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Inspection on 15/08/05 for High Lea House

Also see our care home review for High Lea House for more information

This inspection was carried out on 15th August 2005.

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

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

What the care home does well

The home provides a high standard of care to service users living at the home. The standard of the environment is good providing service users with a safe well-maintained environment to live in. Service users are offered a varied, well balanced diet, which takes into account individual likes and dislikes along with seasonal changes.

What has improved since the last inspection?

This is a home that operates well and remains committed to providing a high standard of care, which is linked closely to the National Minimum Standards for older people.

What the care home could do better:

The home must ensure that all service users have a written care plan and where appropriate risk assessments must be in place. The home must follow it`s stated policy and procedures in relation to the receipt of all medication received into the home.

CARE HOMES FOR OLDER PEOPLE High Lea House Llanforda Rise Oswestry Shropshire SY11 1SY Lead Inspector Karen Powell Unannounced 15 August 2005 09.15 th 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 Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. High Lea House E56 E01 S20713 High Lea House UAI V212737 150805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service High Lea House Address Llanforda Rise Oswestry Shropshire SY11 1SY 01691 654090 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) Miss Y Wakefield Care Home 29 Category(ies) of 29 Old Age registration, with number of places High Lea House E56 E01 S20713 High Lea House UAI V212737 150805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th February 2005 Brief Description of the Service: High Lea House is a privately owned residential home providing personal care to twenty-nine older people. The registered proprietor and manager is Miss Yvonne Wakefield who has managed the home since 1984. Miss Wakefield and her partner Mr Edwards own the cottage opposite the home and provide on call support as well as having active roles in the running of the home.High Lea House is an impressive house, which has been converted and extended. It is set in it’s own grounds in a quiet residential area but within easy reach of the centre of Oswestry. The home benefits from its raised position, with a number of rooms having extensive views across Shropshire and the pleasant gardens of the home.The home provides single and double accommodation some rooms having en-suite facilities. There is a large lounge, a pleasant conservatory, a dining room and a quiet room offering service users choice as to where they wish to spend their time. The first floor is accessed by a shaft lift and all areas of the accommodation are accessible.Visitors to the home are frequent, good links with the local community are maintained by the home. High Lea House E56 E01 S20713 High Lea House UAI V212737 150805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and started at 9.15am and lasted 3 and 3/4 hours. 26 places were occupied. The inspection included discussion with service users and staff. Observation of daily routines, examination of service user records and a home tour took place as part of the inspection. What the service does well: What has improved since the last inspection? What they could do better: The home must ensure that all service users have a written care plan and where appropriate risk assessments must be in place. The home must follow it’s stated policy and procedures in relation to the receipt of all medication received into the home. High Lea House E56 E01 S20713 High Lea House UAI V212737 150805 Stage 4.doc Version 1.40 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. High Lea House E56 E01 S20713 High Lea House UAI V212737 150805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection High Lea House E56 E01 S20713 High Lea House UAI V212737 150805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 3 & 5 Prospective service users are provided with information about the home before they make a choice about where they wish to live. All service users are assessed before moving into High Lea House. Prospective service users and their relatives and friends can visit the home before making a decision about moving in. EVIDENCE: One service user who moved into the home recently, told the inspector that they viewed the home with their family before making a decision about moving in. They also stated that they were provided with written information about the home. The most recent service user who moved into the home was assessed prior to moving in. Evidence of the homes assessment was seen on file. However information contained on the assessment was basic. Discussion with the assessor explained that limited information was accessed from the hospital where the service user was admitted from. Despite the fact that a verbal High Lea House E56 E01 S20713 High Lea House UAI V212737 150805 Stage 4.doc Version 1.40 Page 9 assessment had been gained from the placing social worker, this was not substantiated by a written assessment. High Lea House E56 E01 S20713 High Lea House UAI V212737 150805 Stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7 & 9 Generally there is a clear care planning process, however one service user was found to be without a plan of care. The home has polices and procedures for dealing with medication. However in one instance these had not been applied to the receipt of a controlled drug received at the home. EVIDENCE: All service users have a plan of care, however during examination of two service user records it was identified that the newest service user admitted into the home did not have a care plan. It was discussed with the senior care in charge at the time of the inspection the importance of documenting this individuals needs particularly as the home raised with the inspector the challenges that the