Care Home: Heathside House

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What the care home does well People using this service told us `The kindness shown to us is overwhelming`. `It’s a lovely home we are very lucky to be here and looked after so well`. `We are very warm and comfortable`. People visiting the service told us `The staff are very nice, the home is clean and the food is good, we have no complaints`. `My mother is very well looked after and she is safe `. `The staff are brilliant and Mum has plenty to eat`. Heathside House DS0000030493.V378543.R01.S.doc Version 5.2 People working at the home told us `Lovely home to work in, the manager and senior staff are very supportive and helpful`. `We have lots of training`. `We try very hard to provide good care for each person` `We take people out whenever we can and go to the local church service if someone wishes to go on a Sunday`. What has improved since the last inspection? At the key inspection in February 2009 we made five requirements and five good practice recommendations for improvements to be made at the home. Throughout this inspection we saw evidence that the service has taken the necessary action to make these improvements and has complied with the requirements. Improvements include the medication procedures and storage and the information included in the care plans. The frequency and range of social and recreational activities have improved and the staffing levels for the twenty four hour period have been reviewed. In addition the AQAA completed by the acting care manager informs us more improvements it has made including `Staffing hours and staff training have been increased. Risk Assessments and care plans have been updated and work on a new Care Plan format has started. We have developed much closer working with Health Care Professionals. Increased awareness of Vulnerable Adult Issues and Deprivation of Liberty safeguards. Increased Activities for the Service Users Improved the decoration of some areas of the home`. What the care home could do better: The service user guide should include the weekly fees for the service to ensure that people have the relevant information with regard to deciding whether the service is suitable for their needs. The care plans should contain the full details of a persons assessed care needs to ensure that the care needs are fully met consistently and effectively. To ensure that a person`s privacy is not compromised when using the toilet and bathroom facilities, privacy indicators/vacant/engaged signs should be fitted to the doors.Heathside HouseDS0000030493.V378543.R01.S.docVersion 5.2All areas where personal care is undertaken should be supplied with suitable hand wash facilities for general hand hygiene purposes and for the effective control of infections. Key inspection report CARE HOMES FOR OLDER PEOPLE Heathside House Heathside Lane Goldenhill Stoke on Trent Staffordshire ST6 5QS Lead Inspector Joy Hoelzel Key Unannounced Inspection 2nd December 2009 09:00 DS0000030493.V378543.R01.S.do c Version 5.3 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Heathside House DS0000030493.V378543.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Heathside House DS0000030493.V378543.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Heathside House Address Heathside Lane Goldenhill Stoke on Trent Staffordshire ST6 5QS 01782 234551 01782 234553 karl.shepherd@stoke.gov.uk 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) Stoke on Trent City Council Vacant Care Home 44 Category(ies) of Dementia (44), Old age, not falling within any registration, with number other category (44), Physical disability (44) of places Heathside House DS0000030493.V378543.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home Only (Code PC) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within other category (OP) 44 Physical disability (PD) 44 Dementia (DE) 44 The maximum number of service users who can be accommodated is: 44 17th February 2009 2. Date of last inspection Brief Description of the Service: Heathside House is a care home registered to provide personal care and accommodation for up to 44 older people. It provides long term and respite care and includes an eight-bed dementia care unit. The home is situated in Goldenhill, on the outskirts of Stoke-on-Trent and was purpose-built approximately 25 years ago. It is managed by Stoke-on-Trent City Council. Heathside is located in a residential area and is close to a wide range of community amenities and well served by public transport. There are good local community links including churches, pubs, shops and community centres. The home is situated in its own grounds surrounded by lawns and shrubs. It has a patio area with seating surrounded by secure fencing. Limited on site car parking is provided although parking is available on the surrounding side roads. The home is purpose built with accommodation provided on two floors. There is a passenger lift and stairs access between floors. All bedrooms are single occupancy with a wash hand basin and, although the rooms are quite small, there is compensatory communal space to enable the service to meet the minimum standards. Bedrooms seen are comfortable and homely and have been personalised by people who use the service with their own possessions. Heathside House DS0000030493.V378543.R01.S.doc Version 5.2 Page 5 Although there are no en-suite facilities there is a range of bathrooms with assisted bathing facilities and toilets and separate toilets all conveniently situated throughout the home. There is also a walk-in shower facility. The home is divided into four areas (Wedgwood, Leadale, Newhaven and Goldenview) all of which have their own sitting rooms and dining areas. In addition, there is a dedicated smokers lounge situated off the entrance hall. Three of the lounges offer a domestic style of environment with a kitchenette area for preparing breakfasts, snacks and drinks. Information of the home and the provision of the service are available in the statement of purpose and service user guide, both documents have recently been revised and are readily available. The weekly fees for the service are not included in the service documents. Further information on this can be obtained directly from the home. Care Quality Commission reports for this service are available from the provider or can be obtained from www.cqc.org.uk Heathside House DS0000030493.V378543.