Inspection on 20/07/05 for The Herons Care Home

This inspection was carried out on 20th July 2005.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Herons Care Home 16/07/07

The Herons Care Home 26/07/06

The Herons Care Home 08/11/05

The Herons Care Home 08/03/05

The Herons Care Home 06/07/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE The Herons Care Home Swiney Way Toton Nottingham NG9 6GY Lead Inspector Chrisandra Harris unannounced 20/7/05 10.00am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Herons Care Home C03 C53 S8691 Herons V238495 200705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Herons Care Home Address Swiney Way Toton Nottingham NG9 6GY 0115 9460007 0115 9461363 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) Derwent Housing Association Jennifer Cooper CRH 38 Category(ies) of OP 38 registration, with number of places The Herons Care Home C03 C53 S8691 Herons V238495 200705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 8/3/05 Brief Description of the Service: The Herons is a purpose built home providing care for up to thirty eight older people and is part of the Derwent Housing complex. It is in a residential area of Toton close to the local Tesco and oposite the Chetwynd Army Barracks. The home is on two floors with a passenger lift between the two levels. All the rooms are single and en-suite. The home is pleasantly decorated and clean with well maintained gardens which are regularly used by the service users. There is a gate into the adjoining school and the service users are often invited to activities at the school. The Herons Care Home C03 C53 S8691 Herons V238495 200705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection was carried out by two inspectors and took place over 4 hours. The inspectors looked around the communal areas of the home, the garden area and 4 bedrooms, observed the lunchtime meal and looked at a number of records. The inspectors also spoke to the manager, 8 members of staff, 1 relative who was visiting, 2 relatives of a prospective new service user and four service users. The home has been through a difficult period where staff have been lost and changes in financial backing have taken place. Staff and service users now feel they have “come through” this and are feeling secure again. However the standards of care during this period, as confirmed by the service users, have been maintained. Activities play a big role in the home and there is an Activities Committee which meets once a month. Links with the local community are also encouraged, especially with the adjacent school and the Army Barracks, which is across the road from the Home. What the service does well: What has improved since the last inspection? The majority of agency staff that were employed at the home have been replaced by permanent staff. The Herons Care Home C03 C53 S8691 Herons V238495 200705 Stage 4.doc Version 1.40 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Herons Care Home C03 C53 S8691 Herons V238495 200705 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection The Herons Care Home C03 C53 S8691 Herons V238495 200705 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 5 Prospective service users (and their relatives) are able to visit the home and move in on a trial basis before making the decision to stay. EVIDENCE: During the inspection a prospective service user’s relatives were being shown around the building and were able to look at the facilities and meet staff. New service users are admitted on a trial basis, and evidence was provided that showed that the arrangements for this can be very flexible according to individual needs. The Herons Care Home C03 C53 S8691 Herons V238495 200705 Stage 4.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 9, 10, There are appropriate plans of care for each service user. Procedures are in place in the home to enable appropriate self-medication and all medication is appropriately stored, recorded and distributed. Service users are treated with respect and their right to privacy is maintained. EVIDENCE: Detailed care plans were seen that covered the health, social and personal care needs of individuals and clearly recorded the action that staff needed to take to meet these needs. Plans also included clear risk assessments. Service users were aware of their plans. One service user explained that her plan always went with her when she went to the hospital, for hospital staff to complete. It was seen that plans were reviewed monthly and signed by the service user. Service users said that they are given the choice to self medicate. The ones interviewed chose not to do this, but policies are in place to enable this. It was The Herons Care Home C03 C53 S8691 Herons V238495 200705 Stage 4.doc Version 1.40 Page 10 observed that medication was kept appropriately, handled correctly and that records were up to date and correctly completed. The service users spoken to all said that they felt they are treated with respect and that staff always respected privacy. Each door had not only a key, but also a “spy hole” to see out, in their doors. Observation of care workers interactions with the service users confirmed this information. The Herons Care Home C03 C53 S8691 Herons V238495 200705 Stage 4.doc Version 1.40 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15 Service users social, cultural, religious and recreational interests are being met within the home. Their families and friends are made welcome and maintaining contact within the community is encouraged. There is a positive atmosphere within the home, encouraging service users to continue to exercise control over their lives. Meals are home cooked, looked nutritious and are clearly enjoyed by the service users. EVIDENCE: The home has a social committee that meets each month to discuss and organise activities, and the activities co-ordinator meets with each service user to discuss their interests. A wide variety of activities are arranged including trips out of the home. The annual home pantomime is a particularly popular event. Service users seen said that they were able to pursue hobbies they previously enjoyed. There are religious services within the home, but service users can also attend services elsewhere. One service user said that she goes to “Tesco” every day, to help keep her mobility and feels that the staff encourage her to do this. The school adjacent to the Home has a gate, which gives access for the service users, who attend special events at the school. Family and friends are always The Herons Care Home C03 C53 S8691 Herons V238495 200705 Stage 4.doc Version 1.40 Page 12 welcome and service users said that they could get drinks and snacks if they wanted. One visitor was eating lunch with his relative during the inspection. Efforts are made in a wide variety of ways to maximise individual choice and service users rooms are highly personalised. The service users spoken to said that they have 4 choices of food daily and that they enjoy the meals provided. Efforts are also made to meet individual choices as regards meal times. A service user spoken with said that she is on a special diet and the catering staff try very hard to