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Inspection on 10/01/07 for Heyfields Nursing Home

Also see our care home review for Heyfields Nursing Home for more information

This inspection was carried out on 10th January 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Heyfields offers a high standard of care and service, is extremely well organised, with a committed care management team. Emphasis goes into involving the residents and their families in the process of care, ensuring a highly personal approach to meeting individual needs. The establishment of a professionally accountability towards effective assessment, detailed care planning and review of resident`s needs are meaningful and robust, in formulating an excellent standard of care. Thishighly personable attitude and approach to care is appreciated and welcome by residents and visitors alike. The overall management style demonstrated a professional approach in maintaining an environment conducive to the care of the elderly. There is a constant appraisal and review process of facilities and services to maintain that environment, by the Registered Provider and Care Management

What has improved since the last inspection?

The Home has demonstrated a commitment to caring for the elderly with very high standards, which need to be maintained. In meeting all the care standards, the Home has demonstrated a robust and meaningful commitment to the ethos of continuing improvement of standards.

What the care home could do better:

The achievements have been recognised, areas of detail will continue to play a part in the ongoing development and maintenance of an honest, solid and homely service.

CARE HOMES FOR OLDER PEOPLE Heyfields Nursing Home Tittensor Road Barlaston Stoke On Trent Staffordshire ST12 9HQ Lead Inspector Mr Keith Jones Key Unannounced Inspection 10 January 2007 09:00 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 Heyfields Nursing Home DS0000022338.V322721.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. Heyfields Nursing Home DS0000022338.V322721.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Heyfields Nursing Home Address Tittensor Road Barlaston Stoke On Trent Staffordshire ST12 9HQ 01782 373584 01782 374001 heyfieldshouse@tesco.net 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) North Staffs Residential Homes Limited Mrs Sharon Tracy Jones Care Home 35 Category(ies) of Dementia - over 65 years of age (1), Physical registration, with number disability (35), Physical disability over 65 years of places of age (35), Terminally ill (4) Heyfields Nursing Home DS0000022338.V322721.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 35 Physical Disability (PD) over 60 years only Currently providing 6 Day Care places TI over 60 years only 1 Physical Disability (PD) 58 years or over for named individual Date of last inspection 30th December 2005 Brief Description of the Service: Heyfields is a care home providing residential and nursing care for up to 35 elderly service users. This includes care for one service user with dementia care needs, care for service users over the age of 60 years with physical disabilities and palliative care for four terminally ill patients. Mrs Beverly Warren, as North Staffs Residential Homes Limited privately owns the home. The home is located in a rural position on the outskirts of the village of Barlaston between Stone and Trentham in mid Staffordshire. There are no amenities within the immediate vicinity but Barlaston village centre is a short drive away where there are a limited number of amenities. The home is part purpose built and part original building. The home is set back off the road and is reached via a driveway. There is ample car-parking facility at the entrance car park. Gardens are accessible around the home to service users including wheelchair users. The home overlooks countryside on all aspects and there are stables located immediately next door owned by the proprietor. The accommodation provides for 31 single bedrooms and 2 double bedrooms. All bedrooms, apart from 1 single room, have en suite facilities. There is ample provision of communal and seating areas around the home. Heyfields Nursing Home DS0000022338.V322721.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was conducted over one day by one inspector, with the Registered Providers and the Care Manager, in a professional and cordial atmosphere. A senior manager from Newcastle Social Services was in attendance. In readiness for the inspection the manager completed an excellently prepared pre-inspection questionnaire and provided supplementary information two weeks prior to the visit. The last inspection report was discussed, and it was noted that there were no outstanding requirements or recommendations. On the day of inspection there were 34 service users in residence, of which 33 were categorised as requiring nursing care, and 1 as residential. 13 comment cards were received from family, other professionals and residents, all very complimentary of services and the staff. Comments of “Cannot praise staff enough”, “high expectations met’ were repeatedly reflected, as were several observations, “Visited twice before deciding”, “ managers very helpful”, which were received and noted. The current scale of charges are £600 per week. A tour of the Home allowed free and open access to all areas for inspection. The opportunity was taken to speak with a number of service users, relatives and members of staff. Service users and staff took an active role in the inspection process and contributed to the subsequent report. Throughout the entire inspection a sense of homeliness and familiar confidence pervaded into all aspects of daily activity expressed by those people met. A review of the administrative arrangements confirmed solid practice and effective management. A full verbal report was offered at the end of the inspection to the Providers and