Care Home: Heathfield Lodge

Similar services:

• Thornton Lodge
• Chirnside House
• Keer Sands Residential Home
• Ruskin Lodge
• Bushell House
• Langrigg House
• Parkside
• Dystlegh Grange

What the care home does well People who are thinking about moving in are given up to date information about the home and their needs are properly assessed so that they can be sure that it is the right place for them to live. Available at the home was a care plan for each resident, which clearly set out how staff need to meet the person`s health, personal, and social care needs. Care plans were signed to show that they were put together with the full involvement of the resident and/or their representative. There was also evidence to show that care plans are being regularly reviewed and they are being updated when a persons needs have changed. Staff showed good knowledge and understanding of the needs of the residents, during the inspection visit they were observed talking to residents in a polite manner and treating them with respect. Residents spoken with said that staff are always polite and treat them well they made the following comments to support this: "The staff always treat me well" "They are always kind and polite" "Staff are very caring" "Yes they always knock on my bedroom door before coming in" The home had in place appropriate procedures for responding to concerns complaints and for ensuring that residents are safe from abuse, harm or neglect. The commission have not received any complaints about the home since the last inspection. Everybody spoken with during the inspection said that they had been given information about how to make a complaint if they needed to. People were confident that their complaints would be listened to and dealt with in the correct way. The home was comfortable, well maintained and free from hazards making it a pleasant and safe place for people to live in. More than half of the staff team have achieved or are working towards a National Vocational Qualification in Care level 2 or above and they have all completed or are planning to complete training linked to the aims and objectives of the home and the needs of the residents. The home is well managed to the benefit of the residents and staff. What has improved since the last inspection? Residents are now offered a wider range of opportunities for stimulation through leisure and recreational activities in and outside the home. During the inspection visit residents said: "There is a lot more to do here now". "I have my nails and hair done each week". "I really look forward to the bingo and keep fit". "The hairdresser comes every week". Recruitment and selection procedures carried out at the home are much more robust ensuring the full protection of the residents. The evidence gathered during the inspection showed that all the required checks have been carried out on new staff before they were allowed to work at the home. The homes induction programme has been developed to ensure that new staff receive relevant training during the first part of their employment. Since the last inspection all staff have completed protection of vulnerable adults (POVA) training, which ensures that they know how to respond to evidence or suspicion of abuse. Many improvements have been carried out both to the inside and the outside of the home enhancing the comfort and dignity of the residents A new medication trolley has been purchased since the last inspection which ensures that medication is transported and administered safely. All staff have completed training in subjects of health and safety so that they have the skills and knowledge to ensure residents and their own health and safety. The management team now carry out regular observations and continuously provide staff with advice and guidance around best practice to ensure that residents are treated with respect What the care home could do better: This inspection evidenced that the service is meeting the National Minimum standards which were inspected at this time. CARE HOMES FOR OLDER PEOPLE Heathfield Lodge 22/24 Melling Lane Maghull Liverpool Merseyside L31 3DG Lead Inspector Janet Marshall Unannounced Inspection 8th May 2008 10:00 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 Heathfield Lodge DS0000005374.V365031.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. Heathfield Lodge DS0000005374.V365031.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Heathfield Lodge Address 22/24 Melling Lane Maghull Liverpool Merseyside L31 3DG 0151 526 9463 0151 526 1517 heathfieldlodge@Btconnect.com 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) Mrs Doris J Gidman Mr A J Gidman Mrs Doris J Gidman Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26) of places Heathfield Lodge DS0000005374.V365031.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 26 OP. Date of last inspection 4th May 2007 Brief Description of the Service: Heathfield Lodge is a care home registered to provide personal residential care for a maximum of 26 older people. The home is privately owned by Mr and Mrs Gidman. Mrs Gidman has been the registered manager since it opened in 1988. Heathfield Lodge consists of two large semi-detached Victorian houses that have been amalgamated into one building. It is situated in the well established area of Maghull, and is close to all local amenities and transport links. A large enclosed garden and patio area at the back provides additional space that is well used by residents when weather permits. The space at the front of the home is mainly shrubs and car parking space. The home has a large lower ground floor that contains the kitchen, laundry and storage areas, a ground floor on which residents accommodation and the communal spaces are found, and a first and second floor that contain rooms and bathrooms and toilets. Twenty rooms are single; three are registered as double but each of these currently has one resident living in them. The communal space comprises a sitting room and large dining room that is divided into two smaller areas. The home has a lift to all floors. It cost between £273.00 - £390.00 each week to live at the home. Heathfield Lodge DS0000005374.V365031.