Inspection on 13/07/05 for Highbury House Nursing Home

This inspection was carried out on 13th July 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

Highbury House Nursing Home 21/09/07

Highbury House Nursing Home 13/06/06

Highbury House Nursing Home 07/12/05

Highbury House Nursing Home 12/01/05

Highbury House Nursing Home 21/05/04

Highbury House Nursing Home 28/08/03

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Highbury House Steyning Road Rottingdean Brighton BN2 7GA Lead Inspector Elizabeth Dudley Announced 13 July 2005 10:00am 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 H59-H10 S13999 Highbury House V226571 130705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Highbury House Address Steyning Road Rottingdean Brighton East Sussex BN2 7GA 01273 309447 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) Mrs Zeenat Nanji and Dr Tasneem Osman Naomi Cornford Care Home with nursing (N) 30 Category(ies) of Old age, not falling within any other category registration, with number (OP), 30 of places Highbury House H59-H10 S13999 Highbury House V226571 130705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users should be aged sixty-five (65) years or over on admission. 2. The service can provide up to thirty (30) nursing places and twelve (12) personal care places. 3. The maximum number of service users to be accommodated is thirty (30). 4. No more than four (4) service users who are terminally ill can be resident in the home at any one time. This is to include service users who are already resident within the home and become terminally ill. Date of last inspection 12 January 2005 Brief Description of the Service: Highbury House provides accomodation with nursing for up to 30 older people, it may also 12 older people who need only personal care and assistance. Situated in Rottingdean, all rooms have pleasant views, some with a sea view and there are well maintained gardens which are accessible to service users who use wheelchairs. Highbury House provides a pleasant environment and one which service users are encouraged to treat as home. Public transport passes within walking distance of the home and there is restricted parking in the area of the home, however unrestricted parking is available in roads around the home. Highbury House H59-H10 S13999 Highbury House V226571 130705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection, which forms part of the annual inspection programme for the home, took place on the 13th July 2006 over a period of 7 hours, it was facilitated by Mrs Z Nanji, registered provider and Ms Benitha Siziba, acting manager. This was the first inspection for Ms Siziba in her new role as manager. During the day a tour of the home was undertaken, personnel and training records, care plans, drug records and health and safety documentation examined, and 22 residents, 8 members of staff and 2 visitors were spoken with. Comment cards from residents and visitors were received by the CSCI prior to the inspection and thanks are given to those who completed and returned these. The comments given about the care and life at the home are used when doing the inspection and provide a valuable insight to life within the home. What the service does well: The home is very committed to staff training, and this helps the carers and registered nurses to maintain an interest in their job whilst making sure that the residents in the home receive good care. Documentation within the home has always been of a high standard, and this is continuing under the new manager. There is a pleasant open atmosphere within the home. Residents stated that ‘You couldn’t wish for anywhere better’, ‘ The staff are so kind’, ‘the food is good and plentiful’. Staff turnover has always been relatively low therefore allowing residents to build up relationships with staff. Residents are allowed to make their own choices about the times they get up and go to bed and breakfast is given at any time from 0630, depending on what time the resident wishes. A cooked breakfast is always available. Home made cakes and puddings are on the menu and resident choice is important. One resident stated ‘ The vegetables take up too much space at lunchtime’ – on reporting this to the provider she immediately said , he must have much more meat if that is what he likes, I will make sure the cook is aware of this’. The home provides activities and several residents were seen to be enjoying a game. One resident likes to place bets on horse racing and staff help him with this and enable him to collect his winnings. Overall Highbury House provides a comfortable, happy home for residents, whose welfare appears to be a priority for the provider and manager. Highbury House H59-H10 S13999 Highbury House V226571 130705 Stage 4.doc Version 1.40 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. Highbury House H59-H10 S13999 Highbury House V226571 130705 Stage 4.doc Version 1.40 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 H59-H10 S13999 Highbury House V226571 130705 Stage 4.doc Version 1.40 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) 1,2,3,4,5,Residents are given sufficient information to enable them to be confident that the home is the place they wish to live. EVIDENCE: The home has updated the statement of purpose and service users guide to reflect the management changes within the home . Both these documents contain sufficient information to allow prospective residents