Care Management. The inspector thanked all concerned for their contribution to a very pleasing and constructive inspection. What the service does well: Heyfields offers a high standard of care and service, is extremely well organised, with a committed care management team. Emphasis goes into involving the residents and their families in the process of care, ensuring a highly personal approach to meeting individual needs. The establishment of a professionally accountability towards effective assessment, detailed care planning and review of resident’s needs are meaningful and robust, in formulating an excellent standard of care. This Heyfields Nursing Home DS0000022338.V322721.R01.S.doc Version 5.2 Page 6 highly personable attitude and approach to care is appreciated and welcome by residents and visitors alike. The overall management style demonstrated a professional approach in maintaining an environment conducive to the care of the elderly. There is a constant appraisal and review process of facilities and services to maintain that environment, by the Registered Provider and Care Management What has improved since the last inspection? 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. Heyfields Nursing Home DS0000022338.V322721.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 Heyfields Nursing Home DS0000022338.V322721.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): 1,2,3,4,5 The quality in this outcome area is excellent. This judgement is based on the examination of the homes policies, procedures, practices and discussions with management. Heyfields ensures that prospective residents have the necessary information to enable an informed choice to be made. Aims and objectives, terms and conditions are clearly presented in a way to facilitate easy understanding of services and standards of care. It is recognised that the Statement of Purpose represents the foundation on which the home operates upon, offering service users and their relatives the opportunity to make an informed choice about where to live, through the Service User Guide. Following an assessment the senior/nurse assessor determines the suitability of the application in view of the facilities available, and of the capacity of the home, to manage the individual and any special needs. The Home has demonstrated their commitment to promote a partnership of care, to meet the objectives of providing a home to meet individual needs. Heyfields Nursing Home DS0000022338.V322721.R01.S.doc Version 5.2 Page 9 EVIDENCE: The Statement of Purpose represents an excellent description of the Home’s aims and objectives, philosophy of care and terms and conditions. All the requirements prescribed in Schedule 1 are addressed and effectively presented. It is recognised that the Statement of Purpose represents the foundation on which the home operates upon, offering service users and their relatives the opportunity to make an informed choice about where to live. A separate and well-produced service user’s guide serves as an easily readable summary of the Statement of Purpose and supporting information, widely used to inform all interested parties. The Home continues to deploy a clear statement of contractual agreement. The Statement of Purpose clearly indicates the terms and conditions, which are discussed with service users and relatives prior to admission. Case tracking of four individual residents clearly identified that the Care Manager, or her deputy, at the point of reference, conducts the pre-admission assessment. The documentation was examined and found to be comprehensive, providing a solid foundation for progressive care planning. This assessment is produced with the full involvement of service users and family, allowing them to influence the direction of care. The assessment initiates the process of care, each individual having a plan of care, which includes a daily living plan and longer-term goals and outcomes. Following an assessment the senior nurse assessor determines the suitability of the application in view of the facilities available, and at the capacity of the home, to manage the individual and any special needs. Likewise the applicants are informed of those facilities and are encouraged to seek clarification concerning the general and specific services available for the prospective service user. Any special needs of the individual were discussed fully and documented, ensuring their individual needs would be met. Case tracking confirmed that a valuable exchange between service users and assessor took place and resources made available. These resources were seen to be an appraisal of staffing skills, equipment and general environment. From discussions with staff and service users it was evident that prospective service users and their relatives are able to visit and assess the quality, facilities and suitability of Heyfields at any reasonable time, to meet with staff and management. Service users are admitted for a trial period initially to enable all parties to evaluate whether the home is an appropriate placement and mutual adjustment before any contractual agreement is signed; this is usually a period of 6 weeks. At all times relatives are involved in the process. Heyfields Nursing Home DS0000022338.V322721.R01.S.doc Version 5.2 Page 10 Staff are aware of the special period of personal anxiety that people have under those conditions, a point well illustrated when talking to service users, and examining records on case tracking. Heyfields Nursing Home DS0000022338.V322721.R01.S.doc Version 5.2 Page 11 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 and 11 The quality in this outcome area is excellent. This judgement is based on the examination of four care plans, discussions with service users, staff, managers, general observations and the homes medication system. The care assessment and planning system is a highly organised, yet personalised process offering meaningful and