Inspection on 10/04/06 for Highbury New Park Care Home

This inspection was carried out on 10th April 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 New Park Care Home 14/09/07

Highbury New Park Care Home 14/12/05

Highbury New Park Care Home 19/10/05

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

CARE HOMES FOR OLDER PEOPLE Highbury New Park Care Home 127 Highbury New Park London N5 2DS Lead Inspector Ms Franki Solomon Unannounced Inspection 10th April 2006 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 Highbury New Park Care Home DS0000063987.V287238.R01.S.doc Version 5.1 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. Highbury New Park Care Home DS0000063987.V287238.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Highbury New Park Care Home Address 127 Highbury New Park London N5 2DS 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) 08452010822 02077049926 manager.highburynewpark@careuk.com Care UK Community Partnerships Ltd Donald John Macleod Care Home 53 Category(ies) of Dementia (0), Dementia - over 65 years of age registration, with number (53) of places Highbury New Park Care Home DS0000063987.V287238.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 1st Floor - Dementia - Over 65 DE(E), Personal Care Only (18Service Users) 2nd Floor - Dementia - Over 65 DE (E), Nursing Care (17- Service Users) 3rd Floor - Dementia - Over 65 DE (E), Nursing Care (18 - Service Users) 1 bed can be used in respect of a named individual aged 63 and over 14th December 2006. Date of last inspection Brief Description of the Service: 127 Highbury New Park is a modern purpose-built care home providing care and support for older people with a form of dementia. The home was built and registered in June 2005 and is owned by the company Care UK Community Partnerships Ltd. The service provision is in partnership with Islington Council and Islington Primary Care Trust (PCT). The home is built over four floors. Offices and a day centre are on the ground floor - the day centre is not subject to regulation under the Care Standards Act. Accommodation for service users is as follows: 1st Floor for 18 people needing personal care (residential care unit) 2nd Floor for 17 people needing nursing care 3rd Floor for 18 people needing higher nursing care The home is fully wheelchair accessible with 2 lifts to the upper floors and has up to date equipment and facilities and continues to acquire equipment as identified. There are 53 spacious single bedrooms each with en-suite shower, toilet and washbasin. Each floor has a well-appointed dining room and a choice of relaxing sitting areas and quiet room. In addition the home has a fully equipped hairdressing salon, activities centre and garden room. There are landscaped gardens and patio areas. The home deploys a staff team comprising administrative staff, domestic staff, laundry staff, maintenance staff, care staff, nurses, and unit managers. At the time of this inspection there was no Registered Manager. The home is situated in a residential area in North London, between Arsenal Underground and Highbury & Islington, British Rail and London Underground. A number 393 bus stops outside the home and runs between Highbury and Islington & Stoke Newington. There is limited parking. Highbury New Park Care Home DS0000063987.V287238.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first statutory inspection for the year commencing April 2006. The inspection was unannounced and lasted 10 hours. Concerns had recently been raised with the Commission regarding procedures following a medical emergency in respect of the care of a service user. Both the Commission and Islington Local Authority had received complaints direct from complainants but had not informed the home of their complaints. The findings on complaints, policies, procedures and protocols from this are reflected in the report. The inspection was to view policies and procedures, particularly as they relate to accidents and incidents of a medical emergency. To examine training received and planned for staff. To view staffing levels on the various floors and reception following a complaint. To check on the requirements of the last inspection of 14th December 2005, to check some of the key standards and to do a tour of the building in terms of maintenance and cleaning. To speak with resident, staff and the temporary manager. The home did not have a registered manager at the time, and the day-to-day running of the units were delegated to the Unit Managers who are Registered Nurses, on the 2nd and 3rd floors, each of whom was available throughout the inspection. The inspector also had the opportunity to meet with and discuss with the Operations Director, the Operations Support Manager and the Operations Manager who were at the home. On the day of the unannounced inspection there was a full complement of staff on both shifts during the day on each floor according to the rota and according to the registration requirements. There were no absences. The inspector would like to thank residents, staff and the operations manager for their hospitality and co-operation during this inspection. What the service does well: The home has made progress in developing activities to suit residents’ cultural and religious interest and activities. Highbury New Park Care Home DS0000063987.V287238.R01.S.doc