Inspection on 23/10/09 for Highfields

This is the latest available inspection report for this service, carried out on 23rd October 2009.

CQC found this care home to be providing an Excellent service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Highfields 26/10/05

Highfields 08/07/05

Highfields 11/10/04

Highfields 13/07/04

Highfields 18/03/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 16/02/2010.

Key inspection report CARE HOME ADULTS 18-65 Highfields 53 Park View Kettering Northants NN16 9RJ Lead Inspector Catherine Perrins Key Unannounced Inspection 23rd October 2009 11:00 10/09 Highfields DS0000012811.V378204.R01.S.doc 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 home adults 18-65 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. Highfields DS0000012811.V378204.R01.S.doc Version 5.3 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 Highfields DS0000012811.V378204.R01.S.doc Version 5.3 Page 3 SERVICE INFORMATION Name of service Highfields Address 53 Park View Kettering Northants NN16 9RJ 01536 517751 01536 414924 june.ringrose@btopenworld.com Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Miss June Ringrose Miss June Ringrose Care Home 6 Category(ies) of Learning disability (6), Learning disability over registration, with number 65 years of age (1) of places Highfields DS0000012811.V378204.R01.S.doc Version 5.3 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th October 2006 Brief Description of the Service: Highfields is a large family house in Kettering. Six people with learning disabilities live there with the registered manager / owner. The property overlooks a park and is quite close to the town centre. Nobody new has moved into the home for thirteen years and the manager has stated that she is not planning for anyone else to move in as it would compromise the ‘family’ atmosphere for the people who are living there now. The current fees are between £499.26 and £644.15 per week. Highfields DS0000012811.V378204.R01.S.doc Version 5.3 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is three star. This means the people who use this service experience excellent quality outcomes. This was an unannounced key inspection which means that we focussed on the key national standards. The key standards are those considered by the Commission to have the most impact on outcomes for residents. As part of the preparation for this inspection a period of two hours was spent reviewing the information that CQC has about this service. We looked at all the information that we have received, or asked for, since the last key inspection or annual service review. This included: The annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. Information we have about how the service has managed any complaints. What the service has told us about things that have happened in the service, these are called notifications and are a legal requirement. The previous key inspection and the results of any other visits that we have made to the service in the last 12 months. Relevant information from other organisations. The inspection visit lasted five hours during the morning and afternoon of a weekday. During the inspection two people were case tracked. This involves looking in detail at all aspects of their care and experiences at the Highfields, including looking as their individual plans of care and other records, talking to them and talking to their care staff. Because people with learning disabilities are not always able to tell us about their experiences we also used observations of peoples state of well being and how they interacted with staff members and others. A sample of staff files were also viewed as part of the inspection. Highfields DS0000012811.V378204.R01.S.doc Version 5.3 Page 6 The registered manager was present for the inspection. The next inspection of this service will be based on the Fess and Frequency Regulations 2007 and the assessment of risk of the service. Further clarity will become evident as the new registration and inspection system under the Health and Social Care Act 2008 is confirmed. What the service does well: The manager explained that she always endeavoured to make sure that any choices that people made were “informed choices” by giving people options and letting them try different things before making a decision. Care plans detailed how people should be supported to maintain their dignity, self respect and independence. The atmosphere of the home is very much one of a ‘family’. The people who live at Highfields all know each other very well and have lived in the home for many years One relative told us “People have a very active life going to the pub, gym, swimming and clubs.” The manager told us that the people who live at the home are involved in recruiting any new staff and will spend time talking to any prospective candidates. The manager explained that the home has a very low staff turnover which means that the staff know the people who live at the home well. Staff rotas are planned around the times when people need support and that staff are flexible about working late if for example they are supporting someone to go out for the evening. Throughout the inspection the manager showed an excellent understanding of the needs and preferences of the people who live in the home, built up over the many years that she has known the people for. Discussions with her, and observations, demonstrated a very high level of commitment to giving the people who live at Highfields a good quality of life within a family home environment. Highfields DS0000012811.V378204.R01.S.doc Version 5.3 Page 7 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. Highfields DS0000012811.V378204.R01.S.doc Version 5.3 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Highfields DS0000012811.V378204.R01.S.doc Version 5.3 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3 & 4 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 were given good information and their needs assessed before they moved to Highfields to ensure that the home was right for them.. EVIDENCE: The home has a statement of purpose and service user guide which give people good information about the home and the services it offers. The manager explained that she made a decision some years ago not to admit anyone else to the home because she did not want to compromise the ‘family’ atmosphere for the people currently living in the home. The last person admitted to the home moved in thirteen years ago. The manager told us that peoples needs were thoroughly