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Inspection on 13/02/06 for 27 Highfield Road

Also see our care home review for 27 Highfield Road for more information

This inspection was carried out on 13th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

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

Residents appeared content, this briefly confirmed by one resident who stated they had no complaints and was satisfied with the service provided. Overall the homes documentation in respect of the residents with very few exceptions was maintained to a high standard. Highfields Road is a comfortable and homely environment that as far as possible resembles a domestic style living environment. Assessments of any risks presented to the residents and staff are well documented and clear. Observation of interaction between staff and the residents at the time of the inspection, and examination of care records indicate that the service provided is meeting the needs of the residents at the home and that staff are well supported by a committed and experienced manager.

What has improved since the last inspection?

The home has fully or partly addressed all the requirements raised at the time of the last inspection of the home with all issues identified in respect of obtaining consent to medication, gaining signatures on lifestyle agreements, completing incident forms as necessary satisfied. The homes training plan was also seen to now better identify training required with dates for the majority of the training needed made available by the manager to the inspector. The home is now beginning to record any limitations on the residents far more clearly.

What the care home could do better:

There is a need to develop personal care planning in the form of resident`s individual books, although to enable staff to be able to commence this work appropriate training needs to be provided. There is also a need to provide additional NVQ level 2 training to staff. The home needs to send out questionnaires for stakeholders such as social workers, health authority staff and such like in addition to those completed with residents and sent to relatives. There is still some concern that a resident has access to the kitchen whilst staff are cooking, with agreement that this is to be kept under review. The manager was also advised to take more care with disposal of potentially confidential information.

