Care Home: Heathcote Care Home

Similar services:

• Claremont House
• Oak Ridge
• Sun Court Nursing Home
• Ashville House
• Bilney Hall
• Hill Barn
• Mabbs Hall Nursing Home
• Henrietta House

What the care home does well "I am really surprised at how caring they are. Knowing about other homes, I wanted to come after a month trial, but in the first week I saw how wonderful place this was. I decided in a week to come in", stated a service user explaining the admission, trial, meeting of needs, respect for users and atmosphere in the home. He concluded by saying: "If I knew how good they are, I would have come a long ago." Staff motivation and commitment to the home created a pleasant and comfortable atmosphere. The home had not used any agency staff, and some shifts were covered by regular staff working overtime. This ensured better consistency of care for service users. What has improved since the last inspection? The new owners invested in the home to improve the environment. These improvements lifted staff morale and, consequently, improved care for service users. The open and transparent atmosphere also had a very positive effect on the way staff worked and users felt about being cared for. The presence of a director on at least a weekly basis significantly encouraged progress in all aspects of the operation of the home, as staff and users felt well supported. In their self assessment a director stated: "Improvements have been made in our staff recruitment, induction and training. New quality control audits have been introduced. Internally the Home has been refurbished where necessary including new lounge, new ground floor office, new furniture and hoist, and redecorated bedrooms. Rear garden patio has been created. Risk assessments have been improved." Previous requirements were related to the previous owner, but meeting them under new ownership brought improvements to service and provisions. What the care home could do better: The new owners had already assessed areas for further improvement and stated them in their AQAA: "Further improvements in risk assessment will be introduced shortly, particularly manual handling and nutrition. Further quality assurance surveys covering admission and discharge will be introduced. Supervision forms to be improved. Rear garden patio to be extended and garden improved." By choosing to improve aspects of care the owners showed determination to improve the lives of service users. The site visit and inspection also identified the potential need to add a new category of registration, to cover users` deteriorating conditions and development of dementia for some of them. This new, added category would need to be supplemented with extended training on dementia and with care principles applying to dementia sufferers. CARE HOMES FOR OLDER PEOPLE Heathcote 19-23 Unthank Road Norwich Norfolk NR2 2PA Lead Inspector Dragan Cvejic Unannounced Inspection 5th December 2007 09:30 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 Heathcote DS0000069100.V356168.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. Heathcote DS0000069100.V356168.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Heathcote Address 19-23 Unthank Road Norwich Norfolk NR2 2PA 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) 01603 625639 01603 762356 www.blackswan.co.uk Black Swan International Limited Manager post vacant Care Home 29 Category(ies) of Old age, not falling within any other category registration, with number (29) of places Heathcote DS0000069100.V356168.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th April 2007 Brief Description of the Service: The home has recently been taken over by Black Swan Ltd. Heathcote is a residential care home that provides accommodation for up to 29 elderly people. It comprises of what was previously three separate properties, which have been renovated and modified into one single property consisting of 3 floors and a passenger lift to the first and second floors. There are 5 double rooms and 19 single rooms. Several of these have en suite facilities, which includes a bath. Rooms without en suite facilities have wash hand basins fitted and toilets located outside the rooms. People who are fully ambulant, and selfcaring, are offered accommodation in the 5 single rooms on the second floor. The home has a comfortable lounge that operates as three separated areas. The lounge is open on to a small patio at the front of property. There is another smaller lounge for service users and this is ideal for service users to meet with relatives and friends in private and a large dining room, which is used frequently by the service users who live at the home. Parking is available at the front of the home and the property is located close to the city centre of Norwich and to all amenities. The weekly fee for care and accommodation in the home is £347.00 Heathcote DS0000069100.V356168.