Inspection on 06/11/07 for Highbrake House

This inspection was carried out on 6th November 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 26/09/06

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 Unannounced Inspection 15th October 2007 10:00 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 High Brake House DS0000053551.V351001.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.V351001.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.V351001.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 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. It 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 mainly in single rooms. Two of the rooms are shared Bedrooms are situated on three levels. There is a shared lounge on the lower ground floor with 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 people using the service receive a copy of the homes Statement of Purpose and service guide. Fees range from £315 to £355 per week and residents are charged separately for outings, social escorts, dry cleaning, hairdressing, newspapers and private chiropody. High Brake House DS0000053551.V351001.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A key unannounced inspection, including a visit to the home, was carried out on 6th November 2007. Information was obtained from resident’s care plans, records, management systems, resident’s and relative questionnaires and care observations. The inspector spoke to 2 residents, 3 staff the registered manager and the 2 directors of the home. What the service does well: At High Brake House the staff try to provide the people who use the service with a comfortable, homely environment to live in. The atmosphere at the home was welcoming and friendly residents and relatives responded to the Commission for Social Care Inspection survey with the following comments: “All the staff are friendly and caring they are always ready and willing to answer any questions or requests you may have. My brother has been in High Brake House for over 15 yrs. He’s always cared for very well and allowed to come and go as he pleases”. “The home take great care for the needs the residents require and make them as comfortable as possible my brother is quite happy and content”. “They look after my mothers personal hygiene very well”. “This is the only care home I’ve been in that doesn’t smell great credit to them for this”. “The staff are really lovely. You only have to buzz and the staff are there”. “The home employs good carers with relevant medical nursing experience they have excellent staff”. “I have no concerns about the home and believe it operates in a safe and professional manner”. It is commendable that 100 of the staff have been trained in safeguarding adults. High Brake House DS0000053551.V351001.R01.S.doc Version 5.2 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 report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. High Brake House DS0000053551.V351001.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.V351001.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): OP 1, 3 & 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. New residents are admitted following a full assessment so that care staff know what their needs are. Care plans are based on these assessments to ensure staff can meet these needs. . EVIDENCE: The management team understand the importance of having sufficient information when choosing a care home. There is a clearly written guide for the residents and statement of purpose to help people understand what services the home can provide. Both documents clearly set out the objectives and philosophy of the service. High Brake House DS0000053551.V351001.R01.S.doc Version 5.2 Page 9 The manager said that admission to the home only takes place if they are confident they have the skills, ability and qualifications to meet the prospective residents assessed needs. The care plan of one resident was examined and showed that the registered manager had carried out a needs assessment before admission into the home. The resident had been provided with a contract that is clear and easy to understand so that the resident and their relatives know what service they can expect. Intermediate care is not provided High Brake House DS0000053551.V351001.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. 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. The needs of the people who use the service are clearly set out in a comprehensive plan of care. Medicines in the home are well managed and prevent the risk of mis administration. Observations of the care practiced showed residents privacy and dignity was respected. EVIDENCE: Case tracking of a person who uses the service and discussion with the person in charge confirmed that all resident’s had a plan of care that included enough details for care staff to meet the identified needs. Care plans seen were comprehensive and included details about the resident profile, communication, mobility and dexterity, personal safety, medical history, medication, diet and weight. The plan also detailed other areas such as dental, eye and foot care, the resident’s religion, daily living and social activity. The care plans included moving and handling assessments clearly describing how resident should be assisted around the home, the aids and adaptations used, action to be taken and the risk associated with the activity. Care plans High Brake House DS0000053551.V351001.R01.S.doc Version 5.2 Page 11 had been reviewed regularly and changes in the resident’s needs were identified and acted on immediately. Further records examined indicated that appropriate health care appointments were made available to residents as required or necessary. Care staff were