Inspection on 06/04/05 for Heritage Care Centre

This inspection was carried out on 6th April 2005.

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

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

Other inspections for this house

Heritage Care Centre 11/08/06

Heritage Care Centre 22/11/05

Heritage Care Centre 03/10/04

Heritage Care Centre 01/06/04

Heritage Care Centre 04/05/04

Heritage Care Centre 13/01/04

Similar services:

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

Henry Nihill House

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

CARE HOMES FOR OLDER PEOPLE Heritage Care Centre 30 Gearing Close Tooting London SW17 6DJ Lead Inspector Janet Pitt Unannounced 6th April 2005 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. Heritage Care Centre Version 1.10 Page 3 SERVICE INFORMATION Name of service Heritage Care Centre Address 30 Gearing Close, Tooting, London SW17 1YF 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) 0208 682 9050 LifeStyle Care PLC Pricilla Chibanda Care Home with Nursing 72 Category(ies) of Older People, dementia registration, with number of places Heritage Care Centre Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: Staffing levels on the ground floor, staffing levels on the first floor and ancillary staff. See certificate for details. Date of last inspection 6/10/04 Brief Description of the Service: Heritage Care Centre is a purpose built home comprising of three storeys. The ground floor and first floor have the communal areas and bedrooms of service users. The second storey has the kitchen, laundry and staff areas. Accomodation is provided in single rooms with ensuite facilties. All rooms conform to the space requirements of the Standards. Service users are encouraged to bring in personal possessions. The home is arranged in four discreet units. Nursing care is provided for service users and there is a separate dementia unit. All service users have access to a safe level garden, where seating is provided. There is a passenger lift available. Heritage Care Centre is situated on the site of the Old Tooting Bec Hospital within a housing complex and is accessible by public transport, which is approxiamately ten minutes walk from the home. The home has adeqaute parking spaces for visitors. Heritage Care Centre Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was undertaken unannounced and involved an inspector, a regulation manager and a pharmacy inspector. The inspection commenced at 08:50hrs and concluded at 14:00hrs. Service user files, staff records and training records were examined. A tour of the building was undertaken during that time four service users and six visitors were spoken with. Additional visits were made in October 2004 and January 2005 in relation to Protection of Vulnerable Adults procedures and investigations and complaints. What the service does well: What has improved since the last inspection? What they could do better: Files relating to training need to reflect staff training requirements and a clear indication of when staff have received training. Recording of daily care given needs to be improved to reflect the actual care given and evidence that care needs are being met. Recording of medicines received into the home and when given needs to be improved to evidence that medicines are handled correctly. Heritage Care Centre Version 1.10 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Heritage Care Centre Version 1.10 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 Heritage Care Centre Version 1.10 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 Admission procedures within the home demonstrate that there is a proper assessment prior to people moving into the home and upon admission. EVIDENCE: Four service user assessments were examined. All assessments included details of next of kin, date of birth, allergies and other personal and health information. All assessments were fully completed and there was evidence of service user or their representative being involved in the process. The admission assessment details were noted to be compliant with the Standard. Assessments made by other agencies prior to a service user being admitted were contained within the service user file. Heritage Care Centre Version 1.10 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) 7,8,9,10 and 11 Progress has been made on identifying health needs, but further work is required to ensure that care given is accurately recorded for each individual service user. The home has arrangements for the safe ordering, storage and administration of medication. The majority of service users are administered their medication correctly. On the day of the visit errors in administration and recording of medication were found on the ground floor putting service users health and welfare at risk. EVIDENCE: Four service user plans were examined. All service user plans flowed from the assessments of service users needs. The service user plans demonstrated what care was required to be given to meet service users needs. All service user plans were noted to be evaluated monthly and changes noted. Daily records lacked specific detail and tended to be task orientated, e.g. ‘slept well’ and ‘safety ensured’. There was evidence on one plan of individualised care given being