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The overall quality rating for this service is two stars. This means that the people who use this service experience good quality outcomes. The home did not know that we would be visiting to conduct a full inspection of the service. A look around the home took place, which included a number of bedrooms as well as communal areas. The care documents of four people using the service were viewed including care plans, daily records and risk assessments. Other documents seen included medication records, service records, some policies and procedures and staffing records. Discussions were held with people living, visiting and working at the home. Some people were unable to fully comment about their experience of life at the home. Observations were made of how they spent the day and of the interactions offered by staff in an attempt to obtain an overview of how they may be feeling. Prior to this inspection an Annual Quality Assurance Assessment (AQAA) document was sent to the home for completion. The AQAA is a selfassessment and a dataset that is filled in once a year by all providers. It informs us about how providers are meeting outcomes for people using their service and is an opportunity for providers to share with us areas that they believe they are doing well. It is a legal requirement that the AQAA is completed and returned to the commission within a given timescale. The acting care manager completed this document and returned it to us in December 2009. Comments from the AQAA are included within this inspection report. What the service does well: People using this service told us The kindness shown to us is overwhelming. It’s a lovely home we are very lucky to be here and looked after so well. We are very warm and comfortable. People visiting the service told us The staff are very nice, the home is clean and the food is good, we have no complaints. My mother is very well looked after and she is safe . The staff are brilliant and Mum has plenty to eat. Heathside House DS0000030493.V378543.R01.S.doc Version 5.2 Page 7 People working at the home told us Lovely home to work in, the manager and senior staff are very supportive and helpful. We have lots of training. We try very hard to provide good care for each person We take people out whenever we can and go to the local church service if someone wishes to go on a Sunday. What has improved since the last inspection? What they could do better: The service user guide should include the weekly fees for the service to ensure that people have the relevant information with regard to deciding whether the service is suitable for their needs. The care plans should contain the full details of a persons assessed care needs to ensure that the care needs are fully met consistently and effectively. To ensure that a persons privacy is not compromised when using the toilet and bathroom facilities, privacy indicators/vacant/engaged signs should be fitted to the doors. Heathside House DS0000030493.V378543.R01.S.doc Version 5.2 Page 8 All areas where personal care is undertaken should be supplied with suitable hand wash facilities for general hand hygiene purposes and for the effective control of infections. 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Heathside House DS0000030493.V378543.R01.S.doc Version 5.3 Page 9 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 Heathside House DS0000030493.V378543.R01.S.doc Version 5.3 Page 10 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Admissions are not made to the home, until a full needs assessment has been undertaken. This tells the home all about the person and the support they need. EVIDENCE: Information on the home is provided in two documents. The statement of purpose, which sets out what the service offers and the service user guide which offers more information relevant for when a person decides to move in. Both documents are available directly from the home. The home supplied us with the documents when we asked for them. Heathside House DS0000030493.V378543.R01.S.doc Version 5.3 Page 11 Details of the weekly fees are not included in the service user guide. To comply with the regulations and to give people full information of the service, the levels of fees should be clearly available in the documents. The AQAA gives a clear picture of the action taken prior to offering a person a placement at the home, Prior to any admission the assessment and care management team assess the needs of each individual using the single assessment process. It goes on to tell us that during the past twelve months they have Forged a close working relationship with the liaison team from the Combined Health Care Trust who are a team of dedicated community psychiatric nursing staff offering training and advice to residential homes who provide care for older people with mental health needs. We looked at the case file of the person who recently moved into the home. The contents in the file confirmed that information had been sought regarding this persons needs prior to them moving in. Information had been gathered from the previous health care setting and a pre admission assessment was completed by the service. Other case files looked at included a pre admission assessment by the home in addition to social worker reviews and assessments from other health and social care settings. This gathering of information ensures that the service can be confident of meeting a persons care needs. One person told us that before they came to live at Heathside House they lived in the surrounding area, making the decision to move in an easy one as they knew about the home. This person told us they are very happy and satisfied with my lot. Visitors told us that they visited the home prior to their family member moving in and made the decision on behalf of their relative. They told us they are satisfied with the care provided, My mother is very well looked after and she is safe. Heathside House DS0000030493.V378543.R01.S.doc Version 5.3 Page 12 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the 