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Inspection on 23/04/08 for Highland House Retirement Home

Also see our care home review for Highland House Retirement Home for more information

This is the latest available inspection report for this service, carried out on 23rd April 2008.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

There is a relaxed and homely atmosphere. The people who live in the Service say that members of staff are kind and attentive. People say that they receive the support and assistance they need and that this is in line with their expectations. People are served with good quality meals. There is a varied calendar of social activities.

What has improved since the last inspection?

The individual written plans of care have been reviewed and made more comprehensive. More care workers have completed a relevant National Vocational Qualification. More quality checks are completed on the care that people receive and on the standard of the accommodation.

What the care home could do better:

There are shortfalls in one part of the recruitment system. These could make the system unsafe for people who live in the Service. There are shortfalls in the programme of ongoing staff training. These could make it more difficult for care workers to provide the assistance that people need. There are shortfalls in one part of the fire safety arrangements. These might reduce the level of fire safety protection in place, The last three shortfalls were not picked up in the Annual Quality Assurance Assessment. This exercise is supposed to identify problems so that they can be put right.

CARE HOMES FOR OLDER PEOPLE Highland House Retirement Home Littlebourne Road Canterbury Kent CT3 4AE Lead Inspector Mark Hemmings Unannounced Inspection 23 April 2008 09:00 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 Highland House Retirement Home DS0000023450.V361112.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. Highland House Retirement Home DS0000023450.V361112.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Highland House Retirement Home Address Littlebourne Road Canterbury Kent CT3 4AE 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) 01227 462921 highlandhousech@aol.com Mrs Marian Walsh Post Vacant Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places Highland House Retirement Home DS0000023450.V361112.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th April 2007 Brief Description of the Service: Highland House (the Service) is registered to provide accommodation and personal care for 28 older people. The premises are a detached two-storey property to which a ground level extension has been added at the rear. There is a chairlift that gives step-free access around the original building. When the Service is full, four of the bedrooms can be shared by two people each. In practice, only one of these rooms is usually a double. This is because most people prefer to have their own bedroom. All of the bedrooms have a private wash hand basin and toilet. Four of them also have their own shower. There is a call bell system that is designed to help people summon assistance. The property is set back from the main road and is about half way between Canterbury and Littlebourne. There is plenty of off-street car parking. Canterbury has two mainline railway stations. There is a bus service that passes the Service. People who might want to move in can get information from several sources. There is a Service Users’ Guide. This is a brochure that outlines the main things available in the Service. There is also a document called a Statement of Purpose. This gives a more detailed account than does the Guide. The Registered Provider ensures that a copy of the most recent Inspection Report from the Commission is available for reference. The range of fees charged currently for each person’s residence in Highland House, runs from £320.60 to £600.00 per week. The fees include all accommodation, meals, personal care, laundry and in-house entertainment. They do not cover things such as personal toiletries and hairdressing. Previous reports can be obtained by contacting the home directly. Highland House Retirement Home DS0000023450.V361112.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 Two (2) Star. This means that the people who use this Service experience adequate quality outcomes. The commission since 1 April 2006, has developed the way it undertakes its inspection of care services. This inspection of the Service was an unannounced “Key Inspection”. The Inspector arrived at the Service at 09.00 and was in the Service for about six and a half hours. It was a thorough look at how well the Service is doing. It took into account detailed information provided by the Registered Provider in her self-assessment. This is called the Annual Quality Assurance Assessment (AQAA). Further, it considered any information that the commission has received about the Service since the last inspection. During the inspection visit, we looked at a selection of the records and documents kept in the Service. We spoke with the Registered Provider, the Manager and with members of staff. Also, we spoke with five of the people who live in the Service and spent time in the company of others. We examined parts of the accommodation and grounds. There are 3 Requirements at the end of this Report. What the service does well: There is a relaxed and homely atmosphere. The people who live in the Service say that members of staff are kind and attentive. People say that they receive the support and assistance they need and that this is in line with their expectations. People are served with good quality meals. There is a varied calendar of social activities. Highland House Retirement Home DS0000023450.V361112.