Inspection on 26/04/05 for 109 Higham Road

This inspection was carried out on 26th April 2005.

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.

Other inspections for this house

109 Higham Road 21/01/09

109 Higham Road 15/01/08

109 Higham Road 05/03/07

109 Higham Road 13/01/06

109 Higham Road 12/10/04

109 Higham Road 05/05/04

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Hunter`s Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Higham Road 109 Higham Road Rushden Northants NN8 3AA Lead Inspector Sheila Smith Unannounced 26th April 2005 at 4.00pm 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 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Higham Road Version 1.10 Page 3 SERVICE INFORMATION Name of service 109 Higham Road Address 109 Higham Road Rushden Northants NN8 3AA 01933 358429 01933 358606 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Care Management Group Limited Mrs Hilary Jennifer Watt Care Home 6 Category(ies) of Learning Disability (LD) registration, with number of places Higham Road Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: To include 2 service users over the age of 65 years LD(E) Date of last inspection 12th October 2004 Brief Description of the Service: 109 Higham Road is a care home providing accommodation and personal care for six adults with a learning disability, owned by Care Management Group Ltd. It is situated close to Rushden and to Higham Ferrers town centres and is in close proximity to all local amenities, with good transport links by bus to Wellingborough and Northampton.Higham Road is a detached house in a residential street with a pleasant rear garden. All residents are accommodated in single bed rooms. Communal areas consist of a lounge, a pleasent dining room overlooking the garden, and a kitchen.The garden is enclosed and used during the summer for barbecues and other outside activities. Higham Road Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection of 109 Higham Road was carried out over 4.5 hours; the home is registered for six residents and currently has one vacancy. The Registered Manager is Mrs Hiliary Watts who was present during this unannounced inspection, with one member of staff caring for five residents. . The inspection consisted of individual discussions with the residents, discussion with the Registered Manager and member of staff, a tour of the home, and observation of records, including two of the resident’s personal files. What the service does well: Higham Road is a family home where the residents live as a family and have full access to all areas of the house. Residents are encouraged to contribute ideas to the running of the home through meetings with the staff. The provider company, involve the residents in discussing wider national issues, and one resident was enthusiastic in reporting her trip to a forum held for residents in London, where she was involved in discussions regarding issues such as making friends and holidays. The home was decorated to a reasonable standard and the residents’ bedrooms that were inspected were personalised containing, personal items, and had been decorated in colours chosen by the residents. The home had a warm relaxed and comfortable feel to it, with a dining room bright and airy, overlooking the garden, and a cosy lounge which contained comfortable furniture. Residents were very positive about the services provided which include meals, personal care, activities, and also about the support that they receive from the staff, to maintain their independence. On the evening of the inspection relationships between residents and the staff were observed to be very good. Holidays and weekends away from the home are seen as a very important aspect of the overall care, provided in this home. Residents were very excited about a forthcoming ‘mystery’ holiday that they were going on for two weeks shortly, and had been involved in choosing and buying clothes and other essential holiday items. Higham Road Version 1.10 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 full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Higham Road Version 1.10 Page 7 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 Standards Statutory Requirements Identified During the Inspection Higham Road Version 1.10 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 Resident’s needs are assessed prior to admission, and at regular periods following admission, so that residents and their representatives know that the home will be able to meet their needs. EVIDENCE: Two personal files were examined during the inspection. The assessment process has been revised in line with the required standards including an information gathering process, a pen picture and the resident’s personal lifestyle preferences. Comprehensive assessments had been completed covering areas such as Health, psychological needs, emotions, communication, sexual needs, community presence and participation, education, and relaxation. The format of the reporting was clear, and did not contain language that could not be understood by the residents. A review of the assessment had recently taken place, and resident’s actual comments taken during the review had been recorded. Adverse behaviour had been discussed with the residents, and any restrictions agreed. Other professionals had been contacted to contribute their assessments to the overall process. A new resident is due to be admitted shortly, who has already spent some time at the home and the Registered Manager demonstrated an awareness of the need for compatibility with the other residents and of the need to take account of the needs of the family Higham Road Version 1.10 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,9 Care planning is clear, comprehensive and reviewed regularly, so that staff are clear about their responsibilities in meeting residents needs. . Risk assessments are appropriately documented and residents can take risks in order to promote their independence. EVIDENCE: The Care Plans have been developed from the original assessment