Inspection on 29/03/07 for Highfield

This inspection was carried out on 29th March 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Highfield 30/01/06

Highfield 26/09/05

Highfield 31/01/05

Highfield 17/08/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Highfield Stream Road Kingswinford Dudley West Midlands DY6 9PB Lead Inspector Ms Maggie Bennett Key Unannounced Inspection 29th March 2007 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 Highfield DS0000024964.V330499.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. Highfield DS0000024964.V330499.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Highfield Address Stream Road Kingswinford Dudley West Midlands DY6 9PB 01384 288870 01384 270803 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) Mrs Mary Proctor Mr Arthur Proctor Mrs Mary Proctor Care Home 13 Category(ies) of Old age, not falling within any other category registration, with number (13) of places Highfield DS0000024964.V330499.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th January 2006 Brief Description of the Service: Highfields Care Home is registered by the Commission to provide care to 13 service users who fall within the category of old age. It is owned by a husband and wife partnership and is managed by Mrs Proctor. The home is situated in a pleasant residential area and is located between Kingswinford and Wordsley. The home is a large detached, traditional type property set back from the main road. It has a large attractive garden to the rear and a garden area and car parking space at the front. The home provides a lounge come dining area, nine single and two double bedrooms. One bedroom has en-suite facilities. It provides assisted bathing and showering facilities, a number of assisted and non-assisted toilets, a laundry area and kitchen. Access between floors is enabled by use of a stair lift. Highfield DS0000024964.V330499.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on a weekday between 10.00 a.m. and 7.00 p.m. This is the report of the home’s Key Inspection for the 2006/2007 inspection year. All the key standards of the National Minimum standards were assessed on this occasion. At the last inspection of the home, in January 2006, 13 statutory requirements were made. It was found that all those requirements have now been satisfactorily met. No further requirements were made on this occasion. Two good practice recommendations have been made. Prior to the inspection a Pre Inspection Questionnaire was completed by the Registered Manager of Highfield and returned to the Commission. Service Users and their representatives were asked to complete satisfaction surveys. A total of 14 surveys were returned to the Commission and 2 relatives sent in letters giving their views of the home. Information from the questionnaire, surveys and letters been used in the overall assessment of the home. During the course of the day’s inspection the care plans of 4 service users were seen in order to assess the home’s practice with regard to assessment and care planning. Medication administration was observed and an inspection made of the medication and accompanying records. A variety of documents were seen in order to check that required policies and procedures were in place and that they were regularly reviewed and updated. A tour took place of the building, including the majority of service users’ rooms. A selection of staff files were inspected to assess the home’s recruitment practice and provision of staff training. Discussion took place with a number of service users, some on a “one to one” basis and others as a group. 7 service users’ relatives were spoken to during the inspection. The Registered Manager and Deputy Manager were present throughout the day and 3 other members of staff were spoken to. What the service does well: Highfield Residential Home provides very professional care in a homely and welcoming environment. The service is very well managed and staff well trained, but the overwhelming impression is of a home that provides excellent outcomes for the service users and their relatives, who are very happy with the care provided. Service users’ views and those of their relatives are Highfield DS0000024964.V330499.R01.S.doc Version 5.2 Page 6 expressed within the report. The following four quotes, however, are representative of the majority of the feedback received: “I am happy and well-cared for. All the staff are kind and caring.” “It is most enjoyable to live here. I am very well looked after.” (Service users). “We feel that in setting standards, Highfield should be the target that others strive to achieve.” “We feel that we are lucky to find such a wonderful establishment in which our mother is safe, warm and well cared for.” (Relatives). There are good assessment procedures at Highfield, the needs of each person being carefully considered prior to them moving in. Care planning is of good quality, is person centred and enables service users to be involved in all aspects of their life at the home. The home enjoys an excellent working relationship with healthcare professionals and is proactive in accessing appropriate healthcare for the service users. There are good systems and clear procedures in place to ensure that medication administration is carried out safely. Service users’ rights to privacy and dignity are very much respected. Routines are flexible and service users are free to choose whether or not they wish to join in activities. The meals at the home are of good quality. There are robust policies and procedures in place to deal with any complaints and to protect service users from abuse. The building is