valid documentation of care administered. A broad vision of needs is addressed through the care planning process, meeting personal and health needs. It is recognised that this reflects an individual profile of needs, discussed fully with family. The provision of a secure and safe medicines administration is managed efficiently. The Inspector was impressed with the confidence and closeness within the Home of staff, residents and visitors, and the mutual respect that prevailed. Staff were seen to demonstrate a personal empathy with residents through a respectful, yet friendly discourse. Heyfields Nursing Home DS0000022338.V322721.R01.S.doc Version 5.2 Page 12 EVIDENCE: Care records and case tracking clearly showed that this standard is well met, maintaining a high quality process of assessment. The pre-admission assessment represented the foundation for a well-considered and detailed care planning process. A profile of the service user’s social, physical and psychological status offered an individual plan of care, based upon activities of daily living, to be implemented and frequently reviewed. Each service user’s health, personal and social care needs are carefully assessed in an individual plan of care that is reviewed monthly, including service users and relatives views, to reflect their changing needs. That review is more frequent, dependant upon the individual’s needs and clinical condition. The strength of purposeful planned care lies within the frequency of the review process in monitoring and adapting care profiles. This process would benefit from adherence to a daily report convention. Risk assessments were carried out on an individual basis and frequently reviewed. Included in the care records were applications of established monitoring systems following a process of goals, care and evaluation models of monthly assessment. Case tracking confirmed the extent that the carefully prepared, and well-recorded care plans were appreciated by service users and relatives alike. Tissue viability, continence, psychological and special needs are assessed and documented, along with nutritional screening, hearing and sight tests as appropriate. The GP service is supportive; through this service, arrangements are made to provide professional support. A physiotherapist and dietician had been provided for those service users whose records were examined. Continence is assessed on admission and promoted within the plan of care, and there was evidence that service users nutritional needs, and weights were frequently reviewed. Care staff maintain all aspects of service users personal care, overseen by the trained nurse on a daily basis. The administration of medicines adheres to procedures to maximise protection to service users. The storage was secure with satisfactory added security for controlled drugs. A controlled drug register was examined and found to be in order. Disposal of CDAs and other medicines meet statutory requirements. Service users, if capable may be responsible for their own medication, and are protected by the self-medication procedures in place. Each service user has their own lockable facility in their bedrooms. Oxygen storage was satisfactory. The Statement of Purpose, admission assessment and care plans are geared to engender a sense of individuality and privacy. These policies are reinforced with a staff induction programme and supervised practice. Case tracking Heyfields Nursing Home DS0000022338.V322721.R01.S.doc Version 5.2 Page 13 confirmed that the policies were implemented, with all service users spoken with being complementary of the degree of respect given, by each and every member of staff. The inspector observed the free, courteous interaction between service users and staff based on a level of confidence of mutual trust and respect. Relatives have freedom of visiting, emphasising on the importance of maintaining social contact. Adequate privacy policies exist for all toilet/bathroom areas and bedrooms. The policy and procedure on care of the dying and death had been carefully constructed to meet individual needs, and were in place with the full knowledge of both service users and relatives. Individual spiritual persuasions were documented and respected at all times. Relatives are welcome to stay as long as they liked in times of stress, including overnight stay. The Inspector was impressed with the confidence and closeness within the Home of staff, residents and visitors, and the mutual respect that prevailed. Heyfields Nursing Home DS0000022338.V322721.R01.S.doc Version 5.2 Page 14 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 The quality in this outcome area is excellent. This judgement is based on discussions with service users, staff and examination of records in relation to social activities undertaken and general observations during to course of the inspection. The home had a relaxed and welcoming atmosphere where people were encouraged to continue with their individualised lifestyle. The quality of activity and socialisation monitoring and management was acknowledged, with evidence in each resident’s file of meaningful profiling by the coordinator and senior care staff. EVIDENCE: From talking to service users and staff it was pleasing to report a continuing daily routine that is flexible and non-institutionalised, offering choice for meal times, personal and social activities including recognition of varied religious needs. At pre-admission the service user’s personal interests and customs are determined, and where possible accommodated within the routine of the Home. That routine is seen as flexible; to acknowledge individuality, yet maintain a focal point for service users to latch on to without dictating events. Heyfields Nursing Home DS0000022338.V322721.R01.S.doc Version 5.2 Page 15 Discussions with service users and staff clearly identified a relaxed and informal atmosphere in which the service user’s needs