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Inspection on 23/06/05 for The Heights Care Centre

Also see our care home review for The Heights Care Centre for more information

This inspection was carried out on 23rd June 2005.

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The service users were satisfied with the care and service provision. The inspector received a warm and friendly greeting, at the time of the inspection and their full co-operation during the inspection. The washer had broken down, however the home had increased the staffing hours to ensure that the service to the service users was not diminished. The care plans in some areas were very extensive and gave clear instruction for the provision of care.

What has improved since the last inspection?

There had been redecoration to the rooms that were identified within the last report.

What the care home could do better:

The care plans need to be up to date, evaluated monthly and record the service user`s needs. The documents need to be signed by the relative or service user or person acting on the service user`s behalf or contain information why the document is not signed. The registered person should provide the home with the equipment listed within the body of this report. The registered person should provide adequate floor covering. The registered person must comply with these and previous requirements. There has been non-compliance to 3 of the 5 previous requirements.

CARE HOMES FOR OLDER PEOPLE The Heights Ankerbold Road Tupton Chesterfield S42 6BX Lead Inspector Ivan Barker Unannounced Inspection on Thursday 23rd June 2005 at 10:00am 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 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. The Heights C52 CO2 S2085 The Heights V235063 230605 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Heights Care Centre Address Ankerbold Road Tupton Chesterfield Derbyshire S42 6BX 01246 250345 01246 250520 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) Highfield Care Homes Ltd Mrs Sharon Rogers Care Home with Nursing 36 Category(ies) of 6 DE registration, with number 30 OP of places The Heights C52 CO2 S2085 The Heights V235063 230605 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 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, reutzfeldt Jakob Disease, Korsakoff`s Psychosis, Artereo-Sclerotic Dementia conditions, who are in the latter stages of the illness, and present with similar clinical features, as Dementia. 3. The unit must have at least one member of staff trained in Demential care on each shift. 4. A Registered Mental Nurse must be available for advice and support for the service users, staff and the unit, 24 hours a day. 5. 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. Date of last inspection 28/02/2005 Brief Description of the Service: The Heights Care Centre is a purpose built care home in the village of Tupton. The home has a small unit, on the ground floor, for service users with dementia type needs. The unit consists of six bedroms, a lounge / diner and a bathroom. The remaining part of the home for elderly service users receiving personal and /or nursing care. The elderly section of accommodation including communal facilities which is over two floors. The Heights C52 CO2 S2085 The Heights V235063 230605 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The person present at the inspection were Mrs S Rogers, manager. Within this inspection, which occurred over a three and half hour period, the inspector toured the building, spoke to service users, relatives and staff and examined the care plans and other documentation. He spoke with 11 service users. Unfortunately no relatives were at the home during the inspection. What the service does well: What has improved since the last inspection? What they could do better: The care plans need to be up to date, evaluated monthly and record the service user’s needs. The documents need to be signed by the relative or service user or person acting on the service user’s behalf or contain information why the document is not signed. The registered person should provide the home with the equipment listed within the body of this report. The registered person should provide adequate floor covering. The registered person must comply with these and previous requirements. There has been non-compliance to 3 of the 5 previous requirements. The Heights C52 CO2 S2085 The Heights V235063 230605 Stage 4.doc Version 1.40 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. The Heights C52 CO2 S2085 The Heights V235063 230605 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection The Heights C52 CO2 S2085 The Heights V235063 230605 Stage 4.doc Version 1.40 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 standard(s) 6 Intermediate care was not provided. EVIDENCE: The manager advised the inspector that the home did not provide intermediate care. The Heights C52 CO2 S2085 The Heights V235063 230605 Stage 4.doc Version 1.40 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 standard(s) 7, 8 Inaccurate care plans will not contribute to the delivery of care, and may place the service users at risk. The service users were satisfied with the care and service provision. EVIDENCE: On examination of 4 care plans, the inspector found that some individual needs were evaluated on a daily basis, and included a daily summary, but there had not been a monthly review, when the whole care needs of the service user had been re evaluated. For example: Within one plan, the toileting, and hygiene needs had been reviewed, but not the fluid intake of the service user, as prescribed in the care plan. Also a care plan had been reviewed and stated that the service user required the use of the hoist, but the previous instruction of using a Stand Aid had not been discontinued. This may lead to lifting aids which were not appropriate being used. The Heights C52 CO2 S2085 The Heights V235063 230605 Stage 4.doc Version 1.40 Page 10 However it should be stated that in other areas of the care plans the information was extensive and the plans were well prescribed to meet the service users’ needs. There was no signature from either the relative or the service user, which identified that they had been consulted regarding the care being