make decisions about whether they wish to make Highbury House their home. Every resident receives a statement of terms and conditions on their admission to the home and this has all the information as required by the National Minimum Standard. The majority of prospective residents are assessed by the manager prior to being admitted to the home, unless distance proves this to be impractical. This assessment ensures that the home can meet the medical, psychological and social needs of the resident and to allow the prospective resident to ask any questions and receive information about the home. Prospective residents and their representatives are welcome to visit the home to ensure the home is suitable for their needs. Highbury House H59-H10 S13999 Highbury House V226571 130705 Stage 4.doc Version 1.40 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) 7,8,9,10,11The home appears to provide a good standard of well documented care and residents are confident that their health care needs are met. EVIDENCE: Care plans examined included those of residents admitted for personal care as well as those admitted for nursing care. A total of six care plans were examined and these were seen to include all documentation as required by this standard. Documentation included risk assessments, monthly reviews and the signature of the resident or the relative to indicate that they had been involved in the compilation of the care plan, and also identified visits by GPs and other health care professionals. There was clear indication that the care identified as required was followed by those administering the care. Care plans also included nutritional care plans and the addition of a new form which will show the monthly weight and blood pressure of the resident. The home has a range of pressure relieving equipment and receives visits from the wound care specialist nurse where appropriate. Staff receive training in wound care, the promotion of continence and other matters relevant to the care of the residents. A chiropodist and dentist visit the home and residents can have the GP of their choice within the area, all visits by these health care professionals take place in the residents own rooms. Highbury House H59-H10 S13999 Highbury House V226571 130705 Stage 4.doc Version 1.40 Page 10 Care staff can accompany residents to hospital for appointments. Some residents self medicate and the home has a policy relating to this, monthly reviews of the residents capabilities to continue with this are undertaken. All medication was signed for following administration and the medication was correctly stored. The manager states that stock rotation of medication and dressings takes place. The provider asked for advice regarding the new laws on the safe disposal of medication and this was relayed to her following the inspection. Drug fridge temperatures are recorded daily and oxygen and suction machines are checked weekly. There is an appropriate oxygen policy and notices indicating flammable gasses were in place. Residents stated that they felt they were treated with privacy and dignity and that their preferred form of address was used by staff. Staff were seen to be treating the residents with respect and were seen to be answering call bells promptly. Although there was no resident that was very ill at this time, staff stated that they had received training in the care of the terminally ill resident and that registered nurses have undertaken some study days at the local hospice. Residents spoken with stated that the doctor is always asked to visit when they are unwell, and that they had great confidence in ability of the nursing staff. One resident said that she never worries about her health now as the nurses took such good care of her when she was so ill and she believes that it is thanks to their encouragement and care that she now feels as well as she does. Highbury House H59-H10 S13999 Highbury House V226571 130705 Stage 4.doc Version 1.40 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) 12,13,14,15 Residents are encouraged to make choices relating to their lifestyle and food . The home seeks to provide a comfortable lifestyle for those living there. EVIDENCE: Residents spoken with stated that they can choose the times that they go to bed or get up in the morning and what time they have breakfast. They can also choose whether or not to take part in the activities provided by the home. The home provides a range of activities which includes art, Music for Health and outings to the beach or to the village. A programme of activities needs to be displayed so that residents will know in advance what is taking place. There is open visiting in the home and the provider has arranged for one visitor to stay overnight on a regular basis with one of the residents, in order to give them more time together. All residents can have a cooked breakfast if they wish and the menus show a good choice of food for all meals. Menus are reviewed fortnightly to avoid residents becoming bored with the food. The chef is able to cater for vegetarians, diabetics and some other medical dietary needs, and makes all the cakes and puddings offered. Highbury House H59-H10 S13999 Highbury House V226571 130705 Stage 4.doc Version 1.40 Page 12 Comments received about the food were mainly positive and most residents said the food was good and plentiful, however one comment stated that fruit needed to be requested rather than offered and