were paramount. The Home employs a Diversion Therapist for 20 hours a week, to ensure social activities as an integral part of care. This is applied within the care planning process as an important aspect of care, as evidenced in examination of records and discussion with staff. Weekly activity records, monthly audit of activity and regular residents/family meetings constitute a good quality. The home continues to operate an established open visiting policy, which was seen during the inspection. Relatives and friends are encouraged to maintain social links as part of the planning of care. Comments received from relatives confirm their appreciation and involvement with the progress of their loved ones health and social status. Service users are encouraged to exercise choice and control over their life as far as is possible. Service users are actively encouraged to bring into the home personal possessions. Each individual is encouraged to be independent with regard to financial affairs with the assistance of their relatives. Anyone who is able and wishes to handle their finances, or self-medicate, they do so. Each service user has a lockable facility available in their rooms if they wished to handle their own accounts. Service users expressed their preference for their family to retain control, and Power of Attorney. Small amounts of service users’ cash were efficiently handled through the Provider’s office. On many other matters residents were complementary over the level of choices, but respected the advice and guidance given by their nursing staff. The tour of the Home demonstrated a high degree of expressed individuality in each of the bedrooms inspected. It was pleasing to see the high standards of catering at Heyfields, offering an excellent service, to which all service users spoken to were complimentary of all aspects of quality. The variable menu offered a wholesome, varied and excellent choice. Individual preferences were recorded in assessment and conveyed to cook, who met with, and discussed their requirements. It was confirmed that the cook knew each service user, and some of the relatives. An excellent lunch was served during inspection, served in impressively furnished and spotlessly clean dining rooms. Lunch was homemade lamb pasties with creamed potatoes and two vegetables, with a pineapple meringue pudding and cream for sweet. A light tea was available of cheese oatcakes, tuna mayo sandwiches and a sweet. Staff were seen to offer discreet assistance to those who required it. The choice of dining room, lounge or bedroom was at the discretion of service users. The kitchen was inspected with the cook and found to present a well equipped and organised area. All fridges and freezers were well maintained and checked Heyfields Nursing Home DS0000022338.V322721.R01.S.doc Version 5.2 Page 16 daily by the kitchen staff. One freezer would need to be defrosted. A cleaning schedule was in place and seen to be up to date and accurate. The standard were maintained by ensuring visitors to the kitchen have an overall or coat made available. Kitchen COSHH signs and notices were in evidence with detergents secure, appropriate and under control. Heyfields Nursing Home DS0000022338.V322721.R01.S.doc Version 5.2 Page 17 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, 17 and 18 The quality in this outcome area is good. The home had a meaningful complaints policy, clearly identifying the CSCI as a resource to approach with a complaint or grievance. No complaints had been received via the Commission since the last inspection. One allegation had been dealt with satisfactorily. Service users’ legal rights are protected by the systems in place. Staff induction and in-house training programmes clarified the responsibilities of all staff in their daily contact with service users, especially their privileged position in protecting service users from abuse, of all natures. EVIDENCE: Service users’ legal rights are protected by the systems in place in the home to safeguard them, including their contract, the continual assessment of care planning and policies in place i.e. the complaints procedure. The complaints policy was seen and records examined. The Home has a ‘niggles’ book which effectively handled resident’s and families concerns in a meaningful and effective manner. On discussions it was evident that any small matters were handled immediately, discretely and to the satisfaction of all concerned. No complaints had been received via the Commission since the last inspection. One allegation had been dealt with satisfactorily. The overall policy of openness and transparency was acknowledged. Heyfields Nursing Home DS0000022338.V322721.R01.S.doc Version 5.2 Page 18 All service users had received information on the procedure to complain, including reference to the CSCI. This process was evidenced on examination and case tracking as previously reported upon. Discussion with the Care Manager confirmed that there continues to be satisfactory evidence of a protocol and response to anyone reporting any form of abuse, to ensure effective handling of such an incident. The policy and procedure for handling issues of abuse was examined, and found to present an outstanding protocol. Staff induction and in-house training programmes clarified the responsibilities of all staff in their daily contact with service users, especially their privileged position in protecting service users from abuse, of all natures. Heyfields Nursing Home DS0000022338.V322721.R01.S.doc Version 5.2 Page 19 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 and 26 The quality in this outcome area is good. This judgement was based on discussions with service users, staff and a tour of the premises. The home is well appointed to meet the needs of an elderly population of service users in providing a safe and comfortable environment. On inspection bedrooms were highly personalised, with most displaying