the left of the main entrance. To add a one-off variation for a named individual (CW), under the category of PD. 7th November 2005 3. Date of last inspection Brief Description of the Service: The Heights Care Centre is a purpose built care home within the village of Tupton, Derbyshire. The home has a small unit, on the ground floor, for service users with dementia type needs. The unit consists of six bedrooms, a lounge / diner and a bathroom. The remaining part of the home is for elderly service users receiving personal and / or nursing care. The elderly section of the accommodation, including the communal space is situated over two floors. Heights, The Care Centre DS0000002085.V294586.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. 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 persons present at the inspection were: Mrs S Rogers manager. And latterly, Mrs T Saunders operations manager. Within this inspection, which occurred over a four-hour period, the inspector toured the building, examined requirements relating to the previous inspection, spoke with service users, and staff and examined some documentation. What the service does well: What has improved since the last inspection? What they could do better: The home should have acted upon the issue of the floor coverings prior to it being raised at the inspection. The staff need to be aware of that they should not leave cleaning substances unattended and not secure. Staff training regarding this may be appropriate. Heights, The Care Centre DS0000002085.V294586.R01.S.doc Version 5.1 Page 6 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. Heights, The Care Centre DS0000002085.V294586.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 Heights, The Care Centre DS0000002085.V294586.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): Standards 3 & 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Accurate assessments will ensure that the home has sufficient information to be aware of the service user’s needs prior to admission. EVIDENCE: The home received service user assessments from the Social Services Care managers or the hospital prior to admission. The manager prior to admission to the home assessed all service users. The inspector was shown evidence of the assessments of the service users, who he case-tracked. Regarding Standard 6, the manager advised the inspector that the home did not provide intermediate care. Heights, The Care Centre DS0000002085.V294586.R01.S.doc Version 5.1 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): Standards 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Accurate care plans will contribute to the delivery of care. Service users were satisfied with the care they received. EVIDENCE: On examination of the care plans, from the service users who were being case tracked, the inspector established that all 3 plans was up to date, and had been evaluated on a monthly basis. The inspector discussed the service users’ care needs with care staff, who were knowledgeable about the service users’ needs. Risk assessment were included within the documentation and included moving and handling, pressure area, and nutritional risk assessments. The inspector spoke with the service users who were being case tracked. Heights, The Care Centre DS0000002085.V294586.R01.S.doc Version 5.1 Page 10 They informed the inspector that; ‘The care was good’. ‘Satisfied with the care’. On auditing the storage of medications, the inspector found the door to the medication room closed but unlocked and the room unattended. A dose of Zomorph 10mg had been left within a medicine pot, on the cupboard. The manager raised her concerns regarding this matter, to the nurse in charge. He advised the manager that he had been called to attend a possible emergency raised by one of the care staff, and in his haste had not secured the medication or the room. The manager and inspector accepted that the nurse did need to respond to the situation, and good safe practice would dictate that he had at least secured the room, to prevent access by unauthorised persons. The nurse accepted that he had made an error, which had been created in some part by the ‘emergency’ situation, and he apologised to the inspector and managers. In view of the situation, the information provided, and the nurse being aware of his individual error, the inspector has not made a requirement regarding the storage of medications. The manager identified that she would raise the important of securing medications, to all the qualified staff. On examination of the medication administration the inspector observed that the medication administration records were up to date with all the records signed as appropriate. Visitors were allowed to visit the service user in the communal areas or in the privacy of their own room. Heights, The Care Centre DS0000002085.V294586.R01.S.doc Version 5.1 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): Standards 12,13,14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Various activities were organised within the home, which would provide stimulation to service users and enhance their quality of life. Service users were given the opportunity to exercise their right of choice regarding the provision of meals. EVIDENCE: The manager informed the inspector that an activities co-ordinator was employed and worked 20 hours per week. This was normally Tuesday to Friday and flexible as required by the service users. The activities programme was displayed, and available within the activities co-ordinator’s records. The manager produced the activity co-ordinators records which indicated what activities had occurred and who participated in the activity. On discussing the activities with the service users, the inspector was informed that they were satisfied with the sessions, and enjoyed them, particularly the ‘entertainers’ and they ‘liked some and were not bothered about others’. The inspector was aware that particular activities were designed specifically for the ‘dementia’ type service users. Heights, The Care Centre DS0000002085.V294586.R01.S.doc Version 5.1 Page 12 Regarding the meals, the manager informed the inspector that there was a choice of meal. The manager advised the inspector that the service users were offered the choices after breakfast, approximately between the hours of 10 –11 am, and then their choice was given to the kitchen staff. The inspector received positive comments from the service users, who were being case –tracked. The general comments were that the food was ‘good and a choice was available’. Heights, The Care Centre DS0000002085.V294586.R01.S.doc Version 5.1 Page 13 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): Standards 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. As far as could be established the home had a complaints procedure in