Care Home: Heyfields Nursing Home

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• 10 Whitfield Avenue

What the care home does well .Heyfields continues to deliver a high standard of care to all people that use the service, whilst maintaining a homely environment. The staff treat the people with the up most dignity and respect. Heyfields continues to maintain an extensive training programme for all the staff. What has improved since the last inspection? The home retained the ISO 9001:2008 award with no non-conformances raised. The management have considered the recommendations made at the last inspection and some action has been taken. What the care home could do better: One requirements were made at this visit with regard to individuals signature being required on care plans. Key inspection report Care homes for older people Name: Address: Heyfields Nursing Home Tittensor Road Barlaston Stoke On Trent Staffordshire ST12 9HQ     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Joanna Wooller     Date: 2 5 0 1 2 0 1 0 This is a review of 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. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 26 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. 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 Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Heyfields Nursing Home Tittensor Road Barlaston Stoke On Trent Staffordshire ST12 9HQ 01782373584 01782374001 heyfieldshouse@tesco.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: North Staffs Residential Homes Limited care home 35 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: The maximum number of service users to be accommodated is: 35 The registered person may provide the following category of service only: Care Home with Nursing (Code N) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Physical disability (PD) 35 Date of last inspection Brief description of the care home Heyfields is a care home providing personal and nursing care for up to 35 people. The home is located in a rural position on the outskirts of Barlaston village between Stone and Trentham. Barlaston village centre is a short drive away where there are a limited number of amenities. The home is part purpose built and part original building. There is ample car-parking facility at the entrance car park. Gardens are accessible around the home to people using the service including wheelchair users. The home overlooks countryside on all aspects. The accommodation provides for 31 single bedrooms and 2 Care Homes for Older People Page 4 of 26 1 35 Over 65 0 0 Brief description of the care home double bedrooms. All bedrooms, apart from 1 single room, have en suite toilet facilities. There is ample provision of communal and private seating areas around the home. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 3 star. This means that that people who use this service experience excellent quality outcomes. This unannounced inspection was carried out by one inspector over one day between 09:00 and 14:00 hours. The Manager was in the home and she participated in the inspection process. The inspection included the following elements A walk around the building, observation and inspection of care records, discussions with people who use the service, case tracking whereby we select several people who use the service, chat to them and look at their care plans and lifestyle in the home. Discussions with several of the staff members on duty, observation and sampling of other services provided such as catering and laundry, and an inspection of the managerial aspects such as staffing issues and training, recruitment and health and safety. We were made welcome in the home and all assistance was given to gain the Care Homes for Older People Page 6 of 26 evidence required for the report. We had dealt with no complaints since the last key inspection. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details 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. Care Homes for Older People Page 8 of 26 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People moving into the home do so having had their needs fully assessed and assurances are given that they will be met. The home does not have intermediate care places. Evidence: The AQAA told us We provide an extensive Statement of Purpose and Service Users Guide. This is made available to anyone on request. Contracts are clear and concise with no hidden extras. Preadmission assessments are completed to ensure the home can meet the clients needs and that Heyfields is an appropriate setting for the client. Care planning is then based on these assessments. The individual needs of all our clients are met, but in a situation where this is no longer possible the client would be assisted in transfer to a more appropriate setting. We saw that the Statement of Purpose sets out the homes aims and objectives, philosophy of care and general terms and conditions. The management told us that Care Homes for Older People Page 10 of 26 Evidence: this document assists people that are considering using the service and their relatives, giving them the the opportunity to make an informed choice about whether to live at the home. We also saw a service users guide which was an easily read summary of the Statement of Purpose. Both documents were well presented. We case tracked four people that used the service. Each individual had been assessed prior to admission. This assessment is produced with the involvement of the individual and their family or representative. The pre-admission assessment initiates the plan of care, which includes a daily living plan and longer-term goals and outcomes being identified. Any special needs of the individual, that are identified are discussed fully and documented, ensuring their individual needs would be fully met in the home. The manager and the care staff are considerate to the emotional needs of the person that is newly admitted and they are supported to settle in as soon as possible. One lady told us I was made welcome here from day one and the staff are my friends, they welcome my family whenever they come to see me. I am very settled here. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People that use the service have their health, personal and social care needs set out in an individual care plan. They are able to make decisions about their care including the assistance required with medication administration. People living in the home feel that they are treated with respect and their right to privacy is upheld. Evidence: The AQAA told us Clients are pre-assessed prior to admission by matron to ensure clients needs can be met. Careplans are based on clients needs, maintained as required, a minimum of monthly. These include risk and dependency assessments, pressure sore assessments, nutritional screening. Each client receives the personal support they require individual to their needs. We saw that the peoples health, personal and social care needs were set out in an individual care plan which is now computerised. This system is new in the home and is being gradually developed by the manager. Each plan specifies specific care and medical needs for each person and their past medical history and medication prescription. Risk assessments are in place for falls prevention, mobility, prevention of Care Homes for Older People Page 12 of 26 Evidence: pressure sore development and manual handling. Nutritional assessments are also scored and weights recorded for each individual. Through case tracking four individuals we saw care plans were reviewed each month by the named nurse, and then discussed with the person using the service. One lady confirmed that this does happen however this process is not recorded and signed as agreed, and a system for this will need to be introduced by the manager. We saw that care staff attend to personal care, respecting peoples privacy with the knocking of bedroom doors prior to entering and ensuring they are attended to promptly and sensitively supported for individual care. We saw evidence that health professionals visit the home and support the nurses in meeting the health needs of some individuals for continence, pain relief and tissue viability. People that use the service are supported to access NHS services and other health appointments. We saw evidence of care reviews and updates being recorded and evaluated in the care records for risk assessments and health checks. Through auditing we evidenced that the manager ensures the nurses adhere to the set procedures for the safe handling, storage, administration and recording of medication in the home. The home is supported by the local pharmacy, and no discrepancys in recording were noted. The staff told us they are careful to ensure that the people that use the service are treated with respect and their privacy and dignity is upheld. One member of staff told us We have a full report at the start of every shift to discuss the care to be delivered. Staff also told us they make time to chat to the individuals so they feel part of the home and not isolated and that the individuals are given choices about food and where they want to sit, they are asked to join in the activities or they are offered a one-to-one time with the activity co-ordinator. We spoke to several people that use the service that told us they were very happy with the care they received from the care staff and they stated they were respectful and considerate to their needs. Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home find that their lifestyles match their expectations, they maintain contact with family and friends and have choice and control over their life. People receive a wholesome, appealing balanced diet in pleasing surroundings at a time convenient to them. Evidence: The AQAA told us A clients profile is completed on admission to determine individuals interests, needs and abilities. We ensure clients have a choice in all aspects of their life, activities, care and treatment. An extensive activities programme is in place. Visitors are welcome at any reasonable time and clients are taken to their rooms if they want privacy. There is excellent home cooking with a varied menu. Special dietary needs are catered for. Mealtimes are very much a social time. People that use the service told us that they have a varied choice of activities to join in and socialise with others in the home, they are encouraged to maintain contact with friends and family and any community contact they wish. One lady told us I meet with my family in my room so we can be nice and private, the staff usually ask if we would like a drink, but dont disturb us. My family and I agree that the home is marvelous. I am warm, safe and very well fed. Another person living at the home told Care Homes for Older People Page 14 of 26 Evidence: us I am given plenty of choices all day long, what to wear, what to eat and what to do. The staff assist me when I need help but they generally just try to make us all as happy and content as they can. I do so much more and see more people than I would when I lived at home, and I enjoy my breakfast in bed. We were told that breakfast is served either in bed or in the individuals bedroom to assist them in having a peaceful start to the day. We saw that there were many activities planned on a weekly basis, usually requested by the people living in the home. During December shopping trips and garden centre outings were arranged, children from local schools came to the home to entertain with carol singing, along with the PAT dog and other paid entertainers. A newsletter is printed every month and distributed to everyone in the home, it lists birthdays, forthcoming events, outings, newcomers to the home and general information including items such as poems and thank you letters. The activity co-ordinator is highly motivated and attempts to get the individuals interested in activities they thought they may not enjoy. We saw a large group of people in the lounge enjoying listening to the co-ordinator reading the headlines from the daily paper and they were then discussing the issues. We observed lunch being served in a very pleasant dining room where tables were laid with cloths and the menu visible. Many people were seen to enjoy the dining experience and they told us they always enjoy the food. One lady told us I am so well fed and I enjoy the company of other people whilst I eat. The kitchen has not been recently inspected by the Environmental Health Department. Care Homes for Older People Page 15 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People that use the service are confident that their complaints will be listened to, taken seriously and acted upon. People are protected from abuse. Evidence: The AQAA told us Heyfields has a clear complaints policy in place which is on display and also made available on request. Our internal auditing programme assists us in identifying any internal non-conformances to policies. We have a clear advocacy policy in place and staff attend training to work to policies relating to abuse. Protection of vulnerable adults and the mental capacity act. We saw the complaints procedure within the Service User Guide and in the homes entrance hall. People who use the service confirmed to us that they knew who to complain to and would be confident in doing so if necessary. However they went on to say they felt they can talk to the management and the staff about any issues and because of the openness they were unlikely to need to complain. We read a number of thank you letters and compliments that have been received at the home over the past year about this service they offer. The recruitment procedure and Protection of Vulnerable Adults training offered to staff protects vulnerable people from abuse, Heyfields has all the required policies and procedures on this matter which we evidenced the staff being fully aware of. Care Homes for Older People Page 16 of 26 Evidence: There had been no complaints received by the CQC or social services and no safeguarding referrals. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People that use the service live in a safe, well maintained environment that is clean, pleasant and hygienic. Evidence: The AQAA told us Heyfields continues to be a very well maintained environment both internally and externally, where redecorating is an ongoing process.The gardens are very well kept, safe and tidy. We meet all fire regulations. Heyfields provides sitting, recreational and dining space as well as additional quiet rooms. The management and staff encourage people who use the service to see the home as their own home. Heyfields is very well maintained, safe, comfortable and attractive which has all the specialist equipment and adaptations needed to meet individuals needs. Strict infection control measures were in place, including paper towels, liquid soap, hand sanitizer, laundry management and personal protective clothing. The home employs a maintenance person who carries out any required maintenance on an ongoing basis. The grounds are appealing to the eye and enjoyed by most people that use the service. One lady showed us the squirrels playing in the garden and she told us she enjoyed watching the birds in her window feeder. Many of the Care Homes for Older People Page 18 of 26 Evidence: bedrooms had beautiful views of the garden or the local countryside. Talking with staff it was evident to us that they were aware of issues about cross infection, and it was observed that they were sensitive towards the privacy and dignity of people who use the service. The standard of domestic housekeeping must be complimented as being commendable. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People that use the service have their needs met and are kept safe by the number and skill mix of staff. The homes recruitment policy and practices protect the people living in the home. The staff are trained and competent to do their jobs. Evidence: The AQAA told us Duty rotas are planned at least three weeks in advance for each department. All departments are well staffed, therefore, maintaining good staff to client ratio. A registered nurse is on duty 24hrs a day. Over 90 of care staff are qualified to level 2 and above. All staff are fully inducted including skills for care where applicable. Extensive training records are kept. A recruitment and selection policy is in place. We saw that there was sufficient staff on duty to meet the needs of the people using the service. The staff were seen to be taking time with the individuals and not rushing their tasks. We spoke to many people that used the service and they told us the staff are always available when they call and seem to have time to do their job. One lady told us The staff seem to enjoy their work, they are very professional and considerate. I think that is why we are all happy in the home and do not feel the need to complain about anything because we are so well looked after. Three staff files were seen and two were correct, one file had no photograph, no Care Homes for Older People Page 20 of 26 Evidence: second reference, passport or address details. The member of staff in question had worked at the home for many years and the details were being re-requested by the administrator. We discussed Schedule two of the care standards act and the need to meet the requirements. We saw that the staff had received the mandatory training required to carry out their role in the home. infection control, fire safety, and manual handling had all been covered. Over 90 of staff were NVQ trained and three staff were first aid trained. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home which is well managed by a person of good character. The home is run in the best interests of the people living in it and their financial interests are safeguarded. The health, safety and welfare of people who use the service and the staff are promoted and protected. Evidence: The AQAA told us The registered manager has been in post for 9 years. The management team demonstrate good leadership skills and direction of staff, maintaining excellent standards of care. There is effective communication within the multi-disciplinary team, with an open-door policy which ensures the that management are approachable at all times. The management team closely monitors the practices in the home and there is a robust quality assurance system, action plans are developed and reviewed as required. Care Homes for Older People Page 22 of 26 Evidence: The Home maintains robust systems and records of all finances and property. These are audited on a regular basis. The home is well maintained and records are kept. The manager has completed necessary fire risk assessments. The AQAA completed by the manager confirmed that fire safety is checked and regular fire drills and training provided for all staff. The staff complete the Health and Safety training as well as additional advanced training, where appropriate. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 14 Each care plan must be agreed and signed by the individual or a representative. The manager or named nurse must discuss the care plan with the individual and once agreed - gain a signature to confirm the plan is correct. 31/03/2010 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 29 The home must ensure that all the documents listed in Schedule 2 of the Care Standards Act 2000, are kept in each individual staff file. Care Homes for Older People Page 25 of 26 Helpline: 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. 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