Inspection on 27/08/08 for Higham House

This inspection was carried out on 27th August 2008.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Higham House 08/06/09

Higham House 06/06/08

Higham House 15/01/08

Higham House 04/07/06

Higham House 20/10/05

Higham House 16/06/05

Higham House 10/05/05

Higham House 09/09/04

Higham House 15/04/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 08/11/2008.

CARE HOMES FOR OLDER PEOPLE Higham House 87 Higham Road Rushden Northants NN10 6DG Lead Inspector Lesley Allison-White Unannounced Inspection 27th August 2008 10:30 X10015.doc Version 1.40 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 Higham House DS0000045316.V370681.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 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. Higham House DS0000045316.V370681.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Higham House Address 87 Higham Road Rushden Northants NN10 6DG 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) 01933 314253 F/P 01933 314253 Mr Tissa Nihal Atapattu Mrs Nelum Vijayanthi Atapattu Vacant Care Home 30 Category(ies) of Dementia - over 65 years of age (30), Old age, registration, with number not falling within any other category (30) of places Higham House DS0000045316.V370681.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Fairlawn care home is registered to provide personal care with nursing to male and female service users who fall within the following categories: - Old age, not falling within any other category (OP) 30, Dementia, over 65 years of age (DE (E)) 30. The maximum number of persons to be accommodated at Fairlawn nursing home is 30. 6th June 2008 2. Date of last inspection Brief Description of the Service: On 10th June 2008 the Registered Provider to Fairlawn Nursing Home renamed it to Higham House. The home is situated on the main road through Rushden. The home is a converted building and provides nursing care for up to 30 frail, elderly residents of both sexes with both physical and dementia related illnesses. Accommodation is in both single and shared rooms over two floors. Some of the newer rooms have en suite facilities and there are sufficient additional toilets and bathrooms with assisted bathing facilities. There are two communal sitting rooms, a dining room, kitchen and laundry, with a garden and patio area to the front and side of the property. It is within easy access of the local towns of Rushden and Higham Ferrers. A local bus service is easily accessible. The Statement of Purpose, Service users’ Guide & Inspection Report is available on request (these provide information on how the home is organised and what services they provide). Copies of the Commission for Social Care Inspection (CSCI) reports are available on request from the office. A copy of the CSCI registration certificate and a copy of the current Employers Liability Insurance are displayed at the entrance to the hallway. At the time of the inspection, fees ranged from £478.95 to £500.00 per week. Extras include hairdressing, dry cleaning and phone calls made from the foyer. Higham House DS0000045316.V370681.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is on outcomes for residents and their views of the service provided. The home provides care for up to thirty people. On the day of inspection there were nineteen people living at the home. The inspection took eight hours to complete. Preparation included examining inspection records and looking at the service history and annual quality assurance record (AQQA). This is information sent into CSCI when requested about the service that is provided at Higham House then known as Fairlawn. Discussions were held with both staff and visitors during the inspection. The primary method of inspection used was “case tracking”. This involved speaking with or observing the people who use the service provided, looking at two peoples care plans and making observations. Care plans are records about the care or support provided for an individual. All the required key standards were inspected during this visit. New requirements were made. The acting manager assisted the inspector during the inspection. What the service does well: What has improved since the last inspection? What they could do better: Higham House DS0000045316.V370681.R01.S.doc Version 5.2 Page 6 Environmental risk assessments for each person’s room should be included to ensure that any risk to themselves and others has been considered and reduced wherever possible. The Provider must satisfy themselves that each person has been the subject of all relevant checks, so as to maintain the safety of those living in the home. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Higham House DS0000045316.V370681.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Higham House DS0000045316.V370681.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Assessments are made prior to anyone coming into Higham House for care. EVIDENCE: Since the last inspection report in June 2008 the Registered Provider has changed the name of the care home from Fairlawn to Higham House. The acting manager has said that a copy of the latest Service User Guide and Statement Of Purpose will be sent to the Commission for Social Care Inspection (CSCI) and will be provided to any one who requests a copy, normally this would be on the notice board in the hallway and should include a copy of the latest contact details for CSCI. In the two care plans case tracked the assessments were done and included various assessment tools to enhance the care provided. Standard 6 intermediate care is not offered at this home. Higham House DS0000045316.V370681.