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good outcomes. This was a key inspection. The Commission considers 22 standards for Care Homes for Older People as Key Standards, which have to be inspected during a Key Inspection. All key standards for this type of service are highlighted in bold in the relevant sections of this report. The report has been put together using information gathered from a number of sources including information that the commission have received about the service since the last inspection which took place in May 2007 and details provided in the Annual Quality Assurance Assessment (AQAA). The AQAA, which is in two parts, a self-assessment and dataset, has replaced the preinspection questionnaire. The document, which was sent out to the service was completed in good detail and returned to the commission before the site visit took place. A number of surveys were given out to people as part of the inspection. Responses and comments from those that were filled in have been used to help put together this report. The inspection also involved an unannounced visit to the home (site visit). This was carried out with the help of the registered manager Mrs Doreen Gidman, the general manager, the deputy manager and care staff that were on duty at the time. Records that were examined, staff comments and observations made during the visit have also been used as evidence for the report. A number of residents and relatives were spoken with during the site visit and their views and opinions about the service are reflected within the report. A number of residents were case tracked. This process involved talking to residents, staff and relatives, looking at the environment and a selection of residents records such as assessments, care plans and daily notes to get an idea about peoples experiences and to find out if they are receiving the care and support that they need and which they have agreed. What the service does well: People who are thinking about moving in are given up to date information about the home and their needs are properly assessed so that they can be sure that it is the right place for them to live. Available at the home was a care plan for each resident, which clearly set out how staff need to meet the person’s health, personal, and social care needs. Heathfield Lodge DS0000005374.V365031.R01.S.doc Version 5.2 Page 6 Care plans were signed to show that they were put together with the full involvement of the resident and/or their representative. There was also evidence to show that care plans are being regularly reviewed and they are being updated when a persons needs have changed. Staff showed good knowledge and understanding of the needs of the residents, during the inspection visit they were observed talking to residents in a polite manner and treating them with respect. Residents spoken with said that staff are always polite and treat them well they made the following comments to support this: The staff always treat me well” “They are always kind and polite” “Staff are very caring” “Yes they always knock on my bedroom door before coming in” The home had in place appropriate procedures for responding to concerns complaints and for ensuring that residents are safe from abuse, harm or neglect. The commission have not received any complaints about the home since the last inspection. Everybody spoken with during the inspection said that they had been given information about how to make a complaint if they needed to. People were confident that their complaints would be listened to and dealt with in the correct way. The home was comfortable, well maintained and free from hazards making it a pleasant and safe place for people to live in. More than half of the staff team have achieved or are working towards a National Vocational Qualification in Care level 2 or above and they have all completed or are planning to complete training linked to the aims and objectives of the home and the needs of the residents. The home is well managed to the benefit of the residents and staff. What has improved since the last inspection? Residents are now offered a wider range of opportunities for stimulation through leisure and recreational activities in and outside the home. During the inspection visit residents said: “There is a lot more to do here now”. “I have my nails and hair done each week”. “I really look forward to the bingo and keep fit”. “The hairdresser comes every week”. Recruitment and selection procedures carried out at the home are much more robust ensuring the full protection of the residents. The evidence gathered Heathfield Lodge DS0000005374.V365031.R01.S.doc Version 5.2 Page 7 during the inspection showed that all the required checks have been carried out on new staff before they were allowed to work at the home. The homes induction programme has been developed to ensure that new staff receive relevant training during the first part of their employment. Since the last inspection all staff have completed protection of vulnerable adults (POVA) training, which ensures that they know how to respond to evidence or suspicion of abuse. Many improvements have been carried out both to the inside and the outside of the home enhancing the comfort and dignity of the residents A new medication trolley has been purchased since the last inspection which ensures that medication is transported and administered safely. All staff have completed training in subjects of health and safety so that they have the skills and knowledge to ensure residents and their own