discreetly observed supporting residents moving around the home and meeting their needs according to the care plans. The home has an efficient medication policy supported by procedures that staff understand and follow. The manager makes regular checks to ensure compliance with the procedures. And the supplying pharmacist visits 3 monthly to ensure compliance and give support where necessary. Examination of the medication administration records showed they had been fully completed, contained the required entries and were signed by appropriate staff. All areas of medicines handling, recording and storage including controlled drugs, were well managed. All care staff has completed accredited training in the safe handling of medication. In shared bedrooms screens are provided to ensure their privacy is not compramised when personal care is being given. Resident’s confirmed that clothing worn that day was their own and clothing seen in wardrobes were named accordingly. One resident made positive comments about the care staff and said, “You only have to buzz and they’re there”. High Brake House DS0000053551.V351001.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. 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. There is a range of meaningful activity available to meet the social and cultural needs of the people who use the service ensuring maximised autonomy and choice in their daily lives and routines. EVIDENCE: The person in charge said that wherever possible people who use the service 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 one of the resident’s confirmed that this was the case. The religious and cultural needs of the people who use the service had been assessed and identified when they moved into the home as part of the admission process and details were included in the care plan. Activities at the home were planned and varied to suit the resident’s preferences and capabilities. Some of the resident’s enjoy watching TV, conversation, reading newspapers and magazines. High Brake House DS0000053551.V351001.R01.S.doc Version 5.2 Page 13 The managers are very aware of different religions and how to meet the beliefs of residents. A record of resident’s individual activities were recorded and kept on the resident’s file and included details of the visits from relatives, outings, activities and religious observance. Menus were changed regularly and residents were reminded of the day’s menu each morning. There is always a choice if people don’t like the main meal and 1 resident when asked confirmed she could have what she liked. The lunch for the day was beef stew or cheese and onion pie and a choice of puddings. The meal was well presented and looked wholesome and nutritious. It was apparent from the resident’s comments that they enjoyed their lunch. Hot and cold drinks were served throughout the day. High Brake House DS0000053551.V351001.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. JUDGEMENT – we looked at outcomes for the following standard(s): OP 16 & 18. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The people who use the service and their relatives can access an effective complaints procedure and are protected from abuse EVIDENCE: There is a complaints procedure that 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. Although there have been no complaints to the CSCI since the last inspection the person in charge said that complaints made would include details of the investigation and any action taken. A copy of the homes complaints procedure is available at the entrance of the home. When asked, people who use the service knew who was in charge and who to complain to if they were dissatisfied with their care at the home. There are procedures for staff to follow if they suspect an incident of abuse has taken place. The manager said that all care staff at the home have been trained in safeguarding adults. This means that the staff would be aware of abusive practices and would know how to report them. When asked, a staff confirmed that she had received formal training in this area and said she would inform the manager if she suspected abuse and had read the homes policy and procedure about this issue. High Brake House DS0000053551.V351001.R01.S.doc Version 5.2 Page 15 High Brake House DS0000053551.V351001.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): OP19 & 26. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents live in a clean, safe well-maintained and comfortable environment that supports their independence. EVIDENCE: A tour of the home showed it was suitable for it’s stated purpose. Shared facilities, communal areas, bedrooms, bathrooms and the kitchen were decorated and furnished to a good standard. The lower floor lounge and a bedroom had been recently redecorated with new curtains. The people who use the service were encouraged to personalise their bedrooms with their own furnishings and ornaments. The emergency call system has been replaced with a new up to date model and all residents have a call system in their bedrooms and communal areas to use when requiring staff attention. High Brake House DS0000053551.V351001.R01.S.doc Version 5.2 Page 17 The home was light and well lit, homely, clean and tidy and smelled fresh. When asked about the environment a resident who made positive comments said, “It’s lovely here, I love my room and I can have my own furniture too. My son put those shelves up for me”. High Brake House DS0000053551.V351001.