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 who use the service can be confident that they will receive support and care in the way they prefer and need. EVIDENCE: All people living at the home have a plan of care that is based on an assessment of their personal strengths and abilities. We selected four files to look at (one from each of the four units) and saw that the plans offered an overall picture of the needs of each person. We saw that of the four files, two included the signature of the person to confirm that the plan of care had been discussed with them. Staff confirmed that the plan of care is always discussed with the person or their relative or representative. Heathside House DS0000030493.V378543.R01.S.doc Version 5.3 Page 13 We saw information in the plans of the persons individual preferences and what they like doing. One persons plan recorded that they did not like group activities and declined to participate, but enjoyed talking and spending time with people on an individual basis. One plan recorded the interventions needed from the community nursing service. A risk assessment had been completed giving staff the details of the action they should take if anything unusual was identified. We felt that this plan could be further developed and discussed this with the acting care manager at the time of this inspection. The acting care manager agreed and gave us the assurance that they would review the recorded information. We saw that staff complete a daily report giving the details of how each person spends their day. The daily report recorded that a person had recently fallen, with no severe injuries being sustained. We looked at this persons plan of care and could not see that a risk assessment had been completed. A falls risk assessment and an assessment for maintaining a safe environment would identify any potential hazardous areas. Action could then be taken to reduce the hazards and so reduce the risk of injury to this person. We discussed this with the acting care manager and deputy manager; both offered an assurance that the plan of care would be reviewed. We saw that when a person needs help with personal care, people are asked their preference of which staff they would rather have to support them with their care. This ensures that peoples needs and wishes are carried out effectively. In another of the files in was reported that a person had taken a poor diet over a period of two days. This being very unusual for this person as the strengths based care plan recorded no problems in this area. We did not see that a nutritional risk assessment had been completed for this person or for the other three people whose files we looked at. We asked the care staff on the unit of the action they take when problems are identified. They told us that a record is made of the food offered to all people but when problems are noted the carers refer to the senior staff who then makes the decision if further and more complex monitoring is required. The AQAA identifies that it could Improve the format of the Care Plans. A new format has been identified and we are starting to implement it starting with new service users who are admitted to the home. Ensure all Risk Assessments are completed fully. People living at the home and agreed to talk with us, told us that they were well cared for and that the staff looked after them very well. One person told us It’s a lovely home we are very lucky to be here and to be looked after so well. Heathside House DS0000030493.V378543.R01.S.doc Version 5.3 Page 14 For some people it was not possible to engage them fully in conversation, but they appeared well cared for and quite happy in their surroundings. One person in particular looked extremely comfortable having a midmorning doze in what looked like a very comfortable easy chair. We spoke with staff and they described the diverse care needs of the people and the way they helped and assisted people each day. They told us We try very hard to provide good care for each person. The AQAA details the recent improvements that have been made to the medication procedures The Departmental Medication policy has been reviewed and we now have a new Medication Policy in place which has been completed in consultation with OPUS. All Managers are fully aware of the new Medication Policy and the documentation that we must retain in regards to administration storage and disposal of medication both general medication and controlled drugs. We looked at the systems for administering medication to people and found that the area for storing medication were safe and secure. Staff were very knowledgeable and explained the procedures to us, confirming the information in the AQAA and the improvements that had been made since the last key inspection. We observed staff completing the medication administration records, (MAR), at the time of giving out the medication. It appeared that the charts were being fully completed we did not see any gaps in the recording in the selection of the MAR we looked at. Some people at the home have been prescribed medications that are to be taken on an as required basis. Protocols and instructions for the correct use of these medications have been completed with additional recording checks of the actual times of the medications being given. This ensures that all staff are aware of when the medication was given and when it can be repeated if need be. Medication requiring cool storage is kept in a dedicated medication fridge. The temperatures of the fridge are taken each day, and a record made, this ensures that the medications are stored as to the manufacturers instructions. We saw staff being very patient, understanding and caring. They assisted people with care needs in a discreet and respectful way; they explained what they were going to do before actually starting the task. Thereby putting the person at ease and alleviating any stress that the person may be feeling. The care records recorded the name that people preferred to be called and throughout the day we heard staff addressing people accordingly. During the tour of the building we saw that not all bathroom and toilet doors had been fitted with privacy indicators. To ensure that a persons