assessed and that they were able to visit before they moved into the home. Highfields DS0000012811.V378204.R01.S.doc Version 5.3 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 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): 6,7,8 & 9 People using the 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 have their needs met, their preferences respected and they are given support to make choices and decisions EVIDENCE: Each person who lives at the home has an individual plan of care. This contains their care plans and other information that staff need to care for and support people in the right way. Care plans covered peoples physical health, emotional health, personal care and communication. They contained a lot of detail about peoples preferences. The manager explained that she always endeavoured to make sure that any choices that people made were “informed choices” by giving people options and letting them try different things before making a decision. Highfields DS0000012811.V378204.R01.S.doc Version 5.3 Page 11 Care plans detailed how people should be supported to maintain their dignity, self respect and independence. For example reminding staff of the need to knock on people’s bedroom doors before entering and encouraging independence with discreet observation. The care plan for one person who’s support needs are increasing due to age, detailed how staff should offer support “without undermining his dignity” for example by limiting what the person lifts or carrying and asking if he would like to use his wheelchair when he goes out. Records show that, where they are able to, people sign their care plans to show that they agree with what has been written. Care plans are reviewed on a regular basis with the person and their relatives being involved in the review process. This ensures that people are happy with the care and support that they receive. A relative told us “we could not ask for more. XXX has improved so much, he is living a normal life. We have no worries what so ever. Highfields DS0000012811.V378204.R01.S.doc Version 5.3 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): This is what people staying in this care home experience: 11, 12,13, 14, 15, 16 & 17 People using the 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 enjoy a good quality of life within a “family” setting. EVIDENCE: People were observed to be happy and relaxed and able to come and go as they wished around the home. The atmosphere of the home is very much one of a ‘family’. The people who live at Highfields all know each other very well and have lived in the home for many years. During the day people attend day centres. The manager explained that each person has at least one weekday that they spend at home to ensure that they receive some individual time with staff. Highfields DS0000012811.V378204.R01.S.doc Version 5.3 Page 13 Care plans give staff a lot of detail about people’s likes and dislikes for example one person likes, magazines or books containing pictures of doctors, nurses, animals and popular television characters. Staff explained that people are given a choice of meals with staff assisting with the cooking as required. People are supported to go on holiday at least once a year. One person showed us his photographs from previous holidays he had been on whilst living at Highfields. One relative told us “People have a very active life going to the pub, gym, swimming and clubs.” The manager told us that relatives are able to visit at anytime and that a Christmas meal has been arranged for all of the people who live at the home and their relatives. Highfields DS0000012811.V378204.R01.S.doc Version 5.3 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 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): 18, 19 & 20 People using the 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 are given sensitive support with their personal care and supported to maintain good health. EVIDENCE: Records show that people are supported to attend regular health appointments such as general health checks, blood pressure monitoring, weight checks, flu vaccinations as well as dental, podiatry and optical checks. One person who lives at the home was advised to exercise for health reasons. The manager explained that he does not like going to the gym so has an exercise bike. He was observed using this during the inspection, the manager told us that this has helped him to maintain good health. Highfields DS0000012811.V378204.R01.S.doc Version 5.3 Page 15 The administration of medication is generally well managed with all entries on the medication record being signed to show that people are receiving their medication as prescribed. At the time of inspection the home did not have any facility to store controlled drugs safely and to ensure compliance with the latest requirements of the Misuse of Drugs Act Amendment 2007. Controlled drugs are prescribed medicines which some people abuse them by taking them when they have not been prescribed, there are laws and regulations about how these drugs should be stored and administered. Although no-one living at the home was prescribed any controlled drugs it is possible that they could be in the future. When this was brought to the attention of the manager she arranged to have an appropriate storage cupboard ordered and stated that this would be fitted within two weeks of the inspection. Highfields DS0000012811.V378204.R01.S.doc Version 5.3 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 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): 22 & 23 People using the 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 are kept safe by having staff who know them well and good procedures for raising concerns. EVIDENCE: The home has a complaints procedure which outlines what people should do if they wish to raise a concern about the home and the response that they can expect. The manager said that the home has not received any complaints since the last inspection. The home has not made any alerts to the local authority under the locally agreed Safeguarding Adults procedure. Staff spoken to were aware of how to raise any concerns that they may have and their responsibilities to safeguard people from harm. Relatives also told us that they knew how to raise any concerns that they may have. No evidence was seen during the inspection to suggest that anyone living in the home had any restrictions placed on their liberty. People were able to move around the home as they wished. Highfields DS0000012811.V378204.R01.S.doc