Inspection on 28/04/05 for Highermead

This inspection was carried out on 28th April 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

Highermead 13/02/08

Highermead 01/08/07

Highermead 16/08/06

Highermead 05/10/05

Highermead 20/10/04

Highermead 28/04/04

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

CARE HOMES FOR OLDER PEOPLE Highermead College Road Camelford Cornwall PL32 9TL Lead Inspector Philippa Cutting Announced 28 April 2005 09:30 a.m. 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. Highermead Version 1.10 Page 3 SERVICE INFORMATION Name of service Highermead Address College Road Camelford Cornwall PL32 9TL 01840 212528 01840 211024 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) Ark Care Services Limited Mr Shaun Boundy Care Home 18 Category(ies) of Dementia - over 65 years of age (18) registration, with number Mental Disorder, excluding learning disability or of places dementia - over 65 years of age (18) Highermead Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20 October 2004 Brief Description of the Service: Highermead provides care and accommodation for older peole who have problems with their mental health whether through age or illness. Accommodation is provided on two floors, in single rooms in a large detached house in a quet rural area.in Camelford. There is good circulatory space on the ground floor so that service users can sit or wander in safety. In good weather there is an enclosed garden available. Highermead Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first announced visit to the home by this inspector, therefore the focus of the inspection was to observe the practice, the environment and assess the effect this had on caring for the service users who are a dependent and potentially vulnerable group of people. The inspection was made between 9.45 a.m. and 4.30p.m. The inspector spoke to staff and relatives who were in the home. Some service users were able to hold short conversations but for the main part judgements were made by observing their demeanour and behaviour. The atmosphere in the home was calm and peaceful. Service users were treated with respect and in a non-confrontational way. An occasional disagreement between service users was quickly diffused by staff who intervened and diverted people away to other areas or topics of conversation. Staff all appeared to enjoy their work and those with whom the inspector spoke, said they worked with what was essential a demanding group of people, from choice. What the service does well: What has improved since the last inspection? What they could do better: Attention to all aspects of paperwork, which includes the responsibilities of the responsible individual. Highermead Version 1.10 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Highermead Version 1.10 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 Highermead Version 1.10 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) 1,3,4,5 Sufficient information is obtained and made available so that families can be assured that the home meets their relatives’ needs. EVIDENCE: The service users need help to understand or complete any documentation that relates to their admission and stay in the home and therefore relatives or a responsible person undertakes this on their behalf. Prospective service users are assessed prior to admission. Families and friends are welcome to visit the home in advance to help in their choice of a placement. The home could not accept people with mental health needs who required nursing care. Highermead Version 1.10 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, Service users are treated with dignity and respect with their welfare being paramount. EVIDENCE: Very few service users were able to comment directly on the care that they received and therefore this was gauged by studying the care plans and observation. Notes indicated that health problems were referred on to the relevant agencies; staff said there was good liaison with the community nursing service and a visiting community nurse confirmed this. Staff were seen to be attentive towards the service users throughout the inspection, their presence was very much in evidence in a calm and unhurried manner. Relatives of service users said that they were very content with the care their family member received and that they had noticed improvements in service users’ conduct, which they attributed to the quiet approach, used by staff. None of the service users are able to manage their own medication; this is handled by the staff. The home has written policies and procedures relating to the storage, administration & disposal of medication. Medication administration record sheets were seen to be complete. Highermead Version 1.10 Page 10 Highermead Version 1.10 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 The routines of the home are organised to provide service users with stimulation appropriate to their needs and contact with families and important other people is encouraged. EVIDENCE: Due their illness, many of the service users are limited in how they can exercise choice in their lives but the home tries to offer this within realistic boundaries. For some this may be selecting their clothes or where they want to spend their time; other people are able to be more participative. Visits to and by friends and families are encouraged and local outings are arranged as appropriate. Assistance is needed by all service users in handling their finances. A record of any monies spent on behalf of a service user is kept Everyone is encouraged to eat in the dining room as sitting at a table makes the process of eating easier for service users and reinforces the social stimulus of mealtimes. People