Inspection on 02/05/05 for Highbrake House

This inspection was carried out on 2nd May 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Highbrake House 06/11/07

Highbrake House 26/09/06

Highbrake House 07/11/05

Highbrake House 10/06/04

Highbrake House 12/02/04

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

CARE HOMES FOR OLDER PEOPLE High Brake House 124 Chatburn Road, Clitheroe, Lancs BB7 2BD Lead Inspector Christine Mulcahy Unannounced 2 May 2005 10.00 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 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. Highbreak House F57 F07 S53551 High Brake House V225758 030505 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service High Brake House Address 129 Chatburn Road Clitheroe Lancs BB7 2BD 01200 423286 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Brierley care Limited Mrs Angela Catherine C Moseley Care Home only Personal Care 21 Category(ies) of Old Age, not falling with any other category OP registration, with number 21 of places Highbreak House F57 F07 S53551 High Brake House V225758 030505 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service should at all times employ a suitably qualified manager who is registered with the Commission for Social Care Inspection Date of last inspection 8th February 2005 Brief Description of the Service: High Brake House is registered with the Commission for Social Care Inspection to provide 24-hour personal care and accommodation to 21 older people. High Brake House is a detached 4 storey building in its own grounds. Car parking is available at the front of the house. At the rear of the house are a patio area and a large garden, with lawn, flowerbeds, trees and shrubs. The house is situated on the outskirts of Clitheroe, in a residential area and overlooks Clitheroe Grammar School. Public transport is within easy access of the property. Clitheroe town centre is within a reasonable walking distance. Transport to town can be arranged by the home. At High Break House accommodation is provided in eleven single bedrooms and five shared bedrooms. Bedrooms are situated on the ground floor, lower ground floor and the first floor. All bedrooms have a door lock. On the ground floor there is a lounge, dining room and kitchen. The lower ground floor has a lounge with patio windows leading onto the garden. The office and laundry are situated on the lower ground floor. These floors are accessed via a passenger lift. Aids and adaptations are provided throughout the home including a mobile hoist, a bath hoist, and raised toilet seats with grab rails at the side. Brierley Care Ltd owns the home. The Responsible Individual for the company is Mrs. K Brierley and the Registered Manager at the home is Mrs. A C Moseley. Highbreak House F57 F07 S53551 High Brake House V225758 030505 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was the first unannounced inspection in 2005. The inspection took place over one day. At the time of the inspection 17 residents were accommodated at the home. The inspector arrived at 10.00am and the inspection continued until 4pm. The service was inspected against the National Minimum Standards for Older People and involved examination of records, and discussion with the registered person. There are various references to ‘The Case Tracking Process’. This is a method where the inspector focuses on small representative group. All records pertaining to these people are inspected along with the rooms they occupy in the home. Observations are made of the care provided and the service users are invited to have a discussion with the inspector to discuss their experiences of life in the home. However, this is not to the exclusion of other service users, with a number of others being involved in the inspection process in various other ways. Breaches in Regulations and Standards which pose an immediate risk to service users have been highlighted for urgent action. The inspection was carried out with the co-operation of Mrs. A C Moseley and Mr. M Brierley (Trainee Manager.) Over the course of the inspection all 6 residents, 1 visitor, 3 staff members and the trainee manager were spoken with. 4 resident’s files were examined in with information gained from others. 1 new member of staff had been appointed since the last inspection and this file was examined. A tour of the premises took place, including six bedrooms. Documents were read and care observed. What the service does well: One resident said “ The home is very comfortable”. Another said “ The staff are always helpful and polite, I’ve been here a long time so it can’t be bad.” When asked residents said the food was very good and some were looking forward to a special food tasting afternoon that day. This would help them decide what new dishes would be included on the revised menu. Daily involvement of the owner and the staff team ensured that resident satisfaction was paramount. The residents spoke highly of the daily contact they had with staff team and felt they listened to them and acted on their comments. Highbreak House F57 F07 S53551 High Brake House V225758 030505 Stage 4.doc Version 1.20 Page 6 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 full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Highbreak House F57 F07 S53551 High Brake House V225758 030505 Stage 4.doc Version 1.20 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 Standards Statutory Requirements Identified During the Inspection Highbreak House F57 F07 S53551 High Brake House V225758 030505 Stage 4.doc Version 1.20 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 standard(s) 1, 2 and 3. Written information about the home and the facilities was up to date and set out the aims and terms and conditions of the home. Residents had a plan of care for daily living and longer term outcomes based on the care management assessment. EVIDENCE: A revised Statement of Purpose and Service User Guide had been written and forwarded to the Commission since the last inspection. Both documents contained all the information needed for a prospective resident to understand how the home was run and what facilities were offered. Copies of both documents were displayed on the hallway dresser and available to read. Mr. Brierley said that he was in the process of providing all residents with a copy of their own up dated Service User Guide. When asked two residents