Inspection on 19/01/07 for High Hurlands Nursing Home

This inspection was carried out on 19th January 2007.

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

High Hurlands Nursing Home 25/01/06

High Hurlands Nursing Home 02/08/05

High Hurlands Nursing Home 15/02/05

High Hurlands Nursing Home 22/11/04

High Hurlands Nursing Home 02/03/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 High Hurlands Nursing Home Nr Passfield Liphook Hampshire GU30 7RY Lead Inspector Ms Jan Everitt Key Unannounced Inspection 19th January 2007 09:30 High Hurlands Nursing Home DS0000012133.V322973.R01.S.doc Version 5.2 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 High Hurlands Nursing Home DS0000012133.V322973.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 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. High Hurlands Nursing Home DS0000012133.V322973.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service High Hurlands Nursing Home Address Nr Passfield Liphook Hampshire GU30 7RY 01428 7510202 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) High Hurlands Partnership Mrs Gillian Derbyshire Care Home 22 Category(ies) of Learning disability (22), Physical disability (22) registration, with number of places High Hurlands Nursing Home DS0000012133.V322973.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users may be accommodated over the age of 16 years Date of last inspection 25th January 2006 Brief Description of the Service: High Hurlands nursing home is a well-established service providing care and support to twenty-two young adults with learning disabilities. The service users have very complex needs that can require medical and nursing interventions. Staffing is provided twenty-four hours a day and has links with local General Practitioners and nursing team to support and enhance the service provided. The home is owned and operated by High Hurlands partnership. The home is situated in a rural part of the Hampshire country side and transport facilities are provided for service users to access local facilities in the nearest village of Liphook and larger towns in the area. Fees £1.200 - £1.463 per week Additional charges include: All external activities in the community that service users choose to take part in. Holidays. Hairdressing. Dry cleaning. Internet access. Specialist equipment for which provision is not made in the care plan. High Hurlands Nursing Home DS0000012133.V322973.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced site visit to High Hurlands Nursing Home took place on 19 January 2007 over a period of one day and involved service users at home on the day, one of the partners and staff on duty. The registered manager was not on duty at the time. This report details the results of an evaluation of the quality of the service provided by High Hurlands Nursing Home and brings together accumulated evidence of activity in the home since the last key inspection on 25 January 2006. The visit to High Hurlands formed part of the process of the inspection of the service to measure the service against the key national minimum standards for Younger Adults for the year 2006/7. The judgements made in this report were made from the visit to the home, information gathered prior to the visit from the link inspector, pre-inspection information submitted to the commission by the registered manager, information from the previous report, the service history correspondence, registration activity, touring the home and viewing records. People who use the service have been consulted with and this has been done by questionnaire surveys sent to service users, relatives, other visiting professionals including GPs, staff questionnaires and talking to service users and staff at the time of the inspection visit. Owing to the disabilities of the service users they were unable to respond to the survey questionnaires. Relatives survey questionnaires were not received. Twelve care managers were sent the survey questionnaires but none were received by the CSCI. Two visiting professionals responded to the survey questionnaire very positively. The inspector spent time observing service users, watching how staff members were supporting them. The inspector spoke to staff members throughout the day. Records held in the home were also looked at and these included the service users care plans and information on activities, staff records and quality assurance questionnaires. What the service does well: High Hurlands Nursing Home DS0000012133.V322973.R01.S.doc Version 5.2 Page 6 The home is run for the benefit of its service users and provides good quality care in a homely environment. The home is clean, well maintained and decorated to a high standard. The home is comfortable and relaxed and had a very open and friendly atmosphere. The home has a comprehensive pre-admission procedure that includes the multidisciplinary team and relatives. The inspector saw a very well organised activity programme that helps every person to spend time doing things that they like to do. The home has a day centre on-site that all service users attend for some part of the day to undertake favourite activities or swimming. The home is very well equipped with a lot of different spaces to take part in activities. Staff are provided with appropriate training to enable them to fulfil their roles. The service users are well cared for and trusting relationships exist between carers and service users. The home is managed well and a quality assurance system is in place to ensure the home is consistently meeting the standards. What has improved since the last inspection? What they could do better: Two recommendations were made from this report with regards to the record keeping for the administration of medication and the oxygen notice. There were no other areas for improvement identified on this occasion. High Hurlands Nursing Home DS0000012133.V322973.R01.S.doc Version 5.2 Page 7 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. High Hurlands Nursing Home DS0000012133.V322973.