Version 5.3 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 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): 24, 25, 26, 27, 28 & 30 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 enjoy living in a “family” home EVIDENCE: Highfields has the atmosphere of a family home. This is achieved partly through the furnishing and décor and partly because the people who live there have been there many years and have made it their home. The owner / manager has a bedroom and office on the second floor. There are a further two single bedrooms and two double bedrooms. The manager explained that the people who share a room have done so since before moving to Highfields, as they used to share at their previous home, and chose to Highfields DS0000012811.V378204.R01.S.doc Version 5.3 Page 18 continue sharing when they moved in to Highfields. Rooms seen had been made personal with pictures, ornaments and other personal effects. Communal areas consist of a lounge, a lounge / diner and a kitchen / diner. Communal areas were comfortable with enough space for everybody who lives there. People were observed relaxing in the lounge areas. The property also has two bathrooms and a laundry room. Outside there is a large enclosed garden which people are able to use as they wish to. The manager explained that the path that leads down the garden has been resurfaced to make it more accessible for everyone. The front door to the property is accessed by steps, however there is level access around the side of the property leading to the back door. The property was clean and hygienic throughout. It was noted that none of the radiators in the property have radiator covers. The potential risk of people falling against a hot radiator were brought to the attention of the manager who stated that she would arrange for radiator covers to be fitted to any radiators where there is a risk that someone could burn themselves within two weeks of the inspection. Highfields DS0000012811.V378204.R01.S.doc Version 5.3 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 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): 31, 32, 33, 34, 35 & 36 People using the 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 are supported by a competent staff team who have a good understanding of their needs and preferences. EVIDENCE: The recruitment of staff is well managed with all of the necessary pre recruitment checks being carried out to ensure that staff are suitable to work with people with learning disabilities. The manager told us that the people who live at the home are involved in recruiting any new staff and will spend time talking to any prospective candidates. The manager explained that the home has a very low staff turnover which means that the staff know the people who live at the home well. Highfields DS0000012811.V378204.R01.S.doc Version 5.3 Page 20 Staff were observed supporting people in a respectful way which promoted their dignity and showed a good awareness of their individual needs and preferences. Records show that staff attend training such as safety, first aid, food hygiene, medication, health and safety, the Mental Capacity Act, safeguarding adults, moving and handling, infection control and challenging behaviour. This ensures that staff are able to do their jobs in the right way. The manager explained that staff rotas are planned around the times when people need support and that staff are flexible about working late if for example they are supporting someone to go out for the evening. Highfields DS0000012811.V378204.R01.S.doc Version 5.3 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from the commitment of the manager to run the home in their best interests. EVIDENCE: Throughout the inspection the manager showed an excellent understanding of the needs and preferences of the people who live in the home, built up over the many years that she has known the people for. Discussions with her, and observations, demonstrated a very high level of commitment to giving the people who live at Highfields a good quality of life within a family home environment. Highfields DS0000012811.V378204.R01.S.doc Version 5.3 Page 22 The manager is very involved in supporting and caring for people. She updates all of the care plans and checks people’s health appointments every four weeks to ensure that people’s needs are being met and that they receive the appropriate support. The manager explained that she also audits the medication and people’s finances on a monthly basis. Much of the feedback given by the people who live at the home and their families is informal because of the relationships that have been established. Satisfaction surveys were however available for people to complete, and surveys seen, showed that people were happy with the home and the service it offered. The views of people living in the home and their families are also formally sought as part of the process of reviewing peoples care and support. Again these records showed a high level of satisfaction. Records show that the necessary safety checks such as fire checks, checks on the water system and portable appliance testing have all been carried out recently. Highfields DS0000012811.V378204.R01.S.doc Version 5.3 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 3 4 3 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 4 ENVIRONMENT Standard No Score 24 3 25 3 26 2 27 3 28 3 29 x 30 3 STAFFING Standard No Score 31 4 32 4 33 4 34 3 35 4 36 4 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 4 3 x LIFESTYLES Standard No Score 11 3 12 4 13 3 14 4 15 4 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 x 4 4 4 4 3 4 4 Version 5.3 Page 24 Highfields DS0000012811.V378204.R01.S.doc No Are there any outstanding requirements from the last inspection? 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. 1 Standard YA20 Regulation 13 Requirement The storage of medication must comply with the latest requirements of the Misuse of Drugs Act Amendment 2007. To ensure that any controlled drugs which may be prescribed to people living at the home can be stored safely. Timescale for action 31/12/09 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 YA42 Good Practice Recommendations Assessments should be undertaken and necessary measures put in place to ensure that no-one is at risk from being burnt by a hot radiator. Highfields DS0000012811.V378204.R01.S.doc Version 5.3 Page 25 Care Quality Commission East 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. 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