Inspection on 13/06/07 for The Heathers

This inspection was carried out on 13th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Heathers 10/03/10

The Heathers 08/12/09

The Heathers 11/12/08

The Heathers 13/06/08

The Heathers 16/06/06

The Heathers 15/11/05

The Heathers 09/06/05

The Heathers 08/03/05

The Heathers 21/09/04

The Heathers 19/03/04

Similar services:

Oakmount Hostel

Ark House

St Anne`s Alcohol Services - Leeds

Lynwode Park

Parkfield Rest Home

Priory Road

Elmhurst

Linwood Court

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

CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE The Heathers 1 St Pauls Road Manningham Bradford West Yorkshire BD8 7LU Lead Inspector Karen Westhead Key Unannounced Inspection 13th June 2007 09:15a X10029.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 The Heathers DS0000001162.V332371.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 and Care Homes for Adults 18 – 65*. 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 Heathers DS0000001162.V332371.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Heathers Address 1 St Pauls Road Manningham Bradford West Yorkshire BD8 7LU 01274 541040 P/F 01274 541040 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) Yorkshire Regency Health Care Ltd Maraj Bibi Care Home 29 Category(ies) of Past or present alcohol dependence (7), Past or registration, with number present alcohol dependence over 65 years of of places age (1), Dementia - over 65 years of age (4), Old age, not falling within any other category (12), Physical disability over 65 years of age (5) The Heathers DS0000001162.V332371.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th June 2006 Brief Description of the Service: The Heathers is a care home, which does not provide nursing care. It is privately owned by the Yorkshire Regency Healthcare Limited, which is run by Stuart and Susan Crabtree. The company also has other care homes in the area. The Heathers is a detached house, which was built around 1891. It has been adapted and modernised to provide a home for up to twenty-nine people, and has kept many of the original features. The people who use the service prefer to be called residents and this term is used throughout this report. The residents living at The Heathers have a differing range of needs and this is reflected in the registration categories listed above. The home is registered to look after younger adults as well as older people. The Heathers is within walking distance of the city centre and is close to Lister Park. The home is on a main road and has a good bus route close by. There are a number of local shops, including a post office. There is car parking to the front of the house, which is surrounded by gardens. Bedrooms are on the ground, first and second floors. There are seven double bedrooms and fourteen single. Two double and ten single bedrooms have ensuite facilities. Residents are encouraged to bring their own furniture if they want to. This can help them feel at home and go some way to keeping their independence. There are also communal areas, which are spacious and provide a venue for a wide range of social activities to take place and for residents to meet up in groups. A passenger lift provides access to all floors. There is a call system fitted in all bedrooms, toilets and bathrooms. The laundry, drying area and other storage areas are in the basement. Only staff have access this area. There is a refurbishment plan in place to improve the premises. The fee charged per week is between £364 to £431. This information was provided during the inspection. The fee does not include dry cleaning, hairdressing, private chiropody treatments, telephone installation or calls, personal toiletries, taxis, activities out of the home, cigarettes or alcohol. The Heathers DS0000001162.V332371.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit was done by one inspector and had not been prearranged with the manager. The inspector arrived at 9.15am and left at 4.30pm. At the end of the visit the manager and owners were told how well the home was being run and what was needed to make sure the home meets the standards. The reason for the visit was to make sure the home was being run for the benefit and well being of the residents and in line with requirements. The home was last inspected on 16th June 2006. Before the inspection information received about the home was reviewed. This included looking at the number of reported incidents and accidents, the action plan provided following the last inspection and reports from other agencies such as the fire safety officer’s report. This information was used to plan the inspection visit. On the 7th June 2007 an anonymous complaint was received by the Commission for Social Care Inspection (CSCI). The visit was planned and as part of the inspection the complaint was investigated. The complainant said that the lift had been broken for two weeks and residents had had to be carried up stairs; that out of date food was being provided by the owner to serve to residents and that residents at risk of self harm or needing personal care were not being dealt with properly, as the management of the home give residents the ‘right to choose’ rather than carrying out their ‘duty of care’ role. There was written evidence to show that the complaint was unfounded at this stage. A number of records were looked at which covered all aspects of the home and the care provided. All communal areas of the home were seen and some of the residents bedrooms. Most of the day was spent talking to residents, visitors, staff, the manager and the owners, to find out what it is like to live and work at The Heathers. CSCI questionnaires and post-paid envelopes were left for residents and visitors to complete. Visitors, staff and residents were asked for their views and what they said to the inspector is also included in this report. What the service does well: Residents can visit the home before they