well maintained and provides a comfortable and safe home for the service users. Staffing training is regarded as high priority and service users benefit by being cared for by a skilled and well-trained staff group. There are clear procedures in place with regard to recruitment, which protect the service users. The service is selective with regard to new staff and service users and their relatives are invited to be involved in the interview and selection process. The home is extremely well managed by both the Manager and Deputy Manager, who ensure that service users’ best interests are always paramount. There are excellent quality monitoring systems in place, which take into account the wishes and views of the service users. What has improved since the last inspection? Since the last inspection the Registered Manager has reviewed the home’s medication procedures and policy. There is now an up to date document in place, to ensure that all requirements with regard to medication administration Highfield DS0000024964.V330499.R01.S.doc Version 5.2 Page 7 are met. The Adult Protection Policy and Whistleblowing Policy have been updated and now include contact details for staff should they have any concerns they feel unable to raise with the Registered Persons. A new conservatory has been added to the rear of the property. This has provided service users with additional communal space in a light and airy environment. Various other areas have been refurbished and redecorated. The home are to be congratulated on achieving ISO 9001 in August 2006. 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. The summary of this inspection report can be made available in other formats on request. Highfield DS0000024964.V330499.R01.S.doc Version 5.2 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 Highfield DS0000024964.V330499.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 3. Standard 6 is not applicable, as Highfield does not provide intermediate care. Quality in this outcome area is good. All prospective service users receive the benefit of a full assessment prior to their admission to Highfield. The needs of each person are carefully considered and no one moves to Highfield without being assured that the home is confident that it can meet these needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans of the 3 most recently arrived service users were seen in order to inspect the home’s assessment procedures and practice. In all cases there was evidence that the Registered Manager had obtained a full and proper assessment from the referring social worker prior to the person’s admission to the home. In addition the Registered Manager or Deputy Manager had carried Highfield DS0000024964.V330499.R01.S.doc Version 5.2 Page 10 out an assessment of the person’s needs, either in their own home or in hospital. The assessment information on file contained details of all those areas listed in Standard 3.3 of the National Minimum Standards. Following the assessment, the Registered Manager writes to the service user confirming that the home is able to meet their needs. A comprehensive plan of care is developed from the assessment information (see Standard 7). Service users spoken to during the inspection confirmed that they had either looked around the home themselves before making a decision or that a relative had visited on their behalf. One person said: “my daughter looked around for me”. In their returned survey, a relative stated that the home had provided sufficient relevant information to help the service user with the decision as to whether or not to move to Highfield. She said: “The information was comprehensive and it was helpful when deciding in which home my mother would be living.” Highfield DS0000024964.V330499.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 and 10. Quality in this outcome area is excellent. There is an effective care planning system in place, which is person centred and enables service users to be involved in all aspects of their life. The service users’ rights of access to healthcare services are actively promoted and the home enjoys an excellent working relationship with visiting healthcare professionals. There are good systems and clear procedures in place to ensure that medication administration is carried out safely. Only those staff who are properly trained administer medication. Service users’ rights to privacy and dignity are respected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Highfield DS0000024964.V330499.R01.S.doc Version 5.2 Page 12 The plans of care of 4 service users were seen in order to assess the home’s practice and planning in meeting the personal, social and healthcare needs of the service users. Each of the plans seen contained a “My Life” document, which had been compiled with information from the service user and with assistance from their family and key worker. Care plans contained details of each area of need and clearly explained the process of care, i.e. how the care was to be delivered to meet the service users’ needs and preferences. Each plan contained a risk assessment, including a falls risk assessment. There was evidence that the plans are reviewed on a monthly basis and updated to reflect any changing needs. Where possible, care plans have been signed by the service user. There is evidence from discussions with the service users, returned surveys and the home’s records that the healthcare needs of the service users are very well met at Highfield. Each specific healthcare need is detailed in the plan, with clear instructions for staff to follow. All service users have a risk assessment in place with regard to the