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Individuals’ needs are set out in their plans of care. However, there is a need for further assessments to be made. EVIDENCE: The two care plans seen included evidence of care. However there were areas of the assessment that did not accurately reflect some aspects of care. One person’s activities of daily living sheet written in January 2008 had not been updated and still said that they had clear speech. This was no longer the case and they rarely spoke now as family members and staff explained to the inspector. A new carer could be misled by the information and think that the persons condition had suddenly deteriorated. A more serious concern however was that this persons care plan said that they were now on Oxygen. It was installed into the bedroom but there was no evidence of a risk assessment for this. There was now an increased risk of fire to everyone due to having Oxygen in the bedroom. There were no notices on Higham House DS0000045316.V370681.R01.S.doc Version 5.2 Page 10 the room door to warn relatives or staff and as the home was being decorated some of the fire notices had been removed temporarily. However the inspector informed the decorators and the acting manager that it was important for the fire notices to be replaced or created as soon as possible due to fire safety. The medications of the two people case tracked were checked and fine and the controlled medication (CD) of one of them (A CD is a medication with special requirements by law) was checked and fine. Two upstairs bedrooms were seen of two different people who were able to walk independently, suffered with memory loss, severe dementia or confusion. In both rooms items with the potential for causing harm was left by their sinks. Cupboards for storage were provided under the sinks in each of the rooms seen. Although they were not medications they could cause harm and the acting manager explained that there was no risk assessments on the individual rooms either. A requirement under Health and Safety was made this aspect of care was discussed at the last inspection of the service and the acting manager must review practices at the home. Higham House DS0000045316.V370681.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individuals are encouraged to maintain contact with their families and friends. Visitors are made welcome also. EVIDENCE: On the day of inspection the care home was being decorated and all the people living there were in one lounge or in their bedrooms. They looked contented. Staff was present and able to help anyone who needed it. Activities are provided when the staff are able to offer this. Staff was present and available to anyone who needed them. On the day of inspection the inspector did not see any activities. The assessment of the safety of the outside environment was not assessed, as decorators were busy working inside and using outside. This requirement will be carried forward as a result. The inspector spoke with family members who were visiting at the time. Relatives comments included ‘their relative seems happy here. The General Practitioner (GP) visits when needed.’ Higham House DS0000045316.V370681.R01.S.doc Version 5.2 Page 12 They said that they felt ‘their relative was safe at this home’. Our relative always wears her own clothes and is always tidy when we visit, ‘ they are always presentable. There are no unpleasant smells near their relative. They said that ‘they are always kept informed when they call to ask how their relative has been’. ‘Our relative has put weight on since living here’. The hairdresser visits and their relative has their hair done. ‘Since being here they feel their relative looks happier, more stable. As a family they feel more engaged, more a part of the care.’ ‘Staff are always there when you need them. The atmosphere at the home is definitely getting better’. ‘They have no problems with understanding the speech of the staff no problems with accents and feel that they have never been fobbed off by the staff.’ ‘Different people can be asked about their relatives care and the staff are always happy to explain’. The inspector spoke at length with three staff members about care issues and all the staff was able to explain the choices that they were able to offer the individuals discussed. The majority of meals were taken in the dining room and those needing more help were assisted to have their meals either in the lounge or in their bedrooms. The atmosphere at mealtime was pleasant. Many of the men were seated together and seemed fine with this arrangement. A member of the care staff, not seen at the last inspection was very caring towards the individuals and ensured that individuals did not leave the table without having their mouths wiped or their clothes checked to ensure that they looked fine. Higham House DS0000045316.V370681.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service has a complaints procedure. People associated with the home say that they are satisfied with the service provision. EVIDENCE: The Commission of Social Care Inspection has received a complaint about Higham House since the last inspection. This has been dealt with. The complaints procedure is available within the home although due to the extensive redecoration programme it was not seen in the corridor and is available on request. Visitors who spoke with the inspector felt that their relative was safe and supported living at the Higham House care home. The inspector spoke with three staff members in detail. One staff member was fairly new to the home and to care and had not yet received any training on the Protection Of Vulnerable Adults (POVA). However she explained that if she saw something that was of harm to a person living at the home she would report it to the person in charge. The other staff members who spoke with the inspector had either had training or would seek help from a senior staff member at the home. The acting manager said that training was ongoing and all staff would receive training in POVA along with other relevant courses. Higham House DS0000045316.V370681.R01.S.doc Version 5.2 Page 14 People associated with the home state that they are satisfied with the service provision and feel safe and supported. Higham House DS0000045316.V370681.