Care Home: Heatherway Resource Centre

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What the care home does well Heatherway offers short stay accommodation on a respite care basis only. The service, once again, demonstrated excellent care practices in meeting the needs of the people who come to stay. The manager and staff team work well to ensure that people feel at home when they stay away from their regular carers. The staff group are very committed and work well together to provide a high quality service, which ensures that those using the service enjoy their stay and have all their needs met.Families and carers are also very involved in all aspects of a person`s care and are encouraged to voice their opinions in order that the service continues to be one of quality. Four relatives, carers or advocates gave their views on the service. All were complimentary about the level of care that their relatives receive.For what the service does well,comments said,"Heatherway is a very well run respite care centre.My husband and I are grateful that our X can stay there as we know that X will be well looked after in a happy environment." Another survey said,"The service provided is excellent.X feels its home from home and is most comfortable and happy to have respite there. Three care professionals also returned questionnaires and gave positive responses. CHOICE OF HOME The local authority has clear policies and procedures in place regarding admission;they also ensure that any new person would be central to the process whenthey come to use the service. We looked at records for four people which included one person who recently started using the service. Care managers had provided full needs assessments and staff had also completed an informative support profile following admission. The profile covered a range of areas such as health and personal care needs, mobility, communication,leisure and recreation, behaviour,risks and eating and drinking. An informative needs assessment was available for a person who had recently started using respite care. There were also good records to show that the person had received appropriate support to familiarise themselves with Heatherway.Families and carers are given a feedback form to share their views on how the stay went.Again,responses told us that people are very pleased with the service. INDIVIDUAL NEEDS & CHOICES We looked at five care plans which ranged from ones for people who have regular short breaks to those who stay on an occasional basis. Plans were well organised and contain good information about personal, healthcare and social needs. Generated from assessments completed by the placing local authority, each person has a care plan that outlines what level of support they require. They also detail what each individual likes to do each day, the things that they like and how the staff should do best support them to achieve their personal goals.Plans showed evidence of regular internal review as well as annual reviews by the local authority. Some individuals had person centred care plans with pictorial formats and photographs included. Plans recognised what was important to a person and tell the staff about the best ways to support their needs and preferences. One example said,"likes the pillow dusted with talc as X loves the smell." We looked at risk assessments which matched the needs of each person and tell staff how to make sure the person is kept safe from anything that might harm them. Any risks to people through general health,needs or activities are assessed and clear action to reduce any risks had been recorded. At our last inspection we required the home to ensure that risk plans were reviewed at least six monthly. We saw up to date risk management plans for people that identified what action should be taken to lessen risk, whilst encouraging independence. Examples included use of the kitchen, safety in the community, mobility and eating and drinking. Where needs had changed, risk assessments had been updated accordingly. LIFESTYLE This service provides respite care only but people are encouraged to maintain their usual routines as if living with their main carer. People using the service attend day centres, college classes and various community activities organised by Heatherway. Staff were knowledgeable about people`s care needs, preferences and behaviours. We observed staff using their skills and experience to manage behaviours that can be challenging, and to support people with their preferred routines. Interests, hobbies and preferred leisure activities were clearly recorded in people`s support profiles.For example, one person enjoys hand and foot massages and staff provide this activity for them when they come to stay. Records told us that their other interests are supported such as singing, dancing and going for walks. Meals are planned with people during their stay and records were being kept for all the meals provided. These showed that people are offered a varied and balanced diet that also takes into account individual choice and any cultural preferences. Meals are home cooked and individuals are able to eat at flexible times according to their routines and choices. PERSONAL & HEALTHCARE SUPPORT Health care needs were clearly documented in the care plans and gave a good overview about a person`s medical background and any conditions such as epilepsy.Key information about health check-ups and health screening they may need was also recorded. A key worker system is used to ensure continuity ofcare when people come to stay. The key staff are responsible for updating care plan records as necessary. Staff complete detailed daily notes concerning people`s general well being and if there have been any changes to their care needs.We looked at how the home manages medication, its administration, storage and disposal.All medicines stored in the home on behalf of the people who use the service were stored securely in a lockable cabinet in the office. The administration charts were all signed and accounted for. The balances of medication corresponded with the supply held.Two staff check and sign when medication is administered which is