development of pressure sores. Pressure relieving equipment is provided when needed. Where bed rails are used, they are checked on a daily basis and their use is regularly reviewed. A number of healthcare professionals visit the home on a regular basis, including the Continence Promotion Nurse, District Nurses, Chiropodist, Dentist and Optician. Service users are referred for assistance from other healthcare professionals as needed, including the Dietician and Speech and Language Therapist. All service users have their nutritional needs assessed on admission and this is regularly monitored. Weights are taken regularly and the home have purchased a set of seated scales. In addition to any required home visits the G.P. visits the home on a monthly basis. There are numerous examples in care plans of the home being pro active in promoting the service users’ rights of access to any health and remedial services they may need. There is clearly an excellent working relationship with the local healthcare professionals, some of who returned surveys to the Commission stating their complete satisfaction with the level of care provided to the service users at Highfield. Service users and their relatives, both in person and in returned surveys, spoke of how their healthcare needs had been very well met. Here are some of the things they said: “First class treatment.” “If I have any concern about my mother’s health, one mention to staff and it is dealt with immediately (e.g. Doctor, Optician, etc.).” “The staff are very sensitive to the medical needs of my mother and will be present whenever the Doctor has been needed.” “I don’t think I would be alive today if it weren’t for the staff here.” Healthcare professionals, in their returned surveys, said the following: Highfield DS0000024964.V330499.R01.S.doc Version 5.2 Page 13 “In my opinion all the fundamental needs of the clients in the home are met to the highest level of care.” “As a visiting health professional, the standard of record keeping is excellent, all members of staff ensure I have the client’s notes and any change to any aspect of the client’s care is documented and signed.” “The Standards are excellent.” “Staff have a good working relationship with Practice.” “Very caring for all our patients.” At the last inspection of the home 3 statutory requirements were made with regard to medication recording and administration. It was found on this occasion that those requirements have now been fully met. There are clear policies and procedures in place with regard to the receipt, recording, storage, handling, administration and disposal of medicines. Staff read these documents and sign to verify that they have done so. None of the current group of service users choose to take charge of their own medication. The home use a monitored dosage system for the administration of medication. A sample of the medicines and accompanying administration records sheets were seen at the inspection and there were no discrepancies. A medication “round” was observed and this was carried out in a discreet and satisfactory manner. Any controlled drugs are stored, administered and recorded appropriately and records were seen to verify this. All those staff who administer medication have successfully completed accredited training and have also taken part in the training provided by the Pharmacist. The Registered Manager carries out a regular audit of the medication and also “spot checks” staff to ensure that they are following proper procedures. The Pharmacist also carries out a regular audit. Some medicines requiring refrigeration are kept in a separate container in the home’s domestic fridge. It is recommended that a medicines’ refrigerator be purchased. Service users spoken to during the inspection confirmed that their privacy was upheld at Highfield and that they were treated with respect. One person said: “They always knock and are always respectful.” Another person said: “They’re all good to you.” Since the last inspection service users have been consulted about how they wish to be addressed and this is documented in their care plans. Personal care takes place in private and screening is provided in double rooms. All new staff receive full induction training, which includes instruction on how to treat service users with respect at all times. Highfield DS0000024964.V330499.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 and 15. Quality in this outcome area is good. The routines of the home are flexible to meet the needs of individual service users. A number of social care activities are offered, including “one to one” and small group trips. There are plans to further improve opportunities for activities and stimulation. Family and friends feel welcome and know that they can visit at any time. The meals at the home are of good quality and the home provides nutritious foods in a pleasant and relaxed environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the course of the inspection service users spoken to said that they were able to exercise personal choice in terms of the day to day activities within the home. Evidence of this was observed during the inspection, with service users coming for breakfast at their convenience. In addition a service user chose to eat in her room, rather than the main dining room. Care plans and particularly Highfield DS0000024964.V330499.R01.S.doc Version 5.2 Page 15 the “My Life” section gave details of service users’ interests and hobbies. A regular programme of activities is offered within the home, including quizzes and “Movement to Music”. Some service users have expressed an interest in helping with preparing Spring