Version 5.1 Page 6 The home’s reports on their monthly unannounced Regulation 26 visits undertaken by a representative of the Provider are exemplary in that it sets out clearly any deficiencies that need to be addressed. Additionally the last two visits by the provider under this regulation were unannounced by two persons at 4.00 a.m. lasting over seven hours each. The provider implements robust measures to remedy any deficiencies and to raise standards to ensure the safety, well being and comfort of residents. The home’s complaints procedure has been used positively in that a robust training programme has been implemented immediately to ensure staff are appropriately trained and skilled so that reason for similar incidents for complaint do not recur. Following the resignation of the registered manager the provider advertised the post immediately. A new manager will be in post by the beginning of May 2006. The commission has been informed the new manager’s application for registration will be with the commission promptly. What has improved since the last inspection? What they could do better: Highbury New Park Care Home DS0000063987.V287238.R01.S.doc Version 5.1 Page 7 Care Plans should be used as a working document and reflect in detail all the care and support needs of service users, monitored with action to be taken and date to be reviewed. The Activities Programme needs to take into account the needs of people with Dementia, such as being addressed in quiet tones of voice. To have activities that are stimulating to the mind yet gentle and sensitive to the senses. People who have dementia and who may also be hard of hearing can be alarmed and agitated by fast, quick, loud sounds such as clapping, loud music, or their name being called unexpectedly, insistently and loudly. Alternative methods should be researched on how to gain and maintain the attention of people with dementia who cannot concentrate for too long. The Provider has developed a training programme for further training. Outings for residents need to be arranged. The home’s reception area needs to be reviewed to be more welcoming to visitors and alert to the arrival of emergencies services. The Provider has acknowledged and is in the process of reviewing this with a view to making changes. The new manager should develop a culture and encourage staff to build a rapport with relatives and visitors so that they may feel able to approach the manager and staff with any general enquiry or concern about their relative. As well as creating a culture where service users or their representatives may feel that should a concern arise, the home would welcome it in order to remedy and raise standards for the benefit of service users. The inspection found in line with the Provider’s inspection report, that the décor and furbishing is in need of repair and maintenance. 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 New Park Care Home DS0000063987.V287238.R01.S.doc Version 5.1 Page 8 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 Highbury New Park Care Home DS0000063987.V287238.R01.S.doc Version 5.1 Page 9 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): 3. Standard 6 is not applicable. The assessment process for prospective service users is generally well managed and undertaken so that service users may feel assured their needs will be met appropriately. The assessment process on admittance of service users’ to the home needs an item to be included about service users’ wishes in terms of death & dying, so that the home is properly informed and prepared at such a sensitive time. EVIDENCE: The inspector examined a sample of service users’ assessments, spoke with some service users, and relatives who were visiting and some staff. The assessments were undertaken by appropriately qualified staff, usually the Unit Manager and are generally detailed, clear and well written so that all staff would have the information to give the service user appropriate support and care. Highbury New Park Care Home DS0000063987.V287238.R01.S.doc Version 5.1 Page 10 Following the death of a service user it became evident that the assessment process had a shortcoming. The present assessment format and process does not enable information to be gained from service users or their relatives about last rites. The provider acknowledged this and is in the process of reviewing this part of the assessment process which will be undertaken for all existing service users, and upon admittance to the home for future service users. A requirement has been made. The residents at the home have confusion and dementia and were not able to recall the assessment process. One service user in the residential unit who is alert, confirmed the information in the assessment was accurate. Staff spoken to were familiar with residents’ needs. Service users can feel assured that both nurses and carers are aware of their care and support needs and how to meet them. Highbury New Park Care Home DS0000063987.V287238.R01.S.doc Version 5.1 Page 11 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. There is generally a clear and consistent care planning system in place to provide staff with the information needed to satisfactorily meet service users’ needs. The health needs of service users are well met with evidence of good multi-disciplinary working taking place on a regular