make a decision about moving in. The arrangements are flexible enough to make allowances for residents who need to move in quickly or may need longer to make a decision. The plans of care are clear, regularly reviewed and written in a way so that staff know how to best care for each individual person. The plan includes health, personal and social care needs, wishes and preferences. The Heathers DS0000001162.V332371.R01.S.doc Version 5.2 Page 6 Staff make sure residents have access to a lot of different leisure activities and hobbies if they want. Interpreters and advocates are available to residents and can be invited to meetings and reviews. All residents are asked if they would like this service on admission and this is recorded. Residents are able to live their lives in a way they choose and staff promote residents’ individuality. Examples of this were given, by resident’s comments and policies and procedures in place. The Heathers provides a safe homely place for residents, some of who might otherwise be living on the streets, be in a hostel with little input from staff and could be at significant risk. The staff team are not judgemental and treat the clients with respect and dignity. However, they work with the clients to try and show them a different outlook on life. The manager and staff on duty showed they have a good working knowledge of each resident’s needs. This was shown by the way they dealt with each resident, took time to listen and understand what the resident wanted and the way they explained to the inspector how they were able to meet the residents needs. Comments made by residents and visitors showed they were satisfied with the care provided and that staff were competent and attentive: • • • • • • • I am well looked after here, we all are. Staff are good at what they do, the manager is competent and on top of it. I love it here. It’s a really good place to live, if I wasn’t here where would I go? They know about my condition and the staff know how to help me. This home provides care for some people who are difficult to place in other care home settings. The Heathers does well to help some of the residents who push the boundaries in this communal setting. Staff said they liked working at the home and felt they worked as a team for the benefit of the residents. What has improved since the last inspection? Improvements have been made to the building and the work continues to make sure The Heathers is a safe and comfortable home for residents. An adult protection policy has been formalised and is now in place. Residents and staff talked about the new approach to creating opportunities for activities and recreation and said they felt this was working well. The Heathers DS0000001162.V332371.R01.S.doc Version 5.2 Page 7 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. The Heathers DS0000001162.V332371.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Outcomes Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6, 9, 16 and 18–21) (Standards 7, 15 and 17) (Standards 22–23) (Standards 24–30) (Standards 31–35) (Standards 8, 10 and 37–43) The Heathers DS0000001162.V332371.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. (YA NMS 1) Each service user has a written contract/ statement of terms and conditions with the home. Each Service User has an individual contract or statement of terms and conditions with the home. (YA NMS 5) No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Prospective Service Users’ individual aspirations and needs are assessed. (YA NMS 2) Service users and their representatives know that the home they enter will meet their needs. Prospective Service Users know that the home they choose will meet their needs and aspirations. (YA NMS 3) Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Prospective service users have an opportunity to “test drive” the home. (YA NMS 4) Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 and 5. Standard 6 is not applicable. People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. Residents and relatives get enough information before they decide to move into The Heathers. A pre-admission assessment is carried out so that staff know what sort of care the resident needs and if they can meet that need. EVIDENCE: The Heathers gives all residents and their relative, if appropriate, a Statement of Purpose and a Service User Guide. Residents are not admitted to the home without first being assessed and where possible, visiting the home to ask questions and get a ‘feel of the place’. If that is not possible, then relatives The Heathers DS0000001162.V332371.R01.S.doc Version 5.2 Page 10 are invited to visit on the resident’s behalf. This gives the person moving in the opportunity to talk to other residents and spend time getting to know the staff and sample the food. The manager feels this is vital so that the resident can see if the home is suitable, that they have seen the room they will be moving into and see how the home is run. The Service User Guide gives an outline of what residents can expect. Whilst talking to residents, those who were able to recall moving in said they had been to the home before making the decision and that they were made to feel at home straight away. One resident said the staff were careful not to ‘leave them to their own devices’ at first and showed them ‘the ropes’. As part of the evidence gathering, four residents were case tracked. This involves looking closely at the residents plan of care, talking with the resident, observing staff practices to make sure their care needs are being met as recorded and talking to staff to make sure they have a clear understanding of the residents needs and how these are being met. The residents case tracked included one resident with a specific medical condition; two residents who were referred to as part of the anonymous complaint and one resident because they had recently come to live at The Heathers. The home has to carry out a pre-admission assessment of each