Inspection on 26/09/06 for Highbrake House

This inspection was carried out on 26th September 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

Highbrake House 06/11/07

Highbrake House 07/11/05

Highbrake House 02/05/05

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 129 Chatburn Road Clitheroe Lancs BB7 2BD Lead Inspector Mrs Christine Mulcahy Key Unannounced Inspection 10:00 26 September 2006 th 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 High Brake House DS0000053551.V302685.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. High Brake House DS0000053551.V302685.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service High Brake House Address 129 Chatburn Road Clitheroe Lancs BB7 2BD 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) 01200 423286 Brierley Care Ltd Mrs Angela Catherine C Moseley Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21) of places High Brake House DS0000053551.V302685.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service should at all times employ a suitably qualified manager who is registered with the NCSC 7th November 2005 Date of last inspection Brief Description of the Service: High Brake House is registered with the Commission for Social Care Inspection to provide personal care and accommodation to 21 older people. High Brake House is situated in a residential area on Chatburn Road in Clitheroe. The home is a detached 4 storey building in it’s own grounds. Accommodation is provided in eleven single rooms and five double rooms. Some of the double rooms are currently being used as single rooms but shared accommodation for people who want to share can be made available. Bedrooms are situated on three levels. There is a shared lounge on the lower ground floor and has French windows that lead onto a patio and large garden. All floors can be accessed via a passenger lift. Car parking is at the front of the building. The home is within walking distance to the town centre and public transport is within easy access of the home. New service users receive a copy of the homes Statement of Purpose and service user guide. Fees range from £315 to £355 per week and service users are charged separately for hairdressing, aromatherapy, newspapers and night incontinence pads. High Brake House DS0000053551.V302685.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection took place over one day on 26th September 2006 Information was obtained from care plans, staff records, management systems, observations and policies and procedures. The inspector also spoke to 5 service users, 3 staff, 1relative and the registered manager. There have been no complaints about the service made to the CSCI since the last inspection. What the service does well: What has improved since the last inspection? To maintain service user independence and enable service users to alert staff in emergencies or when in need of support a new nurse call system has been installed throughout the home. A number of improvements to the home have been made to update the living environment for service users. All main and communal areas of the home have been re decorated and re carpeted throughout. Three bedrooms have been re decorated. New curtains in these areas have created a homely and bright atmosphere. The addition of new kitchen refrigerators, washing machines and a chest High Brake House DS0000053551.V302685.R01.S.doc Version 5.2 Page 6 freezer show that the management team are committed to ensuring that service users live in a safe, well-maintained home. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. High Brake House DS0000053551.V302685.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 High Brake House DS0000053551.V302685.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): OP 3 & 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are given enough information about the home to make an informed choice. Service users are admitted following a full assessment. Intermediate care is not provided EVIDENCE: The care plan of one service user was examined and showed that a needs assessment had been carried out before the service user moved into the home. The assessment documentation was available to staff which helped familiarise them with the new service user. One staff spoken to was aware of the need service user assessments and knew that these formed the basis of the care plan. The registered manager said that information about the home was given to the service user relative on moving into the home. A Service user when asked couldn’t remember receiving information about the home. However she said, “I’ve signed that many things. My sister decided on High Brake House DS0000053551.V302685.R01.S.doc Version 5.2 Page 9 the home for me. I came in and got a lovely feeling. One of the staff asked me what colour I would like my room painted and I thought, if I’ve got to go anywhere this is where I’ll come”. High Brake House DS0000053551.V302685.R01.S.doc Version 5.2 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 the following standard(s): OP 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service user health, personal and social care needs were set out in a plan of care. Service users were protected by the homes medicine policies and procedures. Care practiced observed showed Service users privacy and dignity was respected. EVIDENCE: Case tracking and discussion with the registered manager confirmed that all service users had a plan of care that included sufficient details for staff to meet the identified needs The care plan examined had been reviewed regularly and changes in service user needs were identified and acted on immediately. Care plans held information about service users day to day living, preferred rising and retiring times, service users sleep pattern, weight, sight