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection High Hurlands Nursing Home DS0000012133.V322973.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service user’s individual aspirations and needs are assessed prior to living in the home. EVIDENCE: The inspector viewed a sample of service user’s care plans. There was evidence of a comprehensive pre-admission assessment undertaken by the home. Many of the service users have been living in the home for a considerable number of years and their care needs have evolved with age and the care plans are reviewed accordingly to ensure their needs are met. The last admission to the home was 2005 but the partner assisting the inspector, informed her that the home is in the process of assessing and admitting a service user within the next month. The inspector viewed the extensive pre- assessment documentation for this person. The records demonstrated that the home and care manager have liaised and that the potential service user’s parents have visited the home several times. The manager has visited the potential service user in their own home and assessed their needs. The partner then described the next step in the process would be for the young person to visit the home on several occasions and each time for High Hurlands Nursing Home DS0000012133.V322973.R01.S.doc Version 5.2 Page 10 a longer period culminating in an invitation for an over-night stay. The care manager remains involved with the placement and a six-week review is undertaken following admission. High Hurlands Nursing Home DS0000012133.V322973.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A well-developed and comprehensive care planning process demonstrated that the home is identifying and responding to service user’s complex needs. Service users are supported within their capacity to make decisions about their life. Service users can take risks within an assessment framework. EVIDENCE: The inspector sampled four service users plans during the visit. Each of these plans had individual detailed care plans for a wide range of interventions. High Hurlands Nursing Home DS0000012133.V322973.R01.S.doc Version 5.2 Page 12 Instructions to staff are clear and these are kept under regular review. Information on how to support the service users with personal care, health and medical needs, communication, activities, social interaction, sexuality and behaviour are all covered within these plans. The care plans encourage staff to interact and involve each person in decision making. The staff demonstrated that they engage and involve the service users to the best of the service user’s abilities. The pre-inspection document recorded that some service users have various ways of communicating their needs and wants by eye pointing, symbols, makaton. The inspector observed that the carers were able to communicate well with the service users in various ways. The inspector observed a staff member reading care plans and he informed the inspector that he was looking for guidance on how to move a service user to the toilet. The home demonstrates that the care plans are working documents that inform the day-to-day practices and staff sign the care plans as evidence that they have been read. An additional document provides a picture of the person, their dreams, likes and dislikes and goals, which have been completed by key-workers and family members. Comprehensive guidelines are in place for moving and handling and physiotherapy session, supported by photographs. There are also photographs to detail the service user’s position on certain pieces of equipment that is used to improve posture. The inspector also looked at the intervention strategies for one service user who has a large enclosed bed area within their room. The manager explained that this is required to keep the person safe and has been agreed by the social worker and family. Evidence of discussions and agreement for this practice is on file and the home has supported this with a risk assessment. Risk assessments and strategies to minimise risks are also in place, which include medication, transportation, community access, moving and handling, pressure care and health concerns. These are kept with the care plans and are reviewed monthly. High Hurlands Nursing Home DS0000012133.V322973.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from the provision of a well organised activity programme enhanced by contact from families and friends. Service users integrate into the local community. Service users are offered a varied and wholesome diet and their nutritional needs are met in pleasant surroundings. EVIDENCE: High Hurlands Nursing Home DS0000012133.V322973.R01.S.doc Version 5.2 Page 14 The home provides a day service for service users. There are individual programmes of daily activities for all service users. The hydrotherapy pool, which is on-site, is a great favourite with service users and there is a full programme for the use of it. The inspector saw evidence of regular activities within service users plans and one service user told the inspector that she enjoyed all of the group activities that she attended. The inspector observed photographs around the home of the service users using the hydrotherapy pool and enjoying the freedom of movement with the assistance of the physiotherapist and other members of staff. There were other photographs on show that recorded some of the service users enjoying horse riding and carriage rides around the grounds in the better weather. The home is fortunate to have the use of the horses that are owned by the family partners, which are kept in the surrounding fields. The home has the use of three minibuses and on the day of the inspection all buses were being