bedding plants and vegetables for the garden. The Registered Manager explained that in the past the home had provided a range of activities within the home but that these had not been recorded. Now such activities are clearly documented in individual care plans. Visiting entertainers visit and a Church Service takes place each week. There were not many trips out last year, largely because of the very hot weather. Previous outside activities have included the Black Country Museum, Blackpool to see the “Hot Ice Show”, Coronation Street, entertainment at Brierley Hill Civic Hall and the local Community Centre. A possible trip to Chester Zoo is currently being discussed with the service users. There is the opportunity for some service users to go out on a “one to one” trip with a member of staff and at the time of the inspection 2 service users were taken to visit a local Garden Centre. In the majority of the returned surveys service users felt that there were sufficient activities provided at the home. One relative felt that there could perhaps be an improvement in this area. Another person said that more activities were needed, but that steps were being taken by the home, in conjunction with relatives, to raise funds for further activities. Relatives noted that they were always invited to participate in social events. Both service users and relatives who were present at the time of the inspection confirmed that visitors were welcome at any reasonable time. Service users are able to see their visitors in their rooms, but most use the communal areas, including the new conservatory area. Several relatives, in their returned surveys and during the inspection, spoke of how they were always made to feel welcome at Highfield, one person describing the home as “home from home”. Information on the home’s policy on maintaining relatives’ and friends’ involvement with service users is contained in the Service Users’ Guide. Some local schools visit the home, particularly at Christmas time to provide entertainment and service users have also been invited to the school’s Christmas Play. The majority of service users take charge of their own financial affairs and are enabled to do so for as long as possible. In some cases this responsibility is handled by their relatives. The Registered Manager does not act as Appointee for any of the service users. Information on the local Advocacy Service is available in the home. Service users have been able to personalise their rooms according to their taste and this was seen at the inspection. The home has a policy with regard to access to personal records and this has been confirmed in writing to the service users. Both during the inspection and in their returned surveys, service users spoke highly of the quality of the meals provided at Highfield. Three full meals a day are offered, as well as supper and drinks and snacks throughout the day. Special therapeutic diets are provided when necessary. The Registered Highfield DS0000024964.V330499.R01.S.doc Version 5.2 Page 16 Manager stated that low sugar diets are provided and meat is minced if needed. If food has to be pureed, moulds are used to enhance presentation. Menus seen prior to the inspection and during the visit show that a variety of nutritious foods are offered. Service users and staff confirmed that alternatives are always available to the main meal. At the time of the inspection the meal of gammon, with potatoes, vegetables and parsley sauce, followed by blackberry and apple pie, was very much enjoyed. Staff were observed to be offering discreet assistance where needed. The kitchen was seen during the inspection and was found to be clean and in good order. An inspection of the food supplies showed a variety of nutritious foods, including fresh fruit and vegetables. Fresh meat is delivered each week. Highfield DS0000024964.V330499.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18. Quality in this outcome area is good. There is a clear complaints procedure in place and service users and their relatives feel that any complaints they have will be listened to and acted upon. There are robust policies and procedures in place to protect service users from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a satisfactory Complaints Procedure and Policy in place, a copy of which is available to service users and their relatives. The document was reviewed in February 2007. Both in their returned surveys and during the inspection service users and relatives spoken to confirmed that they would be happy to voice any concerns they had to the Registered Manager or Deputy Manager of the home. A service user said that she was quite sure that the Registered Manager would act upon any concerns she had. Neither the home or the Commission for Social Care Inspection have received any complaints about the home in the last 12 months. The home have a copy of Dudley Social Services Adult Protection Procedure (January 2007), which is regularly discussed at Staff Meetings and in supervision sessions. The home has its own Restraint Policy and Whistleblowing Policy. All these documents are in line with the Department of Highfield DS0000024964.V330499.R01.S.doc Version 5.2 Page 18 Health guidance, “No Secrets”. The Registered Manager recently attended an Adult Protection Workshop and has cascaded information from this to all the staff. Staff take part in training in Adult Protection on a regular basis. The Registered Manager is well aware of her responsibilities under the Protection of Vulnerable Adults legislation. Staff spoken to during the inspection were also clear of their responsibilities with regard to “Whistleblowing”. No allegations of abuse have been made at the home. Since the last inspection the home’s procedures have been updated and now include contact names, telephone numbers and addresses of agencies staff should approach if they have concerns about practice or other areas, which they feel unable to raise with the Registered Persons. There are appropriate policies and practices in place with regard to service users’ monies (see also Standard 35). Highfield DS0000024964.V330499.