good practice and minimises the risk of error. COMPLAINTS & PROTECTION The AQAA stated that the service has received no complaints within the last 12 months and there have been no safeguarding concerns reported to us.The complaints procedure was available in an easy read version and explained how complaints would be investigated and how long it would take to do this. Survey responses told us that relatives and c What the care home could do better: We identified three areas for improvement. We saw one report about a safeguarding allegation that had occurred away from the service. Although the incident did not take place at Heatherway,it would be better if we were kept informed about all events that come under the remit of protecting vulnerable adults. This is so we can track that appropriate action has been taken to keep people safe. There was an unpleasant odour in two of the bedrooms.The carpets must therefore be replaced with a more suitable floor covering. This is to ensure that people who use the service can stay in a pleasant and hygienic environment that meets their specific needs. One final improvement is required concerning fire precautions. The office door was propped open with a wedge and this practice could compromise people`s safety in the event of a fire. As the office door needs to be kept open at regular times throughout the day, a suitable door closure device that links to the fire alarm system is needed. Until the work is completed a risk assessment must be put in place.We have made one good practice recommendation for the provider to consider. We suggest that person centred care planning is extended to all other users of respite care and plans are written in a way that give ownership to a person. Random inspection report Care homes for adults (18-65 years) Name: Address: Heatherway Resource Centre 11 Heatherway Monks Hill Estate, Selsdon Croydon Surrey CR2 8HN three star excellent service The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Claire Taylor Date: 2 9 0 4 2 0 1 0 Information about the care home Name of care home: Address: Heatherway Resource Centre 11 Heatherway Monks Hill Estate, Selsdon Croydon Surrey CR2 8HN 02086577763 02086511374 susan.smith2@croydon.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Susan Marie Smith Type of registration: Number of places registered: Conditions of registration: Category(ies) : London Borough of Croydon care home 5 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: 5 The maximum number of service users who can be accommodated is: 5 The registered person may provide the following category of service only: Care Home Only (CRH - PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD Date of last inspection Brief description of the care home Heatherway Resource Centre is owned and managed by the London Borough of Croydon and provides a temporary respite care service for up to five people with learning disabilities. It is situated in the heart of Selsdon and is well placed for local Care Homes for Adults (18-65 years) Page 2 of 11 Brief description of the care home shops, cafes and public transport links. There are five single bedrooms with one located on the ground floor to meet the needs of people with physical disabilities. Shared areas include a spacious lounge, dining area and refurbished kitchen. There is also a large garden at the back of the property with patio, lawned area and swing. The same manager, Sue Smith has run the service for over nine years and is supported by a largely unchanged staff team. At the time of this inspection, thirty-five people were using the service for respite care breaks. The period of stay offered can range from an overnight stay to several weeks, dependant upon the persons needs. Care Homes for Adults (18-65 years) Page 3 of 11 What we found: At the last key inspection in May 2007 we rated this service as excellent and the reason for this inspection was to confirm that people using it continue to experience excellent outcomes. Before making our visit we reviewed all the information we have about the service and looked at information that the manager was asked to send to us on an Annual Quality Assurance Assessment (AQAA). This is a self-assessment that must be completed once a year. It is used to tell us about the services provided, how well outcomes are being met for people using the service and any planned developments.The AQAA was returned when we asked for it and provided us with good information about what the service does well and where it plans to improve. We also wrote to people before we visited to ask what they think about the service. We met with two people who were staying at Heatherway,the manager and three staff during our visit. Some individuals do not have the capacity to fully share their views regarding their care. In order to make judgements about the care that individuals receive, we observed care practices; interactions with staff and tracked records of care. Discussions were held with some of the staff on duty and the manager who was available throughout our visit.We also looked around the building to check that it was safe. We sent out surveys to a selection of people who use the service and received four back. Four relatives or representatives also returned surveys. The responses told us that people and those that are close to them are very positive about the care they receive. We also sent questionnaires to a selection of staff and three care professional involved with the service.We would like to thank all those who took part in this inspection for their time, assistance and hospitality. The reader should also note that a new system of registration and assessment for social care will come into force during 2010. Providers of adult social care and independent healthcare must be registered with us under the new system from 1 October 2010 (registration under the Care Standards Act 2000 will continue until then). Further details can be found at our website www.cqc.org.uk. What the care home does well: Heatherway offers short stay accommodation on a respite care basis only. The service, once again, demonstrated excellent care practices in meeting the needs of