Inspection on 24/08/05 for Herons Park Nursing Home

This inspection was carried out on 24th August 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

Herons Park Nursing Home 14/02/08

Herons Park Nursing Home 23/05/07

Herons Park Nursing Home 12/05/06

Herons Park Nursing Home 23/11/05

Herons Park Nursing Home 31/03/05

Herons Park Nursing Home 14/02/05

Herons Park Nursing Home 12/01/05

Herons Park Nursing Home 09/11/04

Herons Park Nursing Home 14/10/04

Herons Park Nursing Home 21/04/04

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

CARE HOMES FOR OLDER PEOPLE The Herons Nursing Home Heronswood Road, Spennells Wood Kidderminster Worcestershire DY10 4EJ Lead Inspector Yvonne South Unannounced 24th August 2005 09:30am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Herons Nursing Home E52 S4116 The Herons NH V245787 250805.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Herons Nursing Home Address Heronswood Road Spennells Wood Kidderminster Worcestershire DY10 4EJ 01562 825814 01562 753656 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) Regency Old Home Plc Mr Salum Naujeer Care Home with Nursing 58 Category(ies) of OP Old Age - 58 registration, with number PD(E) Physical Disability - 58 of places The Herons Nursing Home E52 S4116 The Herons NH V245787 250805.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Pre-admission assessment will specifically address mental health needs of potential service users and the home will not admit any person identified as having dementia illness. 2. The home may accommodate 9 named current service users who have dementia illnesses. 3. When the service users plans are reviewed (ie at least monthly) an assessment will be made as to whether or not there are any dementia needs and, if so, whether they are being met appropriately in the home and how. 4. Commission for Social Care Inspection will be notified of any resident service user who develops a dementia illness after their admission. Date of last inspection 31 March 2005 Brief Description of the Service: The Herons Nursing Home provides nursing and personal care for a maximum of fifty-eight people of either sex, over the age of sixty-five years who have needs associated with old age and physical disabilities. The home has a condition enabling it to accommodate named service users with a dementiatype illness. This establishment is situated on the outskirts of Kidderminster close to local amenities and the public transport system. The premises are purpose built with en-suite facilities throughout. There are eighteen single bedrooms and twenty double bedrooms. Lounge and dining facilities are provided on each floor. A shaft lift facilitates the movement between floors. The building has good parking facilities and a small garden. Regency Old Homes Plc, for whom Dr Hatif Himoud is the responsible individual, owns the home and the registered manager is Mr Sam Naujeer. The Herons Nursing Home E52 S4116 The Herons NH V245787 250805.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This routine unannounced inspection took place in the morning and extended over four and a half hours. The inspection focused on the care of service users resident on the top floor. Therefore principle assistance was given by the deputy manager who takes responsibility for this area. Further assistance was given by the registered manager and the activities organiser. The inspector spoke to one service user, one visitor and greeted other service users and staff she met. A full assessment was undertaken of one person’s care records and samples from several others. A short tour was undertaken and a check was made that tasks had been completed following the last inspection. What the service does well: What has improved since the last inspection? Since the last inspection all the bedrooms have been fitted with special locks that enable the occupant to lock their bedroom door for privacy if they wish, without becoming trapped. Staff have access in an emergency but the privacy of the residents is respected. Work to maintain a pleasant environment is continuous. When rooms become vacant they are redecorated before they are offered to other people. The Herons Nursing Home E52 S4116 The Herons NH V245787 250805.doc Version 1.40 Page 6 A shower room has recently been installed and has proved popular with residents and staff who help them. A choice is now available between this room and bathrooms with standard or special baths. Health and safety has been improved by the fitting of door closures to some rooms/cupboards and locks on some sluice facilities. This enables only the staff to have access where residents may come to harm. In addition to training in the home the staff are also supported and guided through regular meetings with the manager or the deputy. 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 Herons Nursing Home E52 S4116 The Herons NH V245787 250805.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection The Herons Nursing Home E52 S4116 The Herons NH V245787 250805.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3, 4, 5, The home provides a service to older people whose needs they can meet. People are given the necessary information, and opportunities to visit and trial the service in order to help them make a decision regarding their future. EVIDENCE: The assessment record that was inspected covered all the specified topics. Sufficient information had been obtained to enable the assessor to judge if the home could meet the person’s needs. It was recommended that the details relating to family and friends could be expanded to include more information regarding involvement and social contact. Where possible opportunities were given for pre admission visits. However when people were in hospital this was not always possible and in such situations the family/supporters were encouraged to come and visit the home on their behalf. Everyone came into the home on a trial basis to enable a mutual assessment to take place. The Herons Nursing Home E52 S4116 The Herons NH V245787 250805.