service user’s own furniture, and with personal belongings. All communal areas are of a high standard, offering social as well as private reflection, as the mood takes. The overall environment was found to be safe for service user’s comfort within risk assessed limits. The domestic services in the home were seen to be of a very high standard, with no evidence of unpleasant smells or unsightly debris anywhere throughout the inspection. EVIDENCE: External access is satisfactory for visitors, service users take advantage of attractive gardens and grounds; pathways were safe and recently attended to. Heyfields Nursing Home DS0000022338.V322721.R01.S.doc Version 5.2 Page 20 There was a large attractive wishing well and birdhouse at the rear of the home, with seating areas provided around the gardens. At the front of the home there was adequate car-parking facilities. The home overlooks stables, which make for an interesting and attractive distraction. On admission the provider or care manager assesses each individual service users’ needs for equipment and necessary adaptations. Internal access was facilitated with ample fittings of hand and grab rails, in adequate, well-lit and airy corridors. Wheelchair access was satisfactory throughout all areas of the home. Bedrooms were well maintained to meet service user’s personal preferences. On inspection bedrooms were highly personalised, with most displaying service user’s own furniture, and most with personal belongings. It is the policy that on bedrooms becoming vacant that each room is reappraised for redecoration. There is throughout a good standard of furnishing complimented with a variety of personal belongings. Corridors are wide enough for wheelchair access, well lit and with sufficient handrails. Several service users spoken to expressed a sense of belonging and satisfaction in the quality and presentation of their living areas. Communal rooms were found to be congenial and pleasantly furnished. There were adequate sitting areas with a main lounge, smaller lounge and conservatory area and sun lounge. There was a separate dining room and all the communal rooms were non-smoking areas. All communal areas are of a high standard, offering social as well as private reflection, as the mood takes, allowing activities to be presented in very pleasant, animated areas of the home with furniture and fittings of good quality. The external and internal environment was well maintained and secure. Heating and ventilation were found to be satisfactory and lighting was domestic in style. Most rooms had on-suite facilities. Aids, adaptations and equipment were available throughout the Home. One bathroom had a curtain to protect privacy, which requires address. The home presented a clean and pleasant, odour-free atmosphere, much to the credit of staff. To complement the presentation there were numerous floral and decorative displays. Infection control figures highly within the staff induction and supervisory training programmes. Domestic staff were approached and were fully aware of the importance of infection control. There was a cordless call system in place to which care staff reacted speedily to tests. The care manager expressed a willingness to meet any reasonable demand for special needs. A locked facility was established in each bedroom. And a lockable bedroom door would be made available on request, following suitable risk assessment. The evidence seen on inspection of service user’s Heyfields Nursing Home DS0000022338.V322721.R01.S.doc Version 5.2 Page 21 rooms, and on discussion with the individual service users and family, assured that this standard was well met. There are adequate sluice facilities, each having suitable arrangements to assist in control of infection. There were Sanitizer bottles kept in a general store room, which needed a more appropriate store space. Storerooms would be safeguarded with more suitable locks when not in use. Notices regarding chemical handling were displayed as appropriate COSHH posters and information charts. Kitchen presentation showed good standards of cleanliness and evidence of sound food hygiene practices. The laundry was well organised and equipped to a good standard. COSHH regulations were clearly displayed and relevant to solutions in use. Heyfields Nursing Home DS0000022338.V322721.R01.S.doc Version 5.2 Page 22 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 The quality in this outcome area is ‘good’. This judgement was based on the examination of staff files, working rotas and discussions with staff. The staffing levels in relation to the number of service users in residence and their dependency level was suitable to meet the needs of service users. Staffing stability has been maintained with consistent levels to ensure equilibrium between numbers, skills and qualifications, with a strong presence of long serving experienced staff. The management have established a comprehensive procedure for interview, selection and appointment of staff. The thoroughness of staff selection has a significant effect upon the provision of cares to ensure protection of service users. All staff receive training in care issues within the home from registered nurses and external trainers. EVIDENCE: Three weeks of off-duty were examined, which demonstrated a balance between skills, qualifications and numbers to provide a foundation for a good standard of care. The Care Manager works supernumerary and is supported by a deputy manager, and the registered providers were also working within the home all day in support. Heyfields Nursing Home DS0000022338.V322721.R01.S.doc Version 5.2 Page 23 At the time of inspection the duty rotas confirmed a staff coverage as thus: a.m - 1 trained 5 carers p.m - 1 trained 3 carers N.D - 1 trained 2 carers The catering, domestic and laundry hours were determined and found to be appropriate for the size of the home and the needs of the residents. The home