Inspection on 07/11/05 for Highbrake House

This inspection was carried out on 7th 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

Highbrake House 06/11/07

Highbrake House 26/09/06

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 7th November 2005 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.V253279.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. High Brake House DS0000053551.V253279.R01.S.doc Version 5.0 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.V253279.R01.S.doc Version 5.0 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 3rd May 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 couples and others who want to share can be made available. Bedrooms are situated on the lower ground floor, ground floor and first floor. All bedrooms have door locks. There is a shared lounge on the lower ground floor and has French windows that lead onto a patio and large garden. The laundry and office are also situated on this level. There is another shared lounge on the first floor and this overlooks Chatburn Road and Clitheroe Grammar School. The dining room and kitchen are situated on the ground floor of the home. All floors can be accessed via a passenger lift. 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 home is within walking distance to the town centre and public transport is within easy access of the home. High Brake House DS0000053551.V253279.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was the second unannounced inspection in 2005. The inspection took place over one day. The service was inspected against the National Minimum Standards for Older People and involved examination of records and discussion with a number of service users. There are references to the case tracking process. This is a method where the inspector focuses on a small representative group of service users. 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. This is not to the exclusion of the other service users, with a number of other service users being involved in the inspection process in various other ways. Breaches in regulations and standards that pose an immediate risk to service users have been highlighted for urgent action. The inspection was carried out with the co-operation of the registered manager. Over the course of the inspection the inspector spoke to 3 service users, 3 staff members, and the responsible individual. A tour of the premises took place including all bedrooms and the decorating work that is ongoing. Documents were read and care observed. What the service does well: The staff and management of High Brake House try to make sure that all service users receive a high standard of care within a comfortable environment. All aspects of medication were well managed and service users were protected from mis administration. Service user care plans addressed areas of care such as routines, likes and dislikes, allergies, health needs, personal hygiene and general health. Past interests, hobbies, present needs and wishes were also included in care plans. When asked, one service users commented positively on the care and service received at the home. One service user said, “It’s not like home but the people are very nice here”. There was a good standard of cleanliness and hygiene at the home and the premises were kept clean, hygienic and free from offensive odours. High Brake House DS0000053551.V253279.R01.S.doc Version 5.0 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. High Brake House DS0000053551.V253279.R01.S.doc Version 5.0 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.V253279.R01.S.doc Version 5.0 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): 1, 2, 3, 4, 5, and 6 Written information about the home was comprehensive and clearly told the reader about the facilities and services they would receive at the home. Service users had a plan of care for daily living and longer-term outcomes based on the care management assessment. Service users were always assessed prior to admission to the home EVIDENCE: Case tracking of service user case files confirmed that service users had been provided with a service user guide and statement of purpose. When asked one service user said, “I’m only here for another week but my daughter brought me twice to look before I moved in. I can’t remember seeing any information about the home, but I think my daughter has.” Discussions with staff and records examined confirmed that the service user had received the required information before moving into High Brake House. A thorough needs assessment had been carried out before the service user admission. The home does not provide intermediate care. High Brake House DS0000053551.V253279.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, 8, 9, 10, and 11 Service user health care needs were identified and met through care plans. There was no risk assessment to identify the risk potential to two service users who self medicated. A care plan examined needed reviewing more frequently. The control of medication was well managed promoting good health. EVIDENCE: Case tracking of three service user case files showed that care plans were drawn up from the initial service user assessment. Each care plan addressed areas of care and detailed the care to be given. Choices in day-to-day living, assistance, dietary needs, intellectual cultural needs, interests hobbies, background, life history, and lifestyle choices enabled staff to meet service users needs better. Care plans also contained a service user personal profile and reason for admission to the home that included a medical history, known allergies and last wishes. Care plans also highlighted individual use of bed frames and a ripple mattress to ensure service user safety and comfort in the home. High Brake House DS0000053551.V253279.R01.S.doc Version 5.0 Page 10 The inspector examined a robust service user risk assessment for the use of bed rails. The risk assessment detailed the potential risk to the service user and highlighted how to prevent the use of the bed rails causing harm to the service user. Most care plans had been reviewed regularly and care plan review sheets had been completed and signed by staff. However one care plan had not been reviewed since February 2004 and the inspector required that the care plan should be reviewed to include all recent changes to the service user care. There was a medication policy and procedure at the home. Written guidance was available for staff to follow when administering medication. Policies and procedures examined ensured service user safety. All medicines were stored in a locked trolley within a secure environment ensuring service users were kept safe from harm. The inspector observed the registered manager administering medication to a service user at lunchtime and it was apparent that she was competent in this area of service user care. High Brake House DS0000053551.V253279.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): 12, 13, 14, and 15 Service users were given the opportunity to maintain and develop social interests. Management and staff tried to ensure that service users enjoyed living at the home. Meals were varied and appealing and served in a comfortable environment. EVIDENCE: Case tracking and discussions with service users confirmed that routines and daily living were based on service user wishes. This information was highlighted in care plans. Past interests, hobbies, present needs and wishes were also included in care plans. “We can get up more or less when we want and I still take a walk out even though it’s getting colder”, said one service user. During the inspection the aromatherapist visited the home and provided a foot and hand massage service to people who enjoyed this facility. When asked one service user said, “I do like having my feet massaged, it’s very relaxing”. At quieter moments during the day a senior carer was observed attending to service user hands and finger nails. Some service users had their fingernails trimmed whilst some of the female service users had their nails painted. An afternoon news group was held each Friday for service users who enjoyed keeping up to date with news from the local and surrounding area. Flower arranging, card games, dominoes and bingo were included on the homes list of activities for service users. High Brake House DS0000053551.V253279.R01.S.doc Version 5.0 Page 12 Three full meals were served daily two of these were hot. There is always a choice of meals served and service users are asked individually which meal they would prefer. Service users when asked that they had enjoyed their chosen meal and a number of people commented on how good the food was at the home. One service user said, “The food is very good”, another said, “The food is lovely here”. Meals were served in the dining room that overlooks the large gardens at the back of the home. High Brake House DS0000053551.V253279.