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9, 10, 11 Care plans contain information that guides and enables staff to provide the personal and health care that each person needs. The plans are reviewed to ensure the information continues to be relevant. Medication is well managed for the health and well being of the residents. All physical and emotional support is given to the resident and their family during final illness and death. EVIDENCE: The care plans continue to improve and showed good evidence of development. They contained detailed information to inform and guide staff in the delivery of the care needed. Where possible there had been involvement with the resident and this had been recorded. It was recommended that if the resident or their relative was unable or unwilling to contribute in a formal manner this should be recorded on the plan and the review documents. The Herons Nursing Home E52 S4116 The Herons NH V245787 250805.doc Version 1.40 Page 10 The care plans and supporting documentation indicated that health care needs were assessed and addressed. The residents were registered with a doctor in one of six local surgeries Medication was appropriately stored and the records indicated that it was acceptably managed. None of the residents on the top floor had the ability/wish to manage their own medication so the trained nurses did this for them. It was recommended that this be noted in their care plans. Only trained nurses administered medication and the manager confirmed that refresher training was given each year. This last took place in December 2004. The daily records indicated that the response to medication was monitored and appropriate action was taken when necessary. It was suggested that the care plans should contain guidance describing the action staff should take if a resident refuses medication. The deputy confirmed that all personal care needs were attended to in private. Private mail was either given to the addressee (dependent on ability) and if necessary staff gave assistance, or collected by their supporter. New staff received guidance relating to privacy and dignity during their induction training. A record was seen. The home has a large number of double rooms although the occupants of some had chosen to pay an increased fee to have the sole use of their room. The manager confirmed that occupants had made a positive choice to share with each other and this had been documented. Pre admission visits to see the home and for potential room mates to meet, had taken place. Where this was not possible the relationship should be monitored and documented during the trial period. The deputy said that all current residents who shared rooms on the top floor did so happily. The records were seen of a resident who had recently died in the home. They indicated that all care needs, physical and emotional, had been met to a high standard. Good links and support had been obtained from other health care professionals. The resident’s wishes had been sought, recorded and complied with. Communication and support had been maintained with the family throughout the period. A lovely letter of appreciation had been received by the home from the family. The Herons Nursing Home E52 S4116 The Herons NH V245787 250805.doc Version 1.40 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15 Physical care needs in the morning were not being attended to within a reasonable time frame. Social contacts and activities were provided to stimulate and interest the residents within their abilities. Links with family, friends and the community were maintained. Choice was supported wherever possible. Residents were provided with meals they enjoyed. EVIDENCE: The care plans demonstrated that residents’ preferences were known. Choices were offered regarding clothing, meals and activities. If the resident was unable to make a decision or choice the staff did so on their behalf. As more became know about personal preferences the information was added to the care plan. However it appeared that very little choice was possible regarding the time of rising. The night staff made a check of residents at approximately 6am and attended to their continence needs. They then assisted residents who were ready and wished to get up. The Herons Nursing Home E52 S4116 The Herons NH V245787 250805.doc Version 1.40 Page 12 The day staff served breakfasts when they came on duty and then helped the residents to get washed and dressed. As some people needed help with feeding and drinking and most residents on the top floor needed full help with their personal hygiene and dressing this usually took most of the morning. It could be between 11.30am –12.30pm before everyone had been attended to. The deputy explained that during this time the activities organiser monitored the residents in the lounge and helped with their drinks on the four days she worked and another care assistant (a floater) was available on the mornings that the activities organiser did not work. This is not acceptable. Some residents could be in bed for an excess of twelve hours. In addition, on some mornings there is no staff available for those residents who have been helped to the lounge other than the activities organiser, who should be occupied with her own role and tasks. A review of dependency levels and staffing levels must be undertaken and acted