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: 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. Highland House Retirement Home DS0000023450.V361112.R01.S.doc Version 5.2 Page 7 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 Highland House Retirement Home DS0000023450.V361112.R01.S.doc Version 5.2 Page 8 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): Standards 3 and 6. People who use the Service experience good outcomes. This judgement has been made using available evidence including a visit to the Service. Comprehensive information is collected about the needs and wishes of people who want to move into the Service. People who want to stay for shorter periods are helped to go back home. EVIDENCE: The Manager and the Registered Provider complete an assessment of each prospective person’s needs for assistance. This is done before a decision is made about whether or not the Service is a suitable place for the person’s residence. The assessment is completed in consultation with the person concerned. As appropriate, members of their family and care managers (social workers) are involved. Highland House Retirement Home DS0000023450.V361112.R01.S.doc Version 5.2 Page 9 We looked at three sets of the assessment records. We found a lot of useful information about things such as the assistance needed with washing and dressing, with getting about and with maintaining family contacts. We spoke with two care workers, who said that they are told about this information so that they have a good grasp of someone’s need for help from the point of their admission. We asked one person about their experience of having moved into the Service. They said that their needs had indeed been assessed and that staff had been ready to greet and assist them from the point when he or she moved in. People can stay for shorter periods of time. This might be because they have been in hospital and are not yet ready to go home. Or, it might be so that a carer can have time to themselves. The Manager said that careful attention is given to helping people to go back home so that their stays do not last longer than is necessary. We spoke with one person about this matter. He or she said that they has been encouraged to look upon their time in the Service as being temporary only. They told us that no pressure has been put on her or him to stay and that they were confident that they will be helped to go home once the time is right to leave. Highland House Retirement Home DS0000023450.V361112.R01.S.doc Version 5.2 Page 10 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): Standards 7, 8, 9 and 10. People who use the Service experience good outcomes. This judgement has been made using available evidence including a visit to the Service. People are provided with the personal and health care they need. Medicines are dispensed in the correct manner. People are treated with respect. EVIDENCE: The people who live in the Service say that the care workers offer them all the assistance they need. There is a written individual plan of care for each person. These are important because they are one of the ways that people can be informed about and can agree to the assistance they will receive. Also, the plans are a source of information for staff. This then helps them to provide personal care in a consistent manner. We examined five of these plans. They were clear and suitably detailed. For example, they contained relevant information about the assistance the people need in relation to personal Highland House Retirement Home DS0000023450.V361112.R01.S.doc Version 5.2 Page 11 hygiene, health care, medication, using the bathroom, promoting continence and getting about. There was evidence that plans are kept under active review so that they remain up to date. We spoke with two care workers. They have a good knowledge of the assistance to be provided. As part of this, they are aware that people’s needs and wishes change from day to day and that therefore their response needs to be flexible. Sensible steps are taken to ensure that people do not have any avoidable accidents. For example, someone can choose to have bed rails fitted if they are worried about rolling out of bed. People are assisted to maintain their health. Care workers are alert to the need to identify occasions when someone is becoming unwell. This is so that medical assistance can be sought promptly. For example, we saw written evidence that care workers tactfully check to see that no one is developing a pressure sore. There was evidence to show that family practitioners and other medical services are being contacted as and when necessary. None of the people manage their own medication. The Manager said that this option is actively considered and that people will be assisted to do this if this is their wish. There is a system to check that the correct medicines are received from the pharmacist. Once in the Service, they are stored securely. There is a procedure for administering medicines that is designed to double check that the right medicines are given to the right people at the right time. There is a record that is completed on each occasion that a medicine is dispensed. We examined two sets of these records. They were correctly completed and they corresponded with the medicines remaining in storage. The people who live in the Service praise the care workers. They say that they are courteous and attentive. Two people summed up the general mood in their comments. One said, “the staff here are really kind and attentive. They give me all the care that I need and they do so with a smile, I’ve known some of them for a while now and they are more like family”. The other said, “the staff are always ready for a chat and you get to know them as individuals. Of course they’re busy, but they seem to be happy and this gives the place a nice relaxed feeling”. We noted how the care workers chatted and joked with people sitting in the lounge. We also noted how people were assisted to use the bathroom in a discreet manner. They were quietly helped to leave their armchairs and then once at the bathroom the door was closed to give them privacy. Highland House Retirement Home DS0000023450.V361112.R01.S.doc Version 5.2 Page 12 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): Standards 12, 13, 14 and 15. People who use the Service experience good outcomes. This judgement has been made using available evidence including a visit to the Service. There is a calendar of social activities. People are free to receive visitors and to spend the day as they wish. Good quality meals are served. EVIDENCE: There is a calendar of social events held in the Service. This includes the opportunity to do things such as arts and crafts and to take part in activities such as reflexology. There are also various entertainers who call to play music. As and when the weather permits, some of the people are accompanied for short walks in the