health and safety. The management team now carry out regular observations and continuously provide staff with advice and guidance around best practice to ensure that residents are treated with respect 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. Heathfield Lodge DS0000005374.V365031.R01.S.doc Version 5.2 Page 8 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 Heathfield Lodge DS0000005374.V365031.R01.S.doc Version 5.2 Page 9 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): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are given information about the home and their needs are assessed before a decision is made about them moving there. EVIDENCE: The Homes Statement of Purpose and Service User Guide have been updated since the last inspection. Both documents, which were examined, included all the information which is required by regulation. They were available in clear print and well presented. Details provided in the AQAA and discussion with the manager showed that the documents are given to prospective residents and their relatives before they decide to move into the home. The manager said that she is planning to improve the documents further by producing them in a glossy format with photographs of the home. Heathfield Lodge DS0000005374.V365031.R01.S.doc Version 5.2 Page 10 The AQAA showed that a number of residents have been admitted to the home in the last twelve months. The manager confirmed that pre-admission assessments were carried out for all newly admitted residents. Pre-admission assessments were looked at for three of the most recent admissions to the home. All assessments which were carried out by a member of the management team were detailed and covered, sight, hearing social contacts, medical history, mobility, personal care and safety. Each of the files examined also included an assessment checklist. The manager confirmed that she carries out pre-admission assessments for all new residents as well as obtaining assessments from social workers for those residents who are funded by the local Authority. In the case of an emergency admission the manager confirmed that the assessment would take place within the first few days of admission. . Heathfield Lodge DS0000005374.V365031.R01.S.doc Version 5.2 Page 11 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. Residents personal and healthcare is well monitored and supported ensuring they stay well. EVIDENCE: Each of the resdents had an individual care plan which were kept securley at the home. Since the last inspection the management team have developed and introduced a new care planning format which is now used to set out the care need requirements of the residents and the action that staff need to take to ensure they are met. A selection of care plans were looked at as part of the inspection visit. They included detailed information about the person’s health, personal and social care needs. All care plans which were looked at were well organised and easy to read. Staff spoken with showed a good understanding of care plans and how they use them to ensure that resident’s needs are identified and met. Staff said care plans are important because: “They tell us how a persons needs should be met”. Heathfield Lodge DS0000005374.V365031.R01.S.doc Version 5.2 Page 12 “They are important way of getting to know the person”. “They help us understand the person and how best to support them” Care plans for three residents were looked at in detail as part of the case tracking process. All the care plans looked at were complete and reflected the care need requirements, which were detailed in the person’s pre-admission assessments. Contained within each persons care files were review records, the records showed that each section of the persons care plan has been reviewed and updated each month with the involvement of the resident and or their representative. All surveys completed by residents indicated that they always receive the medical support that they need. Surveys filled in by healthcare professionals showed individual’s healthcare needs are always met by the care service and that the service has always responded by contacting GPs and other Healthcare Services. Records of medical appointments were kept in good detail and showed that residents have regular access to specialist Medical, Nursing, Dental, Chiropody and GP services. Residents spoken with confirmed that they could see their GP when they choose. The manager confirmed the arrangements that are in place at the home to enable residents to access other specialist services such as Speech Therapists and Dieticians. Surveys completed by two Health Care Professionals showed that the service always seeks and acts upon advice that they give. The AQAA provided details of a number of policies and procedures, which relate to the health care of residents. They include control, administration, recording, safe keeping, handling and disposal of medication. Medication was stored safely at the home and records, which were looked at, were well maintained. It was recommended as part of the last inspection report for more suitable trolley to be used for transporting medication. This was because during the last inspection visit an open top trolley was being used to transport medication from the office to the dining room and medication was left unsupervised on the open trolley throughout the medication round, which had the potential to put residents at risk. Since the last inspection a lockable drugs trolley has been purchased and is now used during the medication round. Surveys completed by Healthcare Professionals showed that the service always manage medication correctly. The manager confirmed that they receive an excellent service from the local Pharmacist who prepares and delivers prescribed medication to the home. Discussion took place with the Pharmacist who attended