Care Home: Heathside Rest Home

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What the care home does well Service users live in a home which is pleasant, comfortable and suitable to meet their individual needs. It continues to be improved and upgraded for the benefit of those who live there. There are systems in place to consult with service users, which make sure that their wishes and feelings are known. Care and support are provided to them as they wish and need. As far as possible and is safe, service users are encouraged to develop their own routines for daily living. The system for supporting prospective service users to become familiar with the home before they make any decisions about their future is good. They are able to visit the home as often as they wish to look around and talk with service users already living there. The manager from the home also meets with them to assess their needs and confirm or not if the home is able to meet those needs before the service users make any decisions about moving in. Care planning is good. Service users are supported to, as far as possible, maintain good health, with routine and appropriate health checks in place. What has improved since the last inspection? Many aspects of the service have been improved and developed since the last key inspection. A new medication management and administration procedure has been put into place. Medication administration training has been provided to the appropriate staff and the manager has assessed their practice and competences. Formal supervision has been undertaken with staff. They have been trained and receive guidance about treating service users in a respectful and dignified manner, moving and handling and providing personal care support appropriately. The home`s complaints procedure has been reviewed. Service users and relatives have received information about the complaints system and a complaints/suggestion box is readily available within the home, which enables complaints to be anonymous if they require. The manner in which staff files are maintained, has improved. All the required documentation was available, including recruitment and training records. The home continues to improve the environment. Since the last inspection redecoration, carpeting and new fixtures and fitting have been completed. Furthermore, a substantial decking system has been put into place to the rear of the property, which will support service users to gain access to the garden directly from the ground floor. Service users have a more varied menu, which has been developed after consultation with them. What the care home could do better: The home has worked hard since the previous inspection to meet and comply with all the requirements issued. There are no new requirements made at the conclusion of this inspection. The following are good practice recommendations. The home`s statement of purpose and service user guide should be reviewed and amended to make sure they contain up to date and accurate information.Service users should have access to a daily menu which lets them know what main meal options are available throughout the day, including breakfast and suppers. Alternative options should also be included on the menu. Records should be maintained of the practice undertaken to introduce new staff into the home. Details should include supernumerary hours worked, training, observations and guidance provided. CARE HOMES FOR OLDER PEOPLE Heathside Rest Home 74 Barrington Road Altrincham Cheshire WA14 1JB Lead Inspector Sylvia Brown Unannounced Inspection 21st February 2008 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Heathside Rest Home DS0000063746.V358881.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. Heathside Rest Home DS0000063746.V358881.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Heathside Rest Home Address 74 Barrington Road Altrincham Cheshire WA14 1JB 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) 0161 941 3622 Miss Alicia McDonnell Miss Frances Anne McDonnell Miss Alicia McDonnell Care Home 16 Category(ies) of Old age, not falling within any other category registration, with number (16) of places Heathside Rest Home DS0000063746.V358881.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies 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 any other category - Code OP. The maximum number of service users who can be accommodated is: 16. 13th August 2007 Date of last inspection Brief Description of the Service: Heathside is a residential home that provides personal care and support for up to 16 residents within the category of old age. However, any of the residents could additionally have a physical disability. Heathside is a family run home. The property is large and situated on Barrington Road in Altrincham, close to the town centre. A small car parking area is available at the front of the building. There are gardens to the rear of the property. This area includes a patio/barbecue area, with garden furniture, where residents can sit in the summer months. Internally, there are two lounge/dining areas for communal use. Bathing and toileting facilities are also provided on both the ground and first floors. One bathroom is equipped with a specialised ‘Parker’ bath that supports those who have difficulty with movement. There are 15 bedrooms, some of which are ensuite. One bedroom on the first floor is for double occupation. The home does not have a passenger lift, however there is a suitable stair lift, which supports residents to reach all floors, as they require. The current fee structure ranges from £346.42 to £405. Heathside Rest Home DS0000063746.V358881.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 would experience good quality outcomes. The inspection report is based on information and evidence gathered by the Commission for Social Care Inspection (CSCI) since the last key inspection, which was completed in September 2007. During this inspection process we gathered information from a number of people, which included talking with and seeking the views of service users. We sent out surveys to service users, relatives and members of staff. This gave them an opportunity to talk with us about their opinions on the services provided at Heathside. At the time of writing the report, no comments had been received. Those received at a later date will be included in the next inspection process. On the day of the inspection visit we were able to share a meal time with service users and observe care and support practices by staff as they went about their daily routines. In July 2007 the manager of Heathside, completed a self-assessment form which is called an Annual Quality Assessment Audit (AQAA). This told us what the home had been doing since the last key inspection to meet and maintain the National Minimum Standards. It also told us what they felt they were doing well, how they had improved within the past 12 months and their plans to develop in the next 12 months. The AQAA was completed fairly well and told us what we wanted to know. We also gathered information through general contact with the home, through their reporting procedures and through