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 and 26. Quality in this outcome area is good. Highfield provides a comfortable and safe home for the service users. Further recent improvements have enhanced the environment. There are very good standards of hygiene within the home and robust procedures in place to protect any spread of infection. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Highfield offers its service users a safe and well-maintained home, which is comfortable and homely. There is a routine maintenance plan in place, which was seen at the inspection. A number of improvements and redecoration have taken place since the last inspection. This has included the provision of a new conservatory area, providing service users with increased communal space, which is light and airy. To the rear of the property are attractive gardens, Highfield DS0000024964.V330499.R01.S.doc Version 5.2 Page 20 which are accessible to the service users. The home was visited by the Fire Officer in April 2006 and by the Environmental Health Officer in September 2006. There is a stair lift leading to the first floor. On the day of the inspection the home was clean and bright and free of any offensive odours. There are appropriate policies and procedures in place to prevent any spread of infection and these were seen at the inspection. There is a small laundry next to the office. Staff do not approach the laundry through the kitchen. There are hand wash facilities next to the laundry in the staff toilet. “Dissolvo” bags are used for any foul laundry. The washing machine has a sluice facility and there is a commercial dryer. Highfield DS0000024964.V330499.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 and 30. Quality in this outcome area is excellent. There are sufficient staff on duty to meet the needs of the service users. A good proportion of staff have achieved NVQ2 or above and several are currently completing this training. There are robust recruitment procedures in place to protect the service users. The service is selective and both service users and relatives are invited to participate at interviews. Staff training is regarded as high priority. Service users benefit by being cared for by a skilled and well trained staff group. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A sample of rotas were forwarded to the Commission prior to the inspection. Both these and rotas seen during the inspection confirm that there are sufficient staff on duty to meet the needs of the service users. During the morning shifts there are 2 care staff on duty plus a senior member of staff. During afternoon/evening shifts there 2/3 care staff on duty, depending on the needs of the service users at the time. Overnight there are 2 waking night staff. Either the Registered Manager or Deputy Manager are On Call in the event of an emergency. The Manager’s hours are supernumerary, but she does carry out care duties as needed. Sufficient housekeeping staff, a cook Highfield DS0000024964.V330499.R01.S.doc Version 5.2 Page 22 and cleaners are employed. Agency staff are not employed at the home, any gaps in the rota caused by sickness or holidays being covered by the existing staff group. In their returned surveys the majority of service users felt that staff were available to help them when they needed assistance. This was confirmed by service users spoken to during the inspection. One returned survey showed that the person completing the form felt that there were not always sufficient staff for “one to one” attention and social/pastoral care. During the inspection, however, staff were observed to be chatting to the service users throughout the day and 2 service users were taken on a trip to a local Garden Centre. Six staff files were seen during the inspection in order to assess training and recruitment practice. Records show that over 60 of the staff group are trained to NVQ level 2 or above. Staff files seen demonstrated that there are robust recruitment procedures at Highfield. All contained a completed application form, with a full employment history, two written references and evidence of satisfactory Criminal Records Bureau and POVA checks. All staff receive copies of the General Social Care Council Code of Conduct. Service users and relatives are invited individually to be involved in interviewing new staff and their contribution and views are taken into account at staff selection. There is a training and development programme in place and all members of staff have an individual training plan and record on file. Records seen show that new staff undertake induction training to Skills for Care specifications. In addition to the mandatory health and safety areas (see also Standard 38) staff have taken part in a number of relevant courses including: tissue viability, risk assessment, safe handling of medicines, dementia care and adult protection. There has also been training in MRSA and Clostridium Difficile, as well as training in the new Mental Capacity Act. The Registered Manager is clearly proactive in seeking out appropriate training, which is beyond the basic requirements. Service users, both in their returned