resident’s needs before they are admitted to the home. The home’s registration categories include younger adults and older people with past or present alcohol misuse, residents with old age some of whom may have dementia and disabled older people. The pre-admission documentation used at The Heathers outlines a basic checklist of needs, which identify where assistance or support will be needed. The information is then used to write a more comprehensive plan of care once the resident has moved in and staff have had time to get to know them. All the files seen contained sufficient information for the home to know the residents needs and make a decision to admit them for a trial period. At the point of admission, each resident is given a contract that sets out the terms and conditions, the fees, and the room allocated. A sample of these were seen on residents files. Not all the contracts had been signed. The reasons for this were explained by the manager. All future contacts will be signed by a representative if the resident is unable to sign for themselves. The Heathers DS0000001162.V332371.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6, 9, 16, 18 –21 (Adults 18-65) are: 7. The service user’s health, personal and social care needs are set out in an individual plan of care. Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. (YA NMS 6) Also Service Users are supported to take risks as part of an independent lifestyle. (YA NMS 9) Service users’ health care needs are fully met. Service Users physical and emotional health needs are met. (YA NMS 19) 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, retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicine. (YA NMS 20) Service users feel they are treated with respect and their right to privacy is upheld. Service Users rights are respected and responsibilities recognised in their daily lives. (YA NMS 16) Also Service Users receive personal support in the way they prefer and require. (YA NMS 18) Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The ageing, illness and death of a Service User are handled with respect and as the individual would wish. (YA NMS 21) 8. 9. 10. 11. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 9, 16, 18, 19 and 20 (Adults 18-65) are the key standards. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 and 11 People who use the service experience adequate quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. The plans of care are clear, regularly reviewed and written in a way so that staff know how to best care for each individual person. Further work is needed to make sure all identified risks are adequately recorded and staff are clear about what action needs to be taken to minimise risk. The Heathers DS0000001162.V332371.R01.S.doc Version 5.2 Page 12 EVIDENCE: Staff are clear about what they need to do to meet the needs of the residents. Their knowledge and practice were reflected in the records. However, additional work is required to make sure staff know what to do in circumstances where residents are at risk. For example, a resident is involved in repeated incidents, which require careful handling. These are recorded properly and staff are aware of the needs of the resident and when to contact other agencies. However, there was nothing written down to minimise the risk to the resident and give staff guidance to make sure they are dealing with the matter in a consistent way. The management aims to involve residents and those who know them well in all aspects of their care if appropriate. This includes other professionals, family members and friends. It was clear when talking to the staff team that they were proactive in getting as much relevant information as possible to make the residents move as successful as possible but also to inform their long term care needs. Staff are aware of their skills but also their limitations and when necessary call other professionals in to assist. Case records showed regular and ongoing involvement from other agencies. Staff carried out their duties in a professional and competent way apart from two instances where the attention being given would have been more dignified had it been carried out in private i.e. when shaving a resident or when cutting a residents finger nails after bathing. The medical administration record is well recorded by staff. Medicines are kept safe in a locked cabinet and only those staff trained to do so, give out medication. Residents have access to a wide range of NHS services via the usual referral processes. All residents are registered with a local doctor. Those admitted from out of the area are registered with one of two local practices. If the resident has lived locally they retain their doctor if they remain in that catchment area. Staff spoken to said they had a good relationship with the local doctors surgery and valued the way in which residents were treated as individuals by the doctors. Residents are accompanied when attending outpatient appointments. Community Psychiatric Nurses and District Nurses are involved in the treatment and monitoring of some of the residents. Residents, who were able to comment, said they were able to please themselves and become involved as far as they wished with things in the home. Three residents said they followed their own routines and were given enough time alone if they wished. Different levels of engagement with staff were seen throughout the visit. The Heathers DS0000001162.V332371.R01.S.doc Version 5.2 Page 13 Four care plans were viewed in detail and included monthly reviews. The information held, matched the resident it referred to. Two residents said they knew about their file and one resident said he often reads his notes and asks staff to make an entry if he does not agree with what is written. He said staff are good at discussing his care needs with him and ask him if he needs anything else to make his stay better. There have been two notifications from the home in the last twelve months. One was about the lift breaking down and the measures put in place to make sure residents were all right and the other about a resident leaving the home and being admitted to hospital. Residents who cannot make their views known were observed interacting with staff during the visit. It was clear that staff knew the residents well enough to be able to understand what they needed and they responded to residents who seemed ‘lost’ or distressed in a caring and attentive way. Staff, although busy, did not pass residents without acknowledging them or engaging with them in some way. The Heathers DS0000001162.V332371.