Inspection on 05/10/05 for Heliosa Nursing Home

This inspection was carried out on 5th October 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 10/05/05

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 Announced Inspection 5th October 2005 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Heliosa Nursing Home DS0000018732.V253439.R01.S.doc Version 5.0 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. Heliosa Nursing Home DS0000018732.V253439.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Heliosa Nursing Home Address 54 Boundary Lane Congleton Cheshire CW12 3JA 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) 01260 273 351 01260 297794 Takepart Limited Mrs Lyndis Swinden Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35) of places Heliosa Nursing Home DS0000018732.V253439.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Within the maximum of 35 beds, 3 OP beds are provided for personal care 10th May 2005 Date of last inspection 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 three cottages built in the early 1800`s and was converted for use as a nursing home in 1970. 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 and 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. 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 end of the year. Heliosa Nursing Home DS0000018732.V253439.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was carried out on 5 October, 2005 and lasted approximately eight and a half hours. The manager was on duty together with the agreed numbers of care and ancillary staff. During the inspection nine residents, a GP, a member of the clergy, the manager and six members of staff on duty were spoken with. A range of care, health and home records were examined and a tour of the premises, including all lounges, other shared areas and a number of bedrooms, was undertaken. Comment cards for use by residents, relatives, GP`s and health and social care professionals in contact with the home were forwarded to Heliosa prior to the inspection. One service user, two relatives, one GP and one care professional returned completed cards. What the service does well: What has improved since the last inspection? The care of residents admitted under the Intermediate Care scheme is significantly better managed. Care plans describing the care to be given to residents are much improved. Care staff take action to ensure that residents at risk of developing pressure sores are identified. Heliosa has an adequate supply of pressure relieving mattresses. Lights in the corridor of the first floor of the home are in good working order. Heliosa Nursing Home DS0000018732.V253439.R01.S.doc Version 5.0 Page 6 Wheelchairs are fitted with footrests and are used when transporting residents around the home. Risk assessments are provided for residents who refuse to have footrests. The social interests, hobbies, religious and cultural needs of residents are documented on admission to the home. 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 DS0000018732.V253439.R01.S.doc Version 5.0 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 Heliosa Nursing Home DS0000018732.V253439.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 6 Information about Heliosa is available but is not displayed. Residents are assessed prior to admission to ensure that Heliosa will be able to meet their needs. Residents are encouraged to visit before moving in permanently. The management of residents admitted under the Intermediate Care scheme is good. EVIDENCE: Information about Heliosa is contained within a Statement of Purpose and Service User Guide. These information leaflets were last updated in January 2005. Neither document was displayed in the reception area of the home. The manager said that this information was kept in the office during building work. Heliosa Nursing Home DS0000018732.V253439.R01.S.doc Version 5.0 Page 9 Before residents move in, new residents are visited either in their own home or other setting, to make sure that that their care needs can be met. The manager talks to the person and writes notes about their care needs. The resident’s care needs are reassessed when they move into the home. A full written assessment was seen for two residents who had recently moved into the home. Written assessments may also be provided by a nurse or social worker. If a resident’s needs change the home contacts appropriate health and social care professionals to assist in carrying out a reassessment of their needs. Assessments include biographical and social data about residents which is good practice. Heliosa admits residents under the Intermediate Care scheme. This provides residents with a short period of rehabilitation at the home before returning to their own home. Health care professionals visit Heliosa to assess the progress of residents admitted under this scheme and work with staff at the home to ensure that residents can return to their own home wherever possible. The care plans of two residents admitted under this scheme were looked at. The content of the plans was satisfactory and had identified most care needs. Heliosa Nursing Home DS0000018732.V253439.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Progress has been made with care plans but further improvements are needed to make sure that all residents’ care needs are met effectively. The system for managing the residents’ medications is generally satisfactory apart from the signing for the administration of medication. Residents’ rights to privacy and dignity are upheld. EVIDENCE: The care plans of three residents were looked at including two residents admitted under the Intermediate Care scheme. The physical care needs of residents were assessed on admission using a professionally recognised tool (Barthel). This is good practice if it is used to check regularly on the progress being made by the resident. Some care plans were pre printed and others were written by nursing staff. The content of these care plans was good. Appropriate risk assessments were provided. Most care needs had been identified and a care plan provided for that