Inspection on 05/07/05 for Highfield

This inspection was carried out on 5th July 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

Highfield 25/06/07

Highfield 04/07/06

Highfield 20/10/05

Highfield 14/03/05

Highfield 19/10/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Highfield 50 Abington Avenue Northampton Northants NN1 4DA Lead Inspector Moira Mosley Unannounced 5 July 2005 14.00 th 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 C51.C08.S12810.Highfield.V236138.050705.Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Highfield Address 50 Abington Avenue Northampton Northants NN1 4DA 01604 632614 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) Mentaur Limited Vacant Care Home 6 Category(ies) of LD Learning Disability (6) registration, with number of places Highfield C51.C08.S12810.Highfield.V236138.050705.Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. To include two current named service users who have Sensory Impairments in additional to their Learning Difficulties 2. It is a condition of this registration that the home is authorised to care for the named service user who has a mental health diagnosis in addition to a Learning Disability Date of last inspection 14th March 2005 Brief Description of the Service: Highfield is situated close to Northampton town centre in a large terraced house. It is convenient to local facilities including shops and leisure provision with good public transfer links. The home is a terraced property offering single accomodation over three floors, plus the laundry in the basement of the property. The home can accommodate six young adults with Learning Disabilities, currently three male and three females. In addition the home has conditions on its certificate to care for two service users who have additional Sensory disabilities, and one with an additional Mental health diagnosis. The home has a dining area, and small lounge, and a garden, which is used by the service users. The home is owned by Mentaur Ltd, who also own two other homes and a day centre in Northampton. Highfield C51.C08.S12810.Highfield.V236138.050705.Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a statutory unannounced inspection held as a result of a complaint received by the CSCI; 3 hours were spent gathering information and planning for the inspection and 3 hours were spent in the home. The care of two service users was reviewed to include their care plans and other records. Two of the service users were in the home at the start of the inspection and the other four returned to the home following day placements. Due to their learning disability some were unable to comment on their care however a period of observation and discussion with three of the service users and three staff members was undertaken to find out how they felt about living in the home. Service user questionnaires were returned to the Commission for Social Care Inspection from all six service users and comments received from one service user relative. The complaint received raised concerns about the financial management of the home and alleged that service users were not being given choice about how their money was being used and that a member of the staff team had used a service user credit card without their consent. This was investigated and there was no evidence to support the allegation. What the service does well: The service users questionnaires were all very positive about the home and this was supported through observations and discussions. They have a very stable and experienced staff team and the service users were seen to interact positively with staff. Choice is offered in all aspects of the care provided and one service user spoke about how her independence is encouraged and they have input into all aspects of the home, from meals to activities and daytime occupation to times for going to bed. They have a weekly service user meeting and the minutes show a wide range of topics and agreements made. Individualised packages are supported depending on service user choice and need. One service user has chosen not to attend their day placement and there is a lot of work with both the staff in the home and other disciplines to find an occupation that he wishes to attend. . Highfield C51.C08.S12810.Highfield.V236138.050705.Stage 4.doc Version 1.40 Page 6 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. Highfield C51.C08.S12810.Highfield.V236138.050705.Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Highfield C51.C08.S12810.Highfield.V236138.050705.Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1. The lack of availability of the statement of purpose restricts the staff and service users knowing fully what service is to be provided. EVIDENCE: The statement of purpose was not available in the home, it had been amended following the inspection ion March 2005 and sent to head office for approval and had not yet returned. The staff spoken to were aware of the document but were unsure of its content. Highfield C51.C08.S12810.Highfield.V236138.050705.Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,8,9. There are effective systems in place to ensure the needs of the service users are being met with clear consistent documentation to aid staff in providing care. EVIDENCE: Care plans were available for all assessed needs and the files were well organised with evidence of keyworker and service user involvement with regular reviews and updates made. One service user has obviously progressed greatly in developing independence skills and is being supported to develop these with fully documented and agreed care plans and risk assessments. There was evidence of detailed plans indicating what action was required by staff to meet needs and a useful overview of the service user within a service user profile document. The management of service user money is clearly documented with signed agreement from both service users and key representatives to support decisions made. One service user spoken to manages their