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Inspection on 31/05/06 for Highcliffe House Nursing Home

Also see our care home review for Highcliffe House Nursing Home for more information

This inspection was carried out on 31st May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Highcliffe provides residents with a friendly and relaxed environment to live in. All areas of the home are nicely presented and are comfortable, clean and tidy. Residents and relatives spoke highly about the manager, the home and the staff. Interactions between residents and staff were friendly and appropriate. During a discussion with a resident they told the inspector that they considered the interaction between residents and care staff, catering and management to be very good. Visitors are encouraged to visit at any time and relatives were seen visiting during the inspection. One relative commented, "my relative is very well looked after and looks well, staff keep me informed if my relative is unwell". Residents spoken with felt that they lived in a home where staff respected their dignity and privacy. Staff were observed knocking on residents doors and waiting before entering their room. The home provides a wide range of activities for residents, which are in keeping with the age, range of the people living in the home and meet their expectations. A resident that had recently moved into the home told the inspector " I spend my time socialising with others in the lounge or sitting in my room watching television or reading." Another resident spoke of enjoying the bingo sessions, and said they had won a prize of a reindeer, they also said "I enjoy sitting in the garden in summer and going for walks along the sea front". The catering arrangements within the home provide residents with a nutritious and balanced meal on a daily basis, with a good variety of choice. Residents spoken with described the food as "variable, sometimes good and sometimes not so good, but felt that this was mostly due to personal choice". A residentcommented, "If I do not like what is offered I can always ask for something else". Food seen on the day looked appetising and was nicely presented.

What has improved since the last inspection?

Risk assessments are in place for residents who have bedsides to help prevent falls from beds. Issues highlighted from the last inspection and from the visit of the health and safety executive officer relating to window restrictors and radiator covers have been appropriately addressed to promote residents` safety.

What the care home could do better:

The care plans varied in their detail, the nursing assessments seen on the six care plans tracked were very detailed. In most cases residents with a diagnosed condition had very clear guidelines for staff to follow and the signs and symptoms to look for to prevent and recognise when the resident was becoming unwell. Care plans need to be reviewed to reflect the changing needs of the residents as appropriate.

CARE HOMES FOR OLDER PEOPLE Highcliffe House Nursing Home 10 Cobbold Road Felixstowe Suffolk IP11 7HQ Lead Inspector Jan Davies Key Unannounced Inspection 31st May 2006 12:30 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 Highcliffe House Nursing Home DS0000024414.V297451.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 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. Highcliffe House Nursing Home DS0000024414.V297451.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Highcliffe House Nursing Home Address 10 Cobbold Road Felixstowe Suffolk IP11 7HQ 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) 01394 671114 01394 671298 alison@highcliffehouse.com www.highcliffehouse.com Highcliffe House Limited Mrs Susan Margaret Filmer Care Home 27 Category(ies) of Old age, not falling within any other category registration, with number (27), Terminally ill (1) of places Highcliffe House Nursing Home DS0000024414.V297451.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named resident who is terminally ill Date of last inspection 6th December 2005 Brief Description of the Service: Highcliffe House is registered as a care home with nursing, providing care for a maximum of 27 older people. The home is registered to provide general nursing care to one individual service user falling within the registration category of terminal illness. The home is privately owned by Highcliffe House Limited and is managed by Mrs Susan Filmer. Highcliffe House is a large Edwardian building situated in a residential area of Felixstowe within walking distance of the sea front and local amenities. It is a detached building with gardens to the front of the property and parking at the rear. Accommodation is over three floors with communal rooms located on the ground floor. Access to the upper floors is by stairs or passenger lift. Fees range from £600 to £700 per week depending on level of dependency. Highcliffe House Nursing Home DS0000024414.V297451.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection started at 12.30 pm and was a key inspection, which assessed the core standards for older people. Standards that were not entirely met at the last inspection were also re assessed. It took place over six hours during a weekday. The inspector spent time with the manager to discuss progress on requirements from the previous inspection in December 2005. A tour of the premises was made and a number of records were examined including those relating to the care of residents, staff and a selection of policies and procedures. The inspector spent time talking with residents collectively and with six residents individually and with one relative of a resident who was visiting the home on the day of the inspection. What the service does well: Highcliffe provides residents with a friendly and relaxed environment to live in. All areas of the home are nicely presented and are comfortable, clean and tidy. Residents and relatives spoke highly about the manager, the home and the staff. Interactions between residents and staff were friendly and