place, which was operating according to the company policy and complaints were resolved within the expected timescales. The home was able to evidence that the staff had received Adult Protection training. Therefore staff would be aware of their responsibility regarding the protection of vulnerable adults and this may provide protection for service users. EVIDENCE: The complaints procedure was displayed and available to the service users and relatives. No complaints were recorded in the complaints file. On discussing complaints with the service users, they informed the inspector that they had no complaints. No complaints were addressed to the inspector, at the time of this visit. The home had policies and procedures relating to the Protection of Vulnerable Adults. The manager was able to provide training records that indicated that all staff had received Adult Protection training. Heights, The Care Centre DS0000002085.V294586.R01.S.doc Version 5.1 Page 14 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): Standards 19 and 26 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to the service. The environment, monitored at this inspection, had not been maintained to the required standard to provide a safe, environment for services users. EVIDENCE: On touring the home the inspector found that the home was generally well maintained, well decorated throughout and odour free. However within rooms 28,29,31 and 34, the carpets had shrunk and were away from the walls. The manager informed the inspector that she would need to raise a maintenance order with the company regarding the replacing of the carpets. On visiting the laundry, the inspector found that one washing machine was broken. The manager advised the inspector that during this period whilst the Heights, The Care Centre DS0000002085.V294586.R01.S.doc Version 5.1 Page 15 machine was broken, then the laundry staff hours had been extended and care staff were ‘helping out’. The inspector raised the issue that care staff should not be reduced from care to attend to the laundry. The manager assured him that the small amount of input from the care staff was not affecting the care. Heights, The Care Centre DS0000002085.V294586.R01.S.doc Version 5.1 Page 16 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): Standards 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The staff recruitment process should provide protection for the service users. The manager was able to provide evidence that staff had received training, which should reflect on the quality of care being delivered to the service users. EVIDENCE: On examination of the rota the following was indicated. Am shift. 1 qualified nurse plus 5 care staff. Pm shift. 1 qualified nurse plus 4 care staff. Night shift. 1 qualified nurse plus 2 care staff. Plus, the manager and activities co-ordinator. Caring for 30 service users on two units. A full assessment of the dependency levels of the service users was not undertaken by the inspector and compared with the indicated staffing levels. On examination of the 3 staff files, all 3 contained the required documentation, including Criminal Records Bureau checks. Heights, The Care Centre DS0000002085.V294586.R01.S.doc Version 5.1 Page 17 In relation to Moving and Handling, Fire training and Adult Protection, the manager showed the inspector the training records that indicated these and other specific clinical training had occurred Heights, The Care Centre DS0000002085.V294586.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): Standards 31,33,35, and 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. The management of the home does comply with the requirements of the Care Homes Act, and woks well as a team. Extensive quality assurance systems were in place that should assist the manager and operation manager to measure the home against expected outcomes. The poor practice of leaving of chemical substances unattended in a service user’s area may place service users at risk. EVIDENCE: Within the management structure of the company there was a registered manager who was supported by a regional operations manager. Heights, The Care Centre DS0000002085.V294586.R01.S.doc Version 5.1 Page 19 The registered manager had obtained The Certificate in Health and Social Care. The company had quality assurance systems, which were implemented by the manager and validated by the operations manager. The quality assurance monitoring system was extensive and monitored areas such as care plans, risk assessments, complaints, and service provision. On examination of the staff supervision records, the inspector established that staff had received supervision in March and May 06. The standard required supervision to occur six times a year. The home was on course to achieve this number of supervisions. Regulation 26 visit occurred and reports produced. These were shown to the inspector. Regarding the service users’ personal monies the home operated a basic credit and debit system, but involved the storage of monies in separate envelopes. On examination of the system, examining the accounts of the service users who were being case-tracked, the inspector observed that the money in the envelopes was correct to the accounting record. Regarding Standard 38, whilst touring the building the inspector observed cleaning fluids, which were left unattended in a corridor. No member of staff was in the vicinity of these substances. Cleaning substances should be secured when not being used, under the Control of Substances Hazardous to Health Legislation. The manager raised this matter with the member of staff, who had left the substances. It was established that this had not been a case of an emergency situation, as with the medication issue, previously stated within the report. Therefore a requirement has been made. Heights, The Care Centre DS0000002085.V294586.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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 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 3 2 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Heights, The Care Centre DS0000002085.V294586.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 Standard OP19 Regulation 16 Requirement The registered person must ensure that the rooms identified within the body of the report have adequate floor covering. The registered person must ensure that cleaning substances are not left unattended and unsecured so as to place service users at risk. Timescale for action 19/08/06 2 OP38 12 26/06/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Heights, The Care Centre DS0000002085.V294586.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Heights, The Care Centre DS0000002085.V294586.R01.S.doc Version 5.1 Page 23 - 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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