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 7, 11– 15 and 17 (Adults 18-65) are: 12. 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 have opportunities for personal development. (YA NMS 11) Also Service Users are able to take part in age, peer and culturally appropriate activities. (YA NMS 12). Also Service users engage in appropriate leisure activities. (YA NMS 14) Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service Users are part of the local community. (YA NMS 13) Also Service Users have appropriate personal, family and sexual relationships. (YA NMS 15) Service users are helped to exercise choice and control over their lives. Service Users make decisions about their lives with assistance as needed. (YA NMS 7) Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Service Users are offered a healthy diet and enjoy their meals and mealtimes. (YA NMS 17) 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15 and 17 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. Residents are satisfied with the planned activities. Food is good and meets the dietary and cultural needs of residents. EVIDENCE: Residents said meals were good and there was a variety of food available. One resident commented about the lack of wholemeal or brown bread. The manager was asked about the choice of bread available and said white and The Heathers DS0000001162.V332371.R01.S.doc Version 5.2 Page 15 brown bread was provided. On the day of the visit only white bread was seen. The manager said the cook knew the residents well and knew what they liked to eat. This was reflected in the menu planning. The cook serves the food and is keen to get direct feedback from residents about their likes and dislikes. A range of different tastes are catered for including diabetics and those needing a soft diet. Cultural and religious needs are also thought about and discussed when the menus are being planned. Residents are able to eat at different times of the day and this was seen during the visit. Daily records also showed that residents were given snacks and drinks during the night if required including beans on toast, sandwiches or cakes. Staff are now making sure there are age appropriate, educational and personal development activities available to all of the residents. Practices do not restrict the lifestyle choices of residents and take into account their wishes. Residents were seen taking part in meaningful activities, watching television, reading, chatting to one another or going out. A visiting community psychiatric nurse said the staff were very good in their approach to residents and that they cared for the whole person. He said that the manager was competent and had a good insight into the conditions of residents. He said she was fair and honest with residents and was able to talk to them about the limitations of communal living and the boundaries that imposes in a way which residents were able to identify with. The laundry at the home has industrial sized machines and are not suitable for residents to use. It is also in the basement, an area only used by staff. The current group of residents are not required to deal with their own laundry. However, they are involved in keeping their own bedrooms clean and tidy if they are able and want to. The Heathers DS0000001162.V332371.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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 feel their views are listened to and acted on. (YA NMS 22) Service users’ legal rights are protected. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Service users are protected from abuse. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. Residents are safe and protected from abuse. They are listened to and complaints are taken seriously. EVIDENCE: The complaints procedure is included in the information given to residents and their relatives. In March 2007, a complaint had been investigated by the owners and the outcome of the complaint was that the home had acted properly and the complaint was not upheld. On 7th June 2007, an anonymous complaint had been received by CSCI and this was investigated during the inspection visit. Two of the four concerns involved the lift being out of order and out of date food being provided for residents. These two concerns had been raised in the complaint investigated in March by the owners. Again there was written evidence in the home to show that the complaint was not upheld. The lift had been out of order for one day, whilst the contractor waited for a part to be delivered. Plans had been put in place to make sure residents were being properly cared for. The other two concerns were about practices in the home not protecting two residents. The Heathers DS0000001162.V332371.R01.S.doc Version 5.2 Page 17 One resident is at risk of self-harm and the other resident had not received the personal care they needed. The complainant said that the management of the home give residents the ‘right to choose’ rather than carrying out their ‘duty of care’ role. The inspector spoke to residents and saw written evidence which demonstrated the complaint was not upheld at this time. The information had been passed to CSCI by the Adult Protection Unit in Bradford and they have been told of the outcome of the investigation. The home now has an adult protection policy and has made links with the Bradford Adult Protection Unit for reporting and information sharing. Staff said what they would do if an allegation was made or there was evidence of suspected abuse or harm. Staff showed a good understanding of what signs to look for, especially if the resident was not able to voice concerns or communicate. The Heathers DS0000001162.V332371.