Inspection on 02/08/05 for High Hurlands Nursing Home

This inspection was carried out on 2nd August 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

High Hurlands Nursing Home 19/01/07

High Hurlands Nursing Home 25/01/06

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 Gentles Lane Nr Passfield Liphook Hampshire GU30 7RY Lead Inspector John Vaughan Unannounced 2 August 2005, 10:10 nd 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. High Hurlands Nursing Home H54 S12133 High Hurlands Nursing Home V243137 020805.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service High Hurlands Nursing Home Address Gentles Lane, Nr Passfield, Liphook, Hampshire GU30 7RY 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) 01428 7510202 High Hurlands Partnership Mrs Gillian Derbyshire Care Home 22 Category(ies) of Learning disability (22) registration, with number Physical disability (22) of places High Hurlands Nursing Home H54 S12133 High Hurlands Nursing Home V243137 020805.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 Any service user with a physical disability placed in High Hurland`s Nursing Home must also have a learning disability. 2 No service user may be accommodated under the age of 16 years Date of last inspection 15/02/2005 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 provide for service users to access local facilities in the nearest village of Liphook and larger towns in the area. High Hurlands Nursing Home H54 S12133 High Hurlands Nursing Home V243137 020805.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over three and a half hours and involved the manager, one of the partners and service users at home on the day. The inspector spoke to and spent time with service users, watching how they were being helped by staff. Records held in the home were also looked at and these included the service users care plan and information on activities, meals and servicing equipment in the home. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. High Hurlands Nursing Home H54 S12133 High Hurlands Nursing Home V243137 020805.doc Version 1.40 Page 6 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 High Hurlands Nursing Home H54 S12133 High Hurlands Nursing Home V243137 020805.doc Version 1.40 Page 7 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 and 3 The homes approach to the assessment and orientation of service users means that their needs are acknowledged and clearly documented. EVIDENCE: The inspector discussed the possible admission of a service user in the near future. The manager has been working with the family and care manager to determine the needs of the individual and if they can be met within this home. An assessment of needs has been completed by one of the partners and the manager as part of this process. The service user’s social worker has already visited to see the home on behalf of the service user. The home would support service users to visit the home to meet service users and staff, stay for a meal and have an overnight visit as part of the orientation process. The inspector noted that the person would be under eighteen on admission and he and the manager discussed its implications for additional checks on staff. The manager was advised that all staff will need to have a new Criminal Records Bureau (CRB) Check which included checking the POCA Protection of Children List. This list is similar in effect to the POVA (Protection of Vulnerable Adults List) however it relates to children’s services. High Hurlands Nursing Home H54 S12133 High Hurlands Nursing Home V243137 020805.doc Version 1.40 Page 8 The manager and one of the partners present stated that they would address this as they are registered to take service users from 16 years and they wished to retain this age range. No one under eighteen is currently accommodated in the home. High Hurlands Nursing Home H54 S12133 High Hurlands Nursing Home V243137 020805.doc Version 1.40 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 and 9 A well developed and comprehensive care planning process demonstrated that the home is identifying and responding to service user’s complex needs. EVIDENCE: The inspector sampled three service users plans during the visit. Each of these plans has individual detailed care plans for a wide range of interventions. 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 and the inspector noted instructions to ‘compliment’ service users on their appearance and ‘ let the person know what you are going to do for them” demonstrating a service who want to engage and involve each person to the best of their abilities. High Hurlands Nursing Home H54 S12133 High Hurlands Nursing Home V243137 020805.doc Version 1.40 Page 10 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. 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 these risk are also in place, which include medication, transportation, community access, moving and handling, pressure care and health concerns. These are all kept under review with the care plan. High Hurlands Nursing Home H54 S12133 High Hurlands Nursing Home V243137 020805.doc Version 1.40 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) 12,13,15 and 17 Service users benefit from the provision of a well organised activity programme enhanced by contact from families and friends. EVIDENCE: High Hurlands Nursing Home H54 S12133 High Hurlands Nursing Home V243137 020805.doc Version 1.40 Page 12 The home provides a day service for service users. This is currently closed for summer however activities continue for all service users and an activity plan has been put in place for this period. At the last inspection the inspector had the opportunity to join in with a number of groups to observe the activities and discuss these activities with staff and service users. 