Inspection on 10/10/06 for Highbury

This inspection was carried out on 10th October 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

Highbury 01/10/08

Highbury 03/01/06

Highbury 01/08/05

Highbury 20/09/04

Highbury 13/04/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Highbury 114 Irchester Road Rushden Northants NN10 9XQ Lead Inspector Ms Sarah Jenkins Unannounced Inspection 10th October 2006 07:00 DS0000012809.V314193.R01.S.doc Version 5.2 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 DS0000012809.V314193.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 Adults 18-65. 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. DS0000012809.V314193.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Highbury Address 114 Irchester Road Rushden Northants NN10 9XQ 01933 395511 01933 395511 m.mather-franks@ntlworld.com 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) Mrs Marie Jeanette Judith Mather-Franks Mrs Marie Jeanette Judith Mather-Franks Care Home 8 Category(ies) of Learning disability (8) registration, with number of places DS0000012809.V314193.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The total number of service users must not exceed 8 All service users have a Learning Disability Date of last inspection 3rd January 2006 Brief Description of the Service: Highbury is one of three homes in Rushden owned by Mrs Mather-Franks. It is an eight-bedded house in the residential area of Rushden with good access to local facilities and amenities. It is a spacious home offering individual bedrooms and a range of communal space including an enclosed garden area. The home provides personal care for up to eight Service Users within the category of Learning Disability. The service users from all three homes meet as part of their work placements and some social activity is organised between the homes. Details of the home can be obtained from the Registered Owner who is also the Registered Manager and are available in the form of a Statement of Purpose and a Service Users Guide (Advice was given at this inspection of the need for these documents to be updated). Fees range from £420 to £500 per week with additional charges payable for Hairdressing, Toiletries magazines and some activities such as cinema trips. DS0000012809.V314193.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for Service Users and their views of the service provided. This process considers the home’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. The primary method of inspection used was ‘case tracking’ which involved selecting 2 service users and tracking the care they receive through meeting with the service users, a review of their records, discussions with the care staff and observation of care practices. The Inspector visited during the early morning to observe practices by staff and to meet with service users. Service users have Learning Difficulties and communication for some is difficult. Establishing Service Users choices and informed decisions is dependant to some extent upon the consistency of staff, service users relationships with staff, and the quality of communication. Feedback obtained from Service Users in this report was mainly through observations of their relationships with staff, and also through interpretations of their general levels of happiness with their routines. The Inspector spent an hour and a half preparing for the inspection and four and a half hours in the home. The inspection was also informed by the PreInspection questionnaire returned by the Registered Owner/ Manager and some comment cards. A total of nine comment cards were received including two from relatives, one from the General Practitioner surgery, one from a Care Manager, one from a visitor supporting staff training, and 5 from service users (mostly assisted by staff or relatives). All comment cards expressed general satisfaction with the service and some positive comments were received about staff. What the service does well: Service Users individual needs are recognized and well met in a homely caring environment. They have developed trust in the staff team, which provides consistency through a low rate of staff turnover. Service Users were seen to have positive relationships with staff who have a good understanding of Service Users needs and abilities, and who enable them to make choices and maintain or develop their potential and their independence skills. DS0000012809.V314193.R01.S.doc Version 5.2 Page 6 The home is generally homely and well decorated and maintained. Service Users bedrooms in particular are well decorated, furnished and maintained, in a manner that meets the personal preference of individual Service Users. 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. DS0000012809.V314193.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000012809.V314193.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The process for admitting Service Users is professional and enables informed choice. EVIDENCE: There have been no new admissions to the home for some time. There are sensitive and flexible admission procedures which include a full assessment of the prospective service users needs and visits both by the homes staff to the prospective service user, and by the service user and their family to the home. Documentation supporting the admission process is generally good although the Statement of Purpose and the user friendly Service Users Guide both need to be updated. DS0000012809.V314193.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service Users wishes even when not directly expressed, are observed and responded to by staff. EVIDENCE: There was evidence that Service Users changing needs are scrutinized and the care plans appropriately adapted. A new format for service user care plans, which shows service users individual needs in a more accessible form, is being introduced. Risk management was evidenced in the records and Service Users are enabled to take reasonable risks within their chosen lifestyles. Regular reviews are held and relatives and relevant professionals are invited to participate. Staff expressed confidence that the care delivery at the home was in the individual Service Users best interests. DS0000012809.V314193.R01.S.doc Version 5.2 Page 10 Service Users were observed to have developed positive relationships with staff and were responsive to gentle guidance. Those who spoke with the Inspector expressed general content with the home and the staff. Service users seemed content with their routines and the support that they received. DS0000012809.V314193.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service Users lifestyles are conducive to their happiness and wellbeing. EVIDENCE: Service Users lead active lifestyles and were seen to be content when they left for their work placements. Those who spoke with the Inspector expressed their general enthusiasm for their placements. The downstairs activities room, which was in the process of adaptation for day activities at the time of the last inspection, is now fully functional. A maximum of six service users at a time from any of the three homes in the group, attend. The room was seen to be well equipped and there was evidence of the professionalism with which service users who attend are supported in various creative activities by dedicated staff. Service users are reported to be enthusiastic to attend and service users themselves evidenced this. Service Users lead active lives within the community and are encouraged to develop friendships through mixing with other Service Users at the owners DS0000012809.V314193.R01.S.doc Version 5.2 Page 12 other two homes, the day centres, and local clubs. Annual holidays are also arranged for those service users who wish to go. Appropriate visitors to the home are encouraged and made warmly welcome. Staff were aware of service users rights in relation to choice, respect and dignity and were seen to promote these principles in their everyday interactions and in the general routines of the home. The Registered Owner is aware of the need to offer service users informed and balanced choices about their rights, for example to vote. Observations of Service Users interactions with staff showed that Service Users are encouraged to understand their rights and responsibilities and are enabled to exercise choice in relation to these. Service users were offered choices of breakfast when they arrived downstairs, and were seen to enjoy interaction with each other and with the staff. Menus show a variety of nutritious dishes, and incorporate service users preferences and choices. There is flexibility in the provision of meals to accommodate service users routines. (See also Management section of report) DS0000012809.V314193.