appropriate. During a discussion with a resident they told the inspector that they considered the interaction between residents and care staff, catering and management to be very good. Visitors are encouraged to visit at any time and relatives were seen visiting during the inspection. One relative commented, “my relative is very well looked after and looks well, staff keep me informed if my relative is unwell”. Residents spoken with felt that they lived in a home where staff respected their dignity and privacy. Staff were observed knocking on residents doors and waiting before entering their room. The home provides a wide range of activities for residents, which are in keeping with the age, range of the people living in the home and meet their expectations. A resident that had recently moved into the home told the inspector “ I spend my time socialising with others in the lounge or sitting in my room watching television or reading.” Another resident spoke of enjoying the bingo sessions, and said they had won a prize of a reindeer, they also said “I enjoy sitting in the garden in summer and going for walks along the sea front”. The catering arrangements within the home provide residents with a nutritious and balanced meal on a daily basis, with a good variety of choice. Residents spoken with described the food as “variable, sometimes good and sometimes not so good, but felt that this was mostly due to personal choice”. A resident Highcliffe House Nursing Home DS0000024414.V297451.R01.S.doc Version 5.2 Page 6 commented, “If I do not like what is offered I can always ask for something else”. Food seen on the day looked appetising and was nicely presented. 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. Highcliffe House Nursing Home DS0000024414.V297451.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Highcliffe House Nursing Home DS0000024414.V297451.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5, Prospective residents have the opportunity to visit the home and receive detailed information in the statement of purpose and service users guide to enable them to make decision about where they want to live. Residents cannot always expect to have a completed pre admission assessment of their needs prior to moving into the home. EVIDENCE: Information was examined relating to six residents at the home. One resident was quite new to the home. There was evidence that the home had assessed the resident before they moved into the home and had obtained an assessment from the social worker and information from the family. Upon speaking to the individual and their relative they confirmed that the home knew what care they needed before they moved into the home and that ‘the service provided lived up to expectation.’ The home has a written contract agreed with each private paying resident which is kept filed in the main office, however the contracts for residents that Highcliffe House Nursing Home DS0000024414.V297451.R01.S.doc Version 5.2 Page 9 are funded by social services are signed and returned. The home does not keep copies and were advised to retain a copy on file. One resident informed the inspector that their relative had assisted them to view the home prior to moving in. The care plans of six residents were inspected. All six care plans had a pre admission assessment, however, two were incomplete and were not signed and dated whereas the third was complete signed and dated by the manager. These assessments included information about the resident’s mental health, recreation and social care, safety, communication, falls, personal hygiene and the reason for their admission. The home does not provide intermediate care and therefore standard 6 is not applicable to this service. Highcliffe House Nursing Home DS0000024414.V297451.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Residents, who use this service can expect to have their care needs identified, however care plans varied in the level of detail required to ensure that all aspects of the residents, health personal and social care needs are met. Residents cannot expect to have all their health and welfare needs met until risk assessment tools are fully utilised to highlight and monitor specific areas of risk, for example pressure areas and bedrails. Residents are not currently protected by the home’s procedures for dealing with medication. Residents can expect to be treated with dignity and respect. EVIDENCE: During the inspection the care of six residents was tracked. This involved looking at their care plans and spending time with the residents individually. The inspector was able to speak with a relative of one of the residents who was visiting on the day of the inspection. The care plans contained information on resident’s physical, social and psychological health care needs. Nursing assessments were in place, which detailed the resident’s needs in relation to maintaining their safety, breathing, and their ability to manage their own hygiene and to move independently. These were being reviewed on regular basis. Highcliffe House Nursing Home DS0000024414.V297451.R01.S.doc Version 5.2 Page 11 However reviews did not include the clarity and detail of the initial plan and often the only review recorded was ‘no change.’ This did not incorporate the current risk assessment (of higher risk) given for one resident. From discussion with the manager the appropriate care plan had been implemented in practice but not recorded in a review of the plan. A physiotherapist is paid for by the home to visit once a week offering treatment to residents and to assess new residents needs. They also assist and advise staff on necessary risk assessments for current residents and provide moving and handling training to staff. The inspector met and spoke with the physiotherapist briefly during the inspection and they spoke highly of the home and staff. The inspector looked at the medication records immediately following administration of the evening medication. This was incorrect in that medication had been signed for as given at 18:00hrs when the time was only 17:40 hrs. It was explained that this was done because of time constraints on staff who ‘would be unable to get through all the medication administration before some residents bedtimes.’ This is not acceptable practice for several reasons, Medicines must be signed for at the actual time given and this should be the time indicated on the MAR sheet for administration. Other times on the MAR sheet had been altered, without the authorisation of the dispensing pharmacist and ‘inked in’ on the MAR chart. This practice indicated that there were time management problems for staff in completing all care tasks at this time of the day. The home should undertake a review of staffing at ‘peak’ times. Highcliffe House Nursing Home DS0000024414.V297451.R01.S.doc Version 5.2 Page 12 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): 12,13,15 Residents can expect to live in a home that supports a life style that matches their needs. Residents can expect to receive a good standard of fresh and appealing food with a wide variety of choice as part of their daily diet. EVIDENCE: Relatives were observed visiting during the inspection. A relative spoken with said they visit the home every day. They were observed spending time with their relative and helping them with their lunch. The relative informed the inspector “ my relative is very well looked after, they get a good breakfast, dinner and tea every day and plenty of fluids” and “ my relative looks well, staff keep me informed if my relative is unwell”. Another resident spoken with had only been at the home for a few months and told the inspector “ I spend my time socialising with others in the lounge or sitting in my room watching television or reading” They considered that the interaction between residents and care staff, catering and management was very good. Residents spoken to described the food as “variable, sometimes good and sometimes not so good, but this was mostly due to personal choice”. A resident commented, “If I do not like what is offered I can always ask for something else”. Highcliffe House Nursing Home DS0000024414.V297451.R01.S.doc Version 5.2 Page 13 The inspector viewed the menu for the day. There was a choice of beef stew or meat pie with mashed potatoes and vegetables. The kitchen manager had catered for one resident who was vegetarian. The main meal was followed by bread and butter pudding and cream. Alternatively residents could have a choc-ice or custard or stewed apple. The inspector was shown the week’s menu. The inspector observed that afternoon tea was served with an appetising carrot cake and that visiting relatives were offered refreshments and made welcome. Following a training day with the speech and language therapist the kitchen manager plays an active role in the care planning process when new residents’ move into the home. They discuss special dietary requirements, for example diabetics and any known allergies. Staff keep a food and fluid intake chart, which is monitored for residents who are unwell. Some resident’s food is pureed but the cook explained that they keep food items separate on the plate to identify the individual foods, colour and texture. The inspector observed staff encouraging and supporting a resident who appeared to be unwell to eat their meal, which was done discreetly and with concern about their health. The food store was seen and had a good supply of fresh fruit and vegetables. The home had a good selection of dry foods. The expiry dates of foods were checked and were found to be in date. The fridges had foods being stored correctly, covered, dated and labelled. Temperatures of the fridge and freezers were being recorded and were within the recommended temperature range. Residents told the inspector how much they enjoyed the activities that the home arranges and that they particularly enjoy the music and entertainment. One resident enjoys a quiz and this was encouraged as assisting reminiscence and memory skills. There was no formal plan for activities and no record kept other than the published information about the event or activity on the day. This was on the ‘white’ information board but was ‘wiped’ at the end of the day so did not constitute a record. Highcliffe House Nursing Home DS0000024414.V297451.R01.S.doc Version 5.2 Page 14 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 Residents can expect that their complaints will be listened to but they cannot expect to be fully protected from abuse until the home has systems in place to ensure that all staff members are appropriately trained in protection of vulnerable adults and aware of all the risks of harm to residents. EVIDENCE: The home has a policy for the protection of vulnerable adults and a whistleblowing policy. Staff spoken with had received some training and some were able to identify appropriate action to take in the event of an allegation being made. However not all were familiar with the home’s whistle blowing policy and they would benefit from ‘step-by-step’ guidance on how to follow this if the need arose. It was noted that training is planned in the near future for staff on protecting vulnerable adults and it is strongly recommended that this occurs as planned. There have been no complaints since the last inspection. The complaint procedure was available in the home’s procedures file. This identified the role of the Commission for Social Care Inspection in the process, should a resident or their relative or representative be unhappy with the response from the home. Service users spoken with expressed their contentment with the service being provided but were not all clear about what they should do if the complaint was more of a minor nature and they did not wish to make a formal complaint but did want to express some dissatisfaction to prevent any repetition of a situation occurring. Highcliffe House Nursing Home DS0000024414.V297451.R01.S.doc Version 5.2 Page 15 The home should be pro-active in its approach to complaints and representation and where necessary encourage residents to offer suggestions for improvements and supply information about how this can be progressed. Highcliffe House Nursing Home DS0000024414.V297451.