the provider states that she will look at this. All catering personnel are in possession of the food hygiene certificate and records of fridge and freezer temperatures and the cleaning schedule were seen. Highbury House H59-H10 S13999 Highbury House V226571 130705 Stage 4.doc Version 1.40 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 standard(s) 16,17,18 The home takes complaints seriously and acts in a robust and open manner to safeguard residents. Staff training and rigorous pre employment checks, show that the management is aware of its role in protecting the resident living at the home. EVIDENCE: The home has a complaints policy, which meets this standard, and records are kept of complaints received. The home has only had one complaint in the past 12 months and this was substantiated by and acted upon by the manager. The provider views complaints as a ‘tool for improvement’ and as such deals with them in an open, robust manner Although staff have received training in the protection of the vulnerable adult, this is due to be renewed in the near future. Most staff were aware of their responsibilities towards the residents in their care but there was some confusion about who they should inform within the home. The manager and provider will assist residents to see solicitors and advisors if they are required and these are seen in the privacy of the resident’s room. Highbury House H59-H10 S13999 Highbury House V226571 130705 Stage 4.doc Version 1.40 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 standard(s) 19,20,21,22,23,24,25,26 Highbury house provides a comfortable, homely environment for residents to live in. EVIDENCE: The home is pleasant and comfortable and there is a great improvement in the standard of minor maintenance within the home, the manager was aware of issues that need addressing, which is evidence that these are now being monitored. The provider states that the windows in some areas are being replaced and some carpets will be replaced in the near future. The home has employed a new gardener and the front garden now shows the benefits of this. The gardens do always appear tidy and attractive and it was noted that bird feeders have been placed where residents can see them. Three residents commented on how nice the garden is and that they did enjoy watching the birds. The communal space includes a two dining areas, a large lounge and a smaller lounge area, residents were seen to be using all these rooms. Highbury House H59-H10 S13999 Highbury House V226571 130705 Stage 4.doc Version 1.40 Page 15 The home provides three assisted bathrooms and an assisted shower room and the majority of rooms have an en-suite facility which consists of a wash hand basin and wc. An occupational therapist has assessed the home, and the home provides handrails along most corridors and in the w.c. There are adequate hoists, ramps and moving and handling equipment. The majority of rooms reach the size as detailed in the standard. There is one single room that is below 10 sq m but the resident states that he is not worried about the lack of space and that he likes the room. All residents rooms are comfortably furnished, the majority having a lockable facility for service users use, one resident has declined to have this and has signed a disclaimer to state that she does not wish for this facility. All rooms have a lockable door, radiator guards and window restrictors. Residents can bring in their own possessions and variable height beds are provided for those with nursing needs. It was seen that new towels and some new sheets were needed and the provider said that these have been ordered. Most of the rooms were in reasonable state of decoration but the manager should check this on a regular basis. All water temperatures have been checked regularly and were within recommended parameters. Overall, the standard of cleanliness in the home is good, however there are some areas in the kitchen which need improving, and some carpets that require more frequent cleaning. One room was malodorous, the provider and manager are aware of this and taking steps to rectify this. There was a bath brush and sponge left in the communal bathroom and the manager must ensure that this does not occur to prevent cross infection. The home has a range of infection control policies. Visitors spoken with stated that they felt that the overall maintenance in the home had improved in the past few months and that ‘things were taken care of as they occur now’. Highbury House H59-H10 S13999 Highbury House V226571 130705 Stage 4.doc Version 1.40 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 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) 27,28,29,30 The home shows a commitment to staff training and is thorough in its selection and recruitment of staff, thereby ensuring that the residents receive a good standard of care in a safe environment. EVIDENCE: Highbury House has a very good staff to resident ratio and the manager can bring in extra staff if required. There are two registered nurses during the mornings and six care staff, with one registered nurse and six care staff in the afternoons, a further member of staff being brought in to work the 4-8 shift if the home has its full complement of residents. Residents spoken with stated that there seemed to be sufficient staff on duty to meet their needs, and also said that their call bells were usually answered fairly promptly. The home encourages