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection. It was carried out by analysing the home’s self-assessment and by the site visit to the home. During the visit, we spoke to service users, to staff, to the manager and one of the new owners. We checked case tracked users’ files, staff files and some other documents. A tour of the home provided first hand information about the environment. Combining the sources of information resulted in this report that showed, in general, improvements in the service, since the change of ownership and innovations in working practices as a result of that. What the service does well: What has improved since the last inspection? The new owners invested in the home to improve the environment. These improvements lifted staff morale and, consequently, improved care for service users. The open and transparent atmosphere also had a very positive effect on the way staff worked and users felt about being cared for. The presence of a director on at least a weekly basis significantly encouraged progress in all aspects of the operation of the home, as staff and users felt well supported. In their self assessment a director stated: “Improvements have been made in our staff recruitment, induction and training. New quality control audits have been introduced. Internally the Home has been refurbished where necessary including new lounge, new ground floor office, new furniture and hoist, and redecorated bedrooms. Rear garden patio has been created. Risk assessments have been improved.” Heathcote DS0000069100.V356168.R01.S.doc Version 5.2 Page 6 Previous requirements were related to the previous owner, but meeting them under new ownership brought improvements to service and provisions. 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. Heathcote DS0000069100.V356168.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 Heathcote DS0000069100.V356168.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provided effective and complete information about the home, introduced a trial period and confirmed to service users that their needs would be met if they decide to come into the home. These benefits were well used by service users when they made their decisions to move in. EVIDENCE: New owners of the home looked for how to inform service users better and one of the first things they did was to review and update the information about the home. They stated in their AQAA: “Provide a Service User Guide to each Resident and prospective Resident which includes the Home’s Statement of Purpose, relevant policies within the Home, complaints procedure, inspection reports, quality assurance summary, contracts/statement of terms Heathcote DS0000069100.V356168.R01.S.doc Version 5.2 Page 9 and conditions, individual care plan and the Home’s brochure. An office copy is available to all prospective Residents and their family/representative. Provide a written contract/terms and conditions on admission to the Home and blank copy prior to admission if requested. Complete a comprehensive pre-admission assessment of needs by way of visits to potential service user, invitation to visit the Home, eat at the Home, meet staff and other Residents, free trial overnight stay at the Home. Provide sensitive, supporting re-assurance during the admission process. Provide a trained staff team able to meet the assessed needs of the Resident.” These improvements were confirmed by two service users spoken to. One of them described his admission process, trial and how his needs were met. The files checked demonstrated that the admission details for each user were re-written in order to keep accurate and complete assessment details in the head office. All contracts were also reviewed and re-signed by service users or their representatives and users knew what was written in the new contract. Heathcote DS0000069100.V356168.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users were well looked after and supported to remain as healthy as possible and to express their autonomy and independence. EVIDENCE: “Each resident has an individual care plans based on assessed needs which is driven by the resident. Residents have the right to choose how their personal care is provided. Residents are encouraged to self administer medication following risk assessments. All staff who administer medication are suitably trained. The Homes policy on the safe storage, administration and disposal of medication is adhered to. The wishes of the resident regarding terminal care and death are sensitively Heathcote DS0000069100.V356168.R01.S.doc Version 5.2 Page 11 dealt with and recorded in their records”, stated the home’s AQAA. A service user confirmed that he took part in care planning and stated that his choices, wishes, likes and dislikes were respected. Four users’ files were checked. They contained all the relevant, updated information necessary for their appropriate care. Weight charts, nutrition charts, records of healthcare appointments and chiropody visits were recorded. Medication process was observed, records for 3 service users were checked. The amount of medication was checked for 2 service users. Controlled drug records were also checked, but no service users were on prescribed controlled drugs at the time of the site visit. The new medication sytem improved safety for handling medication and ensured proper risk assessments were drawn up for those who were self medicating, as seen in two of four checked files. A user described how he felt about about respect for privacy and dignity: “You are free to come and go when you want. Staff respond well and quickly when I call them. They are excellent.” Another user added: “We have here people with a wonderful sense of humour.” She stated that she was free to choose the activities she wanted to join or not. Heathcote DS0000069100.V356168.