information we received from other people, such as the general public, including concerns and complaints procedures. We looked in depth at records and the care support of two people living at the home. This helped us get a better view about how people living at home are looked after and supported from admission to present day. Heathside Rest Home DS0000063746.V358881.R01.S.doc Version 5.2 Page 6 This visit was unannounced, the manager and staff were not told that we would be visiting. The registered manager was not on duty, however the assisting manager/provider was on the premises and in management control. As a consequence of the outcome of the last inspection, the registered provider was required to provide us with an improvement plan, which had to clearly tell us how they were going to meet the requirements given at the last key inspection. This was provided within the timescale we asked for and contained concise information about how the home was going to meet the requirements. From the information gathered we made the judgment about how the home was meeting the National Minimum Standards (NMS) and we made the overall judgement on the quality of the service. What the service does well: Service users live in a home which is pleasant, comfortable and suitable to meet their individual needs. It continues to be improved and upgraded for the benefit of those who live there. There are systems in place to consult with service users, which make sure that their wishes and feelings are known. Care and support are provided to them as they wish and need. As far as possible and is safe, service users are encouraged to develop their own routines for daily living. The system for supporting prospective service users to become familiar with the home before they make any decisions about their future is good. They are able to visit the home as often as they wish to look around and talk with service users already living there. The manager from the home also meets with them to assess their needs and confirm or not if the home is able to meet those needs before the service users make any decisions about moving in. Care planning is good. Service users are supported to, as far as possible, maintain good health, with routine and appropriate health checks in place. Heathside Rest Home DS0000063746.V358881.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: The home has worked hard since the previous inspection to meet and comply with all the requirements issued. There are no new requirements made at the conclusion of this inspection. The following are good practice recommendations. The home’s statement of purpose and service user guide should be reviewed and amended to make sure they contain up to date and accurate information. Heathside Rest Home DS0000063746.V358881.R01.S.doc Version 5.2 Page 8 Service users should have access to a daily menu which lets them know what main meal options are available throughout the day, including breakfast and suppers. Alternative options should also be included on the menu. Records should be maintained of the practice undertaken to introduce new staff into the home. Details should include supernumerary hours worked, training, observations and guidance provided. 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. Heathside Rest Home DS0000063746.V358881.R01.S.doc Version 5.2 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 Rest Home DS0000063746.V358881.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1 & 3. Standard 6 is not applicable to this service. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Prospective service users have their needs assessed and are able to visit the home prior to making any decisions about their future. EVIDENCE: The statement of purpose and service user guide continue to need updating in order to ensure that information provided to prospective service users is up to date. Prospective service users are given the opportunity to spend time at the home to look around and talk with other service users before they make any decisions about their future. This helps them feel comfortable and enables them to ask any questions about life within the home. Heathside Rest Home DS0000063746.V358881.R01.S.doc Version 5.2 Page 11 The registered manager visits prospective service users in their own home and or placement to assess their needs and to confirm if the home is suitable and able to meet their identified needs. Heathside Rest Home DS0000063746.V358881.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Service users have their health care needs assessed, recorded and recognised. They receive support to maintain their health and are treated in a respectful manner. EVIDENCE: Each service user had an individual care plan in place, which is kept under review. Those looked at contained relevant information about the needs of the service user. Service users receive appropriate support to, as far as possible, maintain good health. They receive assistance to take their medication in a safe manner and administration practices observed demonstrated good practice. Service users receive additional health care support services as required, such as visits from the GP, district nurse services, continence advisors, dentist, opticians and other relevant professionals. Heathside Rest Home DS0000063746.V358881.R01.S.doc Version 5.2 Page 13 Service users told us that they were well cared for and liked the staff who supported them. Throughout the inspection visit, staff treated service users in a respectful and dignified manner. Staffing records confirmed that, since the last inspection, the manager has addressed staff practice and ensured they understood their responsibility to support service users in a respectful manner. Because of this, service users are confident that their wishes and feelings will be respected and that they are able to make their own decisions and choices, rather than fit in with the routines of staff. Heathside Rest Home DS0000063746.V358881.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. Residents are able to develop their own day-to-day routines; they receive a varied nutritional diet and have the opportunity for social activity and interaction. EVIDENCE: Service users have a varied and enjoyable diet. When asked about food, service users were generally pleased with what they received. The home does not currently display the meal options within the dining areas of the home, and the menu does not reflect the alternative options made available to service users. Because of this, there may be times when service users may wish for an alternative to the main meal and, without a menu, they may not remember what options are available. Heathside Rest Home DS0000063746.V358881.R01.S.doc Version 5.2 Page 15 The home’s notice board displays the weekly activities programme which includes: games, movies, and reading of papers and books. Service users confirmed that they had been consulted about what they would like and those taking part told us they enjoyed the activities on offer. External entertainment visits the home twice a month and arrangements are underway to ensure service users have the opportunity to visit