Inspection on 25/11/05 for Highbarrow

This inspection was carried out on 25th November 2005.

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 15/05/06

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 Unannounced Inspection 25th November 2005 01:30 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 Highbarrow DS0000004954.V270062.R01.S.doc Version 5.0 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.V270062.R01.S.doc Version 5.0 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.V270062.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 1- PD over 54 years Date of last inspection 22nd July 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, 3 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.V270062.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was made to complete the 2005/2006 schedule, and concentrated on those key standards not addressed during the annual inspection of July 22nd. Three members of staff were on duty at all times during the inspection, and resident’s appeared to be well cared for by carers who displayed sensitivity, professionalism, and warmth towards them. A G. P. made a house call during the inspection, and a C. P. N. who had visited for a re-assessment of a resident, commented favourably on the home, and how they made appropriate referrals to her service, when they considered they were no longer able to meet the needs of the resident. 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. Highbarrow DS0000004954.V270062.R01.S.doc Version 5.0 Page 6 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.V270062.R01.S.doc Version 5.0 Page 7 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): 2,4 Residents had an appropriate written contract, and they, and/or their supporters, had sufficient information about the home before admission, to make an informed choice about whether this was the right place to have their assessed needs met. EVIDENCE: The inspector reviewed a random sample of contracts in care plans of the residents, and these covered all those aspects required under this standard. Some contracts were signed by the resident alone, and others had been endorsed on their behalf, by a family member, solicitor, or more formal guardian. The daughter of one resident spoke with the inspector at length, and she confirmed that when looking for a home for her mum, she had been furnished by the proprietor, with all the information she needed, in order to make a decision about whether they could meet her mother’s assessed needs, and also offer an environment she could appreciate and feel secure in. A specialist nurse Highbarrow DS0000004954.V270062.R01.S.doc Version 5.0 Page 8 visited the home at the same time as the inspector, to carry out a reassessment of a resident, and she commented favourably on the home, and how they made appropriate referrals to her service, when they needed advice or assistance, or when they considered they were no longer able to meet the needs of the resident. Highbarrow DS0000004954.V270062.R01.S.doc Version 5.0 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): 7,9,11 Records examined, practices observed, and the comments of residents and staff suggest that their health and personal care needs are being met by the home in association with other identified professionals, clinics, surgeries, and diverse health care facilities. This, where necessary, has included making arrangements for a more appropriate alternative placement following multidisciplinary reviews. EVIDENCE: The inspector reviewed a sample of care plans, some chosen at random, and some to be included in case tracking the care of a particular resident. These may have been identified following observation of aids or equipment in the environment, or from observation or conversation, with or about, that resident. The plans contained adequate information gathered prior to admission to form a working database for the provision of care, and the appreciation of individual’s preferences and choices, and were set out in an ordered fashion that gave easy access to information needed to proffer care professionally. They contained risk assessments on various conditions and activities, and such Highbarrow DS0000004954.V270062.R01.S.doc Version 5.0 Page 10 random examples as sleep patterns, lists of allergies, and monitoring charts of day, and night time well being. Examination of the Medication Administration Record uncovered a couple of issues, and these will be the subject of a requirement. A signature was missing for one item of medication, and the inspector gave advice that when the symbol O, for other, had been used on a sheet, then a clear explanation of what this referred to must be written on the sheet. If this is not done, no verification is provided when an audit trail has to be initiated The senior carer in charge of the home entered into a detailed discussion about liaison with a family who wanted their nonagenarian mother to be made as comfortable as possible during the process of her impending demise, as she herself had expressed the desire to be allowed to die a natural death. Highbarrow DS0000004954.V270062.R01.S.doc Version 5.0 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): 13,14 Residents informed the inspector that they were extremely satisfied with the way the home met their social needs, and allowed them to take decisions affecting their lives. EVIDENCE: As well as taking evidence from care plans, and talking to residents, the inspector had a long discussion with a family member who was very positive about the attitude of the home towards maintaining contact, and visiting, and had been kept involved in planning and discussions regarding her mother’s care, and continued involvement with the local community. Records showed that a musician visited the home on a weekly basis to lead community singing and play his synthesizer. Interviewed in private, one resident was at great lengths to impress upon the inspector how kind people were to her, and the joy she gained from being able to take a constitutional walk around the grounds everyday. Staff members were seen to have her best interest at heart in ensuring that she was properly clad for the prevailing weather conditions, and kept aware of her position, to protect her from any potential environmental dangers. Highbarrow DS0000004954.V270062.R01.S.doc Version 5.0 Page 12 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 Written and anecdotal evidence supported the statement that residents and their families were able to feel confident that their complaints would be listened to and taken seriously and acted upon, and that all steps possible were being taken to prevent them from abuse. EVIDENCE: The inspector was able to trace the progress of a recent complaint made by member of a resident’s family, and was impressed with the thoroughness