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 24, 25, 26, Residents can expect to live in a well-maintained and welcoming environment, which provides a good range of communal and personal accommodation. Residents can expect to be protected from the risk of infection through the homes by the homes policies and procedures. EVIDENCE: Highcliffe House is situated within walking distance of the seafront, promenade and local shopping facilities. The grounds are well maintained and as previously mentioned the home has on several occasions won second prize in the Felixstowe “flower in bloom competition”. The home was nicely presented and appeared clean and tidy with no unpleasant odours. The majority of the bedrooms on the first and second floors have sea views. The home spans three floors. All communal rooms are on the ground floor. Communal areas consist of a television lounge, a smaller quiet lounge and a dining room. Highcliffe House Nursing Home DS0000024414.V297451.R01.S.doc Version 5.2 Page 17 There is a passenger lift providing access to the upper floors. The home has 23 single bedrooms and 2 twin rooms. Each room has a wash hand basin and eleven of the bedrooms have en-suite facilities. Additionally there are four assisted toilets and five assisted bathrooms fitted with Arjo baths. Evidence was seen that these were being serviced on a regular basis. During a tour of the premises the inspector observed bedsides were being used; the care plans seen had risk assessments in place to assess the risks to the residents. A form for the agreement to have bedsides was seen in each care plan, signed and dated. The inspector observed residents having their midday meal. Residents were given the choice of where to eat. Some residents chose to sit in the dining room and others chose to remain sitting in the armchairs in the adjacent lounge. There was a nice atmosphere during lunchtime. Residents and staff were observed engaging in general conversation. The home has plans to expand Highcliffe House to create five additional rooms, a conservatory and a new laundry. Currently the laundry is situated to the side of the property and the residents and staff need to exit the building to gain access to the laundry facilities. The manager is aware that the plans need to be submitted to the Commission for Social Care Inspection (CSCI). The home has undertaken risk assessments for all residents’ bedrooms above ground floor level and has made immediate changes where one particular resident was at risk. The home has had planning permission approved to replace all the windows at the front of the property. These have been replaced with sash windows to replace the originals and, as a safety precaution, will only open at the top half and in the outwards direction to minimise the risk of residents falling from their window. During a tour of the building the inspector observed that all radiators are now fitted with radiator covers. Resident’s rooms seen looked clean, comfortable and were individually personalised. One resident showed the inspector pictures their grandchild had drawn for them. The home’s infection control policy contains comprehensive guidance for staff in infection control covering topics such as personal hygiene and protective clothing, a procedure to be followed in the event of an accident involving the risk of blood borne infection, spillage of blood and bodily fluids, infection and prevention of cross infection, dealing with soiled linen and the control of Methicillin Resistant Staphylococcus Aureaus (MRSA). Highcliffe House Nursing Home DS0000024414.V297451.R01.S.doc Version 5.2 Page 18 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 Residents can expect to be supported by a staff team, who receive ongoing training to obtain the skills and knowledge to care for them. However the home needs to look at increasing the level of staff who hold a National Vocational Qualification (NVQ). EVIDENCE: The home has a manager who is a registered mental nurse supported by three registered nurses at level 1 and three registered nurses at level 2. There are two team leaders who are supported by eighteen healthcare assistants. A kitchen manager supervises two cooks with two assistants and a waiter. There is also one housekeeper and three domestics and one laundry assistant. Additionally there are two maintenance persons and one personal assistant. The responsible individual for Highcliffe is one of the directors of the company and is based at the home. The home provides 24-hour care and the staff roster confirmed that one nurse plus five healthcare assistants work an early shift between the hours of 7am – 1.45pm and one nurse plus four healthcare assistants work between the hours of 1.30pm to 8pm. One nurse plus two healthcare assistants work 7.30pm – 7.30am for the night shifts. A rota seen confirmed this is the normal arrangement for staffing. Staff spoken with during the inspection felt that they had adequate numbers of staff to meet the current needs of the residents. Highcliffe House Nursing Home DS0000024414.V297451.R01.S.doc Version 5.2 Page 19 From discussion with the manager the home had only achieved 20 of the target of 50 of staff to hold a National Vocational Qualification (NVQ) by 2005. A plan for staff training for the year was seen on the notice board in the dining area. The plan demonstrated that there is a lot of training taking place and is an ongoing process. The home had been re assessed since the last inspection and have retained their status with Investors In People (IIP). A record of training that had taken place included moving and handling, tissue viability, dementia care, palliative care, feeding issues, administration of medication, training the trainer in protection of vulnerable adults, basic wound care, malnutrition and supervision in care homes. However this training was not reflected in staff