make sure they get everything right for her. The meals are well cooked, pleasantly presented in serving dishes for service users to help themselves. There are three dining rooms, one large and 2 small ones. The Herons Care Home C03 C53 S8691 Herons V238495 200705 Stage 4.doc Version 1.40 Page 13 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 Although the home does have a complaints procedure which service users are aware of, complaints have not been recorded recently so there is no evidence that appropriate action is being taken when concerns are raised. It is important that the home records each complaint that is brought to their attention together with the action taken. EVIDENCE: The home does have a complaints procedure and both staff and service users were aware of it. However the complaints book showed that the last recorded complaint was some time ago and the manager agreed that complaints had been received since then, particularly in relation to the food when a temporary cook was in post, but had not been recorded or the action taken noted. Service users said that they felt able to complain if necessary and they felt confident that their complaints would be dealt with. The Herons Care Home C03 C53 S8691 Herons V238495 200705 Stage 4.doc Version 1.40 Page 14 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) 20, 23, 24 A variety of well-decorated and comfortable communal rooms are available for service users. There is a pleasant accessible garden. Individual rooms are of a good standard, all are ensuite and service users can bring personal belongings to make their rooms individual. EVIDENCE: Each of the service users seen were happy to give access to their rooms, which had clearly been personalised with their own possessions. One room seen, although cluttered, was still was adequate for the service user’s needs and safety and access was not obstructed. One service user explained how her room was changed at her request in order to have a better view. All rooms are single and en-suite and have a small fridge, locks and a spy hole. There are a variety of communal rooms available and these can be used for different purposes. Seating and lighting is of a domestic kind. The Herons Care Home C03 C53 S8691 Herons V238495 200705 Stage 4.doc Version 1.40 Page 15 All the rooms, and communal areas, were well decorated and clean and service users confirmed that this was always the same. There is a pleasant enclosed garden area with ramped access and a summerhouse, seating and a green house. The Herons Care Home C03 C53 S8691 Herons V238495 200705 Stage 4.doc Version 1.40 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29, 30 The home employers sufficient staff, with a mixture of skills and experience, to ensure that the needs of service users are met. The home operates a thorough recruitment procedure to ensure that service users are protected. New staff receive an induction and all receive regular training. EVIDENCE: At the time of the inspection there were 5 care staff on duty with one team leader and the manager. Staff rotas showed similar numbers on duty throughout the day with 2 waking care staff and one sleeping member of staff overnight. There are allowances made in the rotas for handover to the next group of staff on duty. All service users spoken with all felt that there was enough staff to help them. The youngest member of care staff is 18 and has been recently recruited following on from a successful work experience programme at the home. Most agency staff have now been replaced with permanent staff. From staff files and discussion with staff it is clear that the home operates a thorough recruitment process and checks on new staff. Each new member of the care staff receives a two-day induction from a senior member of the team. During this period future training needs are also The Herons Care Home C03 C53 S8691 Herons V238495 200705 Stage 4.doc Version 1.40 Page 17 identified. All the staff interviewed said they have training programmes. One Team Leader stated that her training had been instrumental in helping her to save a service user who was choking, which helped her to feel much more confident and competent in her role. Staff have individual training files where they keep their own training records. However the records seen had not all been kept up to date. The Herons Care Home C03 C53 S8691 Herons V238495 200705 Stage 4.doc Version 1.40 Page 18 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) 36, 38 Care staff are not currently receiving regular formal supervision, however the manager is working towards this. It is recommended that this be achieved in order to ensure a high level of care is maintained. EVIDENCE: There have been a number of staff changes over the last year and the manager has found it difficult to ensure regular formal supervision for all care staff. Considerable effort has gone into ensuring a continuation of good care and creating a strong senior care team. The manager is currently undertaking professional reviews for each member of the team and has already completed these on the senior members of staff. The manager is aware that a system of regular supervision needs to be put into place and is working towards this. There are no volunteers at the home. Some service users are insisted that the window restrictors in their rooms are removed in order to ensure more ventilation. The manager has sought advice The Herons Care Home C03 C53 S8691 Herons V238495 200705 Stage 4.doc Version 1.40 Page 19 regarding this from the Health and Safety Executive following a recommendation at the last inspection. No specific advice was provided, however each service user who requests this is risk assessed and signs a disclaimer. The current practice is that all upstairs windows still have restrictors and the organisation is liaising with the fire officer and looking at the provision of appropriate grills for the windows. The homes accident book was seen and was completed appropriately. All equipment is maintained and serviced regularly. The Herons Care Home C03 C53 S8691 Herons V238495 200705 Stage 4.doc Version 1.40 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 4 COMPLAINTS AND PROTECTION x 3 x x 3 3 x x STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x x x x x x x 3 x 3 The Herons Care Home C03 C53 S8691 Herons V238495 200705 Stage 4.doc Version 1.40 Page 21 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 16 Regulation 17(2) Schedule 4 -11. Requirement Ensure all complaints are recorded together with the action taken. Timescale for action 1st September 2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 30 36 Good Practice Recommendations Staff should keep their individual training records up to date. Ensure that all care staff receive formal supervision six times a year. The Herons Care Home C03 C53 S8691 Herons V238495 200705 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Edgeley House Tottle Road Nottingham NG2 1RT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Herons Care Home C03 C53 S8691 Herons V238495 200705 Stage 4.doc Version 1.40 Page 23 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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