Care Home: Heatherlea Residential Home

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What the care home does well The manager and staff provide the residents with a caring service which encourages people to remain as independent as possible with support as they need. There are plenty of varied training courses that staff attend, as well as most of them achieving nationally-recognised qualifications, the certificates for which as displayed in the main hall at the entrance to the building. The owners are regularly involved in the home, visiting several times each week, and being readily available for people to meet and talk with. Staff feel supported by the manager and providers, with one-to-one meetings with the manager or senior staff and monthly staff meetings on a regular basis. What has improved since the last inspection? The manager and owner regularly monitor the service provided at the home by asking the residents, their relatives, staff members and now also other people associated with the home for their views on how well they provide the service to the people who live there. What the care home could do better: The propping open of doors in some areas of the building was noted and discussed in depth with the owner. She has agreed, as a matter of urgency, to obtain quotes for, and to fit, appropriate and safe door-guards that react in any instance of a fire alarm being activated, to keep people inside the rooms safe in case of a fire within the home. A relative, when asked what the service might do better, said, "Nothing really. Everything seems fine. I`m very grateful to have [the resident] warm, safe and so welllooked after." Inspecting for better lives Key inspection report Care homes for older people Name: Address: Heatherlea Residential Home Heatherlea House 109 Tor-o-Moor Road Woodhall Spa Lincs LN10 6SD     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Vanessa Gent     Date: 1 0 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Heatherlea Residential Home 109 Tor-o-Moor Road Heatherlea House Woodhall Spa Lincs LN10 6SD 01526353394 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): lizhunt@fsmail.net Mrs Lesley Anne Sutherland,Mr Terry Sutherland Name of registered manager (if applicable) Mrs Elizabeth Margaret Hunt Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Heatherlea is a privately-owned care home that provides personal care for up to seventeen people of both sexes over 65 years of age, including five people who may have dementia. The home is situated in a residential area of Woodhall Spa, within a five to ten-minute walk of the centre of the village. There are various shops and leisure activities including pubs, churches, library, village hall, post office, restaurants and tearooms. Near the home, there is a famous golf club and a kinema in the woods with picnic areas for the locals and summer visitors to enjoy. The village has a regular bus service Care Homes for Older People Page 4 of 25 care home 17 Over 65 5 17 0 0 Brief description of the care home to the surrounding towns. The accommodation consists of eleven single and three double bedrooms, none of which are ensuite. Communally, there are two lounges and dining rooms, two bathrooms with a toilet, a shower-room and five toilets. These are strategically positioned near to communal areas and bedrooms. Outside the front of the home is a parking area for seven vehicles and at the side, a secure garden with a patio and small summerhouse. The garden is in the process of being re-designed to encourage residents to take an active interest in planting and tending plants, if they wish. The owners philosophy is to create a happy and relaxing atmostphere in which residents can feel at ease in a homely environment and that people will be treated as individuals and encouraged to maintain their independence. The weekly fees are from £351 to £450. People pay for their own hairdressing and chiropody charges, personal newspapers and magazines. Information about these costs as well as the day-to-day running of the home, can be found in the statement of purpose and service user guide. These documents and a copy of the latest inspection report are available to people who live there and for those interested in coming to live at the home. On the day of the inspection visit, twelve people were living at the home. Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: An unannounced visit was made to the home as part of our key inspection. It started at 12:15 and lasted five hours. As part of our review and assessment of the service the owner was asked to complete a self-assessment questionnaire called the Annual Quality Assurance Assessment (AQAA). The information we received, as well as that which we hold about the service, was used to plan the visit and produce this report. The main method of inspection we used was called case-tracking. This involved choosing three residents, and checking the care they receive through looking at their records, chatting with them, the care staff, any visitors and observing care practices. Care Homes for Older People Page 6 of 25 Our visit to the home focused on whether key standards had been met and how people feel about the service provided. The care received by three people was followed in detail to check that their health, safety and welfare needs were fully met and that they were supported to maintain their dignity, autonomy and choice. We spoke with the deputy manager, staff on duty, most of the people in the lounge or their own rooms, including those whose care we were following closely. Any comments we received are mentioned in the main body of this report. Personal records, known as care plans, general house records and staff records were looked at, and the way care was given to the people was noticed. We saw most areas of the home and watched the lunch and evening meal being served to and taken by the people who live there. The deputy manager was present throughout our visit. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have enough information to allow them to decide whether the home is right for them. Assessments are done for all people interested in moving into the home, to ensure that the manager and staff can meet the needs of the people who live there. Evidence: The statement of purpose and service user guide we saw were comprehensive documents that people told us gave them sufficient information to help them decide if they wanted to live at the home. We looked at the care given to selected people living at the home and at their care plans, and saw that there were assessments done before they had moved in to the home. These were done by the manager or a senior member of staff. We saw that these were then used to create the care plans and identify any issues or needs that the individual may have. Care Homes for Older People Page 10 of 25 Evidence: The manager does not offer intermediate care although they do have several beds for short-term or respite care, none of which were being occupied by people needing respite at our visit to the home. Care Homes for Older People Page 11 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are met by clear care plans, appropriate liaison with other healthcare professionals and safe medication practices. People are cared for with dignity and as they wish. Evidence: We looked at the care plans of three people who live at the home. The care plans created from the first assessments were very clear and comprehensive. They detailed all the needs of the people and showed a clear audit trail of how those needs are managed and reviewed on an ongoing basis. Staff confirmed they were easy for them to read, write in and understand. The care plans also clearly indicated where and why other people, including healthcare professionals, had been involved at various times of the residents life. In the care plans we looked at we saw that the staff are in the process of making the care plans much more person-centred with evidence that they were involving the resident, where possible, and relatives or a representative in them. The recently-appointed person who concentrates on the activities that people may be Care Homes for Older People Page 12 of 25 Evidence: interested in is in the process of completing peoples life histories, with the families wherever possible, to gain an insight into how to meet the peoples needs even better. Staff told us that although people are supported wherever possible to see to their own medicines, and that there are policies and procedures they follow for this, all of the people who currently live at the home needed support to take their medicines safely. Staff said, and their certificates showed, that they are trained by a professional trainer to give medicines safely and feel safe doing so. We saw that the supplying pharmacist checks the medication practices regularly. The reports show there have been no outstanding issues relating to how they order, store or administer the medications to the residents. We saw that people were treated with respect and dignity all the time during the visit. People confirmed that they are happy with how staff treat them. We saw a friendly and caring rapport between staff and residents that indicated that this is the usual way of living at the home. A relative said that the staff are lovely, caring and very good with the residents and they see a relaxed and calming atmosphere at the home whenever they visit, which is several times a week. Peoples end of life wishes were discussed and recorded in a clear, explanatory and sympathetic manner that showed how staff had been considerate and sensitive at this time. Care Homes for Older People Page 13 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are given respect and flexible choice in their home-life by a thoughtful and conscientious staff team. Meals provided are nutritious, well-balanced and appetising. Evidence: Many of the people living in the home who have limited communication indicated that they enjoy having one-to-one attention to keep them occupied. According to a visitor, the recently-appointed activities organiser has improved the quantity and variety of activities greatly. The activity organiser told us they are working to incorporate more small group activities appropriate for people with a short memory span but who need to be kept occupied and busy. The owner of the home intends to join the charity, NAPA, the National Association for the Provision of Activities for older people, to help them find more meaningful ways to keep the residents busy and offer them more choice in how to spend their time at the home. Visitors told us they feel welcome when they visit. They said the staff are nice and friendly and help to create a homely atmosphere. There have been some events where Care Homes for Older People Page 14 of 25 Evidence: people from the community have come to entertain the people in the home. People indicated that they were given choice and freedom in the home. The philosophy of the home is to be treat people as individuals and encourage them to maintain their independence. The manager told us in her self-assessment, that they encourage people to make their own decisions in accordance with the Mental Capacity Act [2005]. We saw people moving freely around the home as they wished. People and staff told us, and we saw at the lunch and teatime meals, that the food cooked is homemade and fresh and included vegetables. Staff said that vegetables are given at every lunch meal and fruit available at meals and in between. People sitting in the lounges all had a drink by their sides. Fluid charts completed and kept in the rooms of people who were poorly showed that plenty of fluids are encouraged. Care Homes for Older People Page 15 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People feel able to voice any concerns, and are taken notice of and cared for by staff who are trained to protect them and who are committed and caring in their work. Evidence: No complaints or concerns had been received by either us or the manager or staff at the home since the last inspection. The manager, in the self assessment form completed, told us that relationships with the residents, relatives and friends are friendly and comfortable which makes us approachable, and that all staff have received training in safeguarding vulnerable adults. People told us they would speak with the manager or any staff if they were not happy with their care, but all said or showed that they are happy and comfortable and that there are no problems or issues that worry them. We saw the staff files and certificates that