the people who come to stay. The manager and staff team work well to ensure that people feel at home when they stay away from their regular carers. The staff group are very committed and work well together to provide a high quality service, which ensures that those using the service enjoy their stay and have all their needs met.Families and carers are also very involved in all aspects of a persons care and are encouraged to voice their opinions in order that the service continues to be one of quality. Four relatives, carers or advocates gave their views on the service. All were complimentary about the level of care that their relatives receive.For what the service does well,comments said,Heatherway is a very well run respite care centre.My husband and I are grateful that our X can stay there as we know that X will be well looked after in a happy environment. Another survey said,The service provided is excellent.X feels its home from home and is most comfortable and happy to have respite there. Three care professionals also returned questionnaires and gave positive responses. CHOICE OF HOME The local authority has clear policies and procedures in place regarding admission;they also ensure that any new person would be central to the process when Care Homes for Adults (18-65 years) Page 4 of 11 they come to use the service. We looked at records for four people which included one person who recently started using the service. Care managers had provided full needs assessments and staff had also completed an informative support profile following admission. The profile covered a range of areas such as health and personal care needs, mobility, communication,leisure and recreation, behaviour,risks and eating and drinking. An informative needs assessment was available for a person who had recently started using respite care. There were also good records to show that the person had received appropriate support to familiarise themselves with Heatherway.Families and carers are given a feedback form to share their views on how the stay went.Again,responses told us that people are very pleased with the service. INDIVIDUAL NEEDS & CHOICES We looked at five care plans which ranged from ones for people who have regular short breaks to those who stay on an occasional basis. Plans were well organised and contain good information about personal, healthcare and social needs. Generated from assessments completed by the placing local authority, each person has a care plan that outlines what level of support they require. They also detail what each individual likes to do each day, the things that they like and how the staff should do best support them to achieve their personal goals.Plans showed evidence of regular internal review as well as annual reviews by the local authority. Some individuals had person centred care plans with pictorial formats and photographs included. Plans recognised what was important to a person and tell the staff about the best ways to support their needs and preferences. One example said,likes the pillow dusted with talc as X loves the smell. We looked at risk assessments which matched the needs of each person and tell staff how to make sure the person is kept safe from anything that might harm them. Any risks to people through general health,needs or activities are assessed and clear action to reduce any risks had been recorded. At our last inspection we required the home to ensure that risk plans were reviewed at least six monthly. We saw up to date risk management plans for people that identified what action should be taken to lessen risk, whilst encouraging independence. Examples included use of the kitchen, safety in the community, mobility and eating and drinking. Where needs had changed, risk assessments had been updated accordingly. LIFESTYLE This service provides respite care only but people are encouraged to maintain their usual routines as if living with their main carer. People using the service attend day centres, college classes and various community activities organised by Heatherway. Staff were knowledgeable about peoples care needs, preferences and behaviours. We observed staff using their skills and experience to manage behaviours that can be challenging, and to support people with their preferred routines. Interests, hobbies and preferred leisure activities were clearly recorded in peoples support profiles.For example, one person enjoys hand and foot massages and staff provide this activity for them when they come to stay. Records told us that their other interests are supported such as singing, dancing and going for walks. Meals are planned with people during their stay and records were being kept for all the meals provided. These showed that people are offered a varied and balanced diet that also takes into account individual choice and any cultural preferences. Meals are home cooked and individuals are able to eat at flexible times according to their routines and choices. PERSONAL & HEALTHCARE SUPPORT Health care needs were clearly documented in the care plans and gave a good overview about a persons medical background and any conditions such as epilepsy.Key information about health check-ups and health screening they may need was also recorded. A key worker system is used to ensure continuity of Care Homes for Adults (18-65 years) Page 5 of 11 care when people come to stay. The key staff are responsible for updating care plan records as necessary. Staff complete detailed daily notes concerning peoples general well being and if there have been any changes to their care needs.We looked at how the home manages medication, its administration, storage and disposal.All medicines stored in the home on behalf of the people who use the service were stored securely in a lockable cabinet in the office. The administration charts were all signed and accounted for. The balances of medication corresponded with the supply held.Two staff check and sign when medication is administered which is good practice and minimises the risk of error. COMPLAINTS & PROTECTION The AQAA stated that the service has received no complaints within the last 12 months and there have been no safeguarding