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service Users healthcare needs are properly monitored and responded to. EVIDENCE: Records and discussion with staff show that Service Users healthcare needs are monitored and issues raised promptly and appropriately with healthcare professionals. Health Screening opportunities are made available. The Inspector noted that when service users are admitted to hospitals for treatment that staff will often stay with them throughout the daytimes to support them in the different environment. Service Users psychological, emotional, and physical needs are identified on their care plans and review notes. Service Users were observed to be calm and content with the morning’s routines, and confident in the support given by staff. Staff have undertaken Makaton training and welcome input from the visiting speech therapist to enhance communication with service users. Medication is generally well organized and managed, and the local pharmacist regularly inspects the system. Advice was given to ensure all entries on the DS0000012809.V314193.R01.S.doc Version 5.2 Page 14 Medication Administration Sheets are properly checked and that staff always follow the procedures. An incorrect direction on a Medication Administration Sheet had not been noticed by a number of the trained staff administering and signing for the medication given to one service user although the instruction on the medication container itself had been followed. Therefore there had been risk, but no actual error except on the record. Medication profiles were not always updated promptly and the form should be adjusted to make it more user friendly for staff. DS0000012809.V314193.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The commitment of a trained and responsive staff team protect Service users. EVIDENCE: The home has a complaints log but there are no recent entries therein. There have been no recent complaints about the service to the Commission for Social Care Inspection. Staff are trained in Protection of Vulnerable Adults procedures and understand the processes by which service users are safeguarded. Financial procedures for service users personal expenditure are robust and receipts of purchases made with or on behalf of service users are kept. DS0000012809.V314193.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment of the home and garden is very pleasant and conducive to a friendly, family atmosphere. EVIDENCE: Areas of the home were sampled and found to be clean, well maintained and decorated. Service Users bedrooms were personalized according to their needs and interests. There is an ongoing maintenance and decoration programme. The home has been improved since the last inspection through the provision of the downstairs fully equipped day activities room with adjacent toilet. DS0000012809.V314193.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was properly staffed with caring competent staff. EVIDENCE: At the time of the inspectors visit there were two staff on duty assisting service users upstairs, and a senior carer receiving handover from the night staff and then preparing breakfast for service users. The Registered Owner/Manager was also available. One of the staff assisting service users in the early morning was not detailed on the rota as he was only covering for a short period prior to organizing transport for the service users from all three homes to their work placements. Two additional staff arrived later to help support the service users who arrived from the other homes for their day activities. Staff were observed to be caring and responsive to service users and to take trouble to ensure service users with communication needs were properly heard and responded to. Recruitment processes were checked through discussion with staff and a review of staff records and a thorough and professional process was evidenced. DS0000012809.V314193.R01.S.doc Version 5.2 Page 18 Staff feel fully supported in all areas of developmental needs. Individual training plans are available but had not been fully updated with the training that staff had recently undertaken. Staff have received appropriate training in most areas but lack specific training in the nature of Learning Disabilities and are not always fully aware of all the implications of service users conditions. DS0000012809.V314193.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service is well managed and thereby the outcomes for service users are good. EVIDENCE: The Registered Owner/Manager, Mrs Mather-Franks, has a large number of years experience of working with people with Learning Disabilities and continues to offer a homely and caring environment where service users may maintain or develop their skills with caring and competent support. Staff find Mrs Mather-Franks to be approachable and supportive and feel confident that she will always listen to any issues they may have. Staff supervision is both formal and informal and staff report that communication in the home is very good and enhances the quality of care delivery. DS0000012809.V314193.R01.S.doc Version 5.2 Page 20 Records have been generally improved over the last 12 months and further improvements are planned. There is recorded evidence of the Managers commitment to ensuring the environment is safe and well maintained and Quality Audit processes are being implemented. Health and Safety and risk factors are generally recognized and well managed. Mrs Mather-Franks was advised that the breakfast period was not always fully supported when the senior on duty was giving out medication, and that support should be continuous to prevent unnecessary risk to the vulnerable service users. DS0000012809.V314193.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 Adults 18-65 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 x 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 2 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 3 x x x 2 x DS0000012809.V314193.R01.S.doc Version 5.2 Page 22 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. NONE 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. 1 2 3 Refer to Standard YA20 YA35 YA42 Good Practice Recommendations Medication records should be properly checked and overviewed to avoid any risk of mistakes being made. Staff should receive appropriate training in Learning Disabilities. Service users should be fully supervised during mealtimes to guard against unnecessary risk. DS0000012809.V314193.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB 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 DS0000012809.V314193.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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