own money Highfield C51.C08.S12810.Highfield.V236138.050705.Stage 4.doc Version 1.40 Page 10 independently and has opened their own savings account. There is a company run ‘umbrella’ account with a bank, which provides individually named accounts within the service and the service users receive regular statements with interest paid on their individual basis. The service users spoke about the regular meetings they have in the home on a weekly basis where they discuss menus, activities developments in the home and other issues that they want to raise. These are minuted and records maintained of decisions agreed. Risk assessments were cross-referenced to care plans and highlighted action to be taken by staff to minimise the risks. There was evidence for one service user of risk assessments for their increasing independence and they included an initial score of potential risk with further scoring to identify the impact of planned interventions. Highfield C51.C08.S12810.Highfield.V236138.050705.Stage 4.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,15,16 and 17. Daily activities and social interactions are well managed to give service users individual choice and independence is promoted. EVIDENCE: There are a range of daytime activities individually agreed with the service users and two spoken to were very happy with how they spent their day. This includes access to college with one service user having completed a gardening course, another has accessed computer skills and various courses are planned from September including cycling proficiency, art and numeracy courses. The service users enjoy evening and weekend activities including swimming, pub visits and other outings along with in house activities and games. One service user spoke about her friends visiting the home and staff confirmed that families and friends are regular visitors and are always welcome. There was evidence of support and guidance for a service user who is developing personal relationships. Highfield C51.C08.S12810.Highfield.V236138.050705.Stage 4.doc Version 1.40 Page 12 They use local transport to get around including buses and taxis and one service user regularly rides a bicycle in the local park. Staff were observed to interact positively with the service users, they all were able to access all areas of the home and gardens and were able to prepare themselves drinks and snacks. Most service users have their own bedroom key and those spoken to said they felt there privacy and their rights are respected. The kitchen was clean and staff reported that all equipment was working. Part of the worktop is damaged and there are plans for a new kitchen to be fitted within the next few months. The service users all said they like the food and enjoyed eating in the dining room, menus are agreed on a weekly basis and alternatives are offered and recorded. Highfield C51.C08.S12810.Highfield.V236138.050705.Stage 4.doc Version 1.40 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19 and 20 The healthcare needs and personal support for the service users are being met with consideration to individual needs and wishes. EVIDENCE: The staff and service users spoken to were very clear about meeting individual needs and how this is managed. Times for getting up and going to bed are individual and one of the service users spoke about how she had been out late the previous evening and then enjoyed a takeaway pizza and watched a video. Behaviour monitoring assessment was being carried out for one of the service users and regular reviews were evident. Healthcare needs are being addressed and the home is working in liaison with the community learning disability team to introduce a health care and action plan project. One of the service users has been working closely with his keyworker to complete this and it includes all aspects of their health including past history and screening for health interventions. There is regular input from the GP, chiropody, dental and optical services. The medication system includes a clear audit of the medication in the home and the medication administration documentation was cross referenced to the Highfield C51.C08.S12810.Highfield.V236138.050705.Stage 4.doc Version 1.40 Page 14 medication n the home with no concerns raised. One service user is on a partial self-administration programme and this is fully documented and risk assessed. Highfield C51.C08.S12810.Highfield.V236138.050705.Stage 4.doc Version 1.40 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 There are effective systems on place to respond to complaints and service users are protected from abuse. EVIDENCE: The complaints procedure is available on service user notice boards and each service user has information in their rooms about how to raise concerns. The complaints register is maintained and includes informal concerns raised by service users. The one informal complaint from a service user was documented; however there was no evidence that the service user was happy with the outcome although records did show this was discussed. The Commission for Social Care Inspection received a complaint about the management of service user money. This was investigated during this inspection with records viewed and staff and service users spoken to. The statements for service user accounts showed no discrepancies and no payments had been made via the use of a debit or credit card. Items had been purchased on behalf of service users using staff cards and there were full documentation including signed agreements, receipts and head office knowledge of these transactions. Some of the service users have transferred their accounts to the company owned ‘umbrella account’ and this has been made with agreement from the service user and their representative with individual statements received from the bank direct to the service user. Highfield C51.C08.S12810.Highfield.V236138.050705.Stage 4.doc Version 1.40 Page 16 One service user is able to manage her finances independently and has retained her own