utilised to take service users out to various venues in the community. The local shops, clubs and leisure centres are utilised by service users. Shopping trips, meals out and swimming trips are recorded. During this visit the inspector observed staff interacting positively, explaining what they were doing and encouraging service users to participate as fully as possible in the activity. The inspector saw information on activities with clear goals for service users. From examining the records the inspector confirmed that some service users have regular contact from their families and go home at regular intervals. Contact details are on file and care plans provide guidance on how to maintain contact and encourage interaction from service users. The partner reported to the inspector that some families are more involved with the home than others but support and contact with families is always welcome. The inspector observed from viewing service user’s bedrooms, that family photographs were evident throughout the home. Families are invited to be involved in all reviews. The inspector enquired about the formation of meaningful relationships for these young people. The partner explained that it is difficult for them to form close physical and emotional relationships, but as with a recent death of a service user, the reaction from other service users to this happening can manifest itself in unusual behaviours. High Hurlands Nursing Home DS0000012133.V322973.R01.S.doc Version 5.2 Page 15 A menu plan, which is five weekly, was discussed with the cook and partner. The cook confirmed that a balanced and varied diet is offered to service users and they enjoy spicy food. The inspector observed the lunchtime meal being served and found it to be well presented. A number of service users need a liquidised meal and the home makes sure that all parts of the meal are liquidised separately. The inspector observed that carers were giving assistance with the feeding in a sensitive way and talking to service users and discussing what they were eating. A number of service users were able to feed themselves with hand over hand assistance, allowing them a degree of independence. A high proportion of the young people living in the home need to be fed by a Percutaneous Endoscopic Gastrostomy (P.E.G) tube. The inspector saw staff support these individuals in an appropriate and sensitive manner. High Hurlands Nursing Home DS0000012133.V322973.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home provides support for service users to access Health Care professionals to meet their needs. Personal support is given in a way that respects the privacy and dignity of the individual. Safe policies and procedures are in place for the management of the service user’s medication. EVIDENCE: Whilst touring the home the inspector observed that service users were supported to be independent as possible. The inspector admired the numerous pieces of pottery that adorned many areas of the home. A support worker, spoken with, explained that the service user works the pottery with hand-overhand support from a carer. High Hurlands Nursing Home DS0000012133.V322973.R01.S.doc Version 5.2 Page 17 Privacy and gender preferences are taken into consideration when allocating work. The home has an equal proportion of male and female support workers and therefore, it is not always possible to give same gender care. Service users are not able to advocate for themselves and if parents request same gender care this has to be managed sensitively as it is not always possible. The home has clear statements on the rights of service users including privacy and dignity. Service users are supported to receive treatments and to meet visitors in private. Routines are flexible and there are no set times for going to bed or getting up in the morning and service users preferred routines for the activities of daily living are clearly documented in care plans. The care plans demonstrated that each service user’s medical and health care needs are responded to appropriately. Each person is registered with a general practitioner and physiotherapy support is also provided to the home twice a week. A nutritional assessment is undertaken on service users and weights recorded monthly. A dietician will visit the home to monitor those who receive PEG feeding and any other service user who the home has assessed as having nutritional problems. The home has clear policies and procedures for the safe management of service user’s medication. There are no service users able to choose to selfmedicate. The registered manager is responsible for the ordering and management of medication The inspector viewed the medication administration recording sheets. It was observed that there were some gaps in the recording and this was discussed with the senior nurse on duty. She reported that she will identify the concerned nurse and discuss this at supervision, which may identify training needs. A recommendation will be made. The crushing of medication does take place. The inspector evidenced statements for service users and written agreement by the pharmacist for this to take place. The home has a waste contract for the disposal of medication in need of disposal. The registered nurse demonstrated a good knowledge of the legality and procedures for this. The inspector observed that the medication trolley and cupboards were well organised and clean and there was no evidence of any over-stocking of any medication. High Hurlands Nursing Home DS0000012133.V322973.R01.S.doc Version 5.2 Page 18 Oxygen cylinders are stored appropriately and a notice is on the door identifying this gas is being stored. It was observed that an oxygen cylinder has been left in a service user’s room and no notice on the door indicating its use. The partner reported that this is usually taken out of the room following therapy and stored correctly. A recommendation will be made to display a notice on the bedroom door when it is in use. The registered nurse reported that the service users’ medication charts are generally reviewed annually by the GP or before if requested. High Hurlands Nursing Home DS0000012133.V322973.