individual was presenting. Further discussion with the senior carer identified risks to the individual particularly at night, again these were not identified within a care plan or risk assessment. It was agreed that a care plan would be formulated as soon as possible along with any supporting risk assessments necessary. The home uses a Boots monitored dosage system all records relating to these were found to be satisfactory. High Lea House E56 E01 S20713 High Lea House UAI V212737 150805 Stage 4.doc Version 1.40 Page 11 The stock of controlled drugs were checked with a carer on duty. Records and storage of these were found to be satisfactory. On checking it was established that new stock of Fentanyl 25mcg had not been recorded as being received into the home on 1.8.05. It was agreed that these would be checked in and entered into the controlled drugs register by two staff at the time of the inspection. High Lea House E56 E01 S20713 High Lea House UAI V212737 150805 Stage 4.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 & 15 Service users expectations of the home and their lifestyles within the setting appear to be sensitively considered by staff. Service users are able to maintain contact with their family and friends as they wish. Service users are enabled to exercise choice and control over activities of daily living so far as practicable. Service users are offered a varied, well balanced diet, which takes into account individual likes and dislikes along with seasonal changes. EVIDENCE: Service users spoken to described a variety of activities taking place within the home on a regular basis. Service users explained participation is by individual choice. Some service users spoken to were happy to share with the inspector that they regularly see their family and friends. Visitors are not restricted and welcomed into the home at all times. High Lea House E56 E01 S20713 High Lea House UAI V212737 150805 Stage 4.doc Version 1.40 Page 13 Service users told the inspector that where possible they are able to have choice and control over their lives. One service user has maintained continuity with their chiropodist they had prior to moving into the home. Others have maintained their choice over general practitioners. One service user is encouraged to go out regularly which was part of their routine prior to moving into the home. It is pleasing to see that individuals choices are promoted by the staff group. One staff member said that individuals are encouraged to maintain their independence as far as possible and that staff are encouraged to promote independence rather than create individuals to become dependant. Service users spoken to were very complimentary about the quality of food. The home has exceeded in this standard on previous occasions. The quality of food, variety of choice and presentation is always of an excellent standard. High Lea House E56 E01 S20713 High Lea House UAI V212737 150805 Stage 4.doc Version 1.40 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 The home has a clear complaints procedure in place. EVIDENCE: It was stated by the senior carer in charge at the time of the inspection that there have been no complaints received since the last inspection. There have been no complaints received at the Commission for Social Care Inspection. High Lea House E56 E01 S20713 High Lea House UAI V212737 150805 Stage 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 & 26 The standard of the environment is good providing service users with a safe well-maintained environment to live in. The standard of cleanliness was good in areas seen on the home tour. EVIDENCE: The home is well maintained throughout, this was seen during a tour of the home. Service users spoken to were complimentary of the environment and cleanliness throughout the home, including their private space. One service user was keen to share the fact that the home was always clean and what was seen at the inspection is the usual standard. The laundry is carried out on site and service users spoken to were satisfied with the service. High Lea House E56 E01 S20713 High Lea House UAI V212737 150805 Stage 4.doc Version 1.40 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 The home is staffed to a level that ensures service user needs are met at all times. EVIDENCE: The number of staff seen and examination of the duty rota indicated that the home is staffed to a level to ensure service user needs are met at all times. High Lea House E56 E01 S20713 High Lea House UAI V212737 150805 Stage 4.doc Version 1.40 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 Health, safety and welfare of service users and staff are promoted fully by safe working systems in place. EVIDENCE: Accident and fire safety records examined were seen to be satisfactorily maintained. Matters pertaining to fire safety and environmental health were found to be satisfactory at the last inspection carried out by Shropshire Fire and Rescue service and Environmental Health Department. High Lea House E56 E01 S20713 High Lea House UAI V212737 150805 Stage 4.doc Version 1.40 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION 4 x x x x x x 4 STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x x x x x x 3 High Lea House E56 E01 S20713 High Lea House UAI V212737 150805 Stage 4.doc Version 1.40 Page 19 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. 3. Standard 7 7 9 Regulation 15 13(4)(c) 13(2) Requirement Each service user must have a written care plan Risks identified to the health and safety of service users must be recorded Medication received into the home must be recorded Timescale for action Immediate Immediate Immediate 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 Lea House E56 E01 S20713 High Lea House UAI V212737 150805 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection 1st Floor, Chapter House South Abbey Lawn SHREWSBURY SY2 5DE 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 High Lea House E56 E01 S20713 High Lea House UAI V212737 150805 Stage 4.doc Version 1.40 Page 21 - 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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