concerns reported to us.The complaints procedure was available in an easy read version and explained how complaints would be investigated and how long it would take to do this. Survey responses told us that relatives and carers have confidence to raise a concern and that they knew who to speak to if they were unhappy and how to complain.For what the service does well,one relative or carer wrote,listens to our concerns and recognises the service users needs.There are clear policies in place regarding the prevention of abuse including the Croydon local authority procedure for safeguarding vulnerable adults. We saw that the manager and staff completed training on safeguarding vulnerable adults in August 2009. ENVIRONMENT There have been some home improvements including the refurbishment of the kitchen and replacement sofas in the lounge. We had a look round the premises which overall, were well maintained and decorated. Aside from one issue discussed in the next section of the report, the home was very clean and tidy with good hygiene practices in place.Staff have received training on infection control and all people who returned surveys ticked that the premises was always fresh and clean. STAFFING The service benefits from a long established staff team who know each persons needs well. There has been no staff turnover in the last 12 months. We looked at some of the rotas which confirmed that staffing levels are organised flexibly and according to the level of occupancy and peoples individual needs. For example, a waking night staff is provided when one person comes to stay due to their specific support needs.During our visit, two people with high support needs were staying and each person had one to one support.Secure recruitment procedures and practices ensure that staff are vetted correctly before they begin work.This means that people using the service are protected from unsuitable workers. We looked at records for four staff which contained all the required legal checks and documentation. All staff have their Criminal Records Bureau checks renewed every three years.The local authority has a rolling programme of training to ensure that staff update their skills and knowledge in both mandatory and specialist areas. We reviewed the training records of three staff which showed wat courses they had completed and when they were due to update. Certificates included courses on medication, food hygiene, fire safety, safeguarding vulnerable adults; moving and handling and person centred planning. Five staff replied to our questionnaires and gave views about what the service does well. Comments included,we have very good staffing levels and good continuity of staffing to meet the different needs of clients.We have very good relationships with clients and carers. Another survey said,it meets the needs of service users and carers,the manager and staff will go that extra mile to support individual needs, the emergency cover, transport,short notice stays and staff cover. Written comments from relatives and carers included, the staff are extremely caring and understanding and if they have any concerns,phone me immediately. Another wrote,the Care Homes for Adults (18-65 years) Page 6 of 11 staff at Heatherway are very caring and kind and devoted to the clients. A third said,the staff are very good and have a good rapport with clients. CONDUCT & MANAGEMENT OT THE HOME The registered manager is very experienced and has worked at Heatherway for nine years.She has achieved the required qualifications and continues to update any training as necessary.Recent courses have included the Mental Capacity Act,safeguarding and various health and safety updates. The quality of care is consistently monitored and feedback forms are offered to people using the service, their relatives or carers after every stay. A responsible individual from the local authority visits each month to check how well the service is running. Reports were detailed and showed that senior management make sure the conduct of the centre is closely monitored and action taken where necessary.The completed AQAA stated that all relevant safety checks were up-to-date. We looked at some of the servicing and maintenance records for the home. Fire alarms and equipment had been serviced and practice evacuation drills held regularly. Detailed risk assessments were in place concerning the premises and safe working practices. These aim to safeguard the welfare of all people staying and working at Heatherway. We saw that accurate reports are kept for any accidents and incidents and that any actions taken were clearly recorded. Based on the information that we have received since the last key inspection, including our annual service review in April 2009 our judgement is that Heatherway continues to provide an excellent service. 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 2. Care Homes for Adults (18-65 years) Page 7 of 11 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 8 of 11 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, 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 1 23 37 The Commission must be notified of all significant events that are reportable under the remit of safeguarding vulnerable adults. This is so we can track that appropriate action has been taken and people are safe. 31/07/2010 2 26 16 Due to the unpleasant odour 31/10/2010 in bedrooms 3 and 4 the carpets need replacement with a more suitable floor covering. To ensure that people live in a pleasant,hygienic environment that meets their specific needs. Fire doors must not be propped open unless they are secured by a suitable device that activates on the fire alarm sounding. To ensure that peoples safety is not compromised in the event of a fire. 31/10/2010 3 42 23 Care Homes for Adults (18-65 years) Page 9 of 11 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 1 6 Person centred care plans are developed for all individuals who regularly use the service and written in a way that gives ownership to the person. Care Homes for Adults (18-65 years) Page 10 of 11 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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