accounts and access to them. The service users spoken to were very happy with the arrangements and had no concerns. The policies and procedures for financial management were available and records supported their implementation. This complaint was not upheld. Staff spoken to have had training on abuse and how to implement the Protection of Vulnerable Adults procedures. Highfield C51.C08.S12810.Highfield.V236138.050705.Stage 4.doc Version 1.40 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 and 26 The home provides a safe environment for the service users although maintenance records need to be maintained to show evidence of timely repairs. EVIDENCE: The home was clean and tidy. There were satisfactory reports from the fire and environmental health departments. There is a fire door between the dining room and the front entrance that needs to be kept closed, however this restricts movement and visibility and a fire officer approved device to enable this to be open would assist the service users in using the space more freely. Maintenance records were not available, however staff stated there were no outstanding repairs and they submit a weekly maintenance report to the head office, which is then actioned. Communal space is limited with one small lounge area, however this is kept under review and is discussed in service user meetings. The service users do not very often use it and any group activities, meetings and games are usually based around the dining room. Highfield C51.C08.S12810.Highfield.V236138.050705.Stage 4.doc Version 1.40 Page 18 Two of the service users bedrooms were seen and they were individualised with personal effects and both service users had been involved in choosing décor and furniture to suit their needs. Both service users said they really liked their rooms. Highfield C51.C08.S12810.Highfield.V236138.050705.Stage 4.doc Version 1.40 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,33,35 and 36. The staff team have the experience, skills and knowledge and are supported by systems to ensure they are able to meet service user needs. EVIDENCE: Staff spoken to confirmed there was a detailed recruitment process including Criminal records Bureau checks and references prior to employment. There is an induction process and copies of this are kept on staff files. Staff confirmed there is a detailed training programme via the company and they have the opportunity to attend a wide range of courses, and have recently attended training on autism and challenging behaviour as well as regular updates on all statutory training. 33 of the staff have achieved National Vocational qualification (NVQ) at level 2 with a further two staff currently working towards this. They expect to achieve the 50 required by the end of 2005. Staff confirmed that supervision is held every 4-6 weeks and records maintained and agreed. Highfield C51.C08.S12810.Highfield.V236138.050705.Stage 4.doc Version 1.40 Page 20 There is an established and consistent staff team who work well together to provide care for the service users. Staffing is calculated to meet service user needs and extra staff are supplied to support activities and outings as required. Highfield C51.C08.S12810.Highfield.V236138.050705.Stage 4.doc Version 1.40 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,42 and 43 There is an effective management system in place to give clear guidance and support to the staff team and to the service users. In addition the health and safety of the service users is maintained. EVIDENCE: The feedback from both service users and their relatives was very positive about the home and the manager. One relative phoned the CSCI to praise the home and the level of care her son received. There are regular staff and service user meetings and both parties spoken to were very clear about the home runs and their involvement in the decisionmaking processes. There was evidence of statutory training including fire, health and safety and food hygiene. Fire records showed evidence of regular maintenance and checks on equipment. Maintenance records for utilities were also available. There is a trained first aider on each shift. Highfield C51.C08.S12810.Highfield.V236138.050705.Stage 4.doc Version 1.40 Page 22 The insurance certificate was not available at the time of the inspection. Although there was a memo from head office stating cover is provided and the new certificate will be sent. Highfield C51.C08.S12810.Highfield.V236138.050705.Stage 4.doc Version 1.40 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 x x x x Standard No 22 23 ENVIRONMENT Score 2 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x 3 x x x x Standard No 11 12 13 14 15 16 17 x 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x 3 3 x 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Highfield Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 x x x x 3 2 C51.C08.S12810.Highfield.V236138.050705.Stage 4.doc Version 1.40 Page 24 no 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. 2. Standard 1 43 Regulation 4,5 25(2)(e) Requirement The statement of purpose must be available in the home. A copy of the insurance certificate for the home must be submitted to the CSCI Timescale for action 30/08/05 30/08/05 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. 3. Refer to Standard 22 24 24 Good Practice Recommendations The recording of complaints should include agreement as to the outcome from the complainant. Maintenance records should be available in the home. The fitting of an automatic fire closure should be explored for the door between the dining room and hallway. Highfield C51.C08.S12810.Highfield.V236138.050705.Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection 1st Floor, Newland House Campbell Square Northampton NN1 3EB 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 C51.C08.S12810.Highfield.V236138.050705.Stage 4.doc Version 1.40 Page 26 - 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. 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