surveys, and during the inspection spoke highly of the staff. One person commented that the staff “always talk to you”, she said she had been in another home where the staff just “stood around” and didn’t communicate with the service users. This was definitely not the case at Highfield. Other comments were: “they’re very good” and “they’re all good to you.” One relative remarked on the excellent support both she and her mother had received from staff when her mother was admitted to Hospital. Staff spoken to during the inspection were committed and enthusiastic. They clearly enjoyed working at Highfield and took great pride in describing their care of the service users and training achievements. One person said: “I love my job”. Highfield DS0000024964.V330499.R01.S.doc Version 5.2 Page 23 Highfield DS0000024964.V330499.R01.S.doc Version 5.2 Page 24 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35 and 38. Quality in this outcome area is excellent. The Registered Manager is highly competent, well qualified and very experienced. Both she and the Deputy Manager ensure that service users live in a home that is run in their best interests. There are excellent quality monitoring systems in place, which take into account the wishes and views of the service users. Service users’ monies are kept securely and appropriate records maintained. There are policies and procedures in place to promote the health and safety of service users and staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Highfield DS0000024964.V330499.R01.S.doc Version 5.2 Page 25 The Registered Manager, who is also the joint registered provider, has been at Highfield since it opened in 1985 and has had many years of experience of caring for older people, both in a hospital environment and care home setting. The Manager has achieved the NVQ Level 5 in Management and is also a first level Registered Nurse. She continually updates her skills and knowledge by taking part in relevant training. The Manager is highly competent, has sound knowledge and is committed to continual improvement. Staff feel confident in both the Manager and Deputy Manager and those spoken to at the inspection said they would have no problem in discussing any matters of concern with them. One person spoke of the tremendous support and encouragement she had received from the Manager. There are effective quality assurance and quality monitoring systems in place. In August 2006 the home achieved ISO 9001. In addition the home carries out quality audits on a regular basis and seeks the views of all its stakeholders, service users, their representatives and visiting social and health care professionals. All this information is used to provide an annual development plan for the home. Service users’ and staff meetings are held on a regular basis. Evidence was seen at the inspection that policies, procedures and practices are regularly reviewed and updated to reflect current legislation and good practice advice. The home takes charge of the personal allowance of one service user only, all other service users’ monies are handled by their relatives. Appropriate written records are kept of all transactions and receipts kept when items are purchased on behalf of the service user. During the inspection a check was made of the money held in safe-keeping and accompanying records and there were no discrepancies. The manager does not act as Appointee for any of the service users. Staff files seen during the inspection show that staff take part in regular training in the core areas of moving and handling, fire safety, first aid, food hygiene and infection control. Fire safety checks take place at the required intervals and records were seen to verify this. The Registered Manager stated that fire drills take place at least every six months. This needs to be recorded. There is a satisfactory Fire Risk Assessment in place. All fire fighting equipment is regularly inspected and maintained. Records were seen to verify that regular maintenance checks and servicing takes place for the boiler, central heating system, electrical equipment and electrical system. The water system is regularly checked for legionella. The hoists and the stair lift were recently serviced. The Accident Book was seen and the home is compliant in notifying the Commission of any incidents under the terms of Regulation 37 of the Care Homes Regulations. There are risk assessments in place for all safe working practice topics. All hazardous substances are stored securely and an analysis kept of each product used. Highfield DS0000024964.V330499.R01.S.doc Version 5.2 Page 26 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 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 Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 X X 3 Highfield DS0000024964.V330499.R01.S.doc Version 5.2 Page 27 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. Standard Regulation Requirement Timescale for action 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. 2. Refer to Standard OP9 OP38 Good Practice Recommendations It is recommended that a separate medicines’ refrigerator be purchased. The Registered Manager should ensure that records are kept of the six monthly fire drills. Highfield DS0000024964.V330499.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Halesowen Record Management Unit Mucklow Office Park, West Point, Ground Floor Mucklow Hill Halesowen West Midlands B62 8DA National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 DS0000024964.V330499.R01.S.doc Version 5.2 Page 29 - 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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