CARE HOME ADULTS 18-65 27 Highfield Road Colley Gate Halesowen West Midlands B63 2DH Lead Inspector Mr Jon Potts Announced Inspection 13th February 2006 09:20a 27 Highfield Road DS0000025001.V276525.R01.S.doc Version 5.1 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 27 Highfield Road DS0000025001.V276525.R01.S.doc Version 5.1 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 Adults 18-65. 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. 27 Highfield Road DS0000025001.V276525.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 27 Highfield Road Address Colley Gate Halesowen West Midlands B63 2DH 01384 410581 NONE 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) Inshore Support Limited Anita Webb Care Home 3 Category(ies) of Learning disability (3), Mental disorder, registration, with number excluding learning disability or dementia (3) of places 27 Highfield Road DS0000025001.V276525.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 3 MD and up to 3 LD Date of last inspection 24/10/05 Brief Description of the Service: 27 Highfield Road is situated in a residential area of Colley Gate, Near Halesowen. The home is registered to provide care to a maximum of three service users who have been diagnosed as having a learning disability and/or mental disorder. The home is in a favourable position as it is located in a residential area yet; it is close to a main road with a bus route a number of shops and other amenities. The home is a large, traditional, domestic type dwelling, comprising of two lounges, three single bedrooms, a kitchen come dining room, a first floor bathroom and a separate shower room. The garage has been converted into usable space, which has become the office. There is also a small and pleasant private patio area to the rear. As on previous inspections, the inspector was impressed with the home regarding its internal fixtures, fittings and furniture. The home is of a generous size, is well presented, well maintained, is clean, homely and has a warm welcoming atmosphere. 27 Highfield Road DS0000025001.V276525.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out between 9.20am and 12.45pm and involved the registered manager and discussion with staff. The inspector met two residents. Information/evidence was drawn from limited case tracking, staff files; sight of documents, policies and procedures, a pre inspection questionnaire, comment cards from relatives and through discussion with the manager and some staff. What the service does well: What has improved since the last inspection? What they could do better: There is a need to develop personal care planning in the form of resident’s individual books, although to enable staff to be able to commence this work appropriate training needs to be provided. There is also a need to provide additional NVQ level 2 training to staff. The home needs to send out questionnaires for stakeholders such as social workers, health authority staff and such like in addition to those completed with residents and sent to relatives. There is still some concern that a resident has access to the kitchen whilst staff are cooking, with agreement that this is to be kept under review. The manager was also advised to take more care with disposal of potentially confidential information. 27 Highfield Road DS0000025001.V276525.R01.S.doc Version 5.1 Page 6 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. 27 Highfield Road DS0000025001.V276525.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection 27 Highfield Road DS0000025001.V276525.R01.S.doc Version 5.1 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 the following standard(s): 5 Each service user has an individual written life style agreement with the home. EVIDENCE: There was evidence in case files of residents having a contract (called a lifestyle agreement) this setting out terms and conditions as well as costings in respect of the individual service users care. Whilst the actual contract is not at this time in pictorial format there is a pictorial summary of the tasks the staff are to complete for the service user, and the resident’s relatives have now signed all the contracts. 27 Highfield Road DS0000025001.V276525.R01.S.doc Version 5.1 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 the following standard(s): 7,8,10 Residents were seen to be supported in making decisions about their lives. The home has methods for allowing residents to participate in many aspects of life in the home. Information about residents is handled appropriately with most practices in place preserving confidences, with the exception of procedures for disposal of documentation. EVIDENCE: The residents’ were seen on the day of the inspection to be involved with making day-to-day decisions with the assistance of the staff on duty and there is documentation in place in the form of risk assessments and more recently, very clear information on limitations that details where residents involvement maybe limited due to such as risk. There are regular reviews by the resident’s social workers that also seen to consider the way in which residents are to be supported in the decision making process. One relative commented via comment card that they were kept informed of any important matters. The 27 Highfield Road DS0000025001.V276525.R01.S.doc Version 5.1 Page 10 funding bodies and parents have involvement in the resident’s financial affairs, with the home not acting as an appointee. The home is using resident and relative satisfaction survey forms on an annual basis. Although there is no current formal representation of residents on such as management committees the residents do have access to the providers through regular visits and it was stated that any prospective staff do meet residents as part of the recruitment process. Resident’s reactions to prospective staff, or the attitude of applicants would be considered at this point. There was much written evidence in case files to indicate time is taken to ascertain residents views with this informing policy development. This could be further developed with individual residents having Personal care planning, staff needing training in this area. There was evidence of the home continuing to develop documentation in formats appropriate for the needs of the residents. The home was seen to have appropriate policies and procedures in respect of handling of residents information with a clear statement in the case files to inform as to who will have access to the information. The use and handling of information is covered in the induction training for staff, this received by them early on in their employment. There was evidence seen from sight of the case files of one services users signature on some documents. The organisation is known to have communicated its stance on confidentiality to other organisations in the recent past. There was some concern however that some documents relating to residents (old contracts) had been ripped up and put in the waste bin. Such documents must be disposed of so as to ensure confidentiality with use of such as a shredder. 27 Highfield Road DS0000025001.V276525.R01.S.doc Version 5.1 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 the following standard(s): None of the above outcomes were fully assessed at the time of this inspection. EVIDENCE: See comments above 27 Highfield Road DS0000025001.V276525.R01.S.doc Version 5.1 Page 12 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 the following standard(s): 18 Resident’s choices in respect of their physical health could be better documented in some cases. EVIDENCE: There was in most cases clear evidence that the residents were assisted to access health services whether specialised or pertaining to routine health not associated with their learning disability. One of the residents had not however seen a dentist recently, this stated to be a matter of choice by the resident, as she would be uncomfortable with such an examination. Whilst this maybe justified, and was correlated by information and assessments in the case file the manager was advised to document this clearly within the case file. The inspector saw two of the residents and all looked well presented and healthy. 