Inspection on 20/11/06 for Heversham House

This inspection was carried out on 20th November 2006.

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

Heversham House 15/02/06

Heversham House 27/07/05

Heversham House 02/11/04

Heversham House 10/05/04

Heversham House 11/02/04

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 Heversham House Heversham Milnthorpe Cumbria LA7 7ER Lead Inspector Jacqueline Southern-Leigh Unannounced Inspection 20th November 2006 10:00 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 Heversham House DS0000022651.V317267.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. Heversham House DS0000022651.V317267.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Heversham House Address Heversham Milnthorpe Cumbria LA7 7ER 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) 015395 63769 Mrs Isobel Hellena Wales Mrs Isobel Hellena Wales Care Home 13 Category(ies) of Dementia - over 65 years of age (1), Old age, registration, with number not falling within any other category (12) of places Heversham House DS0000022651.V317267.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Old Age not falling within any other category (12). To include one named service user in the category of Dementia over 65 years of age (1) 15th February 2006 Date of last inspection Brief Description of the Service: Heversham House is a care home registered to accommodate 13 older people. It is situated in a small village close to Milnthorpe, a market town on the edge of the Lake District. The premises comprise a detached Georgian residence with a very attractive walled garden. There is a small car park at the rear of the home. The house has many original features including attractive bay windows; delft tiled fireplaces and corniced ceilings. There is a large lounge / dining room and a small quiet sitting room on the first floor where residents can meet visitors in private. The gardens are pleasant and private. The home is owned and managed by Mrs Wales, with her daughter working as the deputy manager. Heversham House DS0000022651.V317267.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced Key Inspection that took place over two days, starting on 20th November 2006 between 10.00am until 2.00pm, as neither the Registered Manager or the Care Manager were present on that day it was necessary to return to the home on 25th November 2006 to complete the inspection. Current Fees for the home are £406 per week. The inspection included a tour of the premises, talking to residents, staff and the Care Manager. What the service does well: What has improved since the last inspection? What they could do better: There are some minor improvements that would benefit the residents, these include upgrading the bathroom, replacing the older metal framed commodes and extending the menu choices from two-weeks to three or four weeks. On the whole this is a well-run service that provides a good level of care for its residents. Heversham House DS0000022651.V317267.R01.S.doc Version 5.2 Page 6 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. Heversham House DS0000022651.V317267.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 Heversham House DS0000022651.V317267.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): 1, 3, 4, 5 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home ensures that it can meet the needs of prospective residents and provides them with relevant information regarding the home. EVIDENCE: Heversham House has a printed information leaflet that is sent to all prospective residents, there is also a statement of purpose and a residents guide available, which contain information on issues that affect the residents. Prospective residents and their families are welcome to come and look around the home; appointments do not need to be made in advance. Either the registered manager or her daughter who is the manager of the home on a day to day basis, go out to assess each new resident prior to them being admitted into the home, they undertake an assessment of need and discuss the residents care and social needs with them to ensure the home can meet their expectations. One resident commented ‘lots of information was given to me so I could make the right decision’ Residents told me that their relatives and visitors are made welcome anytime. Heversham House DS0000022651.V317267.R01.S.doc Version 5.2 Page 9 The home does not offer intermediate care. Heversham House DS0000022651.V317267.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a good assessment procedure that meets the needs of the service users and ensures that health, personal and social care is well maintained. EVIDENCE: Residents plans of care were examined on the day of inspection, they were thorough in terms of the residents physical needs but there was not a great deal of information regarding psychosocial aspects of care. However, it was quite obvious from talking to staff and the residents that the home is aware of the social needs of its residents, but to ensure consistency it would be better to add this information to the plans of care. The care plans were reviewed on a regular basis and there was evidence of new information being recorded. The daily records were all up-to-date. All medication is currently administered by the staff, the staff are aware of the process to follow if residents wish to self-medicate. Only staff with National Vocational Qualification’s at level 3 and above administer medication. The medication charts and stock checked on the day of inspection was correct. Heversham House DS0000022651.V317267.R01.S.doc Version 5.2 Page 11 Several residents spoke to the inspector on the first day of the inspection, the majority of the residents returned their comment cards and questionnaires, they feel very well supported by the home, one resident told me ‘that the staff were wonderful and very caring’ and that ‘she was made to feel that nothing was to much trouble for the staff’, residents told me that staff always knocked on the door before entering. It was also observed that the staff addressed the residents in the manner that the resident preferred; the staff felt this was very important. Heversham House DS0000022651.V317267.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home supports the residents to maintain a balanced lifestyle with options for choice. EVIDENCE: The home offers the residents a very relaxed and homely environment, residents are offered the choice of attending monthly religious services, the staff told me that if anyone had any other culture or religious needs the home would always support them and try to organise someone to come into the home to see them. Visitors are welcome at the home at any time, there is no set visiting time. Residents confirmed that their visitors are made welcome and are offered refreshments. The home maintains close contact with the local village, Heversham is a small community and garden parties are organised by the home in the summer in the lovely walled garden that belongs to the home. The staff organise activities for the residents that wish to take part in the afternoons, examples of some of these activities were seen around the home, a post box for Christmas cards had been made by residents the previous day. Other activities include playing games such as bingo, lots of craft activities, armchair exercises, this was recorded by a member of staff and the residents enjoyed watching the video. The home offer a choice of meals at each meal Heversham House DS0000022651.V317267.R01.S.doc Version 5.2 Page 13 time, the food was well cooked and presented and all the residents in the dining room commented on what a nice meal it was. At the moment the home only has a two-week rota for meals, this should be extended to at least a three-week rota to offer more variety to residents. The food is mostly home cooked with very little frozen food used. One resident told me that she thought ‘the food was lovely’ and she was also very happy with her room and her care. One comment from a residents questionnaire said that they had ‘well balanced meals, always a choice. Well presented good quality food.’ Heversham House DS0000022651.V317267.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a robust complaints process that protects the rights of the residents. EVIDENCE: The home has received no complaints since the last inspection. All the staff have received training on adult protection from an outside provider and additional training is planned. The home has a good complaints procedure and has a whistle blowing policy for staff. Staff and residents who were spoken to on the day of inspection were aware of the correct procedure to follow if that had any concerns or complaints. Heversham House DS0000022651.V317267.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment of the home is clean, warm and safe; it meets the needs of its residents. EVIDENCE: Heversham House is an older property that has been converted to provide accommodation for 12 or 13 residents. The residents bedrooms are on the ground and first floor, they are all single rooms, one room has the capacity to be a double room. At the moment all the residents are female. The rooms are all of varying sizes and shapes and most have a very nice outlook either over the gardens or across the hills. All the bedroom have a sink, three of the bedrooms have en-suite toilets. Most of the bedrooms have old basic metal framed commodes, only one room has a commode chair that looks like a piece of furniture, if commodes are being left in bedrooms on a permanent basis they should be in good condition and look like a piece of furniture. Heversham House DS0000022651.V317267.R01.S.doc Version 5.2 Page 16 Residents are able to bring in their own furniture if they wish and are encouraged to personalise their bedrooms. Most of the residents have their own telephone in their rooms. Downstairs there is a large dining/lounge area for the use of residents. There are two separate toilets downstairs for the residents use. There is a bathroom with a hoist and toilet downstairs. The bathroom in general is not in particularly good condition and consideration should be given to upgrading it in the future. The bathrooms should have hand towel dispensers and disposable paper towels for infection control purposes. On the first floor there is a shower room and toilet and extra toilets. The home has a lovely walled garden, in the summer the residents sit outside and will often have their meals outside. There were no unpleasant smells in the home and all areas were clean. The home has a good-sized kitchen with a mixture of domestic and industrial equipment. The home has a cellar where the laundry is situated, there is a washing machine and dryer, all the homes laundry is done here. There are no linen bags for soiled linen, all linen is put in plastic linen baskets which are cleaned after use. The home has a hoist available, but at present there are no residents that require the support of a hoist. Heversham House DS0000022651.V317267.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A staff team that has been recruited, inducted and trained adequately to give a good standard of care meets the resident’s needs. EVIDENCE: On the day of inspection there was no manager on duty, the Registered Manager was on holiday and the Care Manager was on a course. The person in charge was a Senior Carer with the National Vocational Qualification in care at level 3, she was very competent during the inspection and was able to deal with all questions and issues around the care of the residents. The current staffing levels appear to be adequate for the care needs of the current residents, however the care staff are also expected to do the cleaning, laundry and prepare the evening meal therefore, I would not expect the staffing to fall below the levels witnessed on the day of inspection. The duty rota is usually only prepared one or two weeks in advance, the staff rotas should be done a month in advance to allow staff to plan adequately. The home supports staff to obtain relevant qualifications, there is a good level of staff with National Vocational Qualifications in Care at level 2 and 3. Staff reported that they received all statutory training, H & S, manual handling, medication and food hygiene, two members of staff have undertaken the Fire Wardens training and teach all new starters and undertake 6 monthly up-dates as well as running fire drills. Heversham House DS0000022651.V317267.R01.S.doc Version 5.2 Page 18 The home has a set of recruitment policies, the staff files checked had all relevant documentation in place. The home has a written induction package for all new starters. The following comments came from the from residents questionnaires regarding the staff and the care they receive; ‘The care I receive is excellent nothing is too much trouble for the staff. They encourage my independence in a safe environment’. ‘The care here at Heversham House is very, very good.’ Heversham House DS0000022651.V317267.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36, 37 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management of the home safeguards the rights and best interests of the residents. EVIDENCE: The registered manager is Isobel Wales, but her daughter Cynthia Wales runs the home on a day-to-day basis. Cynthia also has the registered managers qualification. All staff on duty on the day of inspection felt confident to speak to Cynthia if they had any concerns or worries, they said that she was very approachable and they regularly discussed the needs of the residents as a team. The residents spoken to on the day of inspection and comments from the questionnaires received from residents and their relatives were all very positive about the management of the home, they feel well supported. One comment from the questionnaire reported: ‘Mrs Wales and her team are always caring, there could not be a better place to be’. Heversham House DS0000022651.V317267.R01.S.doc Version 5.2 Page 20 There is no formal staff supervision process in place, staff do receive regular appraisals, but should also have more regular opportunities, at least 6 times a year, for one to one meeting with their line manager. The home has a policy on safe guarding the residents money. The home has Health and Safety polices and procedures in place, staff also receive training on Health and Safety issues. Control of Substances Hazardous to Health information was kept with the relevant chemicals. Heversham House DS0000022651.V317267.R01.S.doc Version 5.2 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 3 X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 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 3 3 3 Heversham House DS0000022651.V317267.R01.S.doc Version 5.2 Page 22 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 OP36 Regulation 18.2 Requirement Staff must have 1:1 supervision with the manager 6 times a year. Timescale for action 31/03/07 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 2 3 4 Refer to Standard OP22 OP21 OP21 OP27 Good Practice Recommendations The old basic metal-framed commodes should be upgraded and replaced. The downstairs bathroom was not in the best condition and plans should be made to up-grade it in the future. The bathrooms should have hand towel dispensers and disposable paper towels for infection control purposes. Duty rotas should be done a month in advance Heversham House DS0000022651.V317267.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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 Heversham House DS0000022651.V317267.R01.S.doc Version 5.2 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. 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