the home during the inspection visit. She confirmed that she continues to carry out regular visits to the home to provide management and staff with support and advice as well as checking medication systems and procedures which are in place at the home. Heathfield Lodge DS0000005374.V365031.R01.S.doc Version 5.2 Page 13 Records confirming the visits and details of the checks carried out by the Pharmacist were seen. The Pharmacist confirmed that since the last inspection visit she has provided staff with medication awareness training and guidance on how to use the monitored dosage system (blister Packs). She also said she is planning to provide further training in the near future. A requirement was given as part of the last inspection report for all staff to respect resident’s dignity and their right to privacy. This was because during the last inspection visit a member of staff was seen entering a bathroom occupied by a resident without knocking and another member of staff was assisting a resident to dress in her bedroom whilst the door was open. The AQAA showed that since the last inspection the management team regularly observe staff and remind them of best practice. During this inspection visit staff were seen, knocking on doors before entering rooms, assisting residents with personal care in private, talking to them in a polite manner and treating them with respect. Residents spoken with said that staff always treat them well and respect their privacy and dignity. They made the following comments to support this: The staff always treat me well” “They are always kind and polite” “Staff are very caring” “Yes they always knock on my bedroom door before coming in” Comments made by staff, which supported their understanding of, care values such as privacy, dignity and respect included: “I always close doors when helping residents with personal care” “I knock on doors before entering a room, talk to the person about what I am going to do. “I always give residents choices. “Never do anything against the persons will” I shut doors and blinds when helping a person to wash and dress and I always ask them if them want me to help them A Healthcare Professional survey showed: The service always respects the individual’s privacy and dignity. Heathfield Lodge DS0000005374.V365031.R01.S.doc Version 5.2 Page 14 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. People are happy that there is variety of activities available at the home which suits there personal preferences and lifestyles. EVIDENCE: Pre-admission assessments and care plans detailed peoples social preferences and lifestyles. Information about their likes and dislikes, past lives, social interests and hobbies were recorded to enable staff to appropriately support these needs. The AQAA showed that resident’s routines and daily lives are varied and flexible to suit their individual needs. A weekly activities planner was on display in the hallway at, it provided residents with clear information about a planned activity or service and the date and time it was due to take place. The planner included a variety of suitable activities and services for residents to choose from including pamper days (hairdressing and manicures), keep fit, arts and crafts, aromatherapy, film shows bingo, singing and dancing. Residents and staff spoken with said the range of activities has improved since Heathfield Lodge DS0000005374.V365031.R01.S.doc Version 5.2 Page 15 the last inspection. The manager reported that Church services and Holy Communion are regularly held at the home for those residents who choose to take part. Information detailing religious services was also on display in the hallway. During the inspection visit residents said: “there is a lot more to do here now”. “I have my nails and hair done each week”. “I really look forward to the bingo and keep fit”. “The hairdresser comes every week”. An Aromaptherapist visiting the home at the time of he inspection confirmed that she visits the home each week to provide a service to those residents who have requested it. Surveys filled in by residents showed that there are always activities at the home which they can take part in. The AQAA told us as a result of listening to residents the manager/s are planning a day trip for them on a Canal boat in the Spring as well as other regular social activities outside the home. A visitor’s book, which was seen at the home, showed that residents receive regular visits from friends and family members. Visitors were seen coming and going at intervals throughout the inspection visit. They were welcomed by the manager and staff and offered refreshments. Residents spent time with their visitors in the privacy of their own rooms, the lounge areas and outside in the garden. Discussion took place with a number of visitors, all of them said that they are always made to feel welcome at the home by both the manager and staff. One relative said, “I can come and see mum at any time”. Another relative said, “we usually go into mums room although we can sit anywhere”. During the inspection visit residents were seen making choices for themselves, others were seen being encouraged by staff to make choices. Residents spoken with confirmed that they choose what clothes they were each day and decide what time they get up and go to bed. A member of staff said, “I encourage residents to do as much as they can for themselves”. Assessments and care plans detailed daily tasks and activities, which residents can and should be encouraged to carry out independently. A survey filled in by a healthcare professional showed: The service always support people to live the kind of life they choose. Regular residents meetings which are held at the home provide people with the opportunity to put forward their points of view and make decisions about the running of the home. Records of the meeting