and hearing needs. Dietary, intellectual and cultural needs and reasons for admission were also included in care plans. Relationship with family, hopes for the future and High Brake House DS0000053551.V302685.R01.S.doc Version 5.2 Page 11 other important life events ensured service user needs were properly met through these records. Health needs were identified and access to health professionals was given. Evidence of contact with other services like GP and optician were recorded and kept in the medical treatment file. All areas of medicines handling were well managed and six staff were responsible for administering medication. Screens were provided in all shared bedrooms and service users confirmed that clothing worn that day was their own and clothing seen in wardrobes were named accordingly. High Brake House DS0000053551.V302685.R01.S.doc Version 5.2 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 the following standard(s): OP 12, 13, 14, & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Leisure and recreational activities available met service users social needs and interests Visiting from relatives and friends is flexible. Service users autonomy and choice was maximised in relation to meals and snacks ensuring variety and nutrition. EVIDENCE: The registered manager said that wherever possible service users were able to make choices about aspects of their lives including waking and going to bed times and handling their own finances. Case tracking, examination of records and discussion with service users confirmed that as far as possible service user independence was maintained. Service users commented positively on the variety of activity available. Two service users said they preferred to stay in their own room and read. Another service user said, “We have resident meetings, I’m able to comment about things there. The staff suggested I help do some gardening, so I help with the pots along the retaining wall. I also help to clear the tables after meals”. High Brake House DS0000053551.V302685.R01.S.doc Version 5.2 Page 13 Service users religious and cultural needs had been assessed and identified on moving into the home as part of the admission process. The registered manager said that a number of service users had asked to be considered for the concert at the local Church on Saturday. Activities were varied to suit service user preferences and capabilities and facilities were provided to meet these. One service user said, “I read and play the organ” and pointed to the organ in the dining room. “I like to stay in my room and read but sometimes there is bingo night or a general knowledge quiz, it’s nice to get to know the others”. The visit by the aromatherapist was welcomed by a number of service users who were seen going to their bedrooms to receive foot and hand massage treatment. Menus were changed regularly and service users were reminded of the day’s menu each morning. There is always a choice if people don’t like the main meal and 2 service users when asked confirmed they could have what they like. On the day of the key inspection service users could choose from, sweet and sour chicken or beef stew, both served with seasonal vegetables. “The food is excellent”, said one service user. “The cook is super, lively and so willing” Another service user said, “I like croissants, butter, and preserves. I can buy my own and these are kept in the kitchen fridge for me”. Hot and cold drinks were available throughout the day. High Brake House DS0000053551.V302685.R01.S.doc Version 5.2 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 the following standard(s): OP 16 & 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Complaints made by service users and relatives were acted on and recorded. The lack of staff training in protection of vulnerable adults may result in abusive practices being unrecognised and therefore unreported. EVIDENCE: The homes complaints procedure specifies how complaints can be made and who will deal with them. There is an assurance that complaints will be responded to within a maximum of 28 days. There have been no complaints made to the CSCI since the last inspection. There were procedures for staff to follow if they suspected an incident of abuse had taken place. The manager said that staff training is being sourced and the POVA training will take priority alongside other mandatory training. The registered manager was reminded that the staff might not be aware of abusive practices and would not know to report them without appropriate training. High Brake House DS0000053551.V302685.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): OP 19 & 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The standard of decoration and furnishings in the home had greatly improved making the environment more comfortable and homely. The home was clean, pleasant and hygienic. EVIDENCE: A tour of the building showed that a further three rooms had been re decorated to a good standard. The first floor landing had been re carpeted, re painted. Artwork painted by one of the service users was displayed on the landing walls and created a homely feel along with the new curtains. The broken stair lift that was on the main staircase had been removed enabling service users to use the staircase more safely. A new state of the art nurse call system had been installed in all bedrooms, communal and lounge areas and was demonstrated to be in good working High Brake House DS0000053551.V302685.R01.S.doc Version 5.2 Page 16 order. This will enable service users to alert staff in emergencies or when in need of support. The dining room and small seating area had both been re painted and re carpeted. Two new fridges and a new hot water dispenser had been purchased and were in use in the kitchen. Downstairs in the basement there were two new washing machines that had the specified programming ability to meet disinfection standards. There was also a new chest freezer in place to ensure frozen food was stored at the correct temperature. Aids and adaptations are provided throughout the home including a bath hoist, mobile hoist, raised toilet seats and grab rails. Car parking is at the front of the building The registered provider and management team had made new equipment purchases to ensure the home and facilities were safe, well maintained and suitable for it’s purpose. The home was clean, tidy and refreshing. Furnishings were comfortable with homely finishing touches. One service user said, “The home is very clean. The cleaner works very hard, she’s super. The bedrooms are blitzed every fortnight”. High Brake House DS0000053551.V302685.