Inspection on 15/05/06 for Highbarrow

This inspection was carried out on 15th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

Highbarrow 25/11/05

Highbarrow 22/07/05

Highbarrow 10/01/05

Highbarrow 03/11/04

Highbarrow 05/02/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Highbarrow Toothill Road Uttoxeter Staffordshire ST14 8JT Lead Inspector Mr Berwyn Babb Key Announced Inspection 15 May 2006 14:00 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 Highbarrow DS0000004954.V293332.R01.S.doc Version 5.1 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. Highbarrow DS0000004954.V293332.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Highbarrow Address Toothill Road Uttoxeter Staffordshire ST14 8JT 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) 01889 566406 01889 569799 Mrs Regina Hayes Mr Robert Micheal Hayes Mrs Regina Hayes Care Home 22 Category(ies) of Dementia - over 65 years of age (5), Old age, registration, with number not falling within any other category (22), of places Physical disability (1), Physical disability over 65 years of age (15) Highbarrow DS0000004954.V293332.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 1- PD over 54 years Date of last inspection 25th November 2005 Brief Description of the Service: Highbarrow is a large detached house that has been extended to provide residential accommodation for 22 older people, 16 of whom may have a physical disability, and five of whom may have dementia care needs, and one of whom may have a physical disability and be under the age of 65. The home is situated in rural areas but within a short drive of the town of Uttoxeter. Accommodation is provided in two double and 18 single bedrooms. There are two double and three single bedrooms on the first floor and 16 single bedrooms (10 with en-suite, three of those with showers) on the ground floor. The two double bedrooms on the first floor are being occupied as single, and it is the policy of the home as stated in the service users guide, that double rooms are only shared by partners or friends requesting to do so. Communal facilities consist of a large lounge, smaller quiet lounge, and a dining room. On the first floor there is an assisted bathroom with WC and two separate WCs, and on the ground floor there is an assisted bathroom with WC, a shower room with WC, and three separate WCs. These toilets are situated within close proximity of both lounges and of the dining room. The kitchen and laundry are situated on the ground floor as is the care office and proprietors offices. There is also a staff bathroom, bedrooms and kitchen. Externally there are large landscaped gardens all around the building, with lawns and patios that are fitted with garden furniture, and are accessible to all residents. At the front of the building there is space for car parking. Highbarrow DS0000004954.V293332.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the 2006-07 key inspection for a service that is assessed as being good at the outset of the inspection, Level 3. All core standards identified by CSCI as being necessary for a key inspection were addressed. The deputy manager, two carers and one of the proprietors were on duty at all times during the inspection, and residents appeared to be having their needs met with dignity and without delay. The home was clean throughout and of an ambient temperature and furniture and fittings were seen to be in good order. Residents were in a relaxed mood having just partaken in their lunch, and those with whom the inspector spoke were well pleased with their life at Highbarrow. A very full provider dataset had been received prior to the inspection, and the inspector found this particularly useful for the purpose of triangulation. What the service does well: What has improved since the last inspection? All those carpets mentioned in the good practice recommendations of the previous report have been replaced and the alarm systems have now been made operable in those en-suite toilets where previously they were not working. Highbarrow DS0000004954.V293332.R01.S.doc Version 5.1 Page 6 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. Highbarrow DS0000004954.V293332.R01.S.doc Version 5.1 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 Highbarrow DS0000004954.V293332.R01.S.doc Version 5.1 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 the following standard(s): 3,6 The outcome for this group of service users is judged to be good as no service user had been moved into the home without having their needs assessed, and this home only admits residents for permanent care, and does not undertake intermediate care. EVIDENCE: The inspector reviewed a random sample of care plans of residents and was able to find initial assessments that had been carried out prior to them entering the home and which had later formed the basis for their ongoing care plans. These had been reviewed and amended as necessary at the appropriate intervals of time and where necessary, referrals had been made back to the admitting authority or family, where prolonged knowledge of the residents suggested a review of what had already been stated about them. The inspector spoke to several residents of the part they had taken, in choosing High Barrow as being their future home. Highbarrow DS0000004954.V293332.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 The outcome for this group of residents is felt to be good, because observation of practices on the day, and the views given by residents, together with what was said in the records examined, confirmed that the assessed personal health and social care needs of the residents were being met appropriately, respectfully and with the advice and input of relevant individuals from outside of the homes own resources. EVIDENCE: Several care plans were chosen at random, or as a result of something said during the inspection, or as part of a case tracking exercise where the inspector had spoken with that particular resident. These demonstrated that the information gathered before somebody was admitted to the home had been used as a platform on which to construct an ongoing programme for meeting their assessed needs and responding to their individual choices. Highbarrow DS0000004954.V293332.R01.S.doc Version 5.1 Page 10 They were written in a professional language that was dignified and