which were seen showed they have taken place regularly and are well attended. The dining room is on the ground floor close to the main lounge and ground floor bedrooms. It is at the front of the house over looking mature trees Heathfield Lodge DS0000005374.V365031.R01.S.doc Version 5.2 Page 16 bushes and shrubs. The dining room is split into two areas which are linked by an open doorway. Since the last inspection the dining room has been redecorated to a high standard. There were a number of small dining tables, which were attractively set with new table clothes, napkins and cutlery, there was also a small display of flowers in a vase in the centre of each table. Also since the last inspection all the dining furniture has been repolished and upholstered to a high standard. A menu for the day was displayed on a white board in the dining room. Residents spoken with confirmed that there is a menu on display each day. They also said each morning staff remind them of what is on the menu for that day and ask them what they would like before telling the chef. The lunchtime meal was spent with residents and the food was sampled. Staff served residents individually with their meal. The meal began with staff offering residents a bowl of hot soup followed by sandwhiches or a baked potatoe with a choice of fillings. Residents were offered a choice of desserts following their meal. Some residents were served with other alternatives which they had requested earlier that morning. The meals were nicely presented and generous in portions. Staff assisted residents in a sensitive and unrushed way. Residents were given time to eat their meal at a pace that suited them. Hot and cold drinks were served and residents were offered seconds. Food stores were well stocked with a variety of fresh, frozen, tinned and dried foods. It was equipped with appliances such as a microwave fridge, freezer and had a good supply of cooking utensils. A 4 week menu, which was viewed, included a variety of well-balanced and nutritious meals. Details provided in the AQAA showed that the menus have been improved since the last inspection and residents were fully involved in reviewing and updating them. This was supported by the following comments made by residents and staff during the inspection visit: “The food is better” “Yes I like the food, it is very good” “Residents have a buffet tea at the weekends and they seem to really enjoy it” “Yes we are asked what we like and if we want anything different” “They ask us if we want the menu changed” “The food is good, more variety than before” “Happy with the choice of food, I have plenty to eat “ “Mum has never complained about the food, she seems to enjoy it” Surveys filled in by residents showed that they always like the meals at the home. Heathfield Lodge DS0000005374.V365031.R01.S.doc Version 5.2 Page 17 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. Residents are fully protected by procedures and processes which are in place at the home and they are confident about complaining if they need to. EVIDENCE: The commission have not received any complaints about the home since the last inspection. The AQAA showed two complaints have been received at the home and resolved within 28 days. Surveys completed by residents indicated that they always know who to speak to if they were unhappy and that they know how to make a compalint. Comments made by residents and relatives during the inspection included: “I am happy with everything “. “Yes I would complain and know who to complaint to”. “I would go to the office and tell the manager if wanted to complain but I have nothing to complain about”. Available at the home were a number of policies and procedures, which aim to ensure the protection of both residents and staff. They included, complaints whistle blowing, and protection of vulnerable adults procedures. The AQAA showed that all these policies and procedures have been reviewed and updated since the last inspection. The manager said that she would provide easily read versions of complaints and protection procedures for those people who request or need them. Staff spoken with were familiar Heathfield Lodge DS0000005374.V365031.R01.S.doc Version 5.2 Page 18 with all of procedures and said they were confident about using them if they needed to. The AQAA told us that all new staff sign the procedures to show that they have read and understand them. The AQAA told us that all staff have completed Protection of Vulnerable Adults training. This was also confirmed by a number of staff that were spoken with during the inspection visit. Staff spoken with during the inspection visit were confident about what they would do if they somebody was being abused. Heathfield Lodge DS0000005374.V365031.R01.S.doc Version 5.2 Page 19 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 many improvements which have been made to the environment have enhanced the comfort and dignity of the residents. EVIDENCE: Heathfield Lodge residential Care Home is two large semi detached Victorian houses knocked into one. It is located in a popular residential area of Maghull Merseyside. There is a small shopping centre and a train station within 200 metres of the home. Other transport links and community services and facilities including churches, cafes and community health centres are also within close distance of the home. At the front of the home is a large drive way which is big enough to provide off road parking for a minimum of six vehicles. Mature trees, bushes and shrubs which surround the front of the building provide a pleasant view from the front rooms as well as shielding it from the main road. There are mature gardens and a patio area at the back of Heathfield Lodge DS0000005374.V365031.R01.S.doc Version 5.2 Page 20 the home. The gardens were a little overgrown and untidy however the manager said that there