Inspection on 24/06/09 for High Lee Barn

This inspection was carried out on 24th June 2009.

CQC found this care home to be providing an Adequate service.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

High Lee Barn 27/09/07

High Lee Barn 07/11/06

High Lee Barn 08/12/05

High Lee Barn 08/08/05

High Lee Barn 07/03/05

High Lee Barn 17/01/05

High Lee Barn 05/02/04

Similar services:

Snydale Care Home

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Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 25/11/2009.

Key inspection report Care homes for older people Name: Address: High Lee Barn Sowerby Lane Luddendenfoot Halifax West Yorkshire HX2 6LB     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Cheryl Stovin     Date: 2 4 0 6 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: High Lee Barn Sowerby Lane Luddendenfoot Halifax West Yorkshire HX2 6LB 01422882437 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: www.highleecarehome.com Mrs Patricia Beaumont care home 17 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home High Lee Barn is a privately owned and family run residential care home registered to provide accommodation and care for up to seventeen older people. The establishment is situated in a rural hill top location with panoramic views across the surrounding countryside. The property, a converted barn, is well maintained throughout and furnished and fitted to a high standard. The accommodation is arranged on two floors and provides ten single bedrooms and one shared room, all with the benefit of en-suite facilities. Well maintained garden areas are provided for the use of the people living there. The home places a high priority on staff training which is clearly reflected in the standard of care afforded to the service users. A range of activities are provided for people to participate in, if they choose to do so, and people are encouraged to maintain links with the local community. The current weekly charges at High Lee Barn range from £475 to £520 depending on the room occupied. Additional charges are Care Homes for Older People Page 4 of 27 Over 65 17 0 Brief description of the care home made for hairdressing, personal toiletries and personal newspapers and periodicals. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This report brings together evidence gathered during a key inspection of High Lee Barn. This included an unannounced visit we made to the home on 24th June 2009. The purpose of the inspection was to make sure that the people living at the home are receiving the care and support they want and that they and their families are satisfied with the service. During this visit, a full tour of the building was undertaken, records were examined and we spoke to management, staff and the people living at the home. The visit was carried out by one inspector and a total of six hours were spent at the home. The last inspection of the home was undertaken on 27th September 2007 and no additional visits have been made. We have reviewed our practice when making requirements, to improve national Care Homes for Older People Page 6 of 27 consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The weekly fees the home charges are between four hundred and seventy five pounds and five hundred and twenty pounds. People pay their own personal expenses, such as chiropody and hairdressing. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: To make sure that the home can meet peoples needs all personal and health care issues must be assessed before they are admitted to the home. It can be very disrupting if a person is admitted to the home and subsequently has to move as the home finds it cannot meet their needs. A requirment has been made in respect of this. The care planning process must be improved and details of how the care is actually to be given must be recorded. This makes sure that all staff care for people in a consistent way. This remain an outstanding requirement from the last inspection. The staffing levels at night need to be improved and at least two waking night staff employed. A requirement has been made about this. To make sure that people are protected and only suitable staff are employed at the Care Homes for Older People Page 8 of 27 home Criminal Records Bureau disclosures must be obtained for all members of staff. A requirement has been made about this. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Not all of peoples health and personal care needs are assessed before moving into the home. Evidence: The care records of four people living at the home were seen. Three contained evidence that peoples care needs had been assessed before moving into the home. One persons pre-admission assessment was very brief and no assessment had been made of their metal health and shortly after they had moved in to the home it became apparent that the home was not suitable for them. At the time of the visit staff from another more appropriate service were conducting an assessment and arranging a trial visit. To avoid the disruption to peoples lives care must be taken to make sure that all peoples health and personal care needs are taken into account before being admitted to the home. A requirement has been made in respect of this. People are provided with written information about the home which makes sure that Care Homes for Older People Page 11 of 27 Evidence: everybody knows what services and facilities are provided by the home. People are encouraged to visit the home before moving in to meet the staff and other people living there and to sample the daily routine. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health and personal care needs are met, and personal support is given in a way that promotes and protects people privacy and dignity. Care plans could contain more detail about actually how the care is to be given. Evidence: The care records of four people were looked at. The care plans contained basic information about peoples assessed needs but not much detail as to how the care is actually to be delivered. Very little information is recorded about peoples backgrounds or their previous interests. This means that staff cannot encourage people to maintain their previous social interests or networks, although staff spoken to had a good understanding of peoples current interests and of people important to them. There is no suggestion that peoples needs are not being met but how the care is actually to be provided needs to recorded in more detail, so that all staff provide consistent care in a manner which meets with peoples preferences. This remains an outstanding requirment from the last inspection. Care Homes for Older People Page 13 of 27 Evidence: Healthcare visits and treatments are recorded in detail and everyone who commented said they always receive the healthcare they need. One person said that she only has to ask and the staff do whatever she wants, in the way she prefers. This confirmed our observations that the staff are very aware of peoples needs and their approach to people is calm, friendly, patient and understanding. All the staff have time to spend with everyone and make sure they give people the attention they want. The people we spoke with said they are satisfied with the care they receive and everyone who commented said they are looked after well and that staff attend to their needs promptly. People were seen to be being treated with dignity and their privacy respected. Any medication held at the home are securely stored. The medicines are kept safe and secure in a locked cabinet. Most of the medicines are supplied by the pharmacy in a monitored dosage system, but some remain in the original packaging. We looked at the Medicines Administration Record (MAR) charts, which show clearly the quantities of medicines received and in stock for each person. The medicines supplied in the monitored dosage system appeared to be recorded accurately. Staff had signed the MAR charts each time a dose of medicine was offered and the quantities in stock and the amounts administered tallied with the quantity originally received from the pharmacist. Any medicines that were brought forward from the previous record were recorded. Staff responsible for administering medication have received training to make sure that any medicines are handled safely. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to take part in a wide range of activities. People are offered a good choice of meals to make sure their dietary needs and preferences are met. Evidence: There is a relaxed and homely atmosphere in the home. People living there and their visitors said that this was always the case. People can choose where to spend their time, either in their own rooms or with others in the communal areas. A range of activities are available for the people to join in with if they choose to do so. The relaxed routine means that spontaneous outings can take place which helps people to maintain contact with the local community. During the visit, staff were spending time with people playing dominoes and board games, and generally chatting. People told us that they were happy with the activities provided. Care Homes for Older People Page 15 of 27 Evidence: Also during the visit some people were enjoying sitting out in the attractive garden areas. They were enjoying the sunshine and being entertained by the three dogs that are very much a part of the family at High Lee Barn. Visitors were seen to be warmly welcomed into the home and they confirmed that this was always the case. They also said that they are kept informed of important issues concerning their relative or friend. Mealtimes were seen to be a relaxed and social occasion, with tables being attractively set and food presented attractively. The main meal of the day is served at lunchtime and the lunch on the day of the visit was: steak pie, creamed potatoes, peas and carrots followed by a choice of dessert. An alternative is always available if people dont want what is on the menu. People said that they enjoyed the food served at the home. One person said the meals are to be highly praised. The kitchen has recently been inspected by environmental health officers and awarded a four star rating. This means that food preparation and kitchen hygiene has been assessed as good. The people who live at High Lee Barn said they can do what they want, when they want. This confirmed our observations that the staff support people to live their life in the way they choose. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are aware of how to raise a concern or make a complaint if they are dissatisfied with the service. The staff have received suitable training and understand the adult protection policies and procedures. The homes recuitment practices do not ensure that peoples welfare is protected. Evidence: The home has a complaints procedure which is given to everybody living at the home and their representatives. A copy is also displayed in the home. People spoken to were aware of who to speak to if they were happy about anything in the home. One person said: I have no complaints, I have a good high regard for the home. One complaint has been received since the last inspection. This complaint was made directly to the home, to the local authority and to the Commission. The complaint is still being dealt with and for reasons of confidentiality would be inappropriate to include details in this report. All staff have received training in the Protection of Vulnerable Adults (POVA) and are aware of the safeguarding procedures to follow if they suspected or witnessed people not being treated properly. The recuitment practices (see staffing section) do not fully Care Homes for Older People Page 17 of 27 Evidence: protect people. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a safe, clean and comfortable environment. Evidence: The home is in a rural hilltop location with panoramic views over the surrounding countryside. It is well maintained, both internally and externally, with a routine programme of refurbishment and redecoration. Safe, accessible and well maintained garden areas are provided for people to sit in the warmer weather. There are plans to build a conservatory which will enable to people living at the home to enjoy the far reaching views in all weathers. All bedrooms have en-suite facilities and are furnished and fitted to a good standard. Bedrooms are highly personalised reflecting the individuals interests and tastes. People said that they were satisfied with their rooms and said they had everything they need in them. There are spacious and comfortable lounge and dining areas with sufficient space for social activities to take place. All parts of the home were seen to be clean and hygienic. Visiting relatives confirmed that this was always the case. Care Homes for Older People Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing levels at night are not sufficient to meet peoples needs. Recruitment practices need to be improved to protect the people living at the home. Evidence: At the time of the visit there were sufficient staff on duty to meet peoples needs. There were four care staff on duty plus the manager and the administrator. Staff had plenty of time to sit and chat with people and and relationships between everybody were seen to be relaxed and friendly. There is at present only one member of staff on duty during the night, plus a manager on call. The manager said that the home is currently advertising for additional night staff to provide for two waking night staff. This would make sure that peoples night time needs are met. People said that the staff were kind and treated them well. One person said you couldnt wish for better people. Staff were seen to be attending to peoples needs promptly and sensitively. There is a programme of National Vocational Qualification (NVQ) in care and the majority of the staff team hold the award. This makes sure that the staff are qualified Care Homes for Older People Page 20 of 27 Evidence: to care for the people living at the home. Four staff recruitment files were seen. An application form, two written references and Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) checks were in place in two of the files seen. In one file there was no evidence of a CRB check having been carried out. This member of staff had been employed at the home before CRB checks were mandatory. The manager was advised to carry out a CRB check for this person. In another of the files there was a CRB disclosure in place but it was from a previous employer. To make sure that only suitable staff are employed at the home all staff must have an up to date Criminal Records Bureau disclosure. Care Homes for Older People Page 21 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is adequately managed but the manager must make sure that the home is run in the best interests of the people living there. Evidence: The registered manager of the home is qualified and competent to run the home. He holds the NVQ level 4 Registered Managers Award. Other outcome areas in this report do not fully support that the home is being run in the best interests of the people living there. He is committed to ensuring an open and positive atmosphere is prevalent within the home. People living at the home, and the staff, said that the manager is approachable and available and listens to what they stay. There are clear policies and procedures for handling finances which means that peoples personal finances are held safely. Care Homes for Older People Page 22 of 27 Evidence: There are detailed health and safety policies and procedures in place. All staff receive mandatory training in health and safety and safe working practices. Risk assessments are in place which ensure the health and safety of the people living at the home is protected. Health and safety records seen indicated that all the required checks were in place and certificates seen showing compliance with regulations. Peoples personal information is stored securely when it is not being used. The homes policies and procedures are up to date, which makes sure they provide relevant information to guide staff on how to act in every situation. The home has a range of quality assurance systems in place, to help determine the quality of service the home offers. These include surveys for the people who live at the home, their relatives and visitors and regular meetings with the people who live at High Lee Barn and their relatives. The manager is always available to talk to people. The information and comments that are received are used to improve the quality of the service offered. Care Homes for Older People Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 7 15 To make sure that all people 31/10/2007 using the service receive care in a consistent way, care plans must include details of how the care and support is actually to be delivered. Care Homes for Older People Page 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 3 14 All of peoples health and 31/10/2009 personal care needs must be assessed before admission. To make sure that the home is suitable for people and can meet all of their needs. 2 7 15 That a care plan is held for each person living at the home which identifies how peoples care needs are to be met. To make sure peoples care needs are met in a consistent manner. 31/10/2009 3 27 18 Sufficient staff must be employed during the night. To make sure that peoples health and welfare is protected sufficient staff must be employed at night. 31/10/2009 Care Homes for Older People Page 25 of 27 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 4 29 19 A current Criminal Records Bureau disclosure must be obtained for all members of staff. To make sure that people are protected by employing only suitable people at the home. 31/10/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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