garden to get some fresh air. In the summer, there are events such as a garden party and at Christmas there are the normal festivities. We spoke with six people about the social activities and each said that they have enough to do. We looked at two sets of the records that are kept of each person’s involvement. These showed that the people concerned had taken part in activities on most days. We spoke with someone who takes Highland House Retirement Home DS0000023450.V361112.R01.S.doc Version 5.2 Page 13 part only very occasionally. They told us that this was their choice. They said that staff have offered lots of opportunities to become more involved in the future if he or she changes their mind. The Annual Quality Assurance Assessment says that there is now a clear budget to support the activities calendar. It also says that it is hoped to have more activities in future that involve relatives. People say that the pace of daily life in the Service is relaxed and unhurried. They say that they are free to decide what to do each day. One person said, “there’s a pattern to daily life here, but it’s up to you to decide what it is. I can go to bed when I like and get up when I like. It’s up to me when I go to my bedroom, I could stay in there all day if I wanted”. People are assisted to keep in touch with members of their families, if this is necessary and if it is their wish. Family members and friends are welcome to call to the Service at any reasonable time. The Manager keeps in touch with family members so that they know how things are going. We saw two visitors and we noted how they were chatting with care workers in a relaxed and informal manner. People say that they receive good quality meals and that they have enough to eat. They consider meal times to be a relaxed and pleasant experience. There was written evidence to show that there is a choice dish at each meal time. The menu provides people with a normal healthy diet. Meal times are flexible. We noticed that three people were still having their breakfast at 9.45am on the day of out visit. People can dine in their bedrooms if they want to do so. Highland House Retirement Home DS0000023450.V361112.R01.S.doc Version 5.2 Page 14 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): Standards 16 and 18. People who use the Service experience good outcomes. This judgement has been made using available evidence including a visit to the Service. There is a complaints procedure. The wellbeing of the people in residence is safeguarded. EVIDENCE: There is a written complaints procedure. This explains how the people who live in the Service and other interested parties can go about raising a concern. Since the last inspection, the Registered Provider has looked into two relatively minor complaints. This has been done in a thorough manner. As necessary, steps have been taken to help prevent them happening again. Recently, we have received a further complaint. We have passed this to Kent County Council because it is responsible for looking into the matter. The Registered Provider has said that she will cooperate fully with any requests she receives for information concerning the complaint. Also, she has said that should any improvements prove to be necessary these will be put into effect without delay. We asked four people about how free they feel to raise a concern with the Manager or with the Registered Provider. All of them said that they would be confident to approach either of them. Highland House Retirement Home DS0000023450.V361112.R01.S.doc Version 5.2 Page 15 They also said that there was no need to do so at the moment, because they do not have any concerns. There is a written statement of the Registered Provider’s commitment to promote the wellbeing of the people in residence. We spoke with two care workers about this matter. They are aware of how to go about safeguarding in practice the interests of the people who live in the Service. This includes being alert to things that are not obvious, such as someone becoming anxious or withdrawn. One person summarised a good way of looking at it when she or he said, “I take care of the ladies and gentlemen here as if they were my own mum and dad. I want the best for my mum and dad and I want the best for the residents too”. Highland House Retirement Home DS0000023450.V361112.R01.S.doc Version 5.2 Page 16 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): Standards 19, 22, 25 and 26. People who use the Service experience good outcomes. This judgement has been made using available evidence including a visit to the Service. People live in a comfortable setting that promotes their independence. EVIDENCE: The accommodation is presented to a good domestic standard. The communal rooms and the bedrooms are decorated and furnished in a homely and comfortable way. The premises are fitted with an automated fire detection system. This provides a high level of fire safety protection. The Registered Provider has prepared a Highland House Retirement Home DS0000023450.V361112.R01.S.doc Version 5.2 Page 17 fire risk assessment. This has been done to ensure that there are no particular hazards that might reduce the level of protection in place. The local Department of Environmental Health has awarded the kitchen 3 Stars out of a possible 5 Stars. The Registered provider says that the additional Star should be awarded after some wooden cabinets have been removed. She says that she plans to do this in the near future. We looked in the kitchen and found it to be clean and well organised. We spoke with the cook. She is aware of the importance of maintaining good standards of hygiene and of how to do it in practice. Suitable help can be given to those people who have difficulties with getting about. There is chairlift that gives step-free access around the accommodation. There are two mobile hoists that can be used in the bedrooms and there is a fixed hoist in one of the bathrooms. There are banister rails in corridors. At key places there are assistance poles. These are fitted to the wall and they are there for people to hold onto for extra support. We asked four people in particular to tell us about how warm the accommodation is kept. They said that they are always comfortable even during the coldest weather. The accommodation was warm on the day we called. Care workers say that there is a reliable