Inspection on 12/09/07 for Heron Lea

This inspection was carried out on 12th September 2007.

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

Heron Lea 13/11/08

Heron Lea 04/10/06

Heron Lea 06/02/06

Heron Lea 16/06/05

Heron Lea 21/02/05

Heron Lea 11/08/04

Heron Lea 12/03/04

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

CARE HOMES FOR OLDER PEOPLE Heron Lea Mill Lane Witton Norwich Norfolk NR13 5DS Lead Inspector Mr Pearson Clarke Unannounced Inspection 12th September 2007 10:15 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 Heron Lea DS0000027320.V351342.R01.S.doc Version 5.2 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. Heron Lea DS0000027320.V351342.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Heron Lea Address Mill Lane Witton Norwich Norfolk NR13 5DS 01603 713314 NO FAX # 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) Miss Valerie Etheridge Miss Beverley Howkins Not applicable Care Home 13 Category(ies) of Dementia (13), Dementia - over 65 years of age registration, with number (13) of places Heron Lea DS0000027320.V351342.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th October 2006 Brief Description of the Service: Heron Lea is a care home providing personal care and accommodation for 13 older people who have dementia. The registered providers are Valerie Etheridge and Beverley Hawkins who took over the home in April 2001. Both are actively involved in the home on a daily basis. The home is situated in the village of Witton, near to Brundall and approximately 7 miles from the city of Norwich. The building is a converted hotel and is set in large grounds. The home has 7 single bedrooms, 4 with en suite, and 3 double rooms including 2 with en suite. The ground floor accommodation is spacious and there is a safe garden area to the side of the building that service users are able to access in the summer months. The home has a lift to the first and second floors. The services current fee levels are £391.00 to £494.00 per week. Heron Lea DS0000027320.V351342.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Care services are judged against outcome groups which assess how well a provider delivers outcomes for people using the service. The key inspection of this service has been carried out by using information from previous inspections, information from the providers ,the residents and their relatives, as well as others who work in the agency. This has included a recent unannounced visit to the agency and this report gives a brief overview of the service and current judgements for each outcome. What the service does well: What has improved since the last inspection? Since the last inspection the providers have acted to guard all of the radiators to ensure that people living there are not at risk of scalding. Progress has been made in the use of visual clues and colour to help aid the orientation of the residents when moving around the home. The management have continued to update their practice through training, an example of this being training relating to nutrition which has been translated into nutritional care plans for residents. Staff have also received updated training relating to adult protection. Heron Lea DS0000027320.V351342.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Heron Lea DS0000027320.V351342.R01.S.doc Version 5.2 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 Heron Lea DS0000027320.V351342.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. That the home admits people whose needs it has assessed and is confident that those needs can be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the site visit the inspector spent time with the manager, discussing the admission process and also tracking three recent admissions to the home. From this it was possible to evidence that the home is making appropriate admissions based on external professional assessment and the homes own assessment documentation. Written comment was received from three relatives of people living in the home and in each case it confirmed that there was enough information available when choosing the home. Heron Lea DS0000027320.V351342.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is adequate. The service has a care planning system which helps people receive the social , emotional and health care they need, however errors in the recording of medications administered is an area of concern which must be addressed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Sample care plans were inspected during the site visit and discussion about the care delivered took place with the manager and staff. As such plans are based on the initial assessment and are written in a person centred style. Care plans seen, contained risk assessments and there was evidence of review. Recording within the plans indicated that the service is proactive in the meeting of health care needs and the manager confirmed good working relationships with local doctors and nurses. Heron Lea DS0000027320.V351342.R01.S.doc Version 5.2 Page 10 One of the managers has recently completed a training course relating to the risk of malnutrition in older people and it was good to see that nutritional screening plans were in place. Discussion with staff on duty and observation of the lunch being served showed that staff take great care to ensure that those needing support and encouragement to eat receive it. The written comment received from relatives indicated that the staff treat people with dignity and show appropriate respect. During the visit the arrangements for the management of medication were inspected. Medicines were securely stored and records of administration were sampled. It was of some concern that although staff were signing the records the dates on the records did not accord with the actual dates. This was an initial error by the chemist, however it was clear that the homes management and staff had not identified the error and as such a requirement has been made to review the homes medication system to help ensure that an accurate audit trail is in place for all medicines at all times. It was also noted that where the home was compiling its own record for PRN medication the sheets used were not fully completed - again representing poor practice. Heron Lea DS0000027320.V351342.