need. The psychological care needs of residents needed to be documented and also a care plan for communication for one resident in particular. The care plans had been reviewed but did not evaluate the care given to residents. Heliosa Nursing Home DS0000018732.V253439.R01.S.doc Version 5.0 Page 11 A visiting GP was complimentary about the care provided at Heliosa. Additional health care needs are identified and referral made to relevant health care professionals. Written and verbal comments stated that the dignity and privacy of residents was respected. Medication is generally well managed. However, there were a number of gaps on medication administration records where the nurse had not signed to indicate that the medication had been given. The records relating to controlled drugs were good. The medication room was kept clean and tidy and the temperatures of the fridge and room recorded. Heliosa Nursing Home DS0000018732.V253439.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Standards of catering are good. Group social activities are provided and where possible residents can express choice about their daily lives. Visitors are welcomed at Heliosa. EVIDENCE: Two clergymen representing a number of churches in the Congleton area were visiting Heliosa during the afternoon and most residents joined in a Harvest Festival service. Residents said that they enjoyed the service. Several residents who did not join in said that they had been given a choice about whether to attend or not. Relatives visiting said that they were made to feel welcome and this was also confirmed in writing, “they are always very welcoming.” They were able to visit their relative in private. Heliosa Nursing Home DS0000018732.V253439.R01.S.doc Version 5.0 Page 13 The pre-inspection questionnaire (PIQ) provided details of activities organised at Heliosa. These included music, daily newspapers, a monthly entertainer, choirs, a falconry display, and a dog obedience demonstration. Relatives take residents out. Other activities in the community included boat trips, a visit to a luncheon club and barbecues at the home. A visit to the pantomime was being planned. The care plans did not indicate how the social care needs of residents were being met. The manager said that staff do not have time to sit in lounges with residents. However, Heliosa does not employ anyone to devise and deliver activities on an individual basis. The manager and five carers had recently attended a course on nutrition in the elderly and said that the times of meals had been altered to ensure that there was a longer gap between meals. Breakfast is now available from 8 30am and the manager said that residents are eating better. The standard of catering at Heliosa is good and offers choice. Residents can take all their meals in their own room if they wish but are encouraged to have at least one meal with other residents. The menu is displayed in the lounge and dining room. There are three meals every day with drinks and snacks available mid morning and afternoon and supper in the evening. The lunch menu included chicken or curry with cheesecake or fresh fruit salad for dessert. The evening meal was soup, salmon salad or beef sandwiches followed by egg custard or bananas in jelly with cream. The cook keeps a record of residents who want something different to the advertised menu. Special diets are catered for. Heliosa Nursing Home DS0000018732.V253439.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Heliosa provides a complaints procedure. Some residents and relatives are unaware of this procedure. Policies and procedures are in place to protect residents from abuse. Staff know what to do in the case of alleged abuse of a resident. EVIDENCE: A complaints procedure was not displayed. Most residents and relatives were aware of who to speak to if they were unhappy about any aspect of their care or that of a relative. However, the information leaflet (service user guide) produced at the inspection did not include the name, address and telephone number of the CSCI so that people can contact this organisation if they wish. The manager kept a record of complaints and the outcome of these complaints. Heliosa has a policy and procedure relating to the protection of vulnerable adults which was last reviewed in March 2005. Staff undertake training in this subject as part of their NVQ training. Heliosa Nursing Home DS0000018732.V253439.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 24 and 26 Some older parts of the building need prompt attention to repair walls damaged by damp. There are currently limited bathing facilities for residents requiring assistance to bathe. Overall, Heliosa is well maintained and the environment clean and tidy. EVIDENCE: A tour of the premises was undertaken; this included all communal areas and a number of bedrooms. A new extension providing an additional nine single bedrooms and other facilities is nearly complete. The manager anticipated that building work would be finished within two weeks. Although there has been no disruption to residents several visitors commented about difficulty parking. Heliosa Nursing Home DS0000018732.V253439.R01.S.doc Version 5.0 Page 16 Heliosa is kept clean, hygienic and tidy. This was also commented on by a relative, “always clean.” The laundry is due to be relocated to the new extension when it is complete. A concern was raised about clothes not being ironed but the manager said that clothes are ironed. The clothing worn by residents was ironed and a rack of ironed clothing was also visible in the laundry. The manager said that the home is unable to cater for specialist laundry needs. The décor and furnishings of residents` rooms was of a good standard. Residents confirmed that their rooms were well kept. There was no headboard on four beds in the older part of the building. This has been a recommendation at previous inspections. The nurse call bell was activated and answered promptly by a member of staff. A bathroom and separate shower room in the older part of the building were out of action due to large damp patches on the walls. Another bathroom and toilet at the opposite end of the home was also out of action because of no water supply. The resident in the room next to this bathroom commented that this meant walking to the other end of the corridor to reach a toilet. This also means that the home only has one available bath which is suitable for the needs of residents who need assistance to bathe. The manager said that this problem would be put right in the near future. Heliosa provides a number of aids and adaptations suitable for the needs of residents with varying degrees of disability. It was noted that there were adequate numbers of pressure relieving mattresses. Heliosa Nursing Home DS0000018732.V253439.