Inspection on 10/05/05 for Heliosa Nursing Home

This inspection was carried out on 10th May 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Heliosa Nursing Home 13/11/06

Heliosa Nursing Home 12/07/06

Heliosa Nursing Home 05/10/05

Heliosa Nursing Home 28/10/04

Heliosa Nursing Home 05/07/04

Heliosa Nursing Home 23/02/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE HELIOSA NURSING HOME 54 Boundary Lane Congleton Cheshire CW12 3JA Lead Inspector June Shimmin Unannounced 10 May 2005 09:15 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. HELIOSA NURSING HOME F51 F01 S18732 Heliosa V222920 100505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Heliosa Nursing Home Address 54 Boundary Lane Congleton Cheshire CW12 3JA 01260 273351 01260 297794 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) Takepart Limited Mrs Lyndis Swinden Care Home 35 Category(ies) of OP Old Age (35) registration, with number of places HELIOSA NURSING HOME F51 F01 S18732 Heliosa V222920 100505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 Within the maximum of 35 beds, 3 OP beds are provided for personal care Date of last inspection 28 October 2004 Brief Description of the Service: Heliosa can care for up to 35 older people requiring nursing care but currently only takes up to 31 residents. The home was originally 3 cottages built in the early 1800`s and was converted for use as a nursing home in 1970-80. The home is detached and has a private garden. It is located in a quiet residential area of Congleton. The town centre of Congleton is approximately two miles away. The home is on two floors and there is a passenger lift and staircase to the first floor. There are a variety of aids and adaptations around the building to allow residents to move about more independently. Thirty of the bedrooms are single, twenty of the thirty bedrooms have en suite facilities of toilet and wash hand basin. Two double rooms do not have en suites. The home has a dining room and lounge. There are several communal bathrooms and toilets. The owner is in the process of extending the home to provide an additional 9 single bedrooms with en suite facilities. This extension is expected to be completed by the autumn. HELIOSA NURSING HOME F51 F01 S18732 Heliosa V222920 100505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 8 hours. The manager, four staff members, ten residents, one visitor, and three care professionals were spoken with. A tour of the home was undertaken. Care records for two residents were inspected together with records on fire safety, recruitment and medication. What the service does well: What has improved since the last inspection? The owner has provided an updated information leaflet (statement of purpose and service user guide) about the home and the services it provides. Appropriate pressure relieving equipment is provided for all residents at risk of developing pressure ulcers. The owner has undertaken a survey, to ensure that the home has a process in place, to measure whether the care home is providing a good quality service. Care staff take part in a fire drill twice a year and the owner has provided a comprehensive fire risk assessment of the home. HELIOSA NURSING HOME F51 F01 S18732 Heliosa V222920 100505 Stage 4.doc Version 1.30 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. HELIOSA NURSING HOME F51 F01 S18732 Heliosa V222920 100505 Stage 4.doc Version 1.30 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 HELIOSA NURSING HOME F51 F01 S18732 Heliosa V222920 100505 Stage 4.doc Version 1.30 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) 3 The admission process of permanent stay residents is satisfactory. Assessments completed by nurses for people on the Intermediate Care scheme can be contradictory. The care needs of residents admitted under this scheme are not always identified and documented on admission to Heliosa, and are not reviewed. This can result in residents not receiving all the care they need. EVIDENCE: The home owner has provided the Commission for Social Care Inspection with a copy of Heliosa`s Statement of Purpose and Service User Guide. These documents provide information about the home and the facilities it provides. The home manager assesses the care needs of residents who are moving into the home on a permanent basis. Individual assessments are carried out before the resident moves into the care home, to ensure that individual needs can be met. HELIOSA NURSING HOME F51 F01 S18732 Heliosa V222920 100505 Stage 4.doc Version 1.30 Page 9 Nurses and social workers assess the care needs of residents admitted under the Intermediate Care scheme. The assessments of two residents admitted to the home under this scheme had been written by Intermediate Care Nurses. Two assessments for the same resident contained conflicting information about the state of the resident`s skin. One assessment documented a blister on one heel of the resident, while the other assessment documented that there were no problems with the skin. Staff at Heliosa did not notice this problem on admission and the resident developed a pressure ulcer on the heel which was not detected until 23 days later. The manager said that sometimes staff at the home were not given full information about residents admitted under the Intermediate Care scheme. This resulted in the home admitting a resident whose needs could not be met by the care home. In one particular instance the manager took prompt action to ensure a resident`s care needs were reviewed, so that he could move to a care home suited to his needs. HELIOSA NURSING HOME F51 F01 S18732 Heliosa V222920 100505 Stage 4.doc Version 1.30 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 standard(s) 7, 8, 9 and 10 Care plans of people admitted under the Intermediate Care scheme did not show how all of their care needs should be met. There was no evaluation of whether the care given to residents had met their needs. Other aspects of residents’ care, such as medication and referral for medical treatment, were well managed and residents were treated with dignity and privacy. EVIDENCE: Residents said that they were satisfied with the care they received at the home. They said that staff knocked on their doors before entering and also felt