supply of hot water. Sensible steps have been taken to help reduce the chance of someone being burnt or scalded accidentally. The radiators are fitted with guards and hot water taps are temperature controlled. There is a written record to show that the temperature of the hot water taps is being checked regularly. People say that their clothes are well laundered and that they are returned to them promptly. The laundry is equipped with two commercial grade washing machines. One of them has an extra cycle for items that need an especially hot wash. There is also a large dryer. We spoke with the laundry worker. She has a good knowledge of how to use the various cycles on the washing machines so that items receive the cleaning they need. She keeps the laundry organised and clean. The Registered Provider is going to check that she complies with new regulations about preventing used water from leaking back into the main pipe-work. This will be done by 1 September 2008. Highland House Retirement Home DS0000023450.V361112.R01.S.doc Version 5.2 Page 18 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): Standards 27, 28, 29 and 30. People who use the Service experience good outcomes. This judgement has been made using available evidence including a visit to the Service. There are enough staff on duty to meet people’s needs. Part of the recruitment system is not robust. There are some shortfalls in the training programme. EVIDENCE: From early in the morning until later in the evening there are three care workers on duty. There is also the cook. On most days there is also a housekeeper and a laundry worker present. During normal office hours, the Manager and the Client and Staff Liaison Officer are present. The Manager is responsible for the overall running of the Service. The Liaison Officer consults with staff and with the people who live in the Service to make sure that things are going as planned. At night, there are two care workers on waking duty. The Registered Provider completes a number of security checks in relation to new care workers. This is done to ensure that they are trustworthy people who are suitable to have unsupervised access to the people who live in the Service. The records relating to Care Worker A and B were examined. Most of the checks were recorded as having been completed. These included the receipt of Highland House Retirement Home DS0000023450.V361112.R01.S.doc Version 5.2 Page 19 a disclosure from the Criminal Records Bureau. Also, there were two references. However, there were gaps in the employment histories. This meant that we could not be sure that all of the necessary references had been sought. These shortfalls had not been picked up in the Annual Quality Assurance Assessment. There is a Requirement in relation to this matter at the end of this Report. New care workers receive introductory training before they work without direct supervision. After that, they are provided with ongoing training. This is designed to develop further their ability to provide a high quality residential care experience. We looked at some of the records of this extended training provided for care workers. There were gaps. For example, it appeared that nine care workers had not received training in first aid and 10 had not received it in how best to help people get about. The records showed that only two care workers had done training in care planning and only four in relation to skin care. The Manager said that records are not up to date and that she is going to review them. However, this shortfall had not been noticed in the Annual Quality Assurance Assessment. The Registered Provider said that she is going to introduce a new system that is designed to double check the skills and knowledge that care workers already have. She said that this will be completed by 1 September 2008. There are 14 care workers employed in the Service. Eight of them have acquired a National Vocational Qualification (NVQ) in health and social care and five more are studying for the qualification. This qualification is useful because it provides care workers with a range of opportunities to confirm elements of good care practice and to extend their range of skills. We looked at some of the skills and knowledge of two care workers. They had a detailed knowledge of the needs of each of the people in residence. More generally, they knew about things such as how best to help people to promote their continence and how to engage people who have difficulties with their understanding. Highland House Retirement Home DS0000023450.V361112.R01.S.doc Version 5.2 Page 20 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): Standards 31, 33, 35, 36 and 38. People who use the Service experience good outcomes. This judgement has been made using available evidence including a visit to the Service. The Manager has the relevant qualifications. The quality assurance system does not tell people what is going to be done to implement suggested improvements. People are helped to manage their personal spending allowance. Care workers are supervised. There are limited shortfalls in some of the health and safety arrangements. Highland House Retirement Home DS0000023450.V361112.R01.S.doc Version 5.2 Page 21 EVIDENCE: The Manager is in day-to-day charge of the Service. She has both of the qualifications that are required for someone in her role. The qualifications are designed to guide people who manage residential care services in setting up the necessary systems to provide high quality residential care. The Registered Provider does not have the qualifications in question. So far she has not applied to us to consider the Manager for registration in her post. If this arrangement is to continue, the Registered Provider will need to obtain the qualifications herself. With this in mind, the Registered Provider is going to review the situation. This is so that she can tell us how she is going to comply with the relevant Standard. She is going to do this by 1 August 2008. There are various systems used to promote good teamwork. These include handover meetings at the beginning and end of each shift. We looked at one set of the records of these meetings. They showed that an organised approach is used to deciding what needs to be done each day and who will do it. There are regular staff meetings. The last one was held in