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) Service users have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. (YA NMS 28) Service users have sufficient and suitable lavatories and washing facilities. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. (YA NMS 27) Service users have the specialist equipment they require to maximise their independence. (YA NMS 29) Service users’ own rooms suit their needs. Service Users’ own rooms suit their needs and lifestyles. (YA NMS 25) Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. (YA NMS 26) Service users live in safe, comfortable surroundings. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) The home is clean, pleasant and hygienic. The home is clean and hygienic. (YA NMS 30) The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) 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 People who use the service experience adequate quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. The design and layout of the home meets the needs of residents. Work is still needed to make sure the home is safe and comfortable. EVIDENCE: The home meets the needs of residents. Since the last inspection a year ago the owners have continued to invest time and money in the home and have The Heathers DS0000001162.V332371.R01.S.doc Version 5.2 Page 19 almost finished the major work required to make sure the home meets national minimum standards. Radiator guards are not all in place and redecoration is required to staircases and corridors. The owners have a plan of refurbishment and are working with the maintenance staff to make sure this is being done in a methodical and planned way. The manager said that all equipment had been serviced and was working. Certificates are in place to show that the electrical hardwiring, gas, hoists and lifts are in safe working order. As part of evidence gathering the manager is completing an assessment of the home, which will include written confirmation of all health and safety matters. This is to be forwarded to CSCI. The home was clean and tidy. One room did not smell fresh; this was discussed with the manager. If the smell cannot be removed with cleaning, a suitable replacement floor covering will have to be provided. There is a call system, which residents can use to summon help from staff. Staff said the system worked well if residents understood how to work it. Otherwise checks were made of residents, when they were in their rooms. Of the resident’s bedrooms seen, these seemed to reflect their choices and personalities. They varied in styles, some were personalised others less so. Some residents were happy to show the inspector their room and were proud of ‘their space’. The Heathers DS0000001162.V332371.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 35 (Adults 18-65) are: 27. 28. 29. Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. (YA NMS 33) Service users are in safe hands at all times. Service Users are supported by an effective staff team. (YA NMS 32) Service users are supported and protected by the home’s recruitment policy and practices. Service Users benefit from clarity of staff roles and responsibilities. (YA NMS 31) Also Service Users are supported and protected by the home’s recruitment policy and practices. (YA NMS 34) Staff are trained and competent to do their jobs. Service Users individual and joint needs are met by appropriately trained staff. (YA NMS 35) 30. The Commission considers standards 27, 28, 29 and 30 (Older People) and Standards 32, 34 and 35 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People who use the service experience adequate quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. Residents are protected and supported by the staff recruitment procedure. However, staff need to be trained so that they can do their jobs well. EVIDENCE: The record of training shows that some staff have attended courses in the last twelve months. This includes induction training, eye care, fire safety, heath and safety, challenging behaviour, mental health topics and adult protection. However, further training is needed to make sure staff are kept up to date with current good practice and that their skills are refreshed to allow them to do their job well. Three staff have completed a National Vocational Qualification to level 2. The Heathers DS0000001162.V332371.R01.S.doc Version 5.2 Page 21 Four staff files were examined to see if the home carries out proper interview, recruitment and additional checks to make sure staff are suitable to work with vulnerable adults. Files contained all the necessary records. Four members of staff spoken to said they had received training recently, that the home was a nice place to work, they got on with the owners and worked as a team to make sure the residents were content. One member of staff had worked at the home for thirteen years. The manager has conducted an audit of training needs and has identified where updates are required and these will be built into the training programme. The duty rotas provided during the visit showed sufficient staff on duty at all times. At the time of inspection there were four carers on duty supported by the manager, domestics, maintenance and catering staff. Staff talked about their commitment to their work and the way they could make a difference to people’s lives who live at The Heathers. They talked about regular staff meetings, the guidance and leadership they had and about the shift handover arrangements. Staff morale was described by staff as ‘fair’ to ‘very good’. The residents said that they thought staff were good at their jobs. They referred to the manager and staff in positive