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users wishes, likes and dislikes were known, respected and they were treated with dignity and encouraged to express themselves and remain as autonomous as possible in a structured and organised daily routine. EVIDENCE: A service user spoke of the visits by her daughters and husband with delight. She stated that they were always welcome in the home. Another user stated: “ We have a choice for everything. I like more gravy with my food and they always give me more when I ask for it.” He also explained how the daily routine suited him: “I can choose TV programmes I want to watch, but sometimes I prefer watching TV in my room. I like my room.” The home reported in their AQAA: “Residents choices of activities, interests, food, drink, religion, personal care and personal relationships are listened to and respected. Heathcote DS0000069100.V356168.R01.S.doc Version 5.2 Page 13 Residents can feel free to request changes which affect their lifestyle. Staff are approachable and are trained to treat Residents with dignity and privacy. Contacts with family friends and the community are encouraged and supported. Independence and personal preference is always encouraged. Choice and range of menu is driven by the Residents with an overall view of providing a nutritious, wholesome, balanced and an enjoyable diet. Mealtimes should be an enjoyable experience. Residents choose in which areas they would like to personally develop whether it be educational courses, outside vocational courses, activities and hobbies.” However, as some service users had started showing signs of dementia, the manager was considering how to best respond to their changing needs. This was considered to be the task in the forthcoming period. Service users spoken to praised the food. Lunch time was observed and looked relaxed, those users that needed help were supported to eat. The menu showed variety and nutritionally well chosen food. Heathcote DS0000069100.V356168.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users were protected and reassured that they could complain if there was anything to complain about and were protected by proper vetting process for new staff. EVIDENCE: In their AQAA, the home provided an explanation of their approach to complaints and protection of service users: “Provide a complaints procedure to each Resident and put one on the wall at entrance for visitors. Have an open policy of welcoming suggestions and complaints which will be acted upon. Keep a record of complaints. All staff read, sign and understand the Homes policy on Protection of Vulnerable Adults. All staff are trained in Protection of Vulnerable Adults. All staff go through a rigorous recruitment procedure including employment history, written references and CRB.” There was one complaint recorded in the home’s records, where both complaints and compliments were recorded. The outcomes, some not and some upheld, were used to improve service. The procedure was displayed in the hall and included in documents given to service users, ensuring anyone could complain. The service users spoken to Heathcote DS0000069100.V356168.R01.S.doc Version 5.2 Page 15 stated that they felt comfortable and knew how to complain if there was anything to complain about. Protection of service users through rigorous staff checks had been seen in staff’s new files and staff signatures confirmed that staff were fully aware of POVA procedure. Heathcote DS0000069100.V356168.R01.S.doc Version 5.2 Page 16 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): 19,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was becoming more and more comfortable for service users since the change of ownership and service users had started enjoying the homely atmosphere and setting. EVIDENCE: Major improvements in the home happened since the change of ownership. A new roof had replaced the old, leaking one. Old windows were replaced, the garden was paved and many areas were redecorated. Shared rooms had new curtain type dividers, offering at least a little more privacy to users who opted to share rooms. At the time of the site visit only one double bedroom was shared. Heathcote DS0000069100.V356168.R01.S.doc Version 5.2 Page 17 Service users were pleased to see all these improvements in the home. A new user stated: “It is a lovely place, it is clean, bright and very comfortable. It feels like a home.” New smoking regulations were addressed in the home by introducing a specially designated smoking area, so that non smokers would not be affected by the smoke. There was one outstanding radiator to be covered to improve safety for service users. Currently, the laundry room was accessible through the garden. Staff stated that they did not mind walking around from the main building to access the laundry. The procedure, although not the most comfortable for staff, ensured infection control measures were in place. Heathcote DS0000069100.V356168.