confirmed they had received a contract that clearly stated the terms and conditions of the home. Case tracking confirmed that a short stay resident was referred through care management arrangements and the care plan highlighted the residents day to Highbreak House F57 F07 S53551 High Brake House V225758 030505 Stage 4.doc Version 1.20 Page 9 day living needs; where assistance was needed, weight, sight, hearing, oral health, diet, intellectual/ cultural needs and interests and hobbies. Highbreak House F57 F07 S53551 High Brake House V225758 030505 Stage 4.doc Version 1.20 Page 10 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 standard(s) 7,8,9 and 10 The health care needs of the residents were identified and met. Staff respected residents’ privacy and dignity. The control of medication was well-managed promoting good health. EVIDENCE: At the time of this inspection care plans were being updated and reviewed to reflect changing needs and improve on the existing systems. One service user said, “the optician comes once a year and the chiropodist and health visitor visit some of the people here when they need them.” Another service user said, “There’s no National Health Service dentist in Clitheroe but the staff sort things out for us if we need one.” Two of the residents were case tracked and their care plans examined. Resident or their relatives had been consulted about details contained in the care plans and signed their agreement. Highbreak House F57 F07 S53551 High Brake House V225758 030505 Stage 4.doc Version 1.20 Page 11 The medicines policies, procedures and records ensured safety, and whilst service users could self-administer this would be risk assessed and regularly reviewed. One resident who self medicated had a private lockable space in which to store her medication. She was aware of the medication risk management framework included in her care plan and said “staff are always available to help me with this if necessary.” Medicines in the custody of the home were handled according to requirements of the relevant legislation and Acts. Records examined were kept of all medicines received, administered and leaving the home. A record was maintained of all current medication for each service user. Throughout the day the inspector witnessed residents who were mobile and able to self-care with various levels of supervision and support from staff. Staff used the term of address preferred by the residents. In one case this meant calling a resident by his nickname. There was considerable attention to their needs as individuals and it was clear that the staff actively encouraged them to exercise their rights of choice and respected their privacy and dignity. One service user said “staff are always helpful and polite.” Another said, “They always knock on my door and wait for me to tell them to come in before entering.” When asked one resident told the inspector that there was a degree of flexibility, which allowed some residents to receive staff assistance on request and not as a matter of routine. Highbreak House F57 F07 S53551 High Brake House V225758 030505 Stage 4.doc Version 1.20 Page 12 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 standard(s) 12 and 15 Residents were given considerable opportunity to maintain and develop social, and cultural interests. Management and staff tried to ensure that residents enjoyed living at the home. Meals were varied and appealing and served in pleasant surroundings. EVIDENCE: Some residents described some of the activities they were involved in. A singalong with an organist, chatting and small group activities were enjoyed. One resident was observed quietly doing a jigsaw, others were seen sitting peacefully and watching the birds in the garden whilst some watched T.V. One resident was noted to have Sky T.V. linked to his bedroom. There were a number of magazines, newspapers and books available to read. One resident said that he enjoyed visiting the parish church regularly. Other residents preferred to have the Priest or Vicar visit them at the home once a month. One resident commented, “We used to have a mini bus but we don’t now.” When asked if this was a problem he said “It isn’t for me because I can get out and about on my own, just some of the others aren’t as fit a me.” He then went on to explain that the staff were available to take residents out and about if they wanted. A variety of meals, to meet an individual’s preference were available. Food served was made with fresh ingredients and was available in generous Highbreak House F57 F07 S53551 High Brake House V225758 030505 Stage 4.doc Version 1.20 Page 13 amounts. Residents spoken to confirmed that snacks and drinks were available at varied times during the day. Evidence to confirm that a minimum of two hot cooked meals per day was provided was noted on the menu. A new cook had recently been appointed and was in the process of reviewing the menu. Residents could help plan meals and were looking forward to a “tasting evening” that night at which they would select their favorite meals from a selection of sample dishes. The most popular dishes would then be placed on the menu and served on a rota basis. Lunch was served in the dining room and the inspector took lunch with the residents. The meal was of a choice of either meat and potato bake or orange chicken with seasonal vegetables. The care staff and the cook helped serve the meals. Assistance to eat and drink was given by the care staff where needed. Lunch at High break House was peaceful, unhurried and relaxed. Positive comments like, “I had the orange chicken, it was delicious!” and, “ Mine was very nice thank you” were heard about the meals served for lunch that day. Highbreak House F57 F07 S53551 High Brake House V225758 030505 Stage 4.doc Version 1.20 Page 14 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 standard(s) 16, 17 Residents knew how to make a complaint and who to complain to. Residents were supported to take part in the forthcoming general election. EVIDENCE: Some residents said that they did not want to use the complaints procedure and felt that they could sort out problems with the staff without the need for paper work. One resident said, “If I needed to tell someone, I’d tell them who work here. It doesn’t matter who but I’d probably tell Angela, it would soon get sorted out.” A resident told the inspector, “During election