staff training and 37 of the care staff have attained NVQ level 2 or above with further care staff studying for this qualification. Staff undertake a thorough induction training when commencing work and this is in line with NTO guidelines. Registered nurses are all encouraged to update their knowledge and attend study days. Individual training files are in place. The home consistently shows a commitment to staff training and is to be commended on this. The home has a robust recruitment policy and all staff files were seen to contain the documentation as required by Regulation 19. However the provider stated that as POVA first checks are taking so long at present, this is making recruitment difficult Highbury House H59-H10 S13999 Highbury House V226571 130705 Stage 4.doc Version 1.40 Page 17 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) 31,32,33,36,37,38 The ethos in the home is good and quality is maintained by the use of a quality monitoring system which allows the residents comments to be heard. The health and safety of the residents are maintained by regular servicing of equipment and staff training in health and safety issues. EVIDENCE: The acting manager, Ms Benitha Siziba, is been in post for two months, prior to this she has worked at Highbury House for two years, an RGN with many years experience, Ms Siziba appears to be comfortable within her new role. She intends to split her time between management and nursing, the majority of the time being in a nursing role. She is aware of the need to undertake a management course and to be registered by the CSCI. The manager states that she feels very supported by the provider and the infrastructure within the home. Residents and staff spoke positively about the management change. Highbury House H59-H10 S13999 Highbury House V226571 130705 Stage 4.doc Version 1.40 Page 18 There is an open and friendly atmosphere within the home, residents stated that they were very happy and that the staff ‘ do anything you ask’ and ‘you could not wish for a better place’. One written comment described the home as ‘ heaven on earth’. Positive comments, only, were received regarding the atmosphere and the friendliness of the staff. Staff meetings take place on a monthly basis. The home operates a quality monitoring system insomuch as it sends out questionnaires to residents and visitors which relate to the quality of care , catering , choice and social care. The results of these are collated and given to vistors, residents and care staff. Staff meetings are held and the results discussed and acted upon. The provider uses the quality monitoring to test and discuss the strengths and weaknesses within the home, she intends to draw visitors and residents into discussions around these. One comment card received by the CSCI stated that it would be good to hold combined residents, staff and visitors meetings, the provider agreed with this and intends to commence these. Regulation 26 provider reports are received by the CSCI on a monthly basis, and although the manager is only recently in post, she has continued with the regular supervision of staff: stating that this is a good thing as it enables staff to talk about their concerns whilst discussing their goals for the future. The majority of policies have been reviewed recently and there are some that are being amended at present. All documents are kept within a locked office or in the nurses station, and the staff are aware of confidentiality and data protection laws. All certificates relating to the servicing of utilities and equipment are in place and in date and all staff have received mandatory training. There are 8 members of staff with a first aid certificate. The manager has recently attended a health and safety course and had taken health and safety precautions where water had caused a carpet to come away from the floor. All residents’ doors now have magnetic door guards, which enables the door to shut automatically in case of fire The manager must ensure that any cleaning liquids are put out of sight in the kitchenette or locked away if possible to avoid danger to residents. Highbury House H59-H10 S13999 Highbury House V226571 130705 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 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 3 3 3 3 3 3 2 STAFFING Standard No Score 27 3 28 3 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 2 4 3 x x 3 3 3 Highbury House H59-H10 S13999 Highbury House V226571 130705 Stage 4.doc Version 1.40 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 24 Regulation Reg16(2)( c) Reg 13(3) Requirement That towels and sheets are replaced as discussed and referenced in the main body of the report That personal washing equipment is not left in the communal bathrooms, and areas in the kitchen identified with the manager are kept clean That all detergent and cleaning aids are not kept on the work surfaces in the kitchenette Timescale for action August 30th 2005 Immediate 2. 26 3. 38 reg 13(4) Immediate 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 H59-H10 S13999 Highbury House V226571 130705 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection Ivy House 3 Ivy Terrace Eastbourne East Susssex BN21 4QT 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 Highbury House H59-H10 S13999 Highbury House V226571 130705 Stage 4.doc Version 1.40 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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