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints procedures are in place demonstrating that the views and concerns of service users, their families and representatives are recorded and responded to. Service users are protected from abuse, neglect and self-harm. High Hurlands Nursing Home DS0000012133.V322973.R01.S.doc Version 5.2 Page 20 EVIDENCE: The home has a clear complaints procedure. This is on display in the home. The inspector viewed the homes complaint’s log and one complaint had been recorded. The complaint had been dealt with by the manager and quickly resolved with the parent. The action taken had been recorded. The partner reported that small issues are sometimes raised in the yearly quality assurance returns and these are also recorded and how the issues have been dealt. The complexity of the needs of service users living in the home means that it would be difficult for them to communicate concerns. Communication plans are in place with the service users plan to indicate how each person would communicate when unhappy or distressed and what staff should do when this happens. The partner discussed this and reported that staff become very familiar with the young people’s moods and that they would identify quite quickly if there were something wrong by a look or behaviour. The home has a copy of the Hampshire Adult Protection procedure, which underpins the home’s policy and procedure. Staff receive training in abuse and how to report concerns. Staff spoken with reported that they would report any form of abuse to the senior person on duty. Abuse training forms part of the induction to the home. The home does hold some of the service user’s monies. Service users have their own bank accounts and clear records are maintained of all transactions to demonstrate how this money is received and spent. There have been no allegations of abuse received. High Hurlands Nursing Home DS0000012133.V322973.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a homely, comfortable environment that is clean and safe. EVIDENCE: The inspector toured the home. The large house is situated in beautiful countryside and has its own extensive grounds that provide a variety of indoor and outdoor spaces for service users to use. The photographs around the home showed the grounds being used in the finer weather for picnics amongst the cherry orchard. The house is light and spacious and is decorated pleasingly in bright colours. Service users rooms have been personalised, although there is a number of double rooms, each service user has an individual space to express their interests and display personal belongings. High Hurlands Nursing Home DS0000012133.V322973.R01.S.doc Version 5.2 Page 22 The inspector was able to speak to one service user who reported she was pleased with her room which the inspector observed to be personal and ‘girlie’. She reported that she had lived at the home for many years and liked it very much. Service users rooms are furnished and fitted to a good standard and furniture is domestic in type. The home has an array of equipment but the inspector observed that this was being stored unobtrusively when not in use. The home has four lounges and these are used for dining areas and relaxation and engaging in activities. The day service accommodation is attached to the home with rooms available for pottery, physiotherapy and the hydrotherapy pool. The partner reported that the home has a yearly maintenance plan and the maintenance log was shown to the inspector which recorded when maintenance was requested and when is was undertaken. The maintenance man meets with the manager or partner regularly to discuss ongoing maintenance. The inspector observed one bedroom was being decorated in readiness for the new admission. The house was clean and tidy with no odours detected. The home is accessible and meets the needs of the service users. The laundry was visited and the machines observed to be fit for purpose. The room was clean and tidy and well organised by the two ladies that undertake all of the laundry for the home. The inspector discussed with the member of staff the policy for dealing with foul linen, and she described the use of alginate bags and the infection control procedures and demonstrated a good knowledge of infection control in general. The inspector observed gloves were being used by staff appropriately. The home has a contract for the disposal of waste. High Hurlands Nursing Home DS0000012133.V322973.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. An established training programme demonstrated that service users are supported by staff that are obtaining suitable qualifications. The practices of the home when recruiting new staff members protect service users. EVIDENCE: The home has an induction and training programme for all staff that provides underpinning knowledge for them to carry out their roles and obtain a NVQ. The inspector confirmed that an ongoing programme is in place for staff to obtain a National Vocational Award (NVQ). The pre-inspection information reported that 60 of care staff have achieved NVQ level 2 and above. The home supports the carers to undertake this training. The inspector spoke to staff about their training and support in their roles. The inspector received positive comments from staff about the induction and the High Hurlands Nursing Home DS0000012133.V322973.R01.S.doc Version 5.2 Page 24 training programme and that they consider they are able to undertake regular, appropriate training that they feel supports their development needs. New staff members attend a five-day