on to ensure residents are assisted up at a reasonable time each morning and the welfare of those who have been helped up is safeguarded. The records maintained by the activities organiser were very good and indicated that a programme was made available that was flexible according to the wishes of the residents. It was suggested that she developed display boards for both floors to advise the residents and their families of activities and events that were planned. The further development of individual activity records for all residents would enable the success of specific interaction and activities to be monitored. The inspector was told that during the mornings she engaged the residents upstairs in conversation on a one to one basis and where possible helped them to participate in activities that they enjoyed. These were very limited due to their frailty. During the afternoons individual and group activities were initiated on the ground floor and those residents upstairs who were interested were helped downstairs to join in. A range of activities had been enjoyed this year that had included a trip to the safari park and a pub and a BBQ. Local school children were due to come and perform a singing and dancing concert. A ‘Pat a dog’ therapist, a music and movement therapist and a hairdresser all visited the home. The activities organiser had developed this aspect of care well since she was appointed. She had already undertaken a course in dementia care and it was suggested that she would also benefit from training specifically focused towards activities and stimulation for older people. None of the current residents had expressed a wish to pursue any religious needs. It was confirmed that, as in the past, any such wish would be supported. It was suggested that during the pre admission assessment more direct questions should be asked regarding wishes in this area. The Herons Nursing Home E52 S4116 The Herons NH V245787 250805.doc Version 1.40 Page 13 Residents were observed to be enjoying their lunch and being assisted by staff in an acceptable manner. The food looked and smelt appetising. Records were maintained of known likes and dislikes. Visitors came and went during the morning. One person told the inspector that she was very happy with the quality of care her mother was receiving. The Herons Nursing Home E52 S4116 The Herons NH V245787 250805.doc Version 1.40 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) EVIDENCE: This standard was not assessed during this inspection. However the manager confirmed that no complaints had been received since the last inspection. The Herons Nursing Home E52 S4116 The Herons NH V245787 250805.doc Version 1.40 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) EVIDENCE: These standards were not assessed in full during this inspection but compliance was checked with the requirements that had been previously made. All had been met. In bedroom 2 the carpet had been cleaned and the room attractively redecorated. A walk in shower room was fitted and operational on the ground floor. This had proved successful with many residents and the staff who helped them. Approved bedroom door locks had been fitted throughout the home. The Herons Nursing Home E52 S4116 The Herons NH V245787 250805.doc Version 1.40 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) EVIDENCE: These standards were not assessed during this inspection. However the number of staff available to assist residents each morning must be reviewed. Please see the comments made earlier in this report. The requirement to provide acceptable supervision had been met. The deputy indicated that a programme was displayed in the office and she monitored its successful implementation. Records were being maintained. The Herons Nursing Home E52 S4116 The Herons NH V245787 250805.doc Version 1.40 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) EVIDENCE: These standards were not assessed during this inspection. However the manager was pleased to report that he had received the certificate acknowledging his successful completion and achievement of the registered Managers Award. A requirement was made following the last inspection concerning sluice doors. These should be kept locked when not in use in accordance with the fire authority notice displayed on the door. The maintenance man confirmed that door closures and locks had been fitted to meet the requirement. No doors were open when the inspector toured the building. The Herons Nursing Home E52 S4116 The Herons NH V245787 250805.doc Version 1.40 Page 18 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 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 2 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x x x x x x x The Herons Nursing Home E52 S4116 The Herons NH V245787 250805.doc Version 1.40 Page 19 No 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 12,27 Regulation 18 Requirement Staffing numbers and skill mix must be appropriate to meet the assessed needs of the service users, the size, layout and purpose of the home at all times. Additional staff must be on duty at peak times of activity during the day. Timescale for action 30th September 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. Refer to Standard Good Practice Recommendations The Herons Nursing Home E52 S4116 The Herons NH V245787 250805.doc Version 1.40 Page 20 Commission for Social Care Inspection The Coach House John Comyn Drive, Perdiswell Park Droitwich Road Worcester WR3 7NW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Herons Nursing Home E52 S4116 The Herons NH V245787 250805.doc Version 1.40 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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