informative, and included such items as how a person wished to be addressed, what time they wanted to get up or got to bed, how they would like to have their personal care needs met, whether or not they controlled their own medication or had asked the home to undertake this for them, who their GP was, what clinical appointments they had with hospital or other outpatient departments, and the regular programme of access to tertiary healthcare such as opticians, dentists, chiropodists and hearing aid clinics. Monitoring sheets were included to record visits of various healthcare professionals, and where relevant, of such things as blood pressure, weight, diet and fluid intake, elimination, personal hygiene and tissue viability. The inspector brought to the attention of the proprietor the practice of a member of staff in relation to medication administration, which was contrary to the policy of the home and he took action to rectify this immediately. Highbarrow DS0000004954.V293332.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 The outcome for this particular group of residents is good; as they all indicated their satisfaction with the style of life they were experiencing in the home. They were able to talk about the contact they had with relatives and friends, and where they had chosen to take control over aspects of their lives, or to ask someone else to do it for them. Meals had been appreciated by those people who spoke to the inspector. EVIDENCE: In discussion with the inspector several residents spoke of the contact that they had with members of the family, and about how their particular choices of food were met for them. Whilst there was a full programme of communal activities prominently displayed in the home, many of the residents the inspector spoke to said that they preferred to spend time on their own in their rooms, picking and mixing those activities with which they joined in. On the day of the inspection a group were playing carpet skittles in the large lounge, and that every two weeks an entertainer comes to the home with his electric organ, to lead a sing along. A particular interest of this home was a gentleman who comes round with pictures of gardens and country, in the different seasons of the year, and uses these as a trigger for reminiscence with the residents of the home. Highbarrow DS0000004954.V293332.R01.S.doc Version 5.1 Page 12 In addition to stills pictures he uses home movies of various gardens to bring the plants and the seasons to life, and apparently this is much appreciated by the ladies and gentleman of Highbarrow. They said that they could receive visitors at any time, and generally were very aware of the constraints upon their relatives, whose presence they would have enjoyed more regularly if that were at all possible. The inspector was told that relatives were always welcomed into the home, and if appropriate, were asked if they would like refreshment. In reviewing a care plan, the inspector was able to discuss with the proprietor procedures that had to be put in place to safeguard a resident who continues to enjoy taking regular exercise, but due to increasing frailty and forgetfulness, was increasingly at risk from the environment. Encouragingly, these procedures involved care staff in closer attention and monitoring, but did not unnecessarily restrict the scope of that resident’s perambulations. When discussing meals with residents, the inspector was told that all efforts were made to furnish them with something that they would enjoy, if they did not like what the majority of the other residents were having at any particular meal, and that also if they expressed a particular like to the cook, then she would attempt to include this in the menus. Menus reviewed showed that a variety was available that included seasonal dishes, and a visit to the kitchen revealed sufficient crockery and cutlery and other utensils for the needs of residents, all kept and maintained in clean and tidy conditions. There were copious certificates of food and hygiene training for members of staff on the wall outside the kitchen. Care plans recorded the intervals at which people had their meals, and that they were able to take a light supper. This met with the good practice of spreading the consumption of food throughout the day, and not leaving a long period between the last meal at night and breakfast the next morning. The dining room is a feature of this home, being panelled and contained comfortable furniture with tables for no more than four people, and individual place settings with condiments on each table, good table linen with napkins, the whole aimed at making meal times a relaxed and enjoyable experience. Special diets were available and some of these having a medical determinant were recorded in the care plan for that individual person. Highbarrow DS0000004954.V293332.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 The outcome for this group of residents is good as there is a robust complaints procedure, and adult protection issues are well appreciated by both management and staff. EVIDENCE: The inspector undertook an in depth interview with a member of staff during which they discussed the subject of abuse, and he was satisfied with her knowledge of what constituted abuse, the signs that she should look for and that would alert her to the fact that abuse had taken place, and the procedure that she should follow if she suspected or became aware that in fact it had done so. She told him that abuse training was given to new staff during their induction process. A copy of the complaints procedure is prominently displayed on the wall by the door, and all members of staff have to sign to say they have received and read a fuller exposition of this procedure. Where residents would not benefit from possession of their own copy, this is given to their supporting relatives, so that they may be able to advocate on their behalf. Highbarrow DS0000004954.V293332.R01.S.doc Version 5.1 Page 14 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 the following standard(s): 19,26 The outcome for this particular group of residents is good because the situation and maintenance of this home has much to highly commend it, as does the standard of cleanliness and hygiene experienced throughout. EVIDENCE: A visual inspection of the exterior of the home was made before