confirmed that they have received appropriate training to keep people safe. Staff were able to tell us and demonstrate how they are considerate of the people in their care. Care Homes for Older People Page 16 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a clean, comfortable and well-maintained environment, which enables them to feel they are cared for as they wish and that makes them feel at home. The owner is putting measures in place that will increase and improve the safety of the people who live there. Evidence: We saw that the home was pleasantly decorated and was light and airy. People told us they were happy with their surroundings and they liked their own rooms. Although there are three double bedrooms, all are singularly occupied at present. Visitors said the home was always kept clean, tidy and smelling fresh. A person told us that one of the reasons for picking the home for their relative was that it smelt fine and had a pleasant atmosphere as soon as they walked in. A shower room has been installed to provide more choice for peoples personal hygiene needs. The Fire officers (16/10/07) and Environmental Health Officers reports (29/10/09) both showed that the home was maintained in a safe manner. It was noted, however, that the kitchen, lounge and some doors to peoples rooms were propped open with Care Homes for Older People Page 17 of 25 Evidence: door wedges. Staff and some people told us they wanted their doors kept open, to stop them feeling isolated and to be able to watch what was going on around them. This was discussed with the owner and how this is a safety issue for people living in the home. She has agreed that the matter will be dealt with without further delay. They will urgently acquire quotes for replacing the wedges with appropriate and safe doorguards that react to fire alarms, and without delay, make a programme for putting them in place, to provide all the residents and staff with a safe system should a fire occur. They have agreed to inform us when this task has been completed. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are cared for by enough carefully-recruited and well-trained staff to ensure their health, welfare and choices are maintained and they have enough time to give the residents the attention they need and want. Evidence: A visitor to the home said that staff sometimes seemed to be overworked and to rush around. However, people living at the home said the staff are always available when they wanted them and always had time for them. None of the staff were rushed during the visit and were seen to be able to spend quality time with each resident as they wished or needed. The staff we spoke with and the deputy managers told us they work together well in a good team and although are often busy, are not normally rushed to get work done. The staff duty rota showed there were enough staff on duty at any time to cater for the needs of the residents, considering their dependency needs, the layout of the building and the skills of the staff team. Staff were observed to talk very gently with residents, even when not aware of being seen. Staff files we saw showed that they contained all the items required for safe recruitment and induction. Staff confirmed that they felt well-supported throughout Care Homes for Older People Page 19 of 25 Evidence: their induction period and were able to care knowledgeably and appropriately for the residents. Certificates lined the walls of the main hallway to show that most staff have achieved qualifications in nationally-recognised courses at various levels. Staff said the amount and variety of training they undertook was excellent to support them to care efficiently and safely for the people in their care. Training certificates in the staff files we saw confirmed what the staff told us about how many courses they could and did undertake. They were also able to demonstrate and tell us how to care appropriately for people. All staff said they had had training, and understood their role, in the new legislation that has been put in place to protect peoples rights and choices. Their training files confirmed this. The deputy manager showed us some leaflets that have been given to all the staff, and discussed with them, about what this new legislation means for people and what they must do. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is run in the interests of the residents, who feel safe and happy and enjoy living in the home. Staff feel well-supported and enjoy coming to work. Evidence: The manager has been in post for several years and has achieved the Registered Managers Award to help her manage more effectively and efficiently. People said they can and do go to her at any time and she listens. Visitors said she has an open-door so they know they can go to her with any issues, although we were told they had never had any concerns or complaints about the care of their loved one. To monitor the quality of the service given at the home, an annual survey is given out to residents, relatives and staff. The next one to be distributed will include other health and care professionals associated with the home, such as doctors, district nurses, social workers, chiropodist, and any other people who visit the home regularly. Care Homes for Older People Page 21 of 25 Evidence: The owner visits the home most days every week and people say they speak with her and she asks how they are. The owner said she is in the process of establishing monthly, unannounced visits to monitor the quality of the care given and the service provided, including the building, maintenance and notifications of any incidents. She will then write a report for the manager and for us to see when an inspection is due. Staff said, and their files confirmed, that they had one-to-one meetings with the manager or a senior to discuss their work and how their needs are met to help them care better for the people who live in the home. The deputy managers said they had been given specific training to help them in their supervising roles. We saw records that showed us that the hygiene and maintenance of the home is satisfactory. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 24 of 25 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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