outside places of interest in fine weather. Service users are able to plan their own daily routines and where they would like to spend their day. Some service users prefer the comfort of their own rooms, rather than meeting with others in communal areas. Heathside Rest Home DS0000063746.V358881.R01.S.doc Version 5.2 Page 16 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 aware of the home’s complaints procedure and are protected from abuse by staff who are trained in safeguarding vulnerable adults procedures. EVIDENCE: There are written policies and procedures for the safeguarding of vulnerable adults in place. It was confirmed that all staff have received training from Trafford Social Services in safeguarding vulnerable adults. The manager has improved the complaints procedure and ensured that all service users and relatives are aware of how to raise matters of concern and/or complain about the home. Staff have also received training on the home’s complaints procedures and how to act on any concerns raised. During the inspection service users had no complaints to make and were content and happy with the support and services they received. Heathside Rest Home DS0000063746.V358881.R01.S.doc Version 5.2 Page 17 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 & 21 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Residents live in a clean, well-maintained home that ensures their comfort, safety and enjoyment. EVIDENCE: Since the last inspection the home has been redecorated, painted and new carpets have been laid in both the communal and private rooms used by service users. The home appears much more bright and cheery; new curtains and some new fixtures and fittings have been purchased for residents’ comfort and enjoyment. Bedrooms looked at were found to be personal and inviting. Service users confirmed that they enjoy their private space and spoke positively about the environment. Heathside Rest Home DS0000063746.V358881.R01.S.doc Version 5.2 Page 18 During the inspection visits service users made comments about being able to sit out in the garden in fine weather. One service user invited the inspector to go to the rear window to have a look at the new garden patio. It was observed that an extensive decking system had been put in place which now enables service uses to exit from the rear door (one floor above ground level) to a good size seating area. There are steps in this area leading down to the main lawned garden. Service users told us that they liked being able to sit out in fine weather and were looking forward to using the new seating area. The home was cleaned to a high standard, tidy and free from offensive odours. Heathside Rest Home DS0000063746.V358881.R01.S.doc Version 5.2 Page 19 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. Service users receive support from staff who are appropriately recruited and trained. EVIDENCE: A sample of staff files was looked at. We were able to confirm that recruiting procedures were correct. We were told that staff work supernumerary at the commencement of their employment. It is advised that records of practice and support provided at that time are formalised and recorded. Formal recording of supervisions and staff appraisals has commenced and the practice of observing staff as they complete duties has been undertaken by the manager. The duty rota has been amended to include the full names of staff and their working hours. In addition, staff are now formally deployed by the manager and have specific roles and responsibilities on each duty, which now means service users are not left unattended, with staff readily available to support. Staff continue with their training and are progressing with their achievements with NVQ training at levels 2 and 3. Heathside Rest Home DS0000063746.V358881.R01.S.doc Version 5.2 Page 20 Staff on duty confirmed their training and were observed to be competent and supportive when attending to the needs of service users. This means that service users feel cared for and supported by people they like. Heathside Rest Home DS0000063746.V358881.R01.S.doc Version 5.2 Page 21 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, 32, 33, 35, 36 & 38 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Service users live in a home which is run and managed in their best interest. EVIDENCE: Since the last inspection the registered manager has achieved NVQ level 4 and registered manager’s award. The general positive ethos of the home was more evident at this inspection visit. Heathside Rest Home DS0000063746.V358881.R01.S.doc Version 5.2 Page 22 Service users appeared more relaxed and communicative with each other and staff. The atmosphere at the home was relaxed and pleasant, making Heathside a nicer place to be. The managers appear much more organised and in control. They are now offering more direction to staff and have a clear development plan to continue to develop practice. Health and safety checks are in place, which promote the safety of service users. Certificates of service confirmed that electrical and gas supplies and equipment are fit for purpose and use. Records confirmed the testing for risk of Legionella had been carried out and up to date certificates of service were in place for the stair lift and bath hoist. All accidents are recorded, as is the action taken to ensure the maintenance of the home is carried out in a timely manner for the safety of service users. Fire safety records detailed that safety checks are routinely carried out and staff complete practical fire drill training. Staff receive formal supervision, which supports them to develop and have dedicated time with the manager. The home does not manage any service user’s individual finances; rather, expenditures occurring are invoiced each month. Heathside Rest Home DS0000063746.V358881.R01.S.doc Version 5.2 Page 23 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 3 x x 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 3 3 X 3 3 X 3 Heathside Rest Home DS0000063746.V358881.R01.S.doc Version 5.2 Page 24 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 Refer to Standard OP1 Good Practice Recommendations The statement of purpose and service user guide, should be reviewed. They should contain accurate up to date information, be jargon free and produced in a service user-friendly format. Service users should have access to a daily menu which lets them know what main meal options are available throughout the day, including breakfast and suppers. Alternatives options should also be included on the menu. Records should be maintained to validate the practice undertaken to introduce new staff into the home. Details should include supernumerary hours worked, training and guidance, etc. 2 OP15 3 OP28 Heathside Rest Home DS0000063746.V358881.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Manchester Local Office Unit 1, 3rd Floor Tustin Court Port Way Preston PR2 2YQ 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 Heathside Rest Home DS0000063746.V358881.R01.S.doc Version 5.2 Page 26 - 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. 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