privacy is not compromised when using the toilet and bathing facilities vacant/engaged signs or indicators should be fitted to the doors. Heathside House DS0000030493.V378543.R01.S.doc Version 5.3 Page 15 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the 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 using the service can be assured that they will have the opportunity to be are involved in daytime activities of their own choice and according to their individual interests and capability EVIDENCE: We visited each of the units several times during our visit and saw people participating in activities either in a group, with other people or on a one to one basis with staff. A group of people were completing Christmas cards for their families, some people were enjoying listening and singing along to music. Other people were watching morning television and discussing the content of the programme. Other people were sitting quietly, reading the newspapers, sleeping or watching the activity within the units. The planned activities for each month are displayed on notice boards in each of the units. Heathside House DS0000030493.V378543.R01.S.doc Version 5.3 Page 16 One person told us how they enjoy going to the local chapel to participate in the Sunday service. Staff told us We take people out whenever we can and go to the local church service if someone wishes to go on a Sunday. The AQAA informs that the home will Continue trying to find a church who would possibly visit the home to offer a service to the service users who require it and are unable to attend church outside the home. We spoke with two people visiting the home, both said that they visit at suitable times, were made welcome by the staff and felt at ease when visiting. The main front door is locked for security reasons with staff answering the door and allowing entry. Rear doors and fire exit doors are locked and have an alarm fitted to alert staff when they are opened. No doors within the home are locked, with the exception of storage rooms and the treatment room; people have free access to all areas. We saw many people walking freely around the home. The meals are prepared by the catering staff and served in the dining areas by the care staff. People are encouraged to use the dining facilities as meals and mealtimes are seen as an opportunity for socialising. We were invited to stay for lunch and enjoyed a very pleasant meal with people in one of the units. People told us that the food provided is good and that they have sufficient to eat. We observed good practice when staff were assisting people with their meal, demonstrating a clear understanding of people requirements and needs. A visitor told us -The staff are brilliant and Mum has plenty to eat. Heathside House DS0000030493.V378543.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. If people have concerns with their care, they or people close to them know how to complain. EVIDENCE: The acting care manager told us that they had received no complaints within the last nine months but explained the action taken if any concerns were raised with them. A representative of the local authority has the responsibility for dealing with any issues that are raised regarding the home. We, the commission, have not received any correspondence in this area. People living at the home told us that they would speak with staff or their family if they had any concerns and that it would be sorted out. Visitors told us that they are satisfied with the service that is provided and we have no complaints. Staff told us of the action they would take if they had any concerns or suspicions of any wrong doings. Heathside House DS0000030493.V378543.R01.S.doc Version 5.3 Page 18 The AQAA tells us All staff are aware of the Vulnerable Adults Policy and the procedure to follow if they have any concerns. And that We continue to improve staff awareness of the Adult Protection issues through training courses. The acting care manager informed us that a Deprivation of Liberty Safeguarding Referral has been made as they were concerns regarding the safety of one person. The referral has been reviewed and will be reviewed again in due course. The acting care manager described the least restrictive options that the home had adopted for helping this person to remain safe. The acting care manager confirmed that senior staff have received training in safe guarding vulnerable adults and Deprivation of Liberty safeguards. This is then cascaded and discussed with the other grades of staff at the team meetings. We looked at systems for safekeeping of peoples money and found they were in good order. The home has good records of all transactions and obtains receipts and two signatures. Audits are carried out on a regular basis to ensure the accuracy of the recordings. Heathside House DS0000030493.V378543.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the 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 provides a physical environment that is satisfactory to the specific needs of the people who live there. EVIDENCE: Heathside House was built in the 1970s to provide care and accommodation for up to forty four people. Throughout that time the building has been well maintained, decorated and furnished. The acting care manager told us of the plans to now completely overhaul the premises to modern day standards. The work is planned to begin in about two years time. In the meantime work continues to keep the home well decorated and furnished and comfortable. Heathside House DS0000030493.V378543.R01.S.doc Version 5.3 Page 20 People told us It’s a lovely home; we are very warm and comfortable. Visitors told us that the home is always clean and fresh and that they are satisfied with the accommodation provided to their relative. The gardens are well maintained and provide a safe and secure area for people to use when they wish to go outside. We saw that hand wash facilities are provided in the communal toilets and bathrooms but not in areas where personal care to people is provided. The acting care manager described the actions taken by staff to reduce the risk of the spread of any infections. To ensure general hand hygiene is maintained and to reduce the risk of infections paper towels