are plans in place for them to be improved. The home is made up of three floors and a basement. Resident’s bedrooms are situated on the three floors above the basement. The kitchen, laundry and staff room are located in the basement which is not accessed by residents. Specialist equipment which was in place to assist residents with mobility included a lift which operates from the ground floor up to the top of the house, bath-lifts in the main bathrooms and handrails located around the home. A portable ramp is currently available for use in and out of the main entrance of the home although the manager said there are plans to install a permanent ramp. The AQAA detailed a number of improvements carried out at the home since the last inspection. The improvements which were looked at during a tour of the home included the following: • A number of resident’s bedrooms have been redecorated. • Carpets in newly decorated bedrooms have been replaced with new. • Furniture in newly decorated bedrooms has been replaced with new. • New easy chairs have been bought for the lounge • All communal areas and corridors have been painted and redecorated • External window frames have been replaced with new PVC windows. • Outside Sills and gutters have been replaced. • A number of bathrooms have been redecorated and re tiled. The AQAA told us that an ongoing maintenance programme is in place detailing the plans for further improvements including the redecoration of other bedrooms and the replacement of carpets and bedroom furniture. There was a warm and friendly atmosphere at the home. The following comment was included in a survey filled in by a healthcare professional. “In this particular establishment I feel that this care service creates a friendly, relaxed atmosphere which in my opinion allows the service users to feel at home in the environment”. All parts of the home were clean, peasant and hygienic and there were no hazards identified at the time of the inspection. Residents spoken with said that their rooms and other parts of the home are always clean and tidy. They made the following comments: “My room is always kept clean and tidy” “Oh yes the home is spotless all the time” “The place is kept clean all the time” Surveys filled in by residents showed that the home is always fresh and clean. Heathfield Lodge DS0000005374.V365031.R01.S.doc Version 5.2 Page 21 The laundry, which is located in the basement area, was equipped with sufficient washing and drying machines and ironing facilities. The laundry was clean and well organised. Detailed in AQAA and available at the home were a number of policies and procedures, which aim to ensure a clean and safe environment, they include infection control and disposal of soiled waste. Hand gel was available around the home for peoples use to minimise the risk of cross infection. Staff were seen appropriately using protective gloves and aprons. Heathfield Lodge DS0000005374.V365031.R01.S.doc Version 5.2 Page 22 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. Procedures for recruitment, selecting and training staff ensure that they are appropriately qualified, experienced and fit to work at the home. EVIDENCE: The staffing rota, which was examined as part of the inspection showed that there are a minimum of three care staff and a member of the management team on duty throughout the day and two care staff on duty at night. Discussion with the manager and information provided in the AQAA showed that the turn over of staff is low and agency staff have not been used at the home in since the last inspection. Two members of staff were interviewed during the inspection. General discussion also took place with a number of other staff at intervals throughout the visit. They said that there is always enough staff on duty to meet the needs of the residents. Staff interviewed showed a good understanding of their roles and responsibilities, were very knowledgeable about the needs of the residents and showed a real commitment to ensuring that they are well cared for and have a good quality of life. Residents and their relatives spoken with during the inspection visit made many positive comments about the staff, comments included: “All the staff are very good”. Heathfield Lodge DS0000005374.V365031.R01.S.doc Version 5.2 Page 23 “The staff are very kind, caring and gentle”. “The staff look after us well”. “I like all the staff”. “They know what they are doing”. “The staff treat me very well”. Surveys filled in by residents showed that staff always listen and act on what residents say and are always available when needed. An equal opportunities policy and procedure was available at the home. The AQAA showed that the home employs people of various ages, gender and of different backgrounds. The AQAA told us that there has been a complete review of the homes recruitment and selection procedures to ensure the full protection of residents. This was also evidenced upon examination of records for three new staff that have been recruited since the last inspection. A new administration checklist is now put at the front of each staff file to show the checks which have been carried out. The records showed the required checks were carried out before the people were allowed to start work at the home. Staff files were better organised and presented making them easy to access. The AQAA showed that since the last inspection the homes induction programme has also been reviewed and re-written based on The National Training Organisation for Social Care. Records which were viewed for new staff showed that they received induction training during the first part of their employment at the home. The AQAA showed since the last inspection staff have received a good amount of training relevant to the jobs that they do. It also showed that training is high on the agenda and there is further training