that their privacy and dignity was upheld. The care plans of two people admitted to Heliosa under the Intermediate Care scheme, showed that care home staff had not provided a care plan for one resident who had been living at the home for more than two months. A risk assessment for the prevention of pressure sores, completed on admission to the care home, identified that the resident was at high risk of developing these. The risk assessment had not been reviewed and there was no care plan in place to address this need. There was however, a pressure relieving mattress on the bed. A care plan relating to mobility had been completed by a physiotherapist together with detailed notes. HELIOSA NURSING HOME F51 F01 S18732 Heliosa V222920 100505 Stage 4.doc Version 1.30 Page 11 The resident had particular needs relating to continence and diabetes management. The care given to this resident had not been reviewed to assess whether this had been effective. One care need only, was identified for the second resident, for a pressure sore which was only reported 23 days after admission to the care home. A risk assessment for the prevention of pressure sores was completed on admission, but was incorrect, and had not been reviewed since that date. The pressure sore was on the resident`s heel and could potentially delay the rehabilitation process. The resident stated that he suffered some mild discomfort from the pressure sore. Care records demonstrated that residents were referred to a variety of health care professionals including GPs, specialist nurses, physiotherapist and chiropodist. A number of care professionals were complimentary about the care home and its staff. Medication is generally well managed and there is a well maintained medication room. Both residents admitted under the Intermediate Care scheme had facilities to keep medication in their rooms, but were not encouraged to administer their own medication. As they both live alone and were returning to their own homes, it is good practice to encourage self administration. This is vital both to promote independence and to ensure that the residents are confident to self administer medication. HELIOSA NURSING HOME F51 F01 S18732 Heliosa V222920 100505 Stage 4.doc Version 1.30 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 standard(s) 12, 13, and 15 Relatives and friends can visit at any reasonable time and are made to feel welcome. A number of residents said the standard of food was good. Activities arranged for residents tend to consist of group activities only. EVIDENCE: The care home has a Comfort Club Committee which includes staff, relatives and volunteers and provides fundraising events for the benefit of residents. The commitment of many staff to the wellbeing of residents is evident. One staff member has made individual knee quilts for all the residents, together with friends at the University of the Third Age. At Christmas, schoolchildren performed a concert for the home. A coffee morning is planned in June at Congleton library to raise funds for resident outings. Although there were no specific celebrations over the Easter period, all residents received a small bunch of flowers. The local Brownies visited Heliosa in April to talk to the residents, giving them pots of flowers. A hairdresser visits every week and an entertainer visits every month. The staff said that there is an occasional singa-long in the afternoon. There was little or no documented evidence about the previous and current social and leisure care needs of individual residents. Several residents commented that there was not much going on during the day. Staff said that a church minister visits the home every two months or on request. Residents said that their families and friends were made to feel welcome by care home staff. HELIOSA NURSING HOME F51 F01 S18732 Heliosa V222920 100505 Stage 4.doc Version 1.30 Page 13 The standard of catering at the home is good and provides choice. The cook said that menus were rotated on a five weekly basis. Residents are offered an early morning drink and snack before breakfast. A cooked breakfast is available on request. Meal times are: Breakfast – 9am Lunch – 12.30pm -1pm Evening meal – 4.30pm - 5pm Residents can eat meals in their rooms if they wish but are encouraged to have at least one meal with the other residents. In addition to three meals a day, morning coffee / tea, afternoon tea with homemade cakes and supper at 8. 30pm are provided. Hot and cold drinks are available on request and celebration birthday cakes are provided. Menu boards are in the lounge and dining room. The lunch today was corned beef pie with chipped potatoes and vegetables, with omelette as an alternative. The dessert was fresh fruit salad. The evening meal was bacon sandwiches or assorted sandwiches followed by birthday cake and ice cream. The cook keeps records of those residents who have had an alternative to the main menu and those residents requiring a special diet. HELIOSA NURSING HOME F51 F01 S18732 Heliosa V222920 100505 Stage 4.doc Version 1.30 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 standard(s) 16 and 17 Heliosa has an effective complaints procedure with prompt action taken to address complaints and other issues raised. EVIDENCE: Heliosa provides a complaints procedure which is contained within the information leaflets (Statement of Purpose and Service User Guide). A number of residents said that they would report any concerns to a member of staff. The manager had received two complaints since the last inspection and had taken prompt action to put matters right. Residents were able to vote if they wished. HELIOSA NURSING HOME F51 F01 S18732 Heliosa V222920 100505 Stage 4.doc Version 1.30 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 standard(s) 19, 20 and 26 The home is generally well maintained and clean. The manager had tried hard to ensure that disruption during building work was kept to a minimum. EVIDENCE: Since the last inspection a major building project was undertaken to extend the care home,providing an additional nine single en - suite bedrooms. The main entrance to Heliosa has been moved and a second lounge area closed. A room which was previously closed has been reopened, to provide an additional temporary