terms. Many of them knew who the owners were and felt they could talk to them if the manager wasn’t available. Relationships between staff and residents were good. The home has a busy atmosphere. However, staff did not attend to their duties without involving residents and making time to check they were all right. Despite the ‘hussle and bussle’ of the day there was a calm and homely feel in the home. The manager said she monitors staffing levels on a day-to-day basis and is able to authorise staff working additional hours when necessary. Nothing was observed during the inspection to suggest that current staffing levels are not adequate. The manager is advertising for a senior night carer and a care assistant for day duty. The shortfall in hours is being covered by existing staff in the home on overtime. People were calling at the home during the day to collect application forms and talk to the senior staff on duty. The Heathers DS0000001162.V332371.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 8, 10, 23, 37 – 43 (Adults 18-65) are: 31. 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 a well run home. (YA NMS 37) Service users benefit from the ethos, leadership and management approach of the home. (YA NMS 38) The home is run in the best interests of service users. Service Users are consulted on and participate in, all aspects of life in the home. (YA NMS 8) Also Service Users are confident their views underpin all selfmonitoring, review and development by the home. (YA NMS 39) Service users are safeguarded by the accounting and financial procedures of the home. Service Users benefit from competent and accountable management of the service. (YA NMS 43) Service users’ financial interests are safeguarded. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Staff are appropriately supervised. Service Users benefit from well supported and supervised staff. (YA NMS 36) Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. Service Users know that information about them is handled appropriately, and that their confidences are kept. (YA NMS 10) Also Service Users rights and best interests are safeguarded by the home’s policies and procedures. (YA NMS 40) and (YA NMS 41) The health, safety and welfare of service users and staff are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (YA NMS 42) 32. 33. 34. 35. 36. 37. 38. The Commission considers standards 31, 33, 35 and 38 (Older People) and Standards 37, 39 and 42 (Adults 18-65) 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 People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. The Heathers DS0000001162.V332371.R01.S.doc Version 5.2 Page 23 The manager works closely with staff and residents and her experience and skill level makes sure the home is well managed. The owners and area manager take an active interest in the home. EVIDENCE: The manager has relevant experience and qualifications to be able to run the home in a competent and effective manner. Resident’s finances are dealt with by a friend or relative where possible, otherwise the manager holds a small amount of cash on their behalf. All transactions are covered by a receipt and recorded using two staff signatures. The staff team put residents needs first and take pride in their work. They discuss day to day and care issues with the manager and area manager and find ways of overcoming problems relating to the care of residents. Staff and residents talked about the manager in a positive way and described her management approach and manner as firm, but open and friendly. They said she works with them; to make sure residents are being cared for properly. Rapport between residents and staff was friendly and appropriate. There was an element of banter, however, this was felt to be in accordance with the wishes of residents taking part, who later said they enjoyed the relationships they had with staff and felt included in the atmosphere of the home. The home has a health and safety policy which staff are familiar with. Fire alarms and emergency lighting are tested weekly and routine fire drills were being carried out. The inspector was told there were daily handovers between the morning, afternoon and night staff. On these occasions staff discuss each resident’s wellbeing and whereabouts and what the following shift has to cover. The Heathers DS0000001162.V332371.R01.S.doc Version 5.2 Page 24 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 3 2 2 3 3 4 3 5 3 6 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 2 11 3 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 ENVIRONMENT Standard No Score 19 2 20 3 21 3 22 3 23 3 24 3 25 2 26 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 37 3 38 2 The Heathers DS0000001162.V332371.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? Yes 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 OP2 Regulation 5(1) and 17(2) Schedule 4 Requirement The registered person must make sure the contract is signed by the resident or a representative where appropriate. The registered person must make sure risk assessments include sufficient information. The registered person must make sure the home is conducted in a way, which respects resident’s privacy and dignity. The registered person must carry out the work to make sure the home is safe and maintained: • Fit radiators with covers; • Redecorate staircases and corridors; Replace floor coverings if cleaning does not keep them fresh. The registered person must make arrangements for staff to receive training so that they can do their jobs properly. Timescale for action 13/08/07 8 2 3 OP7 OP10 12 and 13 12(4) 30/07/07 30/07/07 4 OP19 16(2)(c), 16(2)(k) and 23 19/09/07 5 OP30 18 04/10/07 The Heathers DS0000001162.V332371.R01.S.doc Version 5.2 Page 26 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Heathers DS0000001162.V332371.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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. 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