Hebron House Nursing Home Ltd Care Home Service 27 Seabank Road Nairn IV12 4EU Telephone: 01667 452459 Type of inspection: Unannounced Inspection completed on: 23 January 2017 Service provided by: Hebron House Care Home Service provider number: SP2008010148 Care service number: CS2008189589
About the service The Care Inspectorate regulates care services in Scotland. Information about all care services is available on our website at www.careinspectorate.com. This service was previously registered with the Care Commission and transferred its registration to the Care Inspectorate on 1 April 2011. The service is registered to provide care to 22 older people. Hebron House is located in a quiet residential area of Nairn, set in its own grounds and consists of the original two storey building with extensions. Both the home and grounds have been upgraded. The care home consists of 20 single rooms and one double room as well as several communal public rooms and lounges. Seventeen of the 21 bedrooms have ensuite toilet facilities, four of which have shower facilities. There is a passenger lift and stair access between the ground and first floor. The aims and objectives of the service were to strive to provide a good, individual, home life for all residents and that they are cared for with dignity and respect, whilst maintaining their individuality at all times. To promote the need to continue with hobbies, activities and interests and to involve residents and their relatives in the care provided. What people told us During this inspection we spoke with five people who lived there and spent time chatting socially with a group of people spending time in the lounge. They told us that the service was very good and that the staff cared and supported them in a manner which suited them. One person who hailed from the town of Nairn was very proud of the home and to be living there and felt that it was "exceptional". Another said it was the best that it could be, taking into consideration that it was a care home and there were others to look after too. The meals in the home were enjoyed by all and they told us that the quality was good and that there was enough to eat. People were enthusiastic about the new staff member who was helping them to develop the activities programme. They had taken part in various crafts and had been able to use these and have them displayed in the home. Only one questionnaire had been returned to us from the people who live at the home and this was positive in its content. We spoke with two relatives who were very complimentary about the staff and management. They knew who their key worker was, although one felt that this could be better promoted. Relatives felt that the healthcare needs of their loved ones was good and that they were kept informed of any changes. At the formal reviews they were made aware of care plans and said that they were asked for their opinions as to how things could be made better. It appeared that the service had not been able to gather interest in having relatives' meetings. However we were able to gain feedback that this was not necessarily the case. The service was to gain people's opinions and to look again to see whether or not this could be further developed. page 2 of 8
Eight questionnaires had been returned to us prior to the inspection. All of these agreed with the statements within. Individual comments included:- "Hebron House is a first class and a happy home. Cannot fault the care there" "It is genuinely a caring environment and my mother has gradually regained her strength, mobility and zest for life following a long period of ill health. My mother's particular situation of being fully alert and highly functioning cognitively is a sadly uncommon one - there are few companions to chat to. This is where the patience and kindness of staff is so important. Staff are aware and sympathetic. I feel Hebron has given back her quality of life - we are all so grateful" "This is a homely, friendly unit, small enough to allow staff to know each resident's needs and likes. I have found the building clean and very well maintained and the staff consistently kind, competent and caring. Relatives are encouraged to come and go as they wish and the residents are free to out with relatives as appropriate. Altogether a very good care home" "I am happy with the care given to my aunt. The manager is very helpful and kind" "I feel very fortunate to have my mother in Hebron House. The staff are excellent and highly motivated. The owner/manager leads by example setting high standards. All the staff seem very happy in their work and are very helpful. I have every confidence in the care that my mother receives and have never had any cause for concerns about the standard of care. The fabric of the building and internal decoration are well maintained and the garden is nicely looked after with lovely displays of flowers throughout the year" Self assessment The Care Inspectorate received a fully completed self-assessment document from the provider. We were satisfied with the way the provider completed this and with the relevant information included for each heading that we grade services under. The provider identified what it thought the service did well, some areas for development and any changes it had planned. The provider told us how the people who used the care service had taken part in the self assessment process. From this inspection we graded this service as: Quality of care and support Quality of environment Quality of staffing Quality of management and leadership not assessed not assessed What the service does well Hebron House provides good care and support. The service is well managed and benefits from a staff team who work hard to ensure that the quality of life and experiences for the people who live there are good. Relatives told us that staff were patient and kind. People now have opportunities to enjoy a range of activities in house and page 3 of 8