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): OP 27, 28, 29 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care staff are trained and skilled in sufficient numbers to meet the needs of the people who use the service. The homes recruitment policy ensures the protection of the people who use the service EVIDENCE: At High Brake House there is a total of 10 care staff and 4 of these are night care workers. The staff rota showed the home was staffed sufficiently and that particular attention was given to busy times of the day. Specific needs of the people who use the service like medical appointments, leisure interests and at peak times of activity were staffed appropriately. The inspector observed staff involved in a number of daily activities with resident’s during the inspection demonstrating there were enough staff available to meet the resident’s needs. Staff training is ongoing and the staff-training matrix showed details of the training care staff had undertaken since the last inspection. This included dementia awareness, 1st aid, health and safety, manual handling, food hygiene, safeguarding adults, fire induction and fire safety and medication handling. Six care staff have undergone training in challenging behaviour, and nine care staff have completed their NVQ level 2 or 3 in care. There are two managers who have gained their NVQ level 4 and registered managers award. High Brake House DS0000053551.V351001.R01.S.doc Version 5.2 Page 19 There is a good recruitment procedure that clearly defines the process to be followed when recruiting care staff and ensures the protection of the people who use the service. The homes director has recently updated the care staff application pack to ensure that they recruit the right people following the equal opportunities procedure. A Staff member spoken to confirmed pre employment checks required to ensure the protection of the residents were done before she was recruited. She was aware of her responsibilities and the tasks she must undertake to meet the resident’s needs. When asked about training she said that she had received an induction before she worked on her own and the registered manager and senior care staff regularly gave support through observation, discussion and formal one to one supervision. She was aware of the homes policies and procedures and knew whom to contact if she suspected abuse. Two staff files were examined and showed that relevant records were kept to ensure the wellbeing and safety of residents. All of the people who use the service were white British and the current staff team were able to meet the health and specific cultural needs of the group. One of the directors of the home is male therefore the 3 male residents have a choice about whether they wish to have a male carer assist with their personal care needs. The person in charge recognised there was a lack of male carers and said she would welcome male applicants along with others when a vacancy arose. Staff meetings take place regularly as do supervision sessions and, when asked, staff said they found them helpful. High Brake House DS0000053551.V351001.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 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 management and administration of the home ensures the health, safety and welfare of the people who use the service are promoted and protected. EVIDENCE: The registered manager has the required qualifications and over 15 years experience of running the home. She holds the registered managers award and has a clear understanding of the key principles and focus of the service. She has worked alongside the directors to improve the service and the quality of life of the people who use the service. The management team are person centred in their approach and are aware of current developments planning the service accordingly. High Brake House DS0000053551.V351001.R01.S.doc Version 5.2 Page 21 The management team regularly reviews and develops the homes policies and procedures ensuring staff awareness during supervision and practice. Notes of the staff meeting and staff supervision were examined and showed that staff were able to express their views about the service and how to meet the resident’s needs. The management team regularly assess staff knowledge and skill to determine their level of competence so that the residents always receive a good standard of service that is described in the statement of purpose and residents guide. There is a clear health and safety policy that ensures safe working practices. Records and documents examined showed equipment, appliance safety checks were done regularly. The home has the necessary insurance cover in place to fulfil any loss or legal liabilities. There were details and records kept of resident’s fees charged and paid. A record of resident’s cash held at the home was examined and this was stored securely. Resident and staff signatures verified the transaction. An internal audit is carried out to determine relatives and resident’s satisfaction. Where possible the outcome are addressed and acted on and have influenced plans for service development in the New Year. There are sound policies and procedures that the management team regularly review and update in line with current practice. Risk assessments are completed and taken into account when planning resident’s care and routines within the home. High Brake House DS0000053551.V351001.R01.S.doc Version 5.2 Page 22 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 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 4 17 X 18 4 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 4 X 3 X X 3 High Brake House DS0000053551.V351001.R01.S.doc Version 5.2 Page 23 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 High Brake House DS0000053551.V351001.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI High Brake House DS0000053551.V351001.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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!