CARE HOMES FOR OLDER PEOPLE
Heatherdene 3 Upper Brook Street Oswestry Shropshire SY11 2TB Lead Inspector
Janet Oxley Unannounced 24 May 2005 10:00 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. Heatherdene E56 S20668 Heatherdene UBS UI V219809 240505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Heatherdene Address 3 Upper Brook Street Oswestry Shropshire SY11 2TB 01691 670268 01691 670268 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) Mr R J Edwards & Mrs P Edwards Mrs Karen Edwards Care Home 18 Category(ies) of 18 Old Age registration, with number of places Heatherdene E56 S20668 Heatherdene UBS UI V219809 240505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 9 November 2004 Brief Description of the Service: Heatherdene is a care home for older people, which provide personal care. It is situated inthe centre of Oswestry. The home is registered to provide care for a maximum of 18 service users. The home offers respite and permanent care to male and females over the age of sixty-five.The home is owned by Mr and Mrs Edwards. The manager of the home is Mrs Karen Edwards. Mr and Mrs Edwards also own another care home, which is situated, close-by, this home is also called Heatherdene. Heatherdene E56 S20668 Heatherdene UBS UI V219809 240505 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced and commenced at 9.25am. It included observing activity within the home, inspecting the premises, looking at records and case tracking and talking to 3 staff and 2 visitors. The Manager and the two staff on duty were welcoming and helpful throughout the inspection. It was found that the National Minimum Standards assessed had been met with only minor exceptions and that the overall quality of care provided continues to be good. All residents appeared happy, content and very well cared for and those who were able expressed satisfaction with their quality of life at the home. Visitors, relatives and all visiting professionals have also expressed satisfaction with the service and care the residents are receiving and have been complimentary regarding the management and care practices at the home. What the service does well:
This is a home for older people where the residents are looked after well. The staff respect the service users and were seen to be following the detailed individual care plans encouraging each to maintain their independence and take part in a variety of activities that they enjoy and benefit from. The home provides a pleasant and comfortable place to live. It was evident through discussions with staff and manager that there are clear lines of accountability within the homes management structure and through discussions and observations it was considered that the management approach created an open and positive atmosphere from which the residents benefit. The home communicates well with families, representatives and visiting professionals, has a group of staff who have worked at the home for a considerable time and training achievements and opportunities for staff remain on the agenda. Heatherdene E56 S20668 Heatherdene UBS UI V219809 240505 Stage 4.doc Version 1.30 Page 6 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. Heatherdene E56 S20668 Heatherdene UBS UI V219809 240505 Stage 4.doc Version 1.30 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 Heatherdene E56 S20668 Heatherdene UBS UI V219809 240505 Stage 4.doc Version 1.30 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) 1, 3 and 5. The policies and procedures that are in place, and have been professionally followed, ensure that the home undertakes all necessary assessments for successful and satisfactory admissions to take place. EVIDENCE: The home has a Statement of Purpose and a Service Users Guide, which includes all the required information for prospective residents. They may visit the home, stay on a temporary respite basis and also for day care before making a decision. Documentation examined indicated that individuals have a comprehensive assessment of their needs prior to admission, which is reviewed and amended as requirements change. Observations and discussions with residents, the manager and staff on duty indicated that the home continues to meet the individual needs of the elderly people living at the home in a satisfactory and sensitive manner.