events that reflected their personal interests and choice. The newly appointed activity staff member was very committed to making a positive contribution to people's daily lives. Some of the relatives were very positive about this and were pleased that more structured activities were offered. Staff worked with other healthcare professionals to ensure that people's health needs were addressed. When we spoke with staff it was apparent that they had a very good understanding of individual needs and that any change in behaviour may warrant further assistance. Assessments of healthcare needs were carried out and reviewed regularly and these were used to develop the care plans. All people who used the service had care plans in place and some of these showed that the care was based on their preferences, needs and wishes. They covered a range of healthcare needs. People told us that staff were very good and that they were very supportive with their healthcare needs. Relatives said that they knew who their key worker was and that they had been involved with the development of the care plans. They had also taken part in formal reviews where they were able to discuss any topic in relation to their relatives. The overall management and administration of medications was carried out by qualified nursing staff. We saw that GP's were involved with reviews of medication needs. The dining room had been recently decorated and was a pleasant place to sit and eat meals. All of the people we spoke with were very complimentary about the quality of the meals that were provided. We could see that staff supported those who needed help in an appropriate manner and a pleasant social atmosphere was promoted. The service held meetings with people who lived and worked in the home and carried out checks and audits on various aspects of the service. What the service could do better In order that the service was able to meet individual healthcare needs effectively and in line with people's preferences and choice, they were to ensure that the care plans reflected this. Once these had been developed they were to carry out an effective and outcome based review and amend and update these care plans as needed. See recommendation 1. In order to protect the safety of people the service was to ensure that the overall management of medications was reviewed. This was to be carried out in conjunction with the use of our best practice "Guidance about medication personal plans, reviews, monitoring and record keeping in residential services", which can be found on our website www.careinspectorate.com Staff were to be made aware of this guidance so that staff practice improved. See recommendation 2. We shared the Kings Fund tool "Is your care home dementia friendly?"with the service as a way of developing and improving the environment for the people that lived there. We spoke about improving some of the lighting and to assess how people were safely able to get from the dining room to the lounges without the support of staff. The quality assurance policy had been reviewed but this had not resulted in any positive changes. We discussed the use of proven quality assurance tools, which would then enable them to look at all areas of service provision; such as care and support, the environment, staffing and management and leadership. This was so that they could then identify, plan for and assess improvements based on best practice, with regard to living in a care home for older people. See recommendation 3. page 4 of 8
As part of the quality assurance work the service was to look at the overall management and outcomes from staff meetings. The service was to be vigilant about how minute taking was managed, so that the information was clear for all staff as to what needed to change to improve. The service was to ensure that the staff who worked in the care home had the opportunity to discuss their ideas and suggestions about how to make positive changes. The service was also to develop action plans following meetings, so that there was clear direction as to what was going to change and who was responsible. By developing these methods the service would be able to monitor improvements, promote best practice and good standards on behalf of the people who lived there. Requirements Number of requirements: 0 Recommendations Number of recommendations: 3 1. The provider should ensure that care plans are further developed. These should contain personal and unique information, which influences how they support people in their day to day life and makes a positive difference. This should include reference to appropriate strategies to use when supporting people in times of stress and distress. Care plans were then to be effectively reviewed, evaluated and updated, to ensure that the information is a current reflection of people's needs. National Care Standards Care Homes for Older People Standard 6: Support arrangements. 2. The provider should ensure they make proper provision for the administration, dispensing, recording and storage of medication. National Care Standards Care Homes for Older People Standard 5: Management and staffing arrangements Standard 6: Support arrangements Standard 15: Keeping well - medication 3. The provider should ensure they look toward developing and using systems and processes by which they could assure themselves that they were assessing, reviewing and improving the overall provision of the service. Thereby, ensuring that there were continued, positive outcomes for the residents and relatives. National Care Standards Care Homes for Older People Standard 5: Management and staffing arrangements. Complaints There have been no complaints upheld since the last inspection. Details of any older upheld complaints are published at www.careinspectorate.com. page 5 of 8
Inspection and grading history Date Type Gradings 12 Feb 2016 Unannounced Care and support Management and leadership 30 Mar 2015 Unannounced Care and support 3 - Adequate 3 - Adequate Management and leadership 14 Mar 2014 Unannounced Care and support Management and leadership 6 Mar 2013 Unannounced Care and support Management and leadership 6 Mar 2013 Unannounced Care and support Management and leadership 27 Jan 2012 Unannounced Care and support 5 - Very good 5 - Very good Management and leadership 1 Aug 2011 Unannounced Care and support 5 - Very good Management and leadership 5 - Very good 26 Oct 2010 Unannounced Care and support 5 - Very good page 6 of 8
Date Type Gradings Management and leadership 4 Jun 2010 Announced Care and support 5 - Very good Management and leadership 29 Jan 2010 Unannounced Care and support 3 - Adequate Management and leadership 3 - Adequate 28 Jul 2009 Announced Care and support 3 - Adequate Management and leadership 3 - Adequate page 7 of 8
To find out more This inspection report is published by the Care Inspectorate. You can download this report and others from our website. Care services in Scotland cannot operate unless they are registered with the Care Inspectorate. We inspect, award grades and help services to improve. We also investigate complaints about care services and can take action when things aren't good enough. Please get in touch with us if you would like more information or have any concerns about a care service. You can also read more about our work online at www.careinspectorate.com Contact us Care Inspectorate Compass House 11 Riverside Drive Dundee DD1 4NY enquiries@careinspectorate.com 0345 600 9527 Find us on Facebook Twitter: @careinspect Other languages and formats This report is available in other languages and formats on request. Tha am foillseachadh seo ri fhaighinn ann an cruthannan is cànain eile ma nithear iarrtas. page 8 of 8