Inspection on 27/02/06 for Highfield

This inspection was carried out on 27th February 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.

Other inspections for this house

Highfield 04/07/06

Highfield 01/12/05

Highfield 22/02/05

Highfield 26/08/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Highfield Highfield 51 Alpha Road Birchington Kent CT7 9EG Lead Inspector Clair Brown Unannounced Inspection 14:00 27 & 28 February 2006 th th 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 Highfield DS0000023437.V282641.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. Highfield DS0000023437.V282641.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Highfield Address Highfield 51 Alpha Road Birchington Kent CT7 9EG 01843 842116 01843 842190 melanie4baker@hotmail.com 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) Mr Egerton Lionel Keith Eckersley Mrs Anne Margaret Eckersley Mrs Melanie Baker Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21) of places Highfield DS0000023437.V282641.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th January 2003 Brief Description of the Service: Highfield Residential Home is a detached three-storey building with service user accommodation situated over three floors. The home is located within ten minutes walk from local shops and public amenities including public transport, library and church. There is an enclosed rear garden, which is laid to lawn. There is off street parking to the front of the property for approximately six cars. The home provides personal care and support for up to 21 older persons. The home aims to respect service users privacy and dignity. Highfield DS0000023437.V282641.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the home’s unannounced inspection, which was conducted by one inspector. The duration of the inspection was 4 hours but conducted over 2 days, as there was no one available to take the inspection on the first day. The Home representative was the registered manager. Additional time was spent in planning the inspection and report writing. The inspection included assessing the progress being made to meet the previously made requirements. Medication, documents and records were examined and service users files were case tracked. What the service does well: What has improved since the last inspection? What they could do better: Care plans should detail all of the service users needs and provide staff with clear instructions on how to meet these needs. All service users should have nutritional and skin integrity assessments completed. The medication policy and practices need to be improved and brought up to date with current standards and to ensure the safe administration of medicines. Arrangements need to be made, by the training of staff to prevent service users being harmed or suffering abuse or being placed at risk of harm of abuse. Staff files need to contain all of the required documentation. The quality assurance process needs to be developed further, to include other relevant parties views and to produce a written report on the Highfield DS0000023437.V282641.R01.S.doc Version 5.1 Page 6 findings and an action plan. Valid electrical and gas safety certificates need to be obtained. 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. Highfield DS0000023437.V282641.R01.S.doc Version 5.1 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 Highfield DS0000023437.V282641.R01.S.doc Version 5.1 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): EVIDENCE: Highfield DS0000023437.V282641.R01.S.doc Version 5.1 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 the following standard(s): 789 The care planning system is inconsistent and fails to provide staff with adequate information they need to satisfactorily meet service users needs. Assessments of health needs are not conducted, failing to identify potential risks. Medication practices and procedures are unsafe. EVIDENCE: The most recently admitted service user file was case tracked. The care plan did provide a brief description of individual needs but failed to provide care staff with any clear instructions on how to meet these needs. There are no assessments used for skin integrity and nutritional status. Medication practices and procedures are not in line with current standards. The home does not have a safe means of transporting the medicine to service users. There were some gaps in the written records (MAR charts). The home is without a controlled drug register, although service users are prescribed them. Medication is administered from one medicine container rather than the actual persons prescribed, labelled medicine. Lactulose was one medicine that was shared between service users. The medication policy & procedure has not been reviewed and no longer corresponds with current practices including Highfield DS0000023437.V282641.R01.S.doc Version 5.1 Page 10 those of the home. The uses “homely” medicines (over the counter medicines) but this is not in the policy. Highfield DS0000023437.V282641.R01.S.doc Version 5.1 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 the following standard(s): 14 The home offers service users a great deal of choice in all aspects of day-today living. EVIDENCE: Evidence gathered at both inspections this year showed service users are supported to make their own decision and their personal preferences are respected. This includes areas such as daily routines and activities. Highfield DS0000023437.V282641.R01.S.doc Version 5.1 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 the following standard(s): 18 No progress has been made to provide staff with adult protection training. EVIDENCE: Although other training courses have been planned for later in the year no provision has been made for adult protection training. Highfield DS0000023437.V282641.R01.S.doc Version 5.1 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 the following standard(s): EVIDENCE: Highfield DS0000023437.V282641.R01.S.doc Version 5.1 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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 At times staffing numbers are lower than normally provided within the home. Recruitment procedures are not thorough and do not ensure the safety and welfare of the service users. Staff have completed a nationally recognized training programme. EVIDENCE: The most recently employed member of staffs recruitment file was assessed. This showed that recruitment procedures had not been followed; the CRB had been applied but was not returned and the POVA First check had not been received until after the employment start date. The new member of staff was working unsupervised. The induction programme has not been updated to comply with current requirements. The home was experiencing staff shortages due to staff using up annual leave and the home having some vacancies. Due to one of the cooks being on leave the registered manager was covering these duties. Care staff were also covering some of the gaps in the duty rotas. Nine of the seventeen care staff have obtained the NVQ level 2 or above in care qualification. Highfield DS0000023437.V282641.R01.S.doc Version 5.1 Page 15 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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): 33 35 38 The quality of service provided is not regular assessed and monitored. The health & safety and welfare of both staff and service users are not ensured by current procedures. Service users fiancés are handled and recorded appropriately. EVIDENCE: The sending out of questionnaires has started the quality assurance programme but the process needs completing by collating the information gathered and producing a report and action plan. The specialist engineers have been booked to carry out the required environmental health & safety inspections but to date they have not been done. Service users financial records were seen, the records and cash corresponded and receipts were kept. Highfield DS0000023437.V282641.R01.S.doc Version 5.1 Page 16 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 2 X X X X X X X X STAFFING Standard No Score 27 2 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X 3 X X 2 Highfield DS0000023437.V282641.R01.S.doc Version 5.1 Page 17 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 OP7OP8 Regulation 12 13 15 16 Requirement Timescale for action 30/06/06 2 OP9 13 3 OP9 13 4 OP9 13 Care plans must detail all of the service users needs and provide staff with clear instructions on how to meet these needs. All service users must have nutritional and skin integrity assessments completed. The registered person shall make 30/04/06 arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. (Ensure consistency in the use of abbreviations when recording medicines, ensure all medicines entering or leaving the home are recorded, ensure all handwritten entries are countersigned, internal creams are to be stored away from external creams.) Previous timescale: 14/12/05 To review the medication policy 31/05/06 and procedure to bring in line with current requirements. Controlled drugs to be recorded in a controlled register. Medication must not be shared 07/04/06 between service users. DS0000023437.V282641.R01.S.doc Version 5.1 Highfield Page 18 5 OP18 13 6 OP29 19 The registered person shall make 30/06/06 arrangements, by training staff or by other measures, to prevent service users being harmed or suffering abuse or being placed at risk of harm of abuse. Previous timescale: 01/03/06 Ensure all staff files contain all 30/06/06 detailed in schedule 2. Previous timescale: 01/02/06 The registered manager is required to develop the quality assurance process further, to include other relevant parties views and to produce a written report on the findings and an action plan. Copies of valid electrical and gas safety certificates to be forwarded to the commission. Previous timescale: 01/02/06 30/08/06 7 OP33 10 12 15 24 26 8 OP38 12 13 16 17 23 Sch 3 30/06/06 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 OP9 Good Practice Recommendations To consider the use of a medication trolley. Highfield DS0000023437.V282641.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 Highfield DS0000023437.V282641.R01.S.doc Version 5.1 Page 20 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!