and liquid soap should be provided at the point of the delivery of care. Heathside House DS0000030493.V378543.R01.S.doc Version 5.3 Page 21 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the 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 who use the service can be assured that the staff have the skills and knowledge to meet their needs. EVIDENCE: People living at the home told us The kindness shown to us, [by the staff], is overwhelming. The staff are very good. People living at the home but unable to comment looked very much at ease and well cared for. People visiting the home told us My mother is very well looked after; the staff are brilliant and very very kind. We observed staff working positively with the people in their care, they appeared patient, caring and committed to their work. They demonstrated that they have a good understanding of the individual care needs of the people living at the home. Heathside House DS0000030493.V378543.R01.S.doc Version 5.3 Page 22 Each of the units is staffed separately, with the acting care manager explaining they feel the staffing levels are sufficient to meet the needs of the people living at the home. The Statement of Purpose offers information on the qualifications for the staff and details that all of the senior staff hold a National Vocational Qualification at level 3 or above. With fourteen of the care staff team holding a National Vocational Qualification in care Level 2. The AQAA tells us that 80 of care staff hold a National Vocational Qualification. We selected three staff personnel files to look at the recruitment procedures. The files were well organised and contained the information required to safeguard the people living at Heathside House. We spoke with staff; they told us We have lots of training. The acting care manager explained the training opportunities available for all grades of staff. This included the mandatory subjects such as moving and handling and fire safety as well as specialist topics such as dementia awareness and managing challenging behaviour. A training matrix shows the training completed for each member of staff with certificates and proof of training in the personnel files. The AQAA further informs that All Care staff have had dementia training, mental health awareness training and training in applying topical creams. The manager has completed dementia care mapping course at Bradford University. It goes on to identify other areas for training, updates and refreshers in the next twelve months to include managing actual and potential physical aggression, infection control, health and safety, equal opportunities and diversity, dementia awareness, mental health awareness, food hygiene and all managers will receive training in blood sugar testing Heathside House DS0000030493.V378543.R01.S.doc Version 5.3 Page 23 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the 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 can have confidence in the care home because it is led and managed appropriately. EVIDENCE: Since the last inspection in February 2009 there has been a change to the management at the home. A new person has been recruited for the care managers position; a formal application for registration has yet to be submitted to us for consideration. Heathside House DS0000030493.V378543.R01.S.doc Version 5.3 Page 24 The acting care manager was on the premises for the whole of this inspection and was informative and knowledable about the day to day operations of the home. The AQAA was completed by the acting care manager and contains clear, relevant information, telling us what the service does well, what has improved and the further improvements that it plans to make. Staff told us Heathside House is a lovely home to work in, the manager and senior staff are very supportive and helpful. The acting care manager told us that quality assurance monitoring is ongoing with regular audits being completed each month. There are plans to further the monitoring of the service with satisfaction surveys being distributed to visitors and other people with an interest in the home. A representative of the Local Authority visits the home each month as part of the monitoring of the service; reports are produced of the visits and available for inspection. We looked at systems for safekeeping of peoples money and found they were in good order. The home has good records of all transactions and obtains receipts and two signatures. Audits are carried out on a regular basis to ensure the accuracy of the recordings. We saw the records, documents and certificates for the weekly, monthly and annual health and safety checks are being maintained. All requested were readily available for inspection. Heathside House DS0000030493.V378543.R01.S.doc Version 5.3 Page 25 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 2 X 3 X X n/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 2 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 2 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 Heathside House DS0000030493.V378543.R01.S.doc Version 5.3 Page 26 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. 1 2 3 4 5 Refer to Standard OP1 OP8 OP10 OP26 OP31 Good Practice Recommendations To offer people full details of the home the weekly fees should be included in the service user guide. The care plans should contain the full details of a persons assessed care needs to ensure that the care needs are fully met Privacy indicators should be fitted to communal toilet and bathroom doors this will ensure that a persons privacy is not compromised when using the facilities. All areas where personal care is undertaken should be supplied with suitable hand wash facilities for the effective control of infections. The application for the position of registered care manager for the service should be submitted to us for consideration. Heathside House DS0000030493.V378543.R01.S.doc Version 5.3 Page 27 Care Quality Commission West Midlands Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.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) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Heathside House DS0000030493.V378543.R01.S.doc Version 5.3 Page 28 - 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!