files. Staff members spoken with were very positive about the home and felt they were well supported by the management team. All newly appointed staff files were inspected and contained appropriate checks including satisfactory CRBs and professional references. Highcliffe House Nursing Home DS0000024414.V297451.R01.S.doc Version 5.2 Page 20 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): 31,33,35,36,38 Residents can expect to live in a home that is run in their best interests by a manager that is suitably qualified and competent. However they cannot expect all staff to always have individual supervision within the recommended timescale. EVIDENCE: The manager of the Highcliffe appointed in July 2003 is a registered mental nurse and completed their certificate of higher education in nursing. They have had experience of working with the metropolitan police and have worked in various hospitals and nursing homes with the elderly and mentally infirm (EMI). The home encourages feedback about the service from residents, relatives and staff about the service being provided through the use of a suggestion box situated in the front entrance hallway. Highcliffe House Nursing Home DS0000024414.V297451.R01.S.doc Version 5.2 Page 21 However this has not provided an appropriate response and the home would benefit from seeking alternative ways of representation from residents and their relatives to obtain their views on how the service could improve. The company does not get involved with the financial affairs of the residents and residents spoken with confirmed that their relatives looked after their finances. They told the inspector that they held small amounts of money in their purse for every day items and that they have a lockable drawer in their room for locking away personal items. Staff spoken with told the inspector that they were receiving supervision and the manager advised the inspector that group supervisions were taking place. A discussion took place with the manager and the responsible individual that although group supervision is an acceptable way of supervising the team as a whole, all care staff should receive a minimum of six recorded supervisions a year which cover all aspects of practice, and philosophy of care within the care home and career development needs which are individual to the member of staff and may not wish to discuss as part of a group. Following the visit from the health and safety inspector in July 2005, the inspector advised that the home appoint someone as a designated health and safety person to assess the risks to residents, visitors and staff that are present, for example how badly someone may be harmed and how frequently this may happen and to ensure that the home complies with all aspects of health and safety legislation. One of the maintenance staff takes responsibility for health and safety with in the home and has support of one of the directors who holds a National Examination Board of Safety and Health (NEBOSH) Certificate. Risk assessments are undertaken for generic tasks including bathing, hot water supply and the risk of Legionella, which includes assessing water storage tanks and unused pipes, cleaning and the Control of Substances Hazardous to Health (COSHH). The discussion acknowledged the difference between the generic risk assessments and the individual specific related risk assessments for residents for example moving and handling. The accident book was seen and evidence was seen that incidents and accidents were being appropriately reported and recorded. Highcliffe House Nursing Home DS0000024414.V297451.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 2 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 3 3 3 3 X 3 3 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 3 X 3 X 3 2 x 3 Highcliffe House Nursing Home DS0000024414.V297451.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes 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 Requirement Pre admission assessments must be fully completed, signed and dated prior to the resident moving into the home. (This is a repeat requirement from the last inspection.) Residents care plans identified their care needs but must be more specific in level of detail required to ensure that all aspects of the residents, health personal and social care needs are met to include long ands short term goals. (This is a repeat requirement from the inspection.) All residents moving and handling risk assessment must be updated to reflect changes as recommended by the physiotherapist.(This is a repeat requirement from the last inspection.) Timescale for action 06/07/06 2. OP7 15, 2 06/07/06 3. OP8 13, 5 06/07/06 Highcliffe House Nursing Home DS0000024414.V297451.R01.S.doc Version 5.2 Page 24 4. OP9 13, 2 Arrangements must be made for the recording, handling, safekeeping, safe administration and disposal of medicines. 06/07/06 5. OP18 13, 6 All staff must receive training for the protection of vulnerable adults. (This is a repeat requirement from the last inspection.) 01/08/06 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 OP16 Good Practice Recommendations The home should be pro-active in its approach to complaints and representation and where necessary encourage residents to offer suggestions for improvements and supply information about how this can be progressed. Staff training should be in place for the administration and recording of medicines. The home should have a training record that is kept up to date and reflects current training for the whole staff team. All staff should have formal recorded supervision where they can discuss personal aspects and development of the career within the time-scale of a minimum of 6 sessions a year. 2. 3. OP30 OP30 4. OP36 Highcliffe House Nursing Home DS0000024414.V297451.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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 Highcliffe House Nursing Home DS0000024414.V297451.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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