recorded, i.e. ‘dressed warmly’. Comments received from visitors on the day of inspection included ‘’very content’ with care given and ‘love the home’. Heritage Care Centre Version 1.10 Page 10 Service users seen on the day of inspection were observed to be neat and tidy in appearance. Risk assessments were noted to be in place and were applicable to the individual service users identified risks. Service users wishes regarding terminal care and dying were noted to be recorded. Privacy and dignity of service users is respected. One inspector observed care staff informing a service user of what they were about to do, before assisting the service user. All medications in the clinical rooms and in six service users’ rooms and records relating to receipt, storage, administration and disposal of medication were examined. The nurse in charge on each unit was interviewed. All medication was stored securely and under the correct storage conditions. Arrangements were seen to record the receipt, administration and disposal of medication. The home has arrangements for consulting a pharmacist for advice. Four service users did not have the receipt of the current medication recorded. Two service users were recorded as receiving a medication on 6th April 2005 when it was due on 7th April. The medication had not been given. Two service users with a variable dose of medication did not have the quantity of medication given recorded on 6th April 2005. The administration of one service user’s medication on the morning of 6th April 2005 had not been recorded. One service user had received their medication every four days instead of every 3 days as prescribed for the last month. One service user had not received their 06.00am medication on 6th April 2005. One service user had received a dose of medication on 6th April 2005 that had been stopped by the doctor on 23rd March 2005. One service user had been sent the wrong strength of medication from the pharmacy. This had not been identified up until the day of the visit. Heritage Care Centre Version 1.10 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) 12,14, and 15 Social activities and meals are well managed and provide daily variation and interest for people living in the home. EVIDENCE: Heritage Care Centre Version 1.10 Page 12 The activities co-ordinator was observed talking with service users and assisting at lunch. Activities were noted to be recorded in the daily records. A copy of the most recent service users meeting was examined. The activities co-ordinator facilitates the meeting. Comments from service users present indicated that they were happy with the food and tables are set ‘very well’. The minutes of the meeting also covered activities provided within the home and arrangements are being made for a summer garden party and an ‘in home shop’. Service users also requested a day trip and the activities co-ordinator is looking at transport arrangements. The published menu was examined; lunch comprised a starter, a choice of two main dishes and a pudding. Supper was soup, a hot meal and pudding. Sandwiches were also available at suppertime. The chef confirmed that special dietary needs can be catered for and families and service users are surveyed about particular likes and dislikes and welcome to discussed any particular issues with her. The introduction of ‘finger foods’ on the units for persons with dementia has proved successful and service users were seen enjoying the cheese and biscuits that were being offered on the day of inspection. The chef informed the inspectors that cake is a particular favourite ‘finger food’ and the plate ‘was always clean’, when it was returned to the kitchen. Two inspectors observed drinks being served to service users and jugs of soft drinks readily available. All five relatives spoken with on the day of inspection indicated that they thought the meals provided were good and a suitable quantity. The inspectors were invited to sample food from that day’s lunch and the food was well presented and tasty. One relative commented that they thought the food was ‘excellent’ and another stated that their relative had put on weight since being in Heritage. Heritage Care Centre Version 1.10 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 standard(s) 16 and 18 Complaints are handled in accordance with the home’s complaints procedure and relatives are confident that their concerns are listened to and taken seriously and acted upon. Awareness of the adult protection procedures has improved and this must be continued to ensure that service users are protected and not placed in situations of risk. EVIDENCE: The complaints log was examined. There have been three complaints recorded since the additional visit in January 2005. Actions and outcomes were present on all the complaints logged. One relative spoken with stated that the staff of the home responded positively to their complaint and ‘a report of the outcome’ was provided to the relative to ensure that they knew what actions the home had undertaken. All relatives spoken with at the time of inspection were ‘ happy’ and ‘content’ with the care given and felt that the manager and staff were approachable if there were any concerns. Since the additional visit in January 2005 there has been a Protection of Vulnerable Adults investigation. The