27 Highfield Road DS0000025001.V276525.R01.S.doc Version 5.1 Page 13 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 the following standard(s): None of the above outcomes were fully assessed at the time of this inspection. EVIDENCE: See comments above 27 Highfield Road DS0000025001.V276525.R01.S.doc Version 5.1 Page 14 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 the following standard(s): 24,25,26,27,28,29 27 Highfields Rd is a comfortable and overall safe environment that is suitable for the residents accommodated. The resident’s bedrooms are suitable for individual lifestyles, bathrooms and toilets promote privacy, and shared spaces complement and supplement their needs. EVIDENCE: The home is sited in a suitable position and presents as a homely environment in keeping with the provision of ‘normal’ domestic style living. There is no indication that the house is anything other that a domestic home, this ensuring that it blends into the immediate community. The home has a redecoration and refurbishment programme identifying works for the next twelve months. There was evidence of the home having received some redecoration and refurbishment since the time of the last inspection. All the communal living areas within the home presented as being comfortable and clean and there is access to an outdoor area to the rear of the house. The only area that needed attention was the worktop by the kitchen window, which was slightly damaged. The manager stated that this is to be replaced in the very near future. 27 Highfield Road DS0000025001.V276525.R01.S.doc Version 5.1 Page 15 The home is suitable for the needs and lifestyle of the residents with the exception of the following. Risk assessment has identified a need for some form of division between the dining area and the kitchen as necessary, this as there are potential dangers of one resident hurting herself or staff whilst cooking is in progress. The actions taken by staff since the last inspection have improved this situation and reduced the risk present (this fully documented in a risk assessment). It was agreed that whilst the provision of a permanent barrier may not improve the situation, the risks present need to be kept under review. Resident’s bedrooms were seen and were well presented, with items of furniture provided where necessary on a risk assessment basis. One resident confirmed that she had all the furniture she wanted in her room and that she was very happy with it. There was seen to be sufficient toilets and bathrooms available for the residents around the house, some of these recently fitted with new flooring. Where necessary appropriate adaptations have been carried out (i.e. providing covered radiators to protect against hot surfaces). 27 Highfield Road DS0000025001.V276525.R01.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35 The homes training plan identifies where there is input needed in respect of staff training. EVIDENCE: The home was seen to have a training plan that clearly identified training staff held, what was booked and what was needed. There were areas where training that is still needed for some staff has been identified within the plan. The home is still to achieve 50 of staff trained in NVQ 2 or 3 and in light of this a number have enrolled or are to enrol. Whilst there is training input needed in some areas the home has clearly identified where and for whom this training is required, with the manager having some awareness of the timescales for when it would be provided. The home was seen to have a structured induction programme in place with an external training company providing input into accredited induction training. 27 Highfield Road DS0000025001.V276525.R01.S.doc Version 5.1 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39, 42 The views of residents and relatives are taken into account by management. Self-monitoring of the service is also improving. The health, safety and welfare of residents is promoted and protected. EVIDENCE: The home was seen to have a system for monitoring where by a manager from head office visits the home on a monthly basis to carry out an audit on a number of standards. This has shown to be effective in identifying a number of issues and indicates that the organisation is moving towards better selfmonitoring although the standards that are currently assessed would benefit from expansion (this a matter in respect of which senior manager’s are consulting with CSCI). The home was seen to have regular consultation with residents and relatives via questionnaires although this would benefit from expansion to include the full range of stakeholders for the service such as social services departments, health personnel and so on. There was a clear business/development plan available, with evidence of the home working 27 Highfield Road DS0000025001.V276525.R01.S.doc Version 5.1 Page 18 towards reaching identified aims although this needs to be available to all the users of the service in an abbreviated format, this report also to include findings from consultation exercises. Various record in respect of safe working practices were sampled during the course of the inspection this including accident books, other inspection bodies reports, training records, risk assessments and maintenance documentation. The documentation was found to be to a good standard and was consistent with policies and procedures. The only area of concern was in respect of the documentation of staff involvement in fire drills. 27 Highfield Road DS0000025001.V276525.R01.S.doc Version 5.1 Page 19 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 X 2 X 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 X ENVIRONMENT Standard No Score 24 2 25 4 26 4 27 4 28 4 29 4 30 X STAFFING Standard No Score 31 X 32 X 33 X 34 X 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X 3 3 X 2 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 2 X x X X 2 X X 2 X 27 Highfield Road DS0000025001.V276525.R01.S.doc Version 5.1 Page 20 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. 2. Standard YA24 YA32 Regulation 23 18 Requirement To replace the kitchen worktop that is damaged. To continue with staff training in NVQ level 2 so as to enable the home to have 50 of staff so trained. To provide staff with appropriate training in personal care planning. To continue developing the homes systems for selfmonitoring. To ensure staff involvement in fire drills is fully documented. Timescale for action 31/04/06 30/08/06 3. 4. 5. YA35 YA39 YA42 18 24 18 30/06/06 30/06/06 15/03/06 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 YA10 YA19 Good Practice Recommendations To purchase a shredder or take other steps to ensure that confidential documents are disposed of correctly. To ensure that where residents are not seeing certain health professional for valid reasons (i.e. choice) that this is fully and clearly recorded and agreed with the resident DS0000025001.V276525.R01.S.doc Version 5.1 Page 21 27 Highfield Road 3. 4. YA24 YA39 or representative. To keep the actions taken to reduce the risk to resident K.B due to access to the kitchen at certain times of the day (when staff are cooking) under review To seek the views of any stakeholders for the service through such as questionnaires and make these views available to others in a public report. 27 Highfield Road DS0000025001.V276525.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Halesowen Record Management Unit Mucklow Office Park, West Point, Ground Floor Mucklow Hill Halesowen West Midlands B62 8DA 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 27 Highfield Road DS0000025001.V276525.R01.S.doc Version 5.1 Page 23 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!