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): OP 27, 28, 29, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The recent recruitment of staff two was not based on equal opportunities. There were appropriate numbers and skill mix of staff. Staff were trained and competent to do their jobs. EVIDENCE: The duty rota was examined and showed which staff were on duty and at what times. Care staff were on duty in sufficient numbers. Two male staff are employed to ensure the personal needs of male service users are appropriately met The files of two new employees were examined and showed that the registered manager had not fully followed the homes recruitment procedures. Although pre employment checks had been carried out to ensure the protection of service users one new employee had not completed an application form but the home had accepted a comprehensive curriculum vita. Another new employee had 2 references but a family member had written one. To fully ensure the protection of service users the registered manager was reminded to ensure that in future the recruitment process is based on equal opportunities. The new staff had been given a copy of the General Social Care High Brake House DS0000053551.V302685.R01.S.doc Version 5.2 Page 18 Council’s code of conduct this meant that staff had been fully informed about their expected behaviour and responsibilities as social care workers. Discussion with the registered manager and observations of a carer on duty confirmed they both had the skills and competency to effectively carry out their duties. A carer was seen assisting service users around the home and was observed speaking in a manner and tone that was respectful to service users. A record of training and development by all staff was not available for inspection. This meant that it could not be shown that staff had the skills, knowledge and competency to do their work. The registered manager said that training for POVA, moving and handling food hygiene was being sourced and they are awaiting details of course times and dates. 77 of the care staff was qualified to NVQ Level 2 and above High Brake House DS0000053551.V302685.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): OP 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The attitude of the staff and management is to ensure the home is friendly, comfortable and flexible for the service users. Written procedures ensure the health and safety of staff and service users are safe guarded. EVIDENCE: The manager of the home has many years experience of working with older people. She had a job description that outlined her role and responsibilities. The management team were able to demonstrate a clear sense of direction and leadership that related to the aims and objectives of the home and this was evident in the maintenance of the home and positive comments from service users. High Brake House DS0000053551.V302685.R01.S.doc Version 5.2 Page 20 An internal audit is carried out to determine service user satisfaction. Outcomes of the survey were not available although completed service user questionnaires were seen at inspection. The registered manager said that she would forward a copy of the audit outcome to the CSCI once complete. There were details and records kept of service user fees charged and paid. A record of service user cash held at the home was examined and service user and staff signatures verified the transaction. A record of water temperatures was kept along with other relevant health and safety records. All staff had received fire training as part of their induction to the home and the last fire drill was held in August this year. High Brake House DS0000053551.V302685.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 3 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 2 4 X X X X X X 4 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X 3 High Brake House DS0000053551.V302685.R01.S.doc Version 5.2 Page 22 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 OP18 Regulation 13(6) Requirement The registered manager must ensure that all staff receives training in Protection of Vulnerable Adults. Please indicate when this training will take place on the homes staff training plan and forward a copy to the CSCI by the date shown. To fully ensure the protection of service users the registered manager was must ensure that in future the recruitment process is based on equal opportunities. Timescale for action 28/11/06 2. OP29 Schedule 2 Reg 7,9,19 26/09/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations High Brake House DS0000053551.V302685.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington 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. Extracts may not be used or reproduced without the express permission of CSCI High Brake House DS0000053551.V302685.R01.S.doc Version 5.2 Page 24 - 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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