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Higham House provides a homely environment and is generally clean and tidy. EVIDENCE: Higham House was being re decorated during the inspection. This is likely to continue for a while. The outside areas were not assessed on this occasion due to the redecoration process. Bedrooms seen were satisfactory. There were some areas of concern with regard to liquids and other items left near the sinks in individuals rooms where the potential of risk from harm could occur. In the pubic areas seen (staff and visitors toilet area) and in the two bedrooms seen washing and drying facilities to ensure hygiene and cleanliness were available. This judgement has been given because the downstairs corridors, the front lounge and hallway are being redecorated and there are many restrictions to Higham House DS0000045316.V370681.R01.S.doc Version 5.2 Page 16 the movement of anyone living or visiting the home at this moment in time. This also includes restriction to the outside of the building such as the back/side patio area seen at inspection. Higham House DS0000045316.V370681.R01.S.doc Version 5.2 Page 17 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The numbers and skill mix of staff meets individuals’ needs. EVIDENCE: There was noticeable improvement in the staffs’ awareness and caring attitude to the individuals living at the care home. Staff on duty were able to explain themselves quite well and were easily understood. Staff who spoke with the inspector was helpful with their information and were aware of the care issues concerning the people that they care for. Staff explained the training that they had and two staff records were inspected in detail. Staff receives supervision from the acting manager and these are recorded in the staff records. On the rota the shifts are covered with one Registered Nurse and four care staff in the morning and one Registered Nurse and four care staff in the afternoon with one Registered Nurse and a care staff covering night shifts. Higham House DS0000045316.V370681.R01.S.doc Version 5.2 Page 18 A housekeeper is employed for cleaning and laundry duties around the home and on the day of inspection a new member of staff was being given an induction into the kitchen. She was not offered any protective clothes, neither were staff who entered the kitchen neither was the inspector. There did not seem to be any code of conduct for people wishing to enter the Kitchen area. A maintenance person is employed (a sub contractor) who ensures that water temperatures and portable appliance testing is carried out as well as other duties around the home. The acting manager said that there is a current programme of training and there was evidence of some training in the records seen. There was some confusion over the provision of checks for someone undertaking work experience in the home; the Provider must satisfy themselves that the person has been the subject of all relevant checks, so as to maintain the safety of those living in the home. Higham House DS0000045316.V370681.R01.S.doc Version 5.2 Page 19 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Improvements in the care home are being made and the interests of the people who live there are being taken into account as an action plan is being undertaken. EVIDENCE: The acting manager continues to run the home in the absence of a registered manager or registered provider. The registered provider visits the care home and is able to provide evidence of Regulation 26 records. People working at the home and the visitors who spoke with the inspector felt that the home was improving and had no concerns. Many of the people living at the home were unable to express an opinion but looked fine. Higham House DS0000045316.V370681.R01.S.doc Version 5.2 Page 20 The monies of two people case tracked were checked and fine although the acting manager was reminded of the need for two signatures for all transactions. This will help to protect the acting manager from any accusation of theft and will safeguard the individuals’ money. The acting manager explained that the fire alarms were up to date and other evidence of gas and electricity checks were seen. Higham House DS0000045316.V370681.R01.S.doc Version 5.2 Page 21 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 2 X X 2 Higham House DS0000045316.V370681.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes 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 OP9 Regulation 13 (4) (a) Requirement The Registered Person shall ensure that all parts of the home to which service users have access are so far as reasonably practicable free from hazards to their safety. This is a home for people with dementia who could be at risk from in appropriately placed powders, creams and liquids, used razors. 2. OP19 23 (2) (a) & (b) The patio garden area to the side 01/12/08 and back of the property needs further attention to ensure that it is fit for purpose and is safe for anyone who may wish to use it. The patio door has a ridge leading from it, making it difficult to manoeuvre over, if a wheelchair was used. All aspects of safety must be considered. 22/08/08 The Provider must comply with 27/11/08 the Department of Health requirements and should satisfy themselves that the person has been the subject of all relevant checks, so as to maintain the DS0000045316.V370681.R01.S.doc Version 5.2 Page 23 Timescale for action 27/11/08 3. OP29 19 (1) (b) (i) Higham House safety of those living in the home. On this occasion it refers to one person. 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 Higham House DS0000045316.V370681.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Higham House DS0000045316.V370681.R01.S.doc Version 5.2 Page 25 - 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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