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): NOT ASSESSED ON THIS OCCASION EVIDENCE: High Brake House DS0000053551.V253279.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25, and 26 There were sufficient toilet and washing facilities in the home. All areas in the home were safe and well maintained. The home was clean, pleasant, and hygienic. EVIDENCE: Some bedrooms and communal areas had recently been redecorated. Bedrooms and bathrooms were located on the lower ground floor, ground floor and first floor of the building. When asked service users made positive comments about the décor and furnishings of the home. One service user said, “I’m very comfortable in room thank you”. During a tour of the home the inspector noted that some bedrooms had specialist equipment to help maximise service user independence. A call system with an accessible alarm facility, aids such as hoists and assisted toilet and baths were available to meet the service users assessed needs. The home provided grab rails and other aids in communal areas and service users’ own accommodation. Service users had access to all parts of the home through the provision of a passenger lift. High Brake House DS0000053551.V253279.R01.S.doc Version 5.0 Page 15 Bedrooms visited confirmed that bedroom doors were fitted with locks suitable to the service user capability and accessible to staff in an emergency. All service users were provided with a key to their rooms and each room had a lockeble storage space for medication, money and valuables. Screening was provided in a double room to ensure privacy for personal care. One service user bedroom had two electrical extension leads that were used for a number of personal electrical items. Due to risk of harm from overloading the inspector required the registered manager to contact an electrician to give their opinion as to the safety of the extension leads. The use of the extension lead should be monitored through a risk assessment. A tour of the home showed a good standard of cleanliness and hygiene. The premises were kept clean hygienic and free from offensive odours. At the time of the inspection basic redecoration of the home was in progress. Discussions with the registered manager confirmed that the work in progress was extensive and ongoing. High Brake House DS0000053551.V253279.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, and 30 Staff numbers were adequate to meet the service user need. Staff training had taken place and was ongoing. Staff files held information required to ensure service users are safe from harm or abuse. EVIDENCE: A small family team manages the home. It was apparent that the management and staff team rely greatly on staff commitment and employee loyalty to ensure service user needs are met. Discussion with staff and service users highlighted that the skill mix was appropriate to meet service user assessed needs. The inspector spoke to 3 staff who when asked were aware of the homes policies and procedures and knew where they could be located. Staff confirmed they were happy at High Brake House and were comfortable with their employers. A member of staff described her employment route that followed the homes recruitment policy. There was a robust and thorough recruitment and selection process in place based on equal opportunities. Examination of two staff files confirmed that appropriate Criminal Record Bureau and POVA checks were carried out prior to them starting work for the organisation. A staff member confirmed training opportunities at the home were available. When asked she confirmed she had undertaken training in first aid, moving and handling, basic food hygiene, NVQ in care, health and safety and safe handling of medicines. Staff files examined confirmed that information required was held on each file. High Brake House DS0000053551.V253279.R01.S.doc Version 5.0 Page 17 When asked a number of service users commented positively on the staff team and said that he felt safe and well looked after. Service user and visitor questionnaires made positive comments about the staff and the management at the home. When asked staff and service users confirmed they were satisfied with the number of staff on duty. One service user said, “I smoke and when I first came here a carer stood with me to make sure I was safe with my cigarette. They don’t do it anymore. People are very nice here”. The registered manager stated that the home is currently in the process of recruiting carers to add to the existing care staff team. To ensure service user safety the inspector required the registered manager to ensure all people who provide a non-health care service, such as hairdressing, in the home to service users have a satisfactory standard CRB. The staff rota was examined and complied with the minimum staffing levels required by the previous registering authority. Domestic and kitchen staff were employed in sufficient numbers to ensure standards relating to food, meals and hygiene were met. High Brake House DS0000053551.V253279.R01.S.doc Version 5.0 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 35, 36, and 38 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: It was apparent that service users lived in a home that was run to suit the needs and choices of the service users. All the records required for the efficient running of the home were available and stored securely to be accessed by designated senior staff. Service users or their representatives had access to their records on request. Policies and procedures were available to all members of staff. A copy of the complaints procedure was included in the service user guide. No complaints have been made to the home or the commission since the last inspection. The manager explained that detailed records of any complaints would be kept. Thank you and compliment cards were available for inspection. High Brake House DS0000053551.V253279.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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 2 3 3 3 3 3 3 3 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 X X 3 3 X 3 High Brake House DS0000053551.V253279.R01.S.doc Version 5.0 Page 20 NO 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 OP7 Regulation 15 (2) (b) (c) Requirement The registered manager must ensure that all care plans are reviewed frequently to include all recent changes to the service user care. Due to risk of harm from overloading the registered manager is required to contact an electrician to give their opinion as to the safety of the extension leads. The use of the extension lead should be monitored through a risk assessment. Timescale for action 07/11/05 2 OP38OP19 16(2)g 12(1)a 13(4)abc 16/12/05 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 Good Practice Recommendations Standard 1 OP29 To ensure service user safety the registered manager should ensure all non health care people who have access to service users have a satisfactory standard CRB. High Brake House DS0000053551.V253279.R01.S.doc Version 5.0 Page 21 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.V253279.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. 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