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is good. The home offers residents a relaxed atmosphere and good food. Contact with family and friends is successfully supported by staff and management. The provision of activity is an area which would benefit from further development. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the site visit the inspector spent time observing life in the home. The atmosphere was relaxed and residents seemed at ease. Although no visitors were present those that provided written comment indicated that relatives are made welcome and that they are kept informed about matters affecting their relative. Discussion with staff on duty showed that they will try to provide some activity for residents. In the inspectors opinion however, this is an area for potential improvement and one of the comment cards received from relatives stated that it would be nice if there was more activity and perhaps trips out. This was discussed with the homes management on the day who acknowledged that it can be difficult to find transport to take people out and that with increasingly dependant people suitable activity is also problematic. Heron Lea DS0000027320.V351342.R01.S.doc Version 5.2 Page 12 Whilst accepting that these are real difficulties the inspector recommends that ways are sought to improve this area of provision. Written comment received, confirmed general happiness with the food served and staff spoken to stated that the food was always of a good standard with fresh meat and vegetables used where possible. Heron Lea DS0000027320.V351342.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. That the service has increased the protection available to residents through staff training and a more prominent complaints procedure. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The site visit confirmed that the home has given more prominence to its complaints procedure and the service has had no recent complaints. Inspection of records and discussion with staff on duty and the manager confirmed that staff have benefited from safeguarding training since the last inspection. Heron Lea DS0000027320.V351342.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is adequate. Residents live in a comfortable and clean home , which will be further improved when planned redecoration and carpeting is finished. This judgement has been made using available evidence including a visit to this service. Heron Lea DS0000027320.V351342.R01.S.doc Version 5.2 Page 15 EVIDENCE: Since the last inspection the providers have acted to comply with the requirement made to guard all radiators and pipe work and as such the potential risk to residents is now reduced. During the site visit the inspector toured the home and looked at the providers plan for works to take place during the year. The building is old and as such presents a continual challenge to maintain and improve. During the last year there has been redecoration and some new carpeting, however it was acknowledged that there are still areas in need of attention. As such carpet in one corridor is near the end of its life and there is an area of cracked plaster on the first floor. This was discussed with the homes manager and given the assurances made as to the work being carried out then no requirements are made. Since last inspected the management have provided more visual clues to help residents find their way around the home. This is to be welcomed although care should be taken to ensure that such clues are provided at the right level to be easily visible. All areas seen on the day were clean and smelt fresh and the home continues to be homely and comfortable. Heron Lea DS0000027320.V351342.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is good. That residents benefit from staff who have received the training they need, have been subject to thorough recruitment process and are available in sufficient numbers to meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The site visit and information extracted from the providers annual quality assurance assessment confirmed that staffing at Heron Lea is largely unchanged from that found at the last inspection. Although no visitors were present when the inspection took place the written comment received from relatives was positive about the care delivered. Residents spoken to on the day said they were treated with kindness and this was confirmed by the inspectors own observation. From inspection of training and employment records the inspector could see that a satisfactory approach is adopted in these areas. Discussion with the manager and staff on duty confirmed this. Heron Lea DS0000027320.V351342.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 Quality in this outcome area is good. Residents benefit from a service which offers consistent care and in which their best interests are to the fore. This judgement has been made using available evidence including a visit to this service. Heron Lea DS0000027320.V351342.R01.S.doc Version 5.2 Page 18 EVIDENCE: As at the last inspection of the service staff on duty told the inspector that they felt they worked in a good home and that they were well supported by the management. Records were seen which confirmed that the managers continue to complete training which they use to improve their knowledge of best practice. One example of this was the MUST training used to help identify those at risk of malnutrition. The arrangements for health and safety were satisfactory as were the management of residents finances where satisfactory records were inspected. Staff continue to receive regular supervision. Heron Lea DS0000027320.V351342.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 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 3 17 x 18 3 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Heron Lea DS0000027320.V351342.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP9 Regulation 13 (2) Requirement That the Provider carry out an audit of its medication management system to ensure that all aspects of the system are robust and safe. Timescale for action 31/10/07 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 OP12 Good Practice Recommendations That the Providers continue to seek ways to improve the provision of activity and stimulation available to people living in the home Heron Lea DS0000027320.V351342.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Heron Lea DS0000027320.V351342.R01.S.doc Version 5.2 Page 22 - 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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