planned for the future in both mandatory and specialist subjects. Training is provided out side the home at Knowsley Community College and at the home by qualified trainers including the new HR manager who is qualified to deliver training in topics such as Moving and Handling, First Aid and POVA. Records which were looked at during the inspection visit showed staff have completed training to update their knowledge and skills and the training is linked to the aims and objectives of the home and the needs of the residents. Each member of staff now has a training and development plan which is used to assess and identify their individual training needs. A training calendar showing planned training for the next three months was available at the home. The calendar included the following topics: Moving and Handling, Dementia Awareness, Medication, Infection Control and Equality and Diversity. Staff spoken with said that they have completed a lot of training since the last inspection and gave the following examples, fire safety health and safety, POVA, medication awareness and first aid. Heathfield Lodge DS0000005374.V365031.R01.S.doc Version 5.2 Page 24 The AQAA and staff training records held at the home showed that more than half the staff team have achieved a National Vocational Qualification (NVQ) in care level 2 or above. NVQ training was also included in training planned for the future. Heathfield Lodge DS0000005374.V365031.R01.S.doc Version 5.2 Page 25 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, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed to the benefit of the residents and staff. EVIDENCE: Doreen Gidman is the owner/manager of the home and has been since it opened approximately 20 years ago. The last inspection report identified a number of shortfalls in relation to the management and administration of the home. Since the last inspection a general manager has been appointed to work alongside the existing management team which is made up of the registered manager and a deputy manager. Together the management team have reviewed and updated existing management systems as well as implementing new ones all which have contributed to the overall improvement of the service. Heathfield Lodge DS0000005374.V365031.R01.S.doc Version 5.2 Page 26 There was evidence from this inspection that processes and records for staff development and supervision, recruitment and selection of staff and systems for monitoring the quality of the service are all in place and being managed efficiently in the interests of the residents. The AQAA told us that there is an open door policy operated at the home which means people are encouraged to talk to the manager/s in private about any issues which they may have. This was confirmed by staff and residents who said the management team are approachable, easy to talk to and they feel confident about talking to any one of them about both work and personal related issues. Residents and staff spoken with during the inspection were complimentary of the manager/s and the way the home is run, the following comments made during the inspection supported this: “There is always a manager to talk to”. “You can talk to any one of them”. “I have no problem talking to the manager”. “The manager is very good to the residents and always talks to them”. “Yes I feel well supported”. “I get on well with the manager/s”. A survey filled in by a healthcare professional included the following comments: “I feel this particular home is well run, the managers and staff are friendly and helpful which is important. I can compare this establishment with other similar places and this home is one of the best I have visited and I would not hesitate to recommend it to other people”. Discussion with the manager and records, which were examined, showed that the home has in place a number of quality monitoring systems, which aim to ensure that the home is run in the best interests of the residents. Satisfaction questionnaires are given out to residents and their representatives as a way of seeking people’s views about the home and the results of them are used to plan make the necessary improvement and to plan for the future. The service manages small amounts of personal money for some residents. Money and financial records which were examined were in good order and well kept. The health safety and welfare of residents are well protected this was supported by a set of policies and procedures, which were detailed in the AQAA and available at the home. All the homes policies and procedures have been reviewed and updated since the last inspection. Information provided in the AQAA and examination of a selection of health and safety records showed that the required health and safety checks have been carried out on the environment at the required intervals, for example fire system checks, gas and electricity checks and environmental risk assessments. Heathfield Lodge DS0000005374.V365031.R01.S.doc Version 5.2 Page 27 Staff and residents spoken with confirmed that they hear the fire alarm system regularly being tested. Heathfield Lodge DS0000005374.V365031.R01.S.doc Version 5.2 Page 28 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 x 3 X X 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 3 X 3 X 3 X X 3 Heathfield Lodge DS0000005374.V365031.R01.S.doc Version 5.2 Page 29 Are there any outstanding requirements from the last inspection? No 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. Refer to Standard Good Practice Recommendations Heathfield Lodge DS0000005374.V365031.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Manchester Local Office 11th Floor West Point 501 Chester Road Manchester M16 9HU 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 Heathfield Lodge DS0000005374.V365031.R01.S.doc Version 5.2 Page 31 - 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!