of the steps taken by the proprietor to address this matter. He had involved the whole of the care team in ensuring that the proper procedure and policy were carried out, and that all residents had a voice when they wished to comment on some aspect of the service. The inspector undertook an in-depth interview with a member of staff during which discussion they discussed the subject of abuse. She correctly identified that anybody could abuse the vulnerable adults, resident at Highbarrow. She went on to elaborate on a range of events that would constitute abuse, listing not only things which could be done to a person that could be abusive, but also those things that leaving left undone would be abusive. She was aware of the procedures to be followed should she suspect abuse, and was confident that all her colleagues did as well, as this was an integral part of N. V. Q. training, and had recently been endorsed at a staff meeting by the proprietor. Highbarrow DS0000004954.V270062.R01.S.doc Version 5.0 Page 13 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): 19,22,24,26 Observation, discussion, and the examination of records, confirmed to the inspector that residents are living in a safe and well maintained environment, with easy access both internally and externally, and the whole, including comfortable and personalised bedrooms, being well maintained, clean, and free from odours. Additions need to be made to the call system, to make it accessible in every room. EVIDENCE: During the tour of the premises, the inspector noted wear on the tread of one of the stairs, and a broken over bed lamp bracket in the room of one resident. By the time of his follow up contact on 13/12/05, a new stair carpet was that day being fitted, and the lamp had been removed altogether, and replaced with a more suitably domestic, table mounted bedside light. Highbarrow DS0000004954.V270062.R01.S.doc Version 5.0 Page 14 The rooms visited were indicative of the individual personalities of residents, with their own choice of pictures and ornamentation, and some including items of furniture of their own. They were all clean and well lighted and naturally ventilated, with a good standard of decoration and soft furnishing. In some of the en-suites, there was no provision for summoning assistance, and it will be a requirement of this report that this deficiency is rectified. A visit to the laundry confirmed that washing machines included sluice washes in their program, and that the tiled floor and painted walls were clean and impervious, and there were separate hand washing facilities, and each resident’s clean clothing was being kept separate. All other areas of the home visited on this day were clean and hygienic, and there was no hint of any malodour anywhere. Highbarrow DS0000004954.V270062.R01.S.doc Version 5.0 Page 15 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 The number of staff hours on the rota, and the skills and qualifications held by members of staff suggest that resident’s needs were being met by a sufficient number of people with appropriate skills. EVIDENCE: Calculations of hours of care being provided per resident, using the rota for the current week, showed that the minimum being recommended was just being exceeded whilst there were only 20 residents in the home. The flexible use of carers to provide greater numbers at peak activity times, demonstrated sensitive planning to maximise human resources to match the assessed needs of the residents in the home. Observation of the interaction between residents and staff showed there to be a relaxed style of exchange that in no way detracted from the privacy and dignity of the resident being assisted. A discussion with the senior in charge of the home confirmed that mandatory training was provided, and that this together with the care modules of N. V. Q. equipped the members of staff with the necessary skills to meet the assessed needs of the residents in the most appropriate way. Highbarrow DS0000004954.V270062.R01.S.doc Version 5.0 Page 16 The rota showed that separate people were employed to staff the kitchen, and that the domestic cleaning was also performed by personnel dedicated to this task. The ironing was done by the two waking and watchful night staff, in between attending to their other duties. Highbarrow DS0000004954.V270062.R01.S.doc Version 5.0 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): 33, 38 From observation made first hand on the day, and from discussion and the reading of relevant documents, the management and administration of this home appears to be in the best interest of the residents, and to comply with best practice in promoting health and safety. EVIDENCE: This is a private home, with both proprietors working in the establishment, and providing daily access for residents who may wish to consult them over any matter. Residents who spoke to the inspector all said how hard Mr. And Mrs. Hayes worked, and relatives commented on how open they were to discussion and how supportive they were of their residents and their families. Highbarrow DS0000004954.V270062.R01.S.doc Version 5.0 Page 18 Their commitment to the health, safety, and welfare of everybody at Highbarrow was demonstrated by a raft of risk assessments relating to both choices and conditions of residents, and tasks undertaken by staff, in the documents examined during this inspection. Maintenance was judged to be of a very high standard, records of fire safety and training, medication administration training, accidents, complaints, water temperature testing, further confirmed the view that health safety and welfare of residents and any other person in the home was being promoted by the proprietors of Highbarrow. Highbarrow DS0000004954.V270062.R01.S.doc Version 5.0 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 3 X 3 X x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 2 10 X 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 2 X 4 X 4 STAFFING Standard No Score 27 3 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X X X X 3 Highbarrow DS0000004954.V270062.R01.S.doc Version 5.0 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. 1 Standard OP9 Regulation 13.2 Requirement The registered person must ensure that the Medication Administration Record is always a true, accurate, and obvious statement of medications administered, refused, or for any other reason, not given. Call systems with accessible alarm facilities must be provided in every room, especially in ensuite toilets. Timescale for action 25/12/05 2 OP22 16.2 © 25/12/05 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.V270062.R01.S.doc Version 5.0 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.V270062.R01.S.doc Version 5.0 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. 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