staff did not ensure that the procedure was adequately followed and there was a delay in referring the service user to hospital. One member of staff spoken with on the day of inspection was aware of the agencies which had to be informed of a possible Protection of Vulnerable Heritage Care Centre Version 1.10 Page 14 Adult incident. From the multi agency meeting, which took place, the home must ensure that all staff are aware of what procedures have to be followed and ensure there is no delay in accessing an accident and emergency department. Heritage Care Centre Version 1.10 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 and 26 The home is continuing to ensure that the fabric of the building is maintained and consults service users about colour schemes. The home provides service users with safe, comfortable surroundings. EVIDENCE: A brief tour of the premises was undertaken. The corridors in the two upstairs units have been re-painted in soft colours and the manager informed the inspector that the ground floor corridors will also be painted and service users have been consulted about colour choices. Service users rooms were noted to be personalised. Call bells for service users were placed within their reach. The laundry was inspected. It was clean, tidy and organised on the day of inspection. The number of items of ‘lost’ clothing has been reduced since the home purchased a labelling machine and the manager informed the inspector that relatives are requested to inform staff of any new items of clothing, in order that the clothes can be labelled. Heritage Care Centre Version 1.10 Page 16 Heritage Care Centre Version 1.10 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 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, 29 and 30 The procedures for staff ensure that appropriate checks are made on prospective employees and a thorough recruitment procedure is followed. Staffing levels within the home are appropriate to the service users needs. Staff training is in place and meets the requirements of the Standard, however the home must ensure accurate recording of training received to ensure that staff are competent. EVIDENCE: The published duty rota indicates that staffing levels are as follows; Physically Frail Unit: Morning 2 qualified nurses and 7 carers Afternoon 3 qualified nurses and 6 carers :Night 1 qualified nurse and 2 carers. Dementia unit: Morning 2 qualified nurses and 5 carers Afternoon 2 qualified nurses and 4 carers Night 1 qualified nurse and 3 carers. Three staff files were examined. All the staff files contained the information required by the Schedules. CRB checks and registration checks on nurses were in place. Each file contained an application form, two references and a job description. Heritage Care Centre Version 1.10 Page 18 The staff training file was examined. The home is in the process of creating a central training file to record all training undertaken. There was evidence of what items had been covered in the training sessions. The staff have recently attended fire training and training on use of syringe drivers. A record of attendees was in place. The file requires further development to ensure that all information of training is recorded either in staff files or on a matrix, so it is easy to determine training needs of staff and training attended. Heritage Care Centre Version 1.10 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 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) EVIDENCE: None of these Standards were inspected but will be during the inspection year. Heritage Care Centre Version 1.10 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 x x x x x x x x Heritage Care Centre Version 1.10 Page 21 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 Regulation 15 and Scehdule 3 (k) Requirement The registered person must ensure that the daily records of care give specific details in relation to the care given and are individual to each service user. Immediate Requirements were made in relation to the following issues: The registered person must ensure that all medication is administered as the prescriber directed. Where it is not administered and where there are differences in medication appropriate action must be taken and recorded. The registered person must ensure that the receipt of all medication and administration/nonadministration of medication is recorded accurately The registered person must ensure that all staff are aware of what procedures have to be followed if a protection of vulnerable adult investigation is required, and ensure that there is no delay in accessing accident and emergency facilities. The registered person must ensure that all training is Version 1.10 Timescale for action 6th June 2005 2. 9 13 (2) 6th and 7th of April 2005 3. 18 13 (6) 6th June 2005 4. 30 18 (1) (a) 6th June 2005 Page 22 Heritage Care Centre recorded either in staff files or on a matrix. 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 Heritage Care Centre Version 1.10 Page 23 Commission for Social Care Inspection Ground Floor - CSCI 41-47 Hartfield Road Wimbledon SW19 3RG 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 Heritage Care Centre Version 1.10 Page 24 - 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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