time I visit the polling station, I can take myself there.” “Some of the other people here have postal votes.” The registered manager confirmed this and explained that relatives usually got involved in this process although for those whose relatives weren’t able to help the local advocacy service would be used. Highbreak House F57 F07 S53551 High Brake House V225758 030505 Stage 4.doc Version 1.20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 26 Facilities in the home met the criteria for it’s stated purpose. All areas of the home were safe and well maintained. The home was clean pleasant and hygienic. EVIDENCE: There was a ramp leading to the front door of the home. Two lounge areas offered varied facilities. On the ground floor there was a quiet corner with seating. The first floor corridor provided single seating in armchairs. Residents used both lounge areas and had their preferred seats. One resident told the inspector that he preferred to use the downstairs lounge area as he got a good view of the garden and the flowers he had planted in pots. A tour of the home showed a good standard of cleanliness and hygiene. There was a maintenance plan in place and it was apparent that regular building maintenance was taking place. Since the last inspection in January new window restrictors were in the process of being fitted on a number of first floor bedroom windows. A first floor toilet had been redecorated. New emergency lighting had been fitted throughout the home. Walls and floors to the laundry and pantry area had been painted with impermeable washable paint. The dining room carpet had been shampooed and a small area of the lounge carpet Highbreak House F57 F07 S53551 High Brake House V225758 030505 Stage 4.doc Version 1.20 Page 16 was being shampooed whilst residents had their lunch. A cleaning schedule had been forwarded to the Commission. Toilet and washing facilities were clearly marked and provided close to residents’ accommodation. One resident told the inspector that she was happy with the standard of cleanliness in the home. Highbreak House F57 F07 S53551 High Brake House V225758 030505 Stage 4.doc Version 1.20 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29 and 30 The staff numbers were adequate to meet the needs of the residents. A procedure for the recruitment of staff was in place, however some checks to safeguard the residents had not been done. Staff training had taken place and was ongoing. EVIDENCE: Residents spoken to said that there were enough staff on duty to meet their needs. At the time of the inspection there were two care staff on duty on being the registered manager. Mr. Mark Brierley the trainee manager said that he is on the premises and always available if necessary. Both duty staff had the skills and knowledge to carry out all aspects of care for the residents. There was waking night staff and an on call system at nights. The recruitment details in respect of the new cook employed since the last inspection was examined. All checks required to safeguard the residents had been carried out prior to the staff member starting work. On further examination of staff files they did not contain all the required information. This information must be kept on all staff files Some staff training had taken place since the last inspection. This included general care practices. A staff training and development plan was not available for inspection. This would ensure that staff fulfil the aims of the home and meet the changing needs of residents. Highbreak House F57 F07 S53551 High Brake House V225758 030505 Stage 4.doc Version 1.20 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 35 and 38 The attitude of the staff and management is to run the home around the needs and choices of the residents. Written procedures ensured the health and safety of the residents and staff was safeguarded. EVIDENCE: The home had achieved an IIP award in 2003. The award ensured effective quality assurance and monitoring based on seeking the views of the residents. This award is due for review in 2006. Residents meetings were held monthly and notes were examined. Topics discussed were, possible outings, fundraising, and the homes evacuation process. The inspector discreetly witnesses a number of discussions about the service and level of care between residents and staff. This confirmed that daily involvement of the owner and the staff team ensured that resident satisfaction was paramount. The residents spoke highly of the daily contact they had with staff team and felt they listened to them and acted on their comments. Highbreak House F57 F07 S53551 High Brake House V225758 030505 Stage 4.doc Version 1.20 Page 19 All measures to ensure the health and safety of residents and staff was protected were in place. Staff had received appropriate training in health and safety, fire safety, medication administration and moving and handling. Risk assessments were documented for safe working practices within the home. Highbreak House F57 F07 S53551 High Brake House V225758 030505 Stage 4.doc Version 1.20 Page 20 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. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 x x x 3 x 3 2 2 3 Highbreak House F57 F07 S53551 High Brake House V225758 030505 Stage 4.doc Version 1.20 Page 21 YES 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. 1. Standard 29 Regulation Schedule 2 Regulation 7,9,19 Requirement The Registered Person must ensure that information and documents in respect of persons carrying on or managing or working at a care home are kept at the home. Timescale for action Tuesday 31st may 2005 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 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 Highbreak House F57 F07 S53551 High Brake House V225758 030505 Stage 4.doc Version 1.20 Page 22 1. 30 The registered person ensures that there is a staff training and development programme which meets NTO workforce training targets and ensures staff fulfil the aims of the home and meets the training needs of the service users. 2. 3. 4. 5. 6. Highbreak House F57 F07 S53551 High Brake House V225758 030505 Stage 4.doc Version 1.20 Page 23 Commission for Social Care Inspection 1st floor, Unit 4 Petre Road Clayton-Le-Moors- Accrington Lancashire. BB5 5JB 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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