and referred to the relevant areas. The plans documented physical care needs including reference to the personal care required and oral and foot care. References were made to Psychological, emotional and behavioural needs. and advice regarding how to deal with certain behaviour had been obtained from other professionals. Account was taken of residents preferred lifestyle routines, and likes and dislikes were recorded. Resident’s stated that routines were relaxed and in accordance with their wishes and that their care needs had been discussed with them. Case records evidenced that risk assessments are undertaken to a good degree and strategies of management were in place to eliminate or minimise Higham Road Version 1.10 Page 10 risk including behavioural management strategies. Resident’s comments and observations made during the inspection, evidenced that staff provide support, guidance and training to assist residents to manage their own personal safety. The Home has a comprehensive, appropriate missing persons procedure, with individual descriptions of the residents. Higham Road Version 1.10 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13,15,17 Residents are given opportunities for accessing the local community, and encouraged to make friends and maintain family relationships, which leads to a fulfilling lifestyle. Nutritious meals are served in a happy, relaxed atmosphere with staff sensitively assisting where required, providing variety and choice EVIDENCE: Taking the residents out of the home is an important part of the overall care that the residents receive. A mini bus is available to provide transport to the town centres of Kettering, Wellingborough, Higham Ferrers and Rushden, where the residents visit shops, pubs and restaurants. Assistance is given to attend the local polling station and residents were aware of the forthcoming general election, polling cards had been delivered. The residents attend at least two holidays a year, plus weekends away, and were eagerly looking forward to a two week ‘Mystery’ holiday taking place shortly. Higham Road Version 1.10 Page 12 Residents are free to make relationships as they so choose. Family and friends are welcomed in the home and are encouraged to become actively involved with their relatives life at the home. One resident said that she looked forward to visits from her sister, and staff had recorded strategies to ensure that the visits are a positive experience for both the resident and her sister. Menus are agreed with the resident’s on a regular basis, with guidance to ensure that a balanced diet is taken. Meals include a cooked meal every day and snacks are always available. Residents confirmed that the meals were well cooked, and appetising. Meals are mainly taken in the dining area to promote a family ethos, and staff were observed sitting with the residents sensitively assisting and guiding residents where necessary. Barbeques are held in the garden during the summer months. Weight gain/loss is monitored with action taken in consultation with users where problems are identified. Higham Road Version 1.10 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19 Guidance and assistance with healthcare needs and personal support is offered in such a way that it promotes residents rights to privacy, dignity and independence. EVIDENCE: Resident’s physical and emotional needs are met through communication with the residents, the assessment, individual plans of care, and seeking advice of other professionals. A member of staff spoken to demonstrated that he had a good understanding of privacy, dignity and independence. Observations made during the inspection, and the residents comments, confirmed that staff offered care in the way that residents preferred. The Registered Manager and carer on duty, was observed having friendly conversation with residents throughout the inspection, which were appropriate and informal with residents responding in a relaxed way. Staff were observed to take time to communicate with one of the residents who had limited communication to ensure that her wishes were heard Whilst the weekday routines need to be fairly rigid to accommodate day care attendance, a resident confirmed that routines at weekends were flexible and said ‘I can have a lie in the mornings.’ Higham Road Version 1.10 Page 14 Records indicated that healthcare needs were identified and appropriate advice was sought from the relevant professionals. The Registered Manager confirmed that all of the residents were registered with a local General Practitioner, and that the home received good support from the local surgery. There was evidence within the files that residents received regular care from the optician, chiropodist, and dentist, and the Registered Manager confirmed that they received annual medical checks. Higham Road Version 1.10 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23 Complaints are handled objectively and residents were confident that their complaints would be handled sensitively and responded to. Residents are protected from abuse by the homes policies and procedures, and staff training. EVIDENCE: The complaints procedure was clear and written in a format that the residents could understand. The Registered Manager said that a record of complaints was kept although it was not examined on this occasion. A resident indicated that she would complain to the Registered Manager if she had a complaint. The home has a vulnerable adults procedure and there is a copy of the local Northamptonshire inter agency policy and procedures available. A member of staff demonstrated that he was aware of his responsibility for protecting residents from abuse An allegation of poor practice last year was referred appropriately, and although the outcome was inconclusive, recommendations made, were instigated; including all staff receiving training in adult protection / abuse and whistle blowing. Policies regarding resident’s finances were seen to be robust, and a check of one resident’s cash against the records was found to be