the commencement of this inspection, and nothing of note was seen by the inspector to alert him to any discrepancies in the standard of the home. Inside the home was clean and comfortably furnished, with renewed carpets on the stairs, landing and hall, and a continuing programme of refurbishment whenever a room is available. One area however, which remains to be refurbished, is the upstairs shower room which is seriously undermining the standard of the rest of the home, and in discussion with the proprietor the inspector voiced the opinion that this needed to be proceeded with as soon as possible. Highbarrow DS0000004954.V293332.R01.S.doc Version 5.1 Page 15 An inspection was made of residents bedrooms, and this confirmed that they all had such things as are detailed in the standards, including lockable facilities for valuables, a bed of their own choosing, small items of furniture from their own homes, and pictures and ornaments, as well as wash basins and a call bell to attract attention in emergencies. In the room one gentleman who particularly feels the cold, there was a supplementary heater, and this was said by the proprietor to be regulated to ensure that it does not present a danger to the resident should they happen to fall against it. In another room the inspector was intrigued by the second television screen which turned out to be the display unit for an electronic magnifier, under which the resident could place newspapers and books and other articles, leaving her hands free while she was reading their content. Highbarrow DS0000004954.V293332.R01.S.doc Version 5.1 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 The outcome for this group of residents was good because there was a robust rota of staff available to meet residents assessed needs and their choices, with evidence of training in all mandatory and other relevant subjects. EVIDENCE: The staffing rota provided by the providers prior to the inspection, showed that sufficient staff were on duty to meet the assessed and changing care needs of the residents, and those who spoke to the inspector were fulsome in their praise, one saying how very impressed she was with staff who never got impatient, and always remembered her preferences. The proprietor provided a schedule of training that had been undertaken or was planned, and members of staff confirmed they had both ad hoc training and progressive training through national vocational qualification schemes. A session of fire training had been provided on 29th March this year and another was planned for the autumn. New members of staff confirmed that they had received abuse training during their induction, and a large notice was seen on the staff area wall reminding them of the essentials of equal opportunities. Other training made available during the last 12 months had been diabetes awareness, and foot care, and planned for the near future was a further session on dementia awareness, and food hygiene, as well as a member of staff enrolling on level 2 NVQ, and a further member of staff enrolling level 3 NVQ. Currently 55 of staff in this home are qualified to level 2 or above. Highbarrow DS0000004954.V293332.R01.S.doc Version 5.1 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 The outcome for this group of service users is good because the home is run and managed by fit individuals, with the care of their residents at heart, ensuring their financial interests are being guarded, and that the health, safety and welfare of all people in the home, is ensured to the highest possible degree. EVIDENCE: The current care manager who is the female proprietor is not considering taking the management qualification and her husband who has been working in the home since they purchased it, has now been awarded the qualification and is applying to replace his wife in the position of registered care manager. Highbarrow DS0000004954.V293332.R01.S.doc Version 5.1 Page 18 During the inspection, residents told the inspector that their views and the views of their families were regularly canvassed by the home, and with one or other of the proprietors being available every day in the home for consultation, there is a wide opportunity for them to observe the standard of care practices, and for residents to approach them with thoughts and concerns that they may have. In the pre inspection questionnaire received by CSCI, the proprietor had stated that 18 of the current residents have arrangements made for someone to exercise a power of attorney on their behalf. In some cases this is a member of their family, and in a few cases a solicitor or other advocate undertakes this task. The only items not covered by the basic care price are hairdressing, newspapers and private chiropody. This last named item is sometimes felt to be necessary because of the extended periods between appointments being offered by NHS chiropodists, and the actual or perceived needs of some residents to have attention to their feet more often. The inspector questioned a member of staff about her knowledge of first aid, and she was able to assure him that she had the relevant qualifications having been a nursing sister in her own country. The schedule of staff training shows that there are sufficient staff with the emergency first aid certificate for there to be one available every shift. As detailed above food hygiene certificates were on display on the wall outside the kitchen, and contracts were in place for the disposal of contaminated and other waste. The care plans reviewed demonstrated that risk assessments had been carried out were appropriate in relation to residents use of the facilities provided, and the stair lift and bath hoists had been serviced at the recommended intervals, and were certificated as being in good order for current use. Highbarrow DS0000004954.V293332.R01.S.doc Version 5.1 Page 19 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 3 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 4 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Highbarrow DS0000004954.V293332.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? No 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 Highbarrow DS0000004954.V293332.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 Highbarrow DS0000004954.V293332.R01.S.doc Version 5.1 Page 22 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!