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Staff at Heliosa are highly regarded by residents, relatives and other visitors. Staffing levels are not adequate at weekends. Recruitment practices are still not thorough. Staff are supported to undertake appropriate training. EVIDENCE: Staff were described as being, “very nice, grand” and “excellent, very good.” The same staff group have worked at Heliosa for some time which provides stability and continuity of care. Agency staff are not used and `bank` staff, who are known to the home, on a few occasions only. Written comments were however made by three people that staffing levels were sometimes inadequate. At the weekend there should be a second nurse on duty between 8am and 2pm. The manager is a nurse but is supernumerary and does not appear on the duty rota. One comment concerned staff taking their lunch break together. The manager said that a second level nurse was on the floor whilst staff took this break to attend to the needs of residents. If the nurse required assistance this would be provided immediately. The recruitment records of a recently appointed member of care staff were looked at. An application form and satisfactory references were provided. A POVA first check was not seen although the manager said that one had been received. The staff member had worked unsupervised for a number of shifts before a satisfactory enhanced disclosure was received from the Criminal Records Bureau. Heliosa Nursing Home DS0000018732.V253439.R01.S.doc Version 5.0 Page 18 The PIQ indicated that 50 of staff had achieved NVQ level 2 or above. Training had been delivered to nurses and care staff in a number of subjects. Future training had also been planned. Staff said that they received support from management to undertake training. Heliosa Nursing Home DS0000018732.V253439.R01.S.doc Version 5.0 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 35 and 38 Heliosa is a family run business and is well managed. The manager is experienced and well qualified. The home is well maintained and measures are taken to ensure fire safety. EVIDENCE: Staff described the manager as being “very supportive.” The manager is a first level registered nurse and has attained appropriate management qualifications. The PIQ provided information about the servicing of equipment and installations at Heliosa. The manager said that the home does not become involved in the personal finances of residents and that those matters are dealt with by family members. The PIQ indicated that only one resident continues to manage their own financial affairs. Heliosa Nursing Home DS0000018732.V253439.R01.S.doc Version 5.0 Page 20 The manager said that the fire system and alarms were to be updated when the new extension was completed. The fire officer visited the home in March 2005 and made a number of recommendations. Records relating to fire safety were looked at. The manager has taken steps to ensure that fire equipment is adequately maintained and that staff undergo fire training on a regular basis. Heliosa Nursing Home DS0000018732.V253439.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 3 2 2 X 3 X 3 STAFFING Standard No Score 27 2 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X 3 X X 3 Heliosa Nursing Home DS0000018732.V253439.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? Yes 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 OP9 Regulation 13 Requirement Medication administration records must be signed to indicate that prescribed medication has been administered. A complaints procedure must be displayed. The name, address and telephone number of the CSCI must be included within the Service User guide. Adequate toilet and bathing facilities must be available. All beds should be provided with headboards. A second nurse must be employed between 8am and 2pm at all times, including weekends, as agreed in the staffing notice with the previous registration and inspection unit. All staff working at the home must have a satisfactory enhanced disclosure from the Criminal Records Bureau before starting work. (Previous timescale of 10/06/05 not met) Timescale for action 15/11/05 2 OP16 22 15/11/05 3 4 5 OP21 OP24 OP27 23(2)(j) 16(2)(C) 18 15/11/05 15/11/05 15/11/05 6 OP29 19 Schedules 2&4 15/11/05 Heliosa Nursing Home DS0000018732.V253439.R01.S.doc Version 5.0 Page 23 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 5 6 Refer to Standard OP1 OP7 OP7 OP12 OP12 OP27 Good Practice Recommendations The statement of purpose and service user guide should always be displayed. A copy of the service user guide should be given to all service users or their representative. Care plans should be provided to address communication and the psychological needs of residents. The review of care plans should evaluate care delivery and the care plan amended if necessary. Care plans should demonstrate how the individual social care needs of residents are being met. The manager should consider employing a person to deliver individual and group activities. Two members of staff should be working on the floor at all times, including during meal breaks. Heliosa Nursing Home DS0000018732.V253439.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich 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 DS0000018732.V253439.R01.S.doc Version 5.0 Page 25 - 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. 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