CARE HOMES FOR OLDER PEOPLE
Highbury House Care Home Highbury House Care Home 580-582 Lytham Road Blackpool FY4 1RB Lead Inspector
Kevan Royston Announced 24 May 2005 10:00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Highbury House Care Home F57 S9750 Highbury House V211593 240505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Highbury House Care Home Address 580-582 Lytham Road South Shore Blackpool FY4 1RB 01253 344401 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr David Moseley Mrs Barbara Selina Moseley Karen Carter CRH 28 Category(ies) of OP Old Age 28 registration, with number of places Highbury House Care Home F57 S9750 Highbury House V211593 240505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: None. Date of last inspection 17 November 2004 Brief Description of the Service: Highbury House is situated on Lytham Road in the Blackpool south area close to Highfield Road shopping area and close to local bus routes and the airport. The home isregistered for 28 older people of both sexes. the building is a large building with two lifts to access the second floor and garden areas at the front and rear of the building with seating provided.There are 26 single and one double room all provide en-suite facilities.Bathroom and toilet facilities with aids and adaptations are provided on both floors.The communal areas consist of a large lounge,two conservatories and a dining room. Highbury House Care Home F57 S9750 Highbury House V211593 240505 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an announced inspection on the 24/05/05 and took place over 6 hours. Discussion with the registered provider, registered manager, interviews and informal discussion with staff, relatives and residents have gathered the information contained in this report. Questionnaires were sent to relatives, residents, social workers and GP surgeries to comment on the standard of care provided by the home. A tour of the premises took place and examination of documentation formed the basis of the visit. Records of three staff and residents who were spoken to were examined. What the service does well: What has improved since the last inspection? What they could do better:
The environmental standards could be improved in relation to windows in resident bedrooms being restricted and radiator guards being fitted to ensure the health and safety of residents.
Highbury House Care Home F57 S9750 Highbury House V211593 240505 Stage 4.doc Version 1.30 Page 6 The recruitment procedures and the homes application for employment form must be reviewed and updated to contain all the information required on each staff member before employment is agreed and staff take up there posts. Communication between the relatives of residents and the home in relation to the ongoing care and review of care provided could be improved so that relatives and the residents are aware any changes in the delivery of care provided to each individual. 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. Highbury House Care Home F57 S9750 Highbury House V211593 240505 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Highbury House Care Home F57 S9750 Highbury House V211593 240505 Stage 4.doc Version 1.30 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 The admission and assessment procedures were clear to ensure the care needs of residents are met. EVIDENCE: The records of three residents one recently admitted had full assessment information. Staff members confirmed they had access to this information and could describe in detail the care needs of residents. The cook spoken to had been informed about residents who had special dietary needs. One resident confirmed she had been involved in her assessment and was happy that her needs were being met by the home. Highbury House Care Home F57 S9750 Highbury House V211593 240505 Stage 4.doc Version 1.30 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 standard(s) Promotion of health is taken seriously. Residents welfare is closely monitored and health needs were met. EVIDENCE: Individual records are kept for each resident with a plan of care setting out in detail the action that needed to be taken by care staff to ensure all aspects of health, personal and social care needs of the residents were met. Significant events had been recorded and daily entries made setting out the care given. Each resident has separate folders for risk assessments, care plans, activities preferences, reviews and other personal information. This could be condensed in order to make it easier to record more accurate information one relative spoken to said, “We would like to be more involved in the care and support given to my father and notified of any changes”. Two relative responses from questionnaires also requested to be more involved in the reviews of residents care. The care plan for one resident showed how care needs had changed and the action taken by the home to resolve the problem. However one residents records examined did not reflect her true mobility problems when seen and spoken to.