provided. On discussing this fact with the manager, she informed the inspector that some service users were unable to sign and had no relatives, and some had no relatives who visited. The inspector informed the manager that if no signature could be obtained she should record that fact, but also to look to other people who may support the service user for example care managers, advocates etc. The manager took on board these shortfalls and agreed to raise them with the staff. The inspector received positive comment from the service users. They informed the inspector that the care was good and that they enjoyed the activities. The Heights C52 CO2 S2085 The Heights V235063 230605 Stage 4.doc Version 1.40 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 standard(s) 0 These standards were not assessed at this inspection. EVIDENCE: The Heights C52 CO2 S2085 The Heights V235063 230605 Stage 4.doc Version 1.40 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 standard(s) 0 These standards were not assessed at this inspection. EVIDENCE: The Heights C52 CO2 S2085 The Heights V235063 230605 Stage 4.doc Version 1.40 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 standard(s) 19, 20, 22, 24 25, 26. The environment, monitored at this inspection, had not been maintained to the required standard to provide a safe, well-maintained environment for services users. Specialist equipment to meet the service user’s needs had not been provided. EVIDENCE: The inspector monitored the previous requirements from the last inspection, and established the following; The manager informed the inspector that the home was exploring the provision of a portable loop system. She recognised that the requirement was raised at the inspection in November 2003, had the first timescale of 31st March 2004, and was yet have been complied with. The redecoration to the rooms had been completed. The Heights C52 CO2 S2085 The Heights V235063 230605 Stage 4.doc Version 1.40 Page 14 Regarding the locks and lockable storage the inspector recognised that some rooms had locks and lockable storage, but not all. The manager informed the inspector that the provision of locks and lockable storage was ‘in hand’ but had been delayed because of the change of owners. The strip-lighting in the small lounge remained rather than the domestic type. As the loop system, locks and lockable storage and the domestic light were yet to be supplied and fitted, the requirements were repeated. The inspector established that 3 out of the previous 4 requirements had not been met. On touring the building, at this inspection, the following was found: Within room 32, there was a carpet which had shrunk to such a degree that it was approximately 1- 2 cm from the skirting board, on all sides of the room. Therefore not affixed and a possible tripping hazard. The manager agreed that the carpet needed to be replaced. Within the laundry one washer was broken. To compensate for the loss of the washer, the laundry staff worked an additional 2 hours per day to maintain a service and stop the laundry piling up. As the home had put in place additional resources and the outcome for the service users of adequate service provision from the laundry was unaffected, then no requirement was listed. On discussing the laundry issue with the service users, they advised the inspector that they were not aware of the problem and had seen no decrease in service. The Heights C52 CO2 S2085 The Heights V235063 230605 Stage 4.doc Version 1.40 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 Current staffing levels in place would appear to meet the current dependency needs of service users, accommodated within the home. EVIDENCE: On examination of the duty rotas and discussion with the manager the inspector established the following; On the am shifts, there were I qualified nurse and 5 care assistants. On the pm shifts, there were I qualified nurse and 4 care assistants. On the night shifts, there were I qualified nurse and 2 care assistants. In addition there was the manager, administrator, activities co-ordinator and a student nurse, caring for 30 service users (15 receiving nursing care, and 15 receiving personal care.) The service users informed the inspector that the staff were ‘kind’ and that they particularly enjoyed the activities provided by the activities co-ordinator, who was new in post. The Heights C52 CO2 S2085 The Heights V235063 230605 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 0 These standards were not assessed, at this inspection. EVIDENCE: The Heights C52 CO2 S2085 The Heights V235063 230605 Stage 4.doc Version 1.40 Page 17 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION 2 2 x x x 2 x 3 STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x x x x x x x The Heights C52 CO2 S2085 The Heights V235063 230605 Stage 4.doc Version 1.40 Page 18 yes 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 7, 8 Regulation 15 Timescale for action The registered person must 23rd July ensure that the care plans are up 2005. to date, evaluated monthly and signed by the service user, relative, or a person acting on their behalf. The registered person must 23rd July ensure that the floor cover in 2005 room 32 is adequate and safe The registered person must 17th ensure that the lighting is of January domestic type. 2005 This requirement is repeated. The registered person must 17th provide door locks and lockable February storage, as specified in 2005 Standards 24.5 and 24.7. This requirement is repeated. The registered person must 17th provide equipment in accordance February with the assessed needs of 2005. service users, in this instance, a loop system is required. This requirement is repeated for the second time and had a previous timescale of 31st March 2004. Requirement 2. 3. 19, 24 20 16 23 4. 24 12, 16 5. 22 23 6. The Heights C52 CO2 S2085 The Heights V235063 230605 Stage 4.doc Version 1.40 Page 19 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 Good Practice Recommendations The Heights C52 CO2 S2085 The Heights V235063 230605 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection 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 The Heights C52 CO2 S2085 The Heights V235063 230605 Stage 4.doc Version 1.40 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!