basis. Service users may feel assured their health care needs will be appropriately and met. Attention to documenting all support needs in the care plan needs to be firmed up. EVIDENCE: A sample of care plans on each floor was examined. Service users, relatives and staff were spoken to. The care plans seen were generally well documented, setting out service users needs and how they were being met and monitored. One key worker spoken to demonstrated a keen knowledge, care and support to the service user they was allocated to. The keyworker identified all the service user’s care needs verbally and how they were attended to, the service Highbury New Park Care Home DS0000063987.V287238.R01.S.doc Version 5.1 Page 12 user’s needs were documented except for their bowel care. The Unit manager addressed the issue immediately with the relevant nursing staff who acknowledged this had been omitted from the care plan. A requirement has been made. Relatives of one service user expressed concern to the inspector about the nursing care of their relative. They had not spoken to any staff or the Unit Manager about their concerns and declined the suggestion from the inspector to do so. Upon inspection, the care plan was found to be well documented and evidenced that an external specialist nurse had been called in to assess and advise on the specific treatment to be undertaken which was being followed diligently by the home’s nursing staff. The inspector asked the unit manager to talk with the relatives. They were observed to discuss the matter clearly and considerately with the relatives. The inspector spoke with the residents again. They informed they were very satisfied with the explanation and were reassured. A recommendation has been made under this standard and standard 16. Highbury New Park Care Home DS0000063987.V287238.R01.S.doc Version 5.1 Page 13 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 & 15. Service users have confusion and dementia and their wishes and desires cannot always be met safely. Staff could do with more training on support to people with dementia. Cultural and religious needs are met where possible, in terms of safety to self and others. The home, although open to visitors at reasonable times, does not give a welcoming impression to visitors at reception. Meals are wholesome and nutritious and generally menus to appeal to minority ethnic groups are also included. EVIDENCE: The service users have dementia and their wishes are not always safe. One resident said they would like to go out for a walk at 4.a.m. because they could not sleep. Upon checking with staff it was confirmed that the resident did not wish to remain in bed after that time. This applies to several residents who are made comfortable in the lounge at that time and given something to drink with biscuits or a snack. The Regulation 26 reports from the two unannounced visits by the Provider at this time in the morning confirmed this. Highbury New Park Care Home DS0000063987.V287238.R01.S.doc Version 5.1 Page 14 Since the last inspection an Activities Co-ordinator for the two upper floors has been appointed. At the time of the inspection the residents were involved in activities according to the Activities Programme. The activity at the time was wholehearted, and boisterous. One service user did not appear to be enjoying to activity. Most older service users, particularly those with dementia generally enjoy soothing, gentle tones – even when they are hard of hearing and unable to concentrate for any length of time. A staff member was observed to call out a service user’s name jokingly but suddenly and loudly which made the service user start. Activities outside the home have not as yet been programmed. The inspector was informed in the summer months outings will be arranged. Drives out to somewhere pleasant or just different, could also be undertaken in the colder months. Service users have dementia and like to walk about. This is a new building. The home’s design is to ensure safety and security. The design of the reception area does not enable reception staff to see clearly to welcome visitors arriving. The ground floor reception area is not staffed after 5 p.m. This can give the impression that the area is deserted during the day. After 5 p.m. there is no one to meet or greet visitors on the ground floor. The Operations Team of CareUK recognised this design drawback and advised the inspector, CareUK were looking to remedy this. Visitors are able to visit at any reasonable time to visit service users. A recommendation has been made. The home has a two-week rotating menu which is nutritious and generally caters for minority ethnic service users. The inspector observed staff interacting with residents. Staff were sympathetic to residents’ needs. Some service users required assistance with their meals and staff were observed to do this in a caring and patient manner. Some residents required special diets, these were recorded in the Care Plans. There was fresh fruit on the tables. One resident said they liked lunch, but not always dinner. Their happy memories from home and culture was to have dinner which included rashers of bacon. They were delighted at the mention of a “bacon butty” (bacon sandwich). Perhaps the cook could oblige from time to time. A recommendation has been made. Highbury New Park Care Home