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. The inspector was able to speak to one service user who told him about their walk to the green house and cottage garden. The inspector asked the service user if they could show him around this area and they went for a walk to see the garden, supported by the manager. The inspector saw evidence of regular activities within service users plans and the service user told them that they enjoy all of the groups that they go to. Local shops, clubs and leisure centres are utilised by service users. Shopping trips, meals out and swimming trips are recorded. On the day of the inspection a group of service users went out on a community activity. The home provides transportation to access activities and the local community. From examining the records the inspector confirmed that service users have regular contact from their families. Contact details are on file and care plans provide guidance on how to maintain contact and encourage interaction from service users. A menu plan was provided by the manager that confirmed that a balanced and varied diet is being offered to service users. The inspector observed the meal being served on the day 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. One service user said they did not like the meal being offered and they had an alternative meal. A high proportion of the young people living in the home need to be fed by a tube known as 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 H54 S12133 High Hurlands Nursing Home V243137 020805.doc Version 1.40 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 and 20 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. EVIDENCE: The inspector saw evidence on file that each person’s medical and health needs are responded to appropriately. Each person is registered with a general practitioner and physiotherapy support is also provided to the home. The home has clear statements on the rights of service users including privacy and dignity. Service users are supported 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. An inspection has just taken place by the commission’s pharmacy inspector who looked at standard 20 in depth. The manager outlined the actions they were required to take. High Hurlands Nursing Home H54 S12133 High Hurlands Nursing Home V243137 020805.doc Version 1.40 Page 14 The manager supplied evidence to confirm that they had taken action to meet these requirements. The medication policy has been amended to add information on the disposal of medication following changes to the legislation on how to dispose of medication and they have put a policy on crushing medication in place. The manager has also put a new thermometer in place and purchased individual tablet crushers for each service user who needs one. The manager told the inspector about concerns they have had with the medication administration practices of an agency staff used in the home and are discussing this with the agency. High Hurlands Nursing Home H54 S12133 High Hurlands Nursing Home V243137 020805.doc Version 1.40 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 Complaints procedures are in place demonstrating that the views and concerns of service users, their families and representatives are recorded and responded to. EVIDENCE: The home has a clear complaints procedure. This is on display in the home. The inspector checked the homes complaints log and was able to confirm that there have been no complaints since the last inspection. The complexity of the needs of service users living in the home means that it would be difficult to communicate concerns. Communication plans are in place with the service users plan to indicate how each person would communicate when unhappy of distressed and what staff should do when this happens. Staff receive training in abuse and how to report concerns. High Hurlands Nursing Home H54 S12133 High Hurlands Nursing Home V243137 020805.doc Version 1.40 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 and 30 Service users benefit from a comfortable, well maintained, safe and accessible home. EVIDENCE: High Hurlands Nursing Home H54 S12133 High Hurlands Nursing Home V243137 020805.doc Version 1.40 Page 17 The home is set within its own extensive grounds providing a great variety of indoor and outdoor spaces for service users. The home has four lounges, which have multipurpose use with dining areas and areas for relaxation and engaging in activities. The home has a day service attached with rooms for activities such as pottery and physiotherapy. There is also a hydrotherapy pool. The home was found to be clean and tidy and free from unpleasant smells. The home accessible and appears suitable for the needs of the service users. The home has suitable range of furniture, which is of good quality and in sufficient quantity to meet the needs of service users. The inspector observed service users using all parts of the home supported by staff and one service user told the inspector that they liked their home especially their room. High Hurlands Nursing Home H54 S12133 High Hurlands Nursing Home V243137 020805.doc Version 1.40 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) N/A These standards were not assessed at this visit. EVIDENCE: High Hurlands Nursing Home H54 S12133 High Hurlands Nursing Home V243137 020805.doc Version 1.40 Page 19 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 home can demonstrate that the health and safety of service users is promoted. EVIDENCE: The home has a fire risk assessment in place and all staff have training in fire safety on a six monthly basis by an external trainer. The inspector viewed up to date service records for fire, lifting equipment, electrical appliance, electrical systems and central heating systems. The homes clinical waste is collected on contract. Weekly tests of the fire alarm system are carried out. The last fire drill was carried out on 29/07/05. Emergency lighting is checked monthly and a weekly check on the fire system is undertaken. The inspector did not observe any concerns about the health and safety practices in the home. High Hurlands Nursing Home H54 S12133 High Hurlands Nursing Home V243137 020805.doc Version 1.40 Page 20 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 3 x x Standard No 22 23 ENVIRONMENT Score 3 x 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 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 x 3 Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 High Hurlands Nursing Home Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x H54 S12133 High Hurlands Nursing Home V243137 020805.doc Version 1.40 Page 21 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 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 Good Practice Recommendations High Hurlands Nursing Home H54 S12133 High Hurlands Nursing Home V243137 020805.doc Version 1.40 Page 22 Commission for Social Care Inspection Hampshire Area Office 4th Floor, Overline House Blechynden Terrace Southampton SO15 1GW 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. 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