Inspection on 12/06/09 for Highfield Care Home

This inspection was carried out on 12th June 2009.

CQC found this care home to be providing an Excellent service.

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 Care Home 18/11/08

Highfield Care Home 05/09/08

Highfield Care Home 16/11/07

Similar services:

Abbey The

Snydale Care Home

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 16/02/2010.

Key inspection report CARE HOMES FOR OLDER PEOPLE Highfield Care Home Highfield House Woodsetts Road North Anston Sheffield South Yorkshire S25 4EQ Lead Inspector Ivan Barker Key Unannounced Inspection 12th June 2009 09:20 DS0000070354.V375945.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Highfield Care Home DS0000070354.V375945.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Highfield Care Home DS0000070354.V375945.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Highfield Care Home Address Highfield House Woodsetts Road North Anston Sheffield South Yorkshire S25 4EQ 01909 566055 P/F 01909 566055 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) Selvaratnam Balaratnam Manager post vacant Care Home 43 Category(ies) of Dementia (12), Old age, not falling within any registration, with number other category (31) of places Highfield Care Home DS0000070354.V375945.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th November 2008 Brief Description of the Service: Highfield Care Home is located on the outskirts of the village of North Anston, but within easy reach of local shops and facilities. The home is situated in large grounds, which are accessible to people in wheelchairs and those with limited mobility. Accommodation is on two levels. There is a lift to facilitate people getting between the 1st floor bedrooms and the communal rooms, which are located on the ground floor. The service provides care to older people with personal care both physically frail or people with dementia. The fees were £370 - £414 at the time of the inspection. Highfield Care Home DS0000070354.V375945.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is two star – good service. This means that the people who use this service experience excellent quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations – but only when it is considered that people are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The persons present at the inspection were: Mr Balaratnam owner. Ms S Wright, manager Within this site visit, which occurred over a six hour period, we toured the building, examined requirements relating to the previous inspection, case tracked people (Case tracked means looking at the care and service provided to specific people: checking records relating to their health and welfare, care plans and other records; by talking to the people; viewing their personal accommodation as well as communal living areas). Spoke with relatives and staff and examined assessments, care plans, risk assessments, and also menus, complaint files, staff files and quality monitoring documents. The history of the service, telephone contacts, letters, and notifications were examined prior to the site visit. What the service does well: Peoples needs were known to the service prior to admission. The two assessments ensured that people’s individual needs were assessed to ensure that their needs could be met by the service. Accurate care plans will contribute to the delivery of care. The care was being delivered by 2 members of staff to each person. This was due to the very low numbers of people living at the service at the time of the inspection, this made staffing levels were very high. This will contribute to a high level of care. On speaking with the staff, it was established that they were fully aware of the contents of the care plan and the persons needs. Highfield Care Home DS0000070354.V375945.R01.S.doc Version 5.2 Page 6 People spoken with were very satisfied with the care. Activities were well organised to meet the individuals needs. This provided stimulation and enhanced their quality of life. The service had a complaints procedure, which was accessible and operating according to the company policy, this should provide confidence that complaints are taken seriously and acted upon to address any shortfalls in care of service provision. Safeguarding adult training made staff aware of their responsibility regarding the protection of vulnerable adults. The people lived in an environment that had been maintained to a good standard to provide a safe, well-equipped and homely environment. The manager was able to provide evidence that staff had received all the necessary training. The ratio of care staff to people was high. Both of these factors reflected on the quality of care being delivered to the person. There was a 2 staff to 1 person ratio. The high staffing levels and care provided had a positive impact on the low number of people being cared for within the service. The comments from the people were that the staff were excellent, very patient and kind. The management systems in place will contribute to the effective organisation and operation of the service. What has improved since the last inspection? What they could do better: The service should continue to complete the programme of refurbishment as identified by the manager and owner. Highfield Care Home DS0000070354.V375945.R01.S.doc Version 5.2 Page 7 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Highfield Care Home DS0000070354.V375945.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 Care Home DS0000070354.V375945.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards 3 and 6. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs were known to the service prior to admission. The two assessments ensured that the service had sufficient information to assess if the service was able to meet the persons needs. EVIDENCE: On examination of the assessments and discussing these with the manager, we were advised the care management assessment had been provided for the individuals within the service. Also the manager had undertaken her assessment to assess if the service could meet the needs of the individual. The information, within both assessments assisted in providing sufficient information for the staff to decide if the service could meet the persons needs. It also provided sufficient information for care plans to be drawn up. Highfield Care Home DS0000070354.V375945.R01.S.doc Version 5.2 Page 10 The manager advised that the service did not provide intermediate care. Highfield Care Home DS0000070354.V375945.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 and 10. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Accurate care plans will contribute to the delivery of care. People were very satisfied with the care. EVIDENCE: The new care plan documentation was being used. The plan consisted of core care plans, which were prewritten, and then individualised to the person. The plan contained comprehensive risk assessments which included: Skin assessment, Waterlow assessments, Nutritional assessments, Highfield Care Home DS0000070354.V375945.R01.S.doc Version 5.2 Page 12 Mental health assessments, Geriatric depression scales, Behaviour and mood monitoring records, Physical health assessments, Moving and handling assessments, Falls and risk assessment/risk management Interactions / communications with professional healthcare people, families etc Individual risk assessments, for example when dressing etc. There was also a considerable amount of information and guidance, relating to wound care etc. within individual’s records. On discussing this with the manager, she advised that it was ‘readily available reference documents’ for staff. There were daily entries within the care plans. These entries recorded the care delivered on a daily basis. The care plans and risk assessments had been evaluated on a monthly basis. The high ratio of staff was having a positive impacting on the delivery of care. Staff were able to spend considerable time with the people providing physical care and social interaction. On speaking with the staff, it was established that they were fully aware of the contents of the care plan and the persons needs. The storage, ordering, administration and disposal of medication were discussed with the manager. The procedures explained by the manager were satisfactory. The medication administration records were examined and found to be fully completed. Highfield Care Home DS0000070354.V375945.R01.S.doc Version 5.2 Page 13 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 and 15. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Activities were well organised to meet the individuals needs. This provided stimulation and enhanced the quality of life. EVIDENCE: Interests were recorded within the assessment documents and care plans and staff spoken with were aware of this information and acted upon it. It was established that the staff were aware of the people’s interests. It was identified within one plan that a person ‘liked to go out in the fresh air’. During the inspection, it was observed that this individual was sat out in the grounds talking with staff. The conversation was relating to gardening and farming. The activities within the service were driven by what the people expressed that they would like to undertake that day, together with the information obtained from the family and people’s interests recorded in the care plans. Highfield Care Home DS0000070354.V375945.R01.S.doc Version 5.2 Page 14 Regarding the meals, the manager advised that consultation took place concerning the choice of meals and preferred choices, on a daily basis were being provided. Observations and discussions confirmed this. Highfield Care Home DS0000070354.V375945.R01.S.doc Version 5.2 Page 15 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service had a complaints procedure, which was accessible and operating according to the company policy, this should provide confidence that complaints are taken seriously and acted upon to address any shortfalls in care and service provision. Safeguarding adult training made staff aware of their responsibility regarding the protection of vulnerable adults. EVIDENCE: The complaints procedure was available within the Service User Guide. A copy of the procedure was displayed at the entrance. On discussing complaints with the manager, she identified that it was the same system as examined in November 08. Since the last inspection there had been no complaints recorded in the file and no complaints were expressed to us during the inspection. Regarding Safeguarding Adults, the service had policies and procedures, which were available to the staff. There was also the guidance from the Rotherham Highfield Care Home DS0000070354.V375945.R01.S.doc Version 5.2 Page 16 and Sheffield Local Authorities. All staff had undertaken safeguarding adults training. The adult safeguarding cases undertaken by the multi agencies have been concluded. The service continues to be in contact with the Rotherham Metropolitan Borough Council, as they removed the people and suspended contracts and contracts are still suspended at the time of this inspection visit. The requirement listed in the last report and made at the last inspection relating to the safeguarding adult processes, has been deleted, as explained within the Summary section of this report. Highfield Care Home DS0000070354.V375945.R01.S.doc Version 5.2 Page 17 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19, 24 and 26. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People lived in an environment that had been maintained to a good standard to provide a safe, well-equipped and homely environment. EVIDENCE: On touring the building there was new furniture and fittings within one wing of the service. The manager advised that the owner intended to upgrade the other wing, which contained older style furniture. New hospital type beds were in some of the rooms. New sheets, pillowcases were on the beds, and new towels were found in the rooms. Within the linen rooms there were extra sheets, pillowcases, towels. New chairs were in the lounges. Highfield Care Home DS0000070354.V375945.R01.S.doc Version 5.2 Page 18 The manager identified that the owner still intended to replace the stained carpets, as part of the further planned refurbishment. It was clear that the standard of cleanliness had been maintained and the service was clean and tidy and odour free. The service continues not to have a mechanical sluice, as raised in previous reports. However the change in the service’s registration category means that it operates, as a service providing personal care and no longer provides nursing care. The National Minimum Standards identifies that care homes ‘providing nursing has a sluicing disinfector’. Clearly as the services operates at the moment a mechanical sluicing disinfector is not required, however the provision of a such a machine would address any cross infection issues relating to the cleaning of commode pans etc. We received confirmation from the Fire Authority that all the issues raised within the fire officer’s report had been addressed. Highfield Care Home DS0000070354.V375945.R01.S.doc Version 5.2 Page 19 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 and 30. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager was able to provide evidence that staff had received all the necessary training. The ratio of care staff to people was high. Both of these factors reflected on the quality of care being delivered to the person. EVIDENCE: On examination of the staff rotas and examination of staff on duty, the following was established. A.m. shift: P.m. shift: Night shift: 1 senior carer and 1 care staff. 1 senior carer and 1 care staff. 2 care staff. Plus the manager, clinical manager, administrator, cook and domestic. There was a 2 staff to 1 person ratio. The high staffing levels and care provided had a positive impact on the low number of people being cared for within the service. Highfield Care Home DS0000070354.V375945.R01.S.doc Version 5.2 Page 20 There was an on call system in operation. The cover was provided by the clinical manager and manager. On examination of 3 staff files, all contained the required documentation, including the Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) checks. Regarding the staff training, the manager was able to provide staff training files which contained training certificates relating to moving and handling, fire, infection control, food hygiene, medication, end of life care, first aid and nutrition. The staff confirmed that they had received the training. The comments from the people and relatives were that the staff were excellent, very patient and kind. Highfield Care Home DS0000070354.V375945.R01.S.doc Version 5.2 Page 21 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, and 38. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management systems in place will contribute to the effective organisation and operation of the service. EVIDENCE: There was a manager in post. She was yet to apply to be the registered manager. The on going position of none registration had been agreed by us. She informed us that she had 7 years experience in management and 25 years experience in care. She also advised that she was yet to enrol on the NVQ 4 course, but was committed to do so. Highfield Care Home DS0000070354.V375945.R01.S.doc Version 5.2 Page 22 Regarding Quality Assurance, the manager advised that she had identified areas which needed improving. She had prioritised the areas and had previously changed many things such as documentation, and also staff perception and practices. She also identified that she had created a basic monitoring system but this would be further developed, including the offering of surveys to people at the service. There have been no issues raised regarding the health, safety and welfare of people. Regulation 26 documents, (which are a record of the registered person’s monthly visits) had been completed by the owner. There had been previous requirements relating to the owner not undertaking the monitoring. However since September, there has been regular monitoring of the care and service provision by the owner. Highfield Care Home DS0000070354.V375945.R01.S.doc Version 5.2 Page 23 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 4 13 3 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X 3 X 3 STAFFING Standard No Score 27 4 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X 3 Highfield Care Home DS0000070354.V375945.R01.S.doc Version 5.2 Page 24 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 OP26 OP33 Good Practice Recommendations Continue with the plan to replace further carpets in 2009. A more comprehensive quality assurance monitoring system needs to be created. Highfield Care Home DS0000070354.V375945.R01.S.doc Version 5.2 Page 25 Care Quality Commission Yorkshire & Humberside Region Citygate Gallowgate Newcastle upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries.yorkshirehumberside@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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