January 2008. We looked at the records of the meeting. They showed that a number of subjects had been discussed. These included practical things about how best to support the people who live in the Service. Several things are done to consult with people about how well the Service is running. These include informal discussions. Also, new people meet once a week with the Liaison Officer until they are settled in and then once a quarter after that. We looked at three sets of the records of these consultations and noted that the people concerned generally are very happy with how things are going. Relatives are asked to complete questionnaires about once a year. We looked at one of these and again a high level of satisfaction was expressed. The person said, “we are so pleased we chose Highland House for mum, Sue (the Manager) and the team are fantastic and mum has settled in really well making friends. We are made welcome any time of day”. The consultation system does not include members of staff. Also, there is no organised system to tell contributors what is going to be done to respond to any suggested improvements. The Registered Provider is going to address these shortfalls. This will be done in time for the results to be notified to us in 2009, when the Registered Provider submits her next Annual Quality Assurance Assessment. The Registered Provider buys things such as toiletries for some of the people and also pays for their consultations with the hairstylist. This is done at the request of the people concerned and is for their convenience. At set times, their representatives are invoiced for the funds that have been spent. We looked at two sets of records of the various transactions involved. The amounts were for reasonable sums and the entries were in date order. There were receipts for the items of expenditure. We asked two of the people Highland House Retirement Home DS0000023450.V361112.R01.S.doc Version 5.2 Page 22 concerned about the arrangement. They said that they are quite happy with the way in which their personal spending allowances are handled. Each of the care workers meets with the Manager on a planned basis to review their work and to sort out any problems. We asked two care workers about these sessions. They said that they are used to discuss their work and to identify how any additional improvements can be made for the people who live in the Service. Regular checks are completed to ensure that the Service’s fire safety equipment remains in good working order. This includes a weekly test of the fire alarm bells. More detailed periodic checks are completed by a contractor. The monthly checks of the emergency lights and of the fire extinguishers are not being recorded in the correct manner. The Registered Provider said that this shortfall will be addressed without delay. All staff attend an annual fire safety lecture. However, the records do not clearly show that each member of staff has been assessed as knowing how to operate reliably the Service’s fire safety procedure. There is a Requirement in relation to this matter at the end of this Report. There is no programme of unannounced fire drills. There is a Requirement in relation to this matter at the end of this Report. The Annual Quality Assurance Assessment did not pick up these problems with the fire safety system. The electrical wiring system and the gas-fired appliances have been certified as being in a safe-worthy condition. We looked at the record of accidents that have occurred in the Service since the last inspection. There was nothing in the frequency or in the nature of the accidents that caused us to be come concerned. The Registered Provider checks the premises and the accommodation to ensure that there are no hazards that might cause someone to have an accident. We looked at the records relating to one bedroom. These showed that in the recent past three defects had been noted. These included a broken curtain track and a light that was not working. The record showed that the problems had promptly been put right. Highland House Retirement Home DS0000023450.V361112.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 X X 3 X X 3 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 3 X X 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 3 X 2 Highland House Retirement Home DS0000023450.V361112.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. 1. Standard OP29 Regulation 19 (1) Schedule 2 (6) Requirement The registered person shall not employ a person to work at the care home unless ... he has obtained in respect of that person the information and documents specified in paragraphs 1 to 7 of Schedule 2, a full employment history together with a satisfactory written explanation of any gaps in employment- in that, the Registered Provider must ensure that in relation to Care Workers A and B suitably detailed employment histories are obtained. The registered person shall after consultation with the fire authority make arrangements to ensure by means of fire drills and practices at suitable intervals that the persons working at the care home and so far as practicable service users are aware of the procedure to be followed in case of fire including the procedure for saving life - in that, the Registered Provider must ensure that regular DS0000023450.V361112.R01.S.doc Timescale for action 01/06/08 2. OP38 23 (4) (e) 01/06/08 Highland House Retirement Home Version 5.2 Page 25 unannounced fire drills are held and recorded. 3. OP38 23 (4) (e) The registered person shall after consultation with the fire authority make arrangements to ensure by means of fire drills and practices at suitable intervals that the persons working at the care home and so far as practicable service users are aware of the procedure to be followed in case of fire including the procedure for saving life - in that, the Registered Provider must ensure at least once in every period of six months, that all members of staff are competent to operate the Service’s fire safety procedure. 01/06/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Highland House Retirement Home DS0000023450.V361112.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Highland House Retirement Home DS0000023450.V361112.R01.S.doc Version 5.2 Page 27 - 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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