Inspection on 26/07/06 for High Trees

This inspection was carried out on 26th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 Trees 17/02/06

High Trees 18/07/05

High Trees 25/01/05

High Trees 22/07/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 High Trees Bull Lane Bishops Castle Shropshire SY9 5DA Lead Inspector Mike Moloney Key Unannounced Inspection 26th July 2006 08:30 High Trees DS0000020650.V294717.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 Trees DS0000020650.V294717.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 Trees DS0000020650.V294717.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service High Trees Address Bull Lane Bishops Castle Shropshire SY9 5DA 01588 638580 01588 630233 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) Mr Robert Gibson Hicks Mrs Margaret Hicks Timothy Duncan Hicks Care Home 18 Category(ies) of Learning disability (18) registration, with number of places High Trees DS0000020650.V294717.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Further input be sought with regard to Learning Disabilities and associated conditions to increase the manager`s (Tim Hicks) knowledge. That the Registered Managers Award and NVQ Level 4 core elements are completed within the first year of registration. 17th February 2006 Date of last inspection Brief Description of the Service: High Trees is a private care home registered with the Commission for Social Care Inspection to provide a full residential service for up to ten adults with a learning disability. An annexe, built in a traditional design and known as High Trees Nova has been added within the grounds to provide an additional eight places. This is a development over two floor levels, designed to provide maximum comfort and convenience for residents. The home is situated close to the entrance to the South Shropshire market town of Bishops Castle. The Home is owned by Mr & Mrs Hicks. Mr Tim Hicks has day to day management responsibility for the home. Service Users and Staff have created a warm homely atmosphere in which residents can relax and be supported following ordinary life principles. Information is available about the home in the form of a service user guide which is available in an easy read version. Fees currently range from £600 to £1600. High Trees DS0000020650.V294717.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A range of evidence was used to make judgements about this service. This includes: information from the provider, records kept in the home, medication records, discussions with the staff team, tour of the premises, previous inspection reports and observation of care experienced by people using the service. 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 Trees DS0000020650.V294717.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection High Trees DS0000020650.V294717.R01.S.doc Version 5.2 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 the following standard(s): 2 Quality in this outcome area is good. The home has a pre-admission assessment process that establishes the needs of service users being admitted to the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Looking at the records of someone who has recently moved into the home showed that the manager and staff obtain all of the information about them that is necessary to formulate a care plan for them. Talking with the staff established that this is achieved by visiting the person concerned in their own home, or wherever they are staying at the time, to start the process of getting to know them and then that person is invited to make short visits to the home so that they can get used to the environment and express their views about it. High Trees DS0000020650.V294717.R01.S.doc Version 5.2 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is good. The service user plans are updated at appropriate intervals ensuring that the individuals’ needs are met. Where possible service users are consulted and do make decisions about their lives. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Looking at two of the residents’ files established that care plans had been developed for them. The care plans and the assessments of activities contained the information that enable staff to work towards the service users’ goals. Talking with the staff confirmed that they were fully aware of the contents of these plans in that they talked of ways in which they had met the needs that had been identified in the ways outlined in the documents. Observing and listening to the staff interacting with the residents also demonstrated that they offer choices to the residents when they can. The inspection started at breakfast time and many examples of choices being offered in relation to food were seen. During the morning staff were also heard High Trees DS0000020650.V294717.R01.S.doc Version 5.2 Page 9 discussing activities and such things as changes of clothing in a manner that gave the resident concerned control of the situation thereby maintaining their self esteem. Risk assessments for individuals activities as well as those for the group were also seen to be in place and the staff spoken to all appeared to be aware of the contents of these thereby making sure that the residents were not exposed to unnecessary risks. High Trees DS0000020650.V294717.R01.S.doc Version 5.2 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17 Quality in this outcome area is good. Service users are helped and encouraged to keep in contact with their friends and make good use of the local facilities. The home provides good quality food in appropriate quantities. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each of the care records looked at during the inspection contained a weekly activities list for that individual. These contained details of their planned daily activities such as working at a farm or attending social clubs in the evening. Listening to conversations between staff and the service users it was clear that they make good use of the local facilities not just by going shopping but, in some cases, by personally using other services such as banks. Those discussions were also heard to be about the friends and families of the service users. Watching the interactions between the service users it was also clear that this is a well balanced group of people living this home and that they show an understanding of each others needs. High Trees DS0000020650.V294717.R01.S.doc Version 5.2 Page 11 Throughout the inspection the residents were seen to be moving around the communal parts of the houses and in and out of their own bedrooms as they wished. Each resident was given or obtained for themselves a different breakfast and they clearly enjoyed what they had. All of those who were spoken to indicated that all of the meals that they had been given were to their liking and looking at the menus showed that a wide variety of meals are offered. High Trees DS0000020650.V294717.R01.S.doc Version 5.2 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. The personal and healthcare needs of the service users are met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents were observed being treated in a respectful and dignified manner. Any personal care needs were dealt with discreetly. Preferences about how they preferred to be dealt with were seen outlined within their personal plans and all of the residents looked well cared for. Numerous references were seen in the residents’ records that related to arrangements with healthcare professionals towards meeting any medical needs that had been identified. The storage and recording of medication was looked at and was seen to be appropriate. Records showed and the staff on duty confirmed that they all receive training in the safe handling of medication. High Trees DS0000020650.V294717.R01.S.doc Version 5.2 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. The service users are protected from abuse and the staff enable their views to be taken into account despite the nature of their disabilities. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager stated that no complaints or any allegations of abuse had been made since the last inspection. The home had a copy of their complaints procedure and policies which complied with the local policies and procedures for the protection of vulnerable adults, both being part of the systems that ensures that the service users are listened to and protected from abuse, neglect and self-harm. The level of the disabilities of the service users means that most are unlikely to be able to access these formal policies but observation of the staff interacting with them and communicating between themselves indicated that they would be aware of any dissatisfaction expressed. High Trees DS0000020650.V294717.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 The standard of the environment within the home is good and is providing service users with a homely and comfortable place in which to live. This judgement has been made using available evidence including a visit to this service. EVIDENCE: As at the last inspection all of the residents’ rooms were seen to be clean and had been personalised with each of them being encouraged to make their own choices of decoration. All areas of High Trees and Nova visited were seen to be clean, tidy and free from any unpleasant odour. The home has excluded wash hand basins from some residents’ bedrooms due to their inappropriate behaviour. Entries have been made into each individual’s care plan to explain this exclusion. The new build now known as Nova 1 & 2 is organised on two levels, each with its own kitchen, laundry and dining facility promoting a more independent lifestyle for residents in these areas. High Trees DS0000020650.V294717.R01.S.doc Version 5.2 Page 15 All three units have access to the rear garden, which has ample facilities for sitting including a Gazebo and a swing seat. The forecourt area has a ‘tarmac’ finish and is set out for car parking. The whole site is enclosed with a secure door leading out to the street and new fencing / walls. Each of the units has it’s own laundry facility all of which have been sited and equipped in a manner consistent with good infection control practice. The home has recently received an infection control audit report and the home has taken this on board and is currently working towards putting in place any outstanding recommendations. High Trees DS0000020650.V294717.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome area is good. This is an effective and well-supported staff group with the skills and knowledge to enable service users to enjoy a quality of life that meets their individual requirements and aspirations. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Looking at the staffing rota and talking with the staff established that the numbers of staff on duty in each of the units throughout the day is maintained at an appropriate level. The staff also stated and the records confirmed that they have undertaken a wide range of training and that opportunities are regularly available to enhance their skills and thereby improve their ability to meet the needs of the residents. A number of staff are currently working towards the NVQ qualification with 35 of the team already having achieved NVQ2 or above. Staff on duty confirmed that supervision sessions have been established. They also confirmed that team meetings take place on a regular basis enabling them to High Trees DS0000020650.V294717.R01.S.doc Version 5.2 Page 17 discuss and review in more detail the needs of individual residents and how they should meet them. Looking at the records also confirmed that all of the required background checks had been carried out before each new employee had been allowed to start working with the service users so as to ensure that they were suitable to do so. The manager confirmed that an appropriate induction programme was available and implemented ensuring that new staff are given a good understanding of what their job entails. High Trees DS0000020650.V294717.R01.S.doc Version 5.2 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39 and 42 Quality in this outcome area is good. The management team are continuing to develop and maintain a well-supported staff group in order improve the service’s ability to meet residents’ needs and aspirations. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager has completed the Registered Managers Award and has only to complete the components of the NVQ4 not already covered by this to meet the standard of training required of someone who manages such a facility. The staff have commented and it was observed during the inspection that the home continues to benefit from a management style that, as reported at the last inspection, provides a warm and caring environment with supportive directive leadership focusing always on the service users’ needs. There is a managers meeting weekly where the managers of each of the unit are able to co-ordinate their efforts and review their own progress. High Trees DS0000020650.V294717.R01.S.doc Version 5.2 Page 19 Records inspected were found to be appropriately kept and include, fire safety, portable appliance tests and hot water temperature checks ensuring that the residents have a safe home to live in. High Trees DS0000020650.V294717.R01.S.doc Version 5.2 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 Standard No Score 1 x 2 4 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 4 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 4 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 3 x 3 4 3 x x 3 x High Trees DS0000020650.V294717.R01.S.doc Version 5.2 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. 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. Refer to Standard Good Practice Recommendations High Trees DS0000020650.V294717.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate 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. 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