correct. Higham Road Version 1.10 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,30 The home provides a comfortable environment, which was clean and hygienic, and residents are able to express their individuality in personalising their own rooms. EVIDENCE: Since the last inspection two of the bedrooms have been redecorated and refurbished. The kitchen has been retiled, and a new cooker installed. Comments made at the last inspection regarding outside paintwork and the state of the windows have still not been addressed, so that the home is beginning to stand out against others in the area. (A requirement has been made). The garden requires attention so that the residents can enjoy the warmer weather (A requirement has been made) All of the residents are accommodated in single rooms, and although there are no en-suite facilities there is a washbasin in each room. Residents expressed their satisfaction with their rooms and said that they had been involved in choosing the colour of the paintwork. Residents were also keen to show their personal possessions, which included televisions, video and DVD players, stereo music players and a computer. One resident commented ‘ This is a good home and I have a nice clean room’. Higham Road Version 1.10 Page 17 A new boiler had been installed and radiators to the top floor. No radiators have been covered, to prevent the residents being burnt should they fall against them. (A recommendation has been made) The premises were observed to be safe and generally well maintained with hygiene and domestic standards being satisfactory. The laundry is situated in an outhouse at the rear of the building and the home has appropriate policies in place to control the spread of infection. Higham Road Version 1.10 Page 18 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34, 35 Residents are supported and protected, by the company’s robust recruitment and induction policies. Formal staff training to meet the sector skills workforce targets, has not been developed, which could potentially lead to the people who use the service to be at risk, because staff fail to understand their needs and respond appropriately. EVIDENCE: Discussion with residents and observations made during the inspection indicated that they were relaxed and comfortable with the staff on duty. One resident commented that she liked most of the staff although had a few minor problems, this matter was discussed with the Registered Manager who said that she was aware of the difficulty and was dealing with it. One file examined, of a newly appointed person demonstrated that the company carried out a robust recruitment policy which included two written references, satisfactory Criminal Reference Bureau, and Protection of Vulnerable Adults checks, followed by an induction. A member of staff interviewed, said that he had been issued with a general Social Care Council code of practice, and had a copy of the terms and conditions of his employment. Higham Road Version 1.10 Page 19 One resident interviewed said ‘I like the staff, and they take me for walks in the park, or to the pub’. The Registered Manager said that difficulties within the training scheme of the company had meant a delay in staff receiving formal training, but that this matter had now been resolved. There was no training or development plan available. (A recommendation has been made.) The member of staff interviewed said that he was keen to update his skills and to pursue both mandatory and specialist training. The Registered Manager said that regular staff supervision takes place, and the member of staff confirmed this. Higham Road Version 1.10 Page 20 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42. The well being, health and safety of the residents is promoted, and protected through staff observations and actions, policies and procedures. EVIDENCE: Accident records were viewed, and were noted to be satisfactory. The fire logbook demonstrated that the fire alarm was tested on a regular basis, and water temperatures are regularly tested and recorded. General risk assessments were available .The home has a clinical waste agreement in place and control of substances hazardous to health regulations were available for staff. Regular health and safety inspections of the home are carried out by staff using a checklist to ensure all areas are covered. A member of staff commented that he had received comprehensive health and safety training during his induction, and demonstrated that he knew the fire drill, should a fire start in the home .The member of staff also said that faulty equipment is repaired or replaced quickly, and that there was a good supply of disposable aprons and gloves available for staff to use when assisting residents with personal care. Higham Road Version 1.10 Page 21 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. Where there is no score against a standard it has not been looked at during this inspection. 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 3 Standard No 11 12 13 14 15 Higham Road x x 3 x 3 Standard No 31 32 33 34 35 36 Score x x x 3 2 x Version 1.10 Page 22 16 17 x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x Higham Road Version 1.10 Page 23 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 24 Regulation 23 (2) (d) Requirement A maintenence plan must be submitted to local office of Community Social Care inspection The garden must be maintained. Timescale for action 1-07-05 2. 24 23 (2 )(h) 1-07-05 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. 2. Refer to Standard 24 35 Good Practice Recommendations Consideration should be given to covering the radiators. A training needs assessment, and plan should be available Higham Road Version 1.10 Page 24 Commission for Social Care Inspection 1st Floor, Newland House Campbell Square Northampton NN1 3EB National Enquiry Line: 0845 015 0120 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 Higham Road Version 1.10 Page 25 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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