Highbury House Care Home F57 S9750 Highbury House V211593 240505 Stage 4.doc Version 1.30 Page 10 Discussion with staff confirmed they were aware of the needs of residents and the level of care that was required. Medication practices observed were safe and good records had been maintained. Highbury House Care Home F57 S9750 Highbury House V211593 240505 Stage 4.doc Version 1.30 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 standard(s) 12,13,14 and 15 Contact with families is encouraged and supported by staff to maintain relationships. Activities and meals are varied and well managed and choice is provided. EVIDENCE: Residents spoken to confirmed visitors are allowed at any time. One relative said. “ The staff are good and always offer a cup of tea”. Activities are arranged to suit the resident’s wishes. Care plans of residents examined recorded preferences for social activities. However three returned resident questionnaire out of 12 said activities could be improved. Discussion with residents all said they were happy with the routines at the home. One resident said,” It’s very relaxed here and the staff are helpful” The menus were found to provide a varied and balanced diet. Fresh produce from local suppliers is used. Questionnaires returned from residents commented on the high quality of food provided. One resident said “Food is good and we get a choice” Observation of meal times found it to be relaxed and the food well prepared. Observations of residents rooms showed personal belongings are allowed to be brought into the home. Highbury House Care Home F57 S9750 Highbury House V211593 240505 Stage 4.doc Version 1.30 Page 12 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 The arrangements for recording and reporting of complaints are good ensuring people feel listened to. Staff has good knowledge and understanding of adult protection issues, which protect residents from abuse. EVIDENCE: The home has a detailed complaints procedure and staff was able to explain the process. Records of complaints investigations with outcomes are up to date. One resident spoken to knew who to complain to and said, “I would speak to the manager. Another comment from a relative said” I know the correct procedures of complaints at the home”. The home has a procedure in place for dealing with allegations of abuse. The registered manager and staff spoken to had a good understanding of the procedures to be followed in the event of any allegations or suspicion of abuse or neglect. Staff spoken to have received training in relation to complaints and abuse that is covered in they’re NVQ (National Vocational Qualification) training. There have been no complaints since the last inspection. Highbury House Care Home F57 S9750 Highbury House V211593 240505 Stage 4.doc Version 1.30 Page 13 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Recent investment has improved the appearance of the home, which was clean and tidy ensuring the residents comfort. However some minor work still requires to be done in relation ensure the safety of the residents. EVIDENCE: A tour of the building found the home to be clean and tidy. Since the last inspection some radiator guards have been fitted and the programme is ongoing to ensure the safety of the residents. Examination of maintenance records showed there is a rolling programme of general repairs and renewal of the premises. Highbury House Care Home F57 S9750 Highbury House V211593 240505 Stage 4.doc Version 1.30 Page 14 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29 and 30. The procedures for the recruitment of staff are not robust therefore do not provide the necessary safeguards to offer protection to the people living at the home. The numbers of staff on duty were satisfactory to meet the needs of people living in the home. EVIDENCE: Three staff files examined showed not all the recruitment checks were in place. to ensure the protection of residents. One staff file had no references and another only had one. There were no staff photographs on there individual records. Examination of the application form for employment must ask for a full employment history with any gaps explained. Criminal records Bureau checks were in place and POVA checks had been completed. Staffing levels were sufficient for the number of residents living at the home. Residents said they were happy with the care they receive from the staff and management and were well treated. One resident said, “The staff are very kind” Examination of training records show over 50 of care staff is trained to level 2 NVQ in care and meets the requirements. Two staff spoken to confirm they had received induction training on commencement of employment. Highbury House Care Home F57 S9750 Highbury House V211593 240505 Stage 4.doc Version 1.30 Page 15 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,35 and 38. The home is well managed and run in the best interests of residents. EVIDENCE: Residents, visitors and staff members were very positive in their comments about the homes registered manager and her style of management. Residents and visitors spoken to said they found her to be approachable, supportive, willing to listen and helpful. Staff members said they found the manager was supportive and provided a clear sense leadership. The registered manager has good systems to gather staff, residents and relative’s views to enable ongoing improvements to the home. A tour of the premises found some residents bedrooms did not have window restrictors that must be fitted in order to ensure the safety of the residents. Discussion with the registered manager confirmed she has completed level 4 NVQ in management and care. Highbury House Care Home F57 S9750 Highbury House V211593 240505 Stage 4.doc Version 1.30 Page 16 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 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 3 x x x x x 2 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 Standard No 16 17 18 Score 3 x 3 3 x x x 3 x x 2 Highbury House Care Home F57 S9750 Highbury House V211593 240505 Stage 4.doc Version 1.30 Page 17 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. 2. Standard 25 38 Regulation 23 13 Requirement All radiators and pipework must be guardwd or have guaranteed low temperature surfaces. The registered person must provide and maintain window restrictors based on assessment of vulnerabilityof risk to residents. The registered person must ensure all areas specified in schedule 2 of the Care Homes Regulations must be available on staff files. Timescale for action 30/08/05 30/08/05 3. 29 19 schedule 2 30/8/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Highbury House Care Home F57 S9750 Highbury House V211593 240505 Stage 4.doc Version 1.30 Page 18 Commission for Social Care Inspection Area Office, Unit 1 Tustin Court Portway Preston PR2 2YQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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