who need feeding or their meals served in a different way (i.e. a soft diet etc.) are properly catered for. Highermead Version 1.10 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,18. The home is aware of its duties and obligations to a group of vulnerable, dependent people. It takes any complaints or allegations seriously and has procedures in place to address this. Concerns would be investigated with the relevant agencies EVIDENCE: The home has a complaints policy. It is unlikely that service users themselves would be able to instigate this; the information is available in the home and supplied to relatives etc. A change in the behaviour of a service user would be the most likely indication that something was not right or distressing him/her. Any verbal comments by a service user are taken seriously and looked into. Highermead Version 1.10 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19.20.21.22.23.24.25.26 The home is maintained in a clean, satisfactory manner that meets service users’ needs. EVIDENCE: Service users are accommodated in single rooms that are decorated in pleasant colour schemes and give scope for people to have items of personal significance around them. Floor coverings are replaced on a regular basis as they can become worn. The communal space is interlinked so that people can wander freely between them. People are encouraged to spend their time in the sitting rooms rather than in their bedrooms as much as possible because this gives better interaction with the staff. The home has created a small quiet/sensory room for the service users’ enjoyment. Externally there is space for service users to sit or walk outside safely in good weather. At the time of this inspection the home appeared to be clean and hygienic. Highermead Version 1.10 Page 14 Highermead Version 1.10 Page 15 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) 27,28,30 The staff appeared to have a sound understanding of the service users’ needs and their approach to their work was good. EVIDENCE: Sufficient staff are employed to provide service users with the considerable attention that they need. During the inspection the staff were observed to be kind and caring in their approach to the service users and they spent time with them. Staff did not go off into ‘huddles’ with other staff but were able to assist one another if needed. The staff spoke enthusiastically about their work. Highermead Version 1.10 Page 16 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,,37 The registered manager provides effective leadership for the home & staff group. EVIDENCE: The registered manager gave an impression of someone who enjoyed his work and responsibilities and was keen to share his enthusiasm with others, which created a positive atmosphere in the home. The staff team has remained stable and committed. The owners of the home do not live locally and visit occasionally. The registered manager reports that they are supportive and generous in their dealings with the home but records indicated that regulation 26 notices were not being completed showing the responsible individual regular monthly liaison with Highermead. Highermead Version 1.10 Page 17 Records are kept secure but staff records need to be completed fully in order to comply with the requirements of Schedule 2. Highermead Version 1.10 Page 18 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. Where there is no score against a standard it has not been looked at during this inspection. 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 x x 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x 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 3 STAFFING Standard No Score 27 3 28 3 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 x x x x 2 x Highermead Version 1.10 Page 19 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 OP37 Regulation 26 Requirement (2) Where the registered provider is an organisation or partnership, the care home shall be visited in accordance with this regulation by - (a) the responsible individual or one of the partners, as the case may be;(b) another of the directors or other persons responsible for the management of the organisation or partnership; or(c) an employee of the organisation or the partnership who is not directly concerned with the conduct of the care home. (3) Visits under paragraph (1) or (2) shall take place at least once a month and shall be unannounced. (4) The person carrying out the visit shall - (a) interview, with their consent and in private, such of the service users and their representatives and persons working at the care home as appears necessary in order to form an opinion of the standard of care provided in the care home;(b) inspect the premises of the care home, its record of events and records of any complaints; and(c) prepare Version 1.10 Timescale for action Immediate Highermead Page 20 a written report on the conduct of the care home. (5) The registered provider shall supply a copy of the report required to be made under paragraph (4)(c) to - (a) the Commission;(b) the registered manager; and(c) in the case of a visit under paragraph (2) - (i) where the registered provider is an organisation, to each of the directors or other persons responsible for the management of the organisation; and(ii) where the registered provider is a partnership, to each of the partners. 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 Highermead Version 1.10 Page 21 Commission for Social Care Inspection John Keay House Tregonissey Road St Austell Cornwall, PL25 4AD 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 Highermead Version 1.10 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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