DS0000063987.V287238.R01.S.doc Version 5.1 Page 15 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): 16 & 18. The arrangements in place for handling complaints have been assessed as satisfactory. To date four complaints had been received since the last inspection and these were being handled appropriately. The home could be more proactive about encouraging residents or their relatives to make enquiries and to discuss issues or concerns with staff or the manager. The arrangements in place for adult protection were satisfactory. Protocols needed to be more robust to ensure emergency situations were dealt with appropriately. These have now been implemented. EVIDENCE: There is a complaints procedure in place and written information was displayed within the home on how and who to complain to. According to records examined, the home had received four complaints since the last inspection in December 2005. All complaints were responded to swiftly and appropriately investigated. Two of the complaints had been satisfactorily resolved. Two were recently received and in the process of being investigated. Highbury New Park Care Home DS0000063987.V287238.R01.S.doc Version 5.1 Page 16 Two complaints had gone directly to the Local Authority and not received by the home. They were from relatives about apparent staffing shortages (no one being on the floor) and the phone not being answered. One of these complainants preferred to remain anonymous. The Commission had received similar complaints. Another caller stated they had spoken with the manager but their complaint had been dismissed. The manager has since left. In terms of Protection of Vulnerable Adults and the most recent complaint received by the home, policies and procedures were in place but it was found that protocols for dealing with a medical emergency, and a procedure on receiving the emergency services were absent. These deficiencies have been identified by the Provider following the complaint and have since been addressed. When the inspector spoke with two relatives of a resident, they expressed concern over the care given to their relative. However, when questioned it was found they had not attempted to discuss their concerns with any member of staff. The home could develop protocols or training for all staff to encourage residents and relatives to feel free to approach any member of staff or the manager with matters which may concern them about support and care. And to view complaints as a useful tool for quality assurance and service user satisfaction. A recommendation has been made under this standard and standard 8. Highbury New Park Care Home DS0000063987.V287238.R01.S.doc Version 5.1 Page 17 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 & 26. The home is a new purpose-built building opened June 2005 and has been designed to be safe and secure. However as the home is in its first year and is still being established, there are ongoing adaptations being undertaken by the Provider to ensure service user’s safety and comfort. Apart from the usual snagging problems of a newly-built building, the home is showing hard signs of wear and tear. EVIDENCE: The home is safe and secure. Snagging problems such as settling cracks in plaster on walls are to be seen and have been identified in the Provider’s reports under their unannounced Regulation 26 inspection visits. These repairs are in the pipeline for attention in the coming year. However heavy scuffing from wheelchairs have had an unsightly effect in various areas of the home. The temporary manager advised repairs and maintenance are in the process of being undertaken, but that Highbury New Park Care Home DS0000063987.V287238.R01.S.doc Version 5.1 Page 18 certain snagging problems such as plaster cracks need a few more months to settle before permanent repairs can be undertaken. A requirement has been made. The home otherwise looked generally clean and had no unpleasant odour. Highbury New Park Care Home DS0000063987.V287238.R01.S.doc Version 5.1 Page 19 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, 30. The staffing arrangements, evident during the inspection, should ensure service users’ needs are met. The recruitment and vetting of staff were carried out appropriately and should ensure the safety of service users. A comprehensive induction programme was undertaken prior to opening the home, and the home has an ongoing training programme. Further robust training for all staff on the support for people with dementia is necessary. EVIDENCE: The inspector spoke with each unit manager on each floor, with the temporary manager (The Support Operations Manager) and examined a 4-week staffing rota. The rota evidenced that staffing levels were according to the registration agreement. At the time of the inspection the staffing arrangement for the provision of care and support was as agreed at registration. There was the required number of staff available on all floors during this inspection and staff were observed to interact and attend to service users throughout. The inspector rang a call bell after lunch from the normally empty dining room, to monitor the length of time Highbury New Park Care Home DS0000063987.V287238.R01.S.doc Version 5.1 Page 20 it took for the call to be responded to. The call was responded to in three minutes. A sample of four staff recruitment records (D.O; D.S; T.B; E.H;) evidenced that two references were taken up and C.R.B. (police checks) were undertaken. This sample also evidence that the home provided two weeks’ induction training with ongoing and appropriate National Vocational Training (N.V.Q.) was undertaken with an ongoing programme for any outstanding N.V.Q. training. On the day of inspection all staff were receiving a session each of basic training on First Aid to be followed by additional training, as well as training on Resuscitation for nursing staff. Following a recent complaint further training has been identified by the Provider who has informed the inspector a programme for further training would be developed. Highbury New Park Care Home DS0000063987.V287238.R01.S.doc Version 5.1 Page 21 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, 32, 33, 35, 38 The home is awaiting the arrival of a new manager. Service users have not had the benefit of a well-run home. Service users’ finances are well managed. The home is in its first year and still developing protocols to ensure service users’ welfare and best interests. EVIDENCE: A new manager has been confirmed in post and commences beginning May 2006. A requirement has been made. A Registered Manager was appointed by the Provider several months before the home opened in June 2005 to ensure the safety and well-being of service users. He left in January 2006 shortly after the last inspection in December. At the time the manager left, the home was still in the process of becoming established with various deficiencies being identified and needing to be addressed. Highbury New Park Care Home DS0000063987.V287238.R01.S.doc Version 5.1 Page 22 The Provider advertised the post immediately. In the meantime the Operational Support Manager took over as temporary manager. During this time the temporary manager implemented robust measures, such as undertaking rigorous monthly unannounced inspections under Regulation 26 of the Care Standards Act to ensure the safety and well being of service users. The reports under this regulation were submitted to the commission and are clear and transparent, identifying the various deficiencies which the home needed to correct. Policies and procedures were in place, but protocols for certain actions have been identified as absent and these have been put in place. Responses to complaints have been swift and actions undertaken to remedy these as satisfactorily as possible. Additional equipment has been identified as being needed and these are on order. Further training has been identified and these have commenced and an ongoing programme is being drawn up. The Provider has demonstrated a readiness to comply with requirements and to improve standards so that service users may feel comfortable, safe and secure and receive a good standard of care and support. Highbury New Park Care Home DS0000063987.V287238.R01.S.doc Version 5.1 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 2 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 4 3 X 3 X X 3 Highbury New Park Care Home DS0000063987.V287238.R01.S.doc Version 5.1 Page 24 Are there any outstanding requirements from the last inspection? No. STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP3 Regulation 14(2)(ab) Schedule 3. & 15 (2)(b-c) 12(1)(ab) Requirement The Registered Person must ensure the assessment process includes the wishes of all service users’ or their representatives’ regarding arrangements on death and dying. The Registered Person must ensure all support and care needs of service users are documented in the care plan. This relates to the finding of one service user’s bowel care which was not documented. The Registered Person must ensure the home’s environment is well maintained. Scuffs and snagging repairs must be undertaken. The Registered Person must ensure the new manager puts in her application for registration with the Commission. Timescale for action 15/06/06 2. OP7 20/05/06 3. OP19 23(2)(b) 15/09/06 4. OP31 9(1) 01/06/06 Highbury New Park Care Home DS0000063987.V287238.R01.S.doc Version 5.1 Page 25 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 OP13 Good Practice Recommendations The layout in the reception area needs to be reviewed. The office for reception staff is hidden from view and the area is deserted after 5 p.m. and is not encouraging or helpful to visitors to the home. This deficiency has been recognised by the Management Team who are setting up plans to remedy this To ensure not only individual needs are assessed, but also equality and diversity, service users could be asked what little occasional treat they would like to have to eat. Taking into account the health risks to service users, such requests as a bacon sandwich for instance at dinner could be communicated to the manager and cook who could ensure the service user’s wishes are occasionally met without detrimental effect to their health. The Registered Person could consider training for all staff to be encouraging to visitors or relatives to feel free to express concerns or simply enquire about their relative. 2 OP15 3 OP16 Highbury New Park Care Home DS0000063987.V287238.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Camden Local Office Centro 4 20-23 Mandela Street London NW1 0DU 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. 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