has an activity coordinator working 20 hours a week. The care manager emphasised the home’s commitment to training and to achieving targets for NVQ level 2. Records confirmed that the Home currently had 13 (65 ) of care staff with NVQ Level 2 or 3, and more staff were in the process of completing it. 5 staff held first-aid certificates. Heyfields management have established a comprehensive procedure for interview, selection and appointment of staff. Four staff files were examined, presenting standard application form to assess and profile, two references taken and CRB (enhanced) checks gathered before a contract is offered to successful candidates. The thoroughness of staff selection has a significant effect upon the provision of cares to ensure protection of service users. Service users are supported and protected by these practises and all new staff goes through a thorough induction process that will ensure that they are going to be the right person for the home. All staff interviewed had a statement of terms and conditions. It is a declared policy that recruitment is based on equal opportunity. Heyfields Nursing Home DS0000022338.V322721.R01.S.doc Version 5.2 Page 24 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): 31,32,33,34,35,36,37 and 38 The quality in this outcome area is excellent. This judgement was based on discussions with the Registered Provider and Care Manager, the examination of the home policies and procedures with regards to the effective management of the home, general observations during the process of the inspection and discussions with service users and staff. The Care Manager has consistently demonstrated the appropriate skills and experience to effectively manage the home. There is a confidence apparent in the interaction of residents, staff and the Home’s management, that demonstrated a highly positive relationship that pervades throughout the Home. EVIDENCE: The Care Manager Sharon Jones has demonstrated a long-term commitment and competence in running Heyfields, in establishing a solid professional policy Heyfields Nursing Home DS0000022338.V322721.R01.S.doc Version 5.2 Page 25 portfolio that has been implemented, to achieve a high standard of set aims and objectives. A qualified general nurse with an extensive professional portfolio of practical and managerial experience, who proudly declares her ‘passionate professionalism’ approach to her position. The inspector was impressed by the openness and confidence in the observed interactions of staff, relatives and service users. The relationships were seen to be of mutual trust and respect. Appropriate risk assessments are in place for service users, through care planning and recording, staff selection and the general environment, these are up to date and accurate. Health and safety notices can be seen throughout the home. The Registered Providers have a high profile and involvement in the smooth running of the Home, delegating a wide range of management responsibility to good effect. The Providers with the Care Manager, have developed a formal approach to monitoring quality across a wide range of activities. This includes a care plan review process that is recorded at least once a month, a staff training programme, and a quality development programme, including the setting of objectives, and target dates to aim for. The home has an open door policy and a commitment to equal opportunities. An examination of administrative, monitoring, planning and care records showed an organised and professional attitude to effective record keeping. They were found to be well- maintained, accurate and up to date, ensuring that the service users’ rights and best interests are safeguarded. Records inspected included recent gas, and water inspections, and evidence of satisfactory soiled waste disposal, each were examined and found to be satisfactory. The Manager offered evidence of safe working practices including: - Moving and handling training, abuse awareness, Code of Conduct, First Aid and disposal of clinical waste. Training on infection control is also undertaken and the policies and procedures for this subject are working documents in the home. Relevant legislation was discussed and is fully understood by the management, i.e. changes from CSCI, updates on Health and Safety issues, diversity, etc. The health and safety of service users and staff are promoted with safe storage of hazardous substances, regular electrical PAT and servicing of electrical and gas appliances. Heyfields Nursing Home DS0000022338.V322721.R01.S.doc Version 5.2 Page 26 The accident book was seen and found to be in order for staff, service users and reporting arrangements to Riddor. Health and safety notices can be seen throughout the home. The administration and management of the home is efficient, uncomplicated and sensitive to the needs of service users. Heyfields Nursing Home DS0000022338.V322721.R01.S.doc Version 5.2 Page 27 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 4 3 4 3 4 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 4 4 3 4 3 3 4 3 4 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 4 4 3 3 3 3 3 3 Heyfields Nursing Home DS0000022338.V322721.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? None 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. Standard Regulation Requirement Timescale for action 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 OP7 OP38 OP38 OP10 Good Practice Recommendations Maintenance of a daily care report. More suitable locks on utility rooms. Siting of chemicals to appropriate storerooms. Consideration be given to a more suitable privacy arrangements for bathroom. Heyfields Nursing Home DS0000022338.V322721.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 Heyfields Nursing Home DS0000022338.V322721.R01.S.doc Version 5.2 Page 30 - 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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