lounge area for residents. Residents said that disruption to their daily lives had been minimal and that they had enjoyed watching the new extension taking shape. The owner said that the three bathrooms had been redecorated since the last inspection. The home was clean and tidy. Some parts of the first floor corridor require redecoration and a light in the corridor outside room 4 was not working. This had been fixed two days later. There were no headboards on beds in two rooms. The maintenance man had recently stopped working at the home and the owner was planning to recruit to this vacancy. HELIOSA NURSING HOME F51 F01 S18732 Heliosa V222920 100505 Stage 4.doc Version 1.30 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 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, 28 and 29 Staff are generally highly regarded by residents. Staff spoken to enjoyed working at the home. Staffing levels in the morning have temporarily decreased. Recruitment procedures are still not thorough. EVIDENCE: Heliosa has a staff group who have worked at the home for a number of years. The manager is to be commended for continuing to ensure that staff are supported to work towards achieving NVQ qualifications. Of a number of residents spoken to, all except one, were happy with the care they received and spoke highly of the staff. A nurse employed by the home to work between 9am and 2pm during weekdays was off work for two months. The manager had not employed another person to cover these duties. One resident comment that they had to wait when they requested the toilet. A visiting professional also commented that staffing levels were sometimes low. Other residents however, had no concerns about staffing levels. The manager is supernumerary and is not included on the staff roster. The manager had not applied for a check to see if a new member of staff was on the protection of vulnerable adults (POVA) list before they started work at the home. This process had been started two days later. HELIOSA NURSING HOME F51 F01 S18732 Heliosa V222920 100505 Stage 4.doc Version 1.30 Page 17 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) 33 and 38 The manager has started a process to ensure that staff receive formal supervision. Other quality assurance measures are in place to ensure that the home delivers a good quality service. The manager has ensured fire safety at the home. EVIDENCE: Staff are given feedback about how they work at the home and can discuss their training and development needs. The nurse in charge started a continuous process in January 2005 to check if the home gives a quality service. Relatives are able to express their opinions directly to the manager, a nurse, or through the Comfort Club Committee. The home achieved Investors in People status in November 2004. Heliosa maintains close links with visiting professionals from the health and Social Service sectors. Several professionals met with during the visit, were all complimentary about standards of care at the home. HELIOSA NURSING HOME F51 F01 S18732 Heliosa V222920 100505 Stage 4.doc Version 1.30 Page 18 The manager has ensured fire safety at the home. A fire risk assessment was provided in December 2004. All the recommendations made by the fire officer during his visit in March 2005, have been carried out. Fire equipment at the home is checked weekly and staff undergo training in fire safety at regular intervals. Several residents were being transported in wheelchairs without footrests which could result in injury. Although staff said that this had been requested by the residents, there was nothing documented to this effect, and no risk assessment in place. HELIOSA NURSING HOME F51 F01 S18732 Heliosa V222920 100505 Stage 4.doc Version 1.30 Page 19 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 2 x x 2 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x 2 2 3 STAFFING Standard No Score 27 2 28 4 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 x x x 3 x x x x 3 HELIOSA NURSING HOME F51 F01 S18732 Heliosa V222920 100505 Stage 4.doc Version 1.30 Page 20 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 3 Regulation 14 Requirement The needs of residents admitted under the intermediate care scheme must be reviewed on admission to the care home. A care plan must be provided for all service users living at the home including those admitted under the intermediate care scheme. (Previous timescale of 28/12/2004 not met) Residents who are at risk of developing pressure sores must be identified on admission to the care home and appropriate action taken to stop pressure sores developing. (Previous timescale of 28/11/2004 not met) Lights in the corridor of the first floor must be kept in good working order at all times. (Previous timescale of 28/10/2004 not met) All staff working at the home must have a satisfactory enhanced disclosure from the Criminal Records Bureau before starting work. Timescale for action 10 July 2005 10 July 2005 2. 7 15 3. 8 15 10 July 2005 4. 25 13&23 10 June 2005 5. 29 19 Schedules 2&4 10th June 2005 HELIOSA NURSING HOME F51 F01 S18732 Heliosa V222920 100505 Stage 4.doc Version 1.30 Page 21 6. 38 13&23 Wheelchairs must be fitted with footrests and these must be used when transporting service users around the home. (Previous timescale of 28/10/2004 not met.) 10 June 2005 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. 3. 4. Refer to Standard 3 9 24 27 Good Practice Recommendations The social interests, hobbies, religious and cultural needs of service users should be documented on admission to the care home. Service users admitted to the home under the intermediate care scheme should be supported to administer their own medication to promote independence. Headboards should be provided on beds in rooms 1 and 3. Additional staff should be employed to cover for staff sickness. HELIOSA NURSING HOME F51 F01 S18732 Heliosa V222920 100505 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Unit D, Off Rudheath Way Gadbrook Park Northwich Cheshire, CW9 7LT 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 HELIOSA NURSING HOME F51 F01 S18732 Heliosa V222920 100505 Stage 4.doc Version 1.30 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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