induction course and a competency workbook is completed with a senior member of staff. The inspector viewed a completed book and the assessor and the member of staff had signed off the competencies. A newly employed support worker was spoken to who confirmed that he was in the process of completing the induction programme and that he felt well supported by the home. The partner showed the inspector the training programme which confirmed that staff attend courses in Health & safety, Food Handling and Hygiene, Medication, Fire safety, Epilepsy, Abuse, Infection Control, principles of care, service users needs and Moving and Handling. Additional training is provided in feeding via a Percutaneous Endoscopic Gastrostomy (P.E.G) tube, multi-sensory rooms, day services and using the homes vehicles. The inspector examined three staff files and this confirmed that thorough recruitment checks are completed for staff before they take up their employment. One new member of staff had been employed through an agency and the home was awaiting a CRB check. This was discussed with the partner who reported that the carer was undertaking the induction and that he would be working under supervision until the home receives the clearance. Each record contained appropriate application forms, two written references and proof of identity. This included passports, visas, driving licences and birth certificates. The home employs a mixed gender and mixed nationality staff group, which the partner reports, works well as many of care staff have qualifications in care in their own country and are willing to utilise their skills within the limits of their caring role. High Hurlands Nursing Home DS0000012133.V322973.R01.S.doc Version 5.2 Page 25 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported by a well-managed service. The service can demonstrate that an established system is in place to develop the service with views from service users and their families included in this process. The health, safety and welfare of the service users and staff are promoted and protected. High Hurlands Nursing Home DS0000012133.V322973.R01.S.doc Version 5.2 Page 26 EVIDENCE: The manager was not present at this inspection. The structure of the management is such that the two partners/directors of the home, one of which was present at this visit, are present in the home a good deal of the time and therefore the one partner was able to accompany the inspector on this visit. Information gathered from the home and previous reports confirms that the registered manager has significant experience of managing this service for people with a learning disability. She is a registered nurse who has completed the registered manager’s award. The senior registered nurse on duty and other staff made positive comments about the support they receive. Staff said that the service is well organised and they are given a lot of training and information to support them in their roles. The partner discussed with the inspector and the inspector also observed that the complexity of service users needs means that it is difficult to speak to service users about their views on the service they receive. Staff have been identified as key-workers who raise issues on behalf of the individual and the home keeps in contact with families and care managers to obtain their views. The home undertakes a yearly quality survey and sends questionnaires to families. The inspector viewed the replies and the outcomes of any issues highlighted. The home has a quality assurance system that is based on the national minimum standards. The inspector viewed the system. The home’s performance is measured against the standards and this is reviewed yearly. Two of the partners of the organisation are present in the home for four days of the week. The CSCI received one survey comment card from a visiting professional who commented that in general she considers the overall care delivered in the home is good. The visiting physiotherapist had high praise for the care of the young people in the home. Comment cards were not received from the relatives. The inspector viewed the fire log and this demonstrated that the fire alarm system was checked weekly. Fire drills take place two monthly. Staff receive fire training six monthly and there was evidence of who attended. CSCI receive Regulation 37 notices from the home appropriately from the home to report any incidences or accidents that may affect the service users. High Hurlands Nursing Home DS0000012133.V322973.R01.S.doc Version 5.2 Page 27 A sample of servicing certificates were viewed and found to be current. The inspector did not observe any concerns about the health and safety practices in the home. High Hurlands Nursing Home DS0000012133.V322973.R01.S.doc Version 5.2 Page 28 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 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 34 35 36 3 3 X 3 X LIFESTYLES Standard No Score 11 12 13 14 15 16 17 X 3 3 X 3 3 3 X 3 3 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 DS0000012133.V322973.R01.S.doc Score PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 High Hurlands Nursing Home Score 3 3 3 x 3 X 3 X X 3 X Version 5.2 Page 29 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA20 Good Practice Recommendations It is recommended that the registered manager/senior nurse regularly audits the MAR sheets to ensure they are completed every time medication is administered to a service user. It is recommended that a notice be displayed on the door of the room during the time oxygen therapy is being administered. 2. YA20 High Hurlands Nursing Home DS0000012133.V322973.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 High Hurlands Nursing Home DS0000012133.V322973.R01.S.doc Version 5.2 Page 31 - 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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