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The much happier staff team showed better commitment and motivation to help and support service users in a dignified and respectful way. Service users benefited not only from trust, but also from appropriate vetting of the staff and from their up to date training and support through supervision. EVIDENCE: The home’s AQAA reported: “New staff go through a rigorous recruitment process including interview, references, CRB checks. Staff go through an Induction process on joining which may involve Skills for Care induction training. Staff training requirements are reviewed during staff supervision and are trained both internally and externally. Staff are aware of their role within the Home and are trained to support the Residents within the Home. Staffing levels are determined by the needs of the existing Resident group.” Three staff files were checked and confirmed that the home was following their procedures regarding staffing. One of the files did not have two references, but the staff member was employed during the previous ownership. Heathcote DS0000069100.V356168.R01.S.doc Version 5.2 Page 19 Three service users stated that staff were excellent, patient and friendly, and that they always responded when the users called them. A staff member spoken to stated that she was much happier with the new ownership, as training was better, the organisation of work was better and the environment was much improved for service users. Training records showed regular, updated training was provided for staff. A supervision plan was drawn up to ensure appropriate support was provided. At the time of the inspection it was still the responsibility of the manager and the director to provide supervision, although there was a plan to delegate supervision to senior workers in the near future. The director presented areas that were improved since the takeover: “Amended and improved our Application form. Amended and improved our Homes Induction form. Introduced Skills for Care Induction training. Introduced new Adult Abuse training. Introduced new Food Hygiene training. Improved Homes policies on Manual Handling, Infection Control.” Heathcote DS0000069100.V356168.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,34,35,36,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was successfully managed by the manager and by the ownerdirectors who were regularly present in the home, and provided not only good service but firm reassurance to service users that their interests were priority in the operation and management of the home. EVIDENCE: The home was managed by a long serving staff member, who had recently been promoted to the acting manager’s position. She had the skills and experience to manage the home and started working towards her qualifications for this post. She was well supported by the director who visited the home at Heathcote DS0000069100.V356168.R01.S.doc Version 5.2 Page 21 least once a week to offer support and guidance. Both the manager and the director were asked to plan and apply for the manager’s registration with the regulatory authority. Quality assurance was the process that the organisation used to closely monitor the service. They sent questionnaires every 6 months, but they also used both service user and staff meetings to gather information about day to day operation, innovative ideas, and to inform all about the changes introduced as part of the organisation’s package to improve service and provisions. The analysis of the quality assurance review was displayed in the entrance hall and was available to service users, visitors and staff. There were no service users with different cultural or religious needs to those of mainstream society. All carers were female at the time of the inspection, but there were no specific requirements for a male carer. The new owners invested money into the home to improve the environment, staffing cover and training for staff. They invested time to improve procedures and policies and, in general, to improve the life of the service users living in the home. Insurance certificates were displayed and provided reassurance to staff and service users about the financial viability of the service. The home asked social services to get involved with supporting service users to manage their finances when it was necessary. The manager was involved in helping one user to withdraw money from a bank. Two records of service users’ expenditure were checked and money counted: all was found to be accurate. Two case tracked service users were managing their own money, demonstrating that the home encouraged independence for service users who were able to securely manage their finances. A new supervision plan was prepared and had started operating since the change of ownership. Records showed that all checked staff were regularly supervised. Safe working practices were in place and the new owner emphasised their importance. Staff were asked to sign health and safety instructions and protection issues, to ensure safety for service users. Heathcote DS0000069100.V356168.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 3 3 3 X 3 Heathcote DS0000069100.V356168.R01.S.doc Version 5.2 Page 23 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. 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 Refer to Standard OP31 OP38 Good Practice Recommendations The organisation and the manager should apply for the manager’s registration. The home should consider expanding the categories of service users conditions in their registration certificate, to include existing service users who showed signs of deterioration of their health and had started developing dementia. This would trigger the provision of extra training and skills for specific needs of service users with specified conditions, and ensure compliance with relevant regulations. Heathcote DS0000069100.V356168.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 Heathcote DS0000069100.V356168.R01.S.doc Version 5.2 Page 25 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!