Heatherdene E56 S20668 Heatherdene UBS UI V219809 240505 Stage 4.doc Version 1.30 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 and 10. The health and personal needs of the residents are well met with evidence of regular review and of good multi disciplinary working taking place on a regular basis. EVIDENCE: It was evident during the inspection from looking at records, inspecting the facilities and chatting to staff and residents that individual health, personal and social care needs were being met. The home uses the ‘Standex’ documentation system for individual records of care and these were seen to be well organised and clear. Residents were being treated with respect and staff were working both professionally and sensitively in meeting individual needs. Those residents spoken to were complimentary regarding the quality of their lives at the home and visiting health professionals continue to praise the management and care standards there. Heatherdene E56 S20668 Heatherdene UBS UI V219809 240505 Stage 4.doc Version 1.30 Page 10 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 and 15. The routines of daily living at Heatherdene are flexible and each resident finds the lifestyle experienced in the home meets their individual needs. A number of activities take place, there is an open visiting policy and the menu offers a choice of well balanced and wholesome meals. EVIDENCE: The residents are encouraged and enabled to personalise their bedrooms, enjoy good meals in the pleasant areas or in their own rooms and have a number of activities arranged for them within the home and out in the community. Individual needs, likes and dislikes are clearly shown in the care plans. Visitors are always made welcome, are included in events and are given all the necessary information on aspects of the home and the welfare of the residents. Visitors spoken to have been complimentary regarding the quality of life for the residents at the home. Heatherdene E56 S20668 Heatherdene UBS UI V219809 240505 Stage 4.doc Version 1.30 Page 11 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 17. Concerns and complaints are dealt with promptly and professionally and procedures and practices are in place to ensure that individuals are protected from abuse. EVIDENCE: The home has a clear complaints procedure which is given to residents and their relatives before they move into the home. No complaints have been received since the last inspection. The home has all necessary documentation in relation to the protection of vulnerable adults and this subject is included in staff training. Heatherdene E56 S20668 Heatherdene UBS UI V219809 240505 Stage 4.doc Version 1.30 Page 12 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 23, 24 and 26. The standard of the environment within the home is satisfactory, providing residents with a warm, safe and homely place to live. Necessary improvements have been identified and are in hand. EVIDENCE: The location and layout of the home are suitable for elderly residents. Communal rooms are well equipped and are warm, homely and welcoming. Bedrooms are personalised and suit individual needs and the gardens and grounds are well maintained and accessible to residents and their visitors. At the time of the most recent Fire Officer and Environmental Health Officer’s inspections matters were reported to be satisfactory. It was evident that the manager and staff work hard to maintain this environment. It was fully acknowledged that some areas of the home will need refurbishment and redecoration in the near future.
Heatherdene E56 S20668 Heatherdene UBS UI V219809 240505 Stage 4.doc Version 1.30 Page 13 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30. Residents are supported by a well trained and committed staff group who are meeting the needs of each individual in a sensitive and professional manner. EVIDENCE: Recruitment at the home is thorough however not all elements required by Schedule 2 of the Care Home Regulations are maintained on files of two recently recruited staff. The management continue to support staff to undertake their NVQ awards, a good variety of other training has been undertaken and staff on duty indicated that they were very sensitive to the service users needs and disabilities and that their attitudes and practice were monitored and supervised by the management. Recorded staff supervision and appraisals are undertaken. Heatherdene E56 S20668 Heatherdene UBS UI V219809 240505 Stage 4.doc Version 1.30 Page 14 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) 33 and 38. There are clear lines of accountability within the homes management structure and the management approach creates an open and positive atmosphere from which the residents benefit. The home regularly reviews all aspects of its performance through a programme of self review and consultations and meets the requirements of the Fire Officer and Environmental Health Officer, promoting the health, safety and welfare of the residents. EVIDENCE: The home is managed by Karen Edwards, who has twelve years experience of working with older people and will soon be fully qualified. She is supported by a Deputy Manager and a Team Leader and works along side her staff on a daily basis and ensures her staff have formal and informal supervision.
Heatherdene E56 S20668 Heatherdene UBS UI V219809 240505 Stage 4.doc Version 1.30 Page 15 The manner in which the manager and staff responded to this inspection indicated that a sound management approach is in place and that staff are committed to achieving best practice and to developing equal opportunities. Sound quality assurance systems are in place and there was evidence available to indicate the manager ensures, so far as is reasonably practical, the health, safety and welfare of service users and staff. All staff have received necessary Health and Safety training. Heatherdene E56 S20668 Heatherdene UBS UI V219809 240505 Stage 4.doc Version 1.30 Page 16 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 3 x 3 x 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 3 3 x 3 3 3 x 3 STAFFING Standard No Score 27 3 28 x 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x x x x 3 Heatherdene E56 S20668 Heatherdene UBS UI V219809 240505 Stage 4.doc Version 1.30 Page 17 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. 2. Standard 29 29 Regulation 19(4) 19(4) Requirement That two written references are obtained before appointing a member of staff. That new staff are confirmed in post only following a satisfactory CRB check. Timescale for action With immediate effect. With immediate effect. 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 Heatherdene E56 S20668 Heatherdene UBS UI V219809 240505 Stage 4.doc Version 1.30 Page 18 Commission for Social Care Inspection 1st Floor, Chapter House South Abbey Lawn SHREWSBURY SY2 5DE National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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