Inspection on 21/06/05 for Highfield Care Home

This inspection was carried out on 21st June 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 Care Home 07/01/09

Highfield Care Home 23/01/07

Highfield Care Home 08/11/05

Highfield Care Home 02/12/04

Highfield Care Home 06/07/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Highfield Care Home 34-36 Hoe Lane Ware Hertfordshire SG12 9NZ Lead Inspector Jan Sheppard Unannounced 21 June 2005 10:00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Highfield Care Home I52 s19425 highfield v233705 210605 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Highfield Care Home Address 34-36 Hoe Lane Ware Hertfordshire SG12 9NZ 01920 4688976/467508 01920 485728 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) Tamhealth Ltd, a wholly owned subsidiary of Four Seasons Health Care Lilian Ofondu Care home with nursing 54 Category(ies) of OP Old Age - 54 registration, with number of places Highfield Care Home I52 s19425 highfield v233705 210605 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: This home may accommodate 54 older people who require general nursing care. This home may accommodate up to 10 older people who require personal care. Date of last inspection 2 December 2004 Brief Description of the Service: Highfield Care Home provides nursing care and accommodation for 54 older people. It is owned and managed by Tamhealth Limited which is a member of the Four Seasons Health Care group. The home is located on a hill on the outskirts of Ware, about a mile from the main shopping centre and local amenities. The home was opened in 1999 and consists of a two storey building set in beautiful well maintained gardens. The majority of the homes bedrooms are for single occupation but there are some double rooms which are currently being shared. Some rooms have ensuite facilities. The attractive level garden gives easy access for the service users. Highfield Care Home I52 s19425 highfield v233705 210605 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first inspection of the inspection year with two inspectors visiting the home over one day. One inspector spent the majority of their time talking to the residents, visitors and staff whilst the other spent time with the manager discussing the homes procedures, policies and plans, looking at residents care plans, the staff files and examining other statutory records. The residents and staff made the inspectors very welcome in the home and openly discussed all aspects of their work, the care they received, and the recent achievements and goals of the home. This was a positive inspection, feedback received was good and the standard of most aspects observed was high. No requirements were made with just three recommendations being made. What the service does well: What has improved since the last inspection? Most noticeable was the increased training opportunities for all the staff. Training needs are identified during regular supervision meetings and this links in to the annual appraisal system, which has recently commenced. The statutory records and minutes of meetings are being well maintained and the organisation of the administration of these and the management of the main office has improved since the last inspection. To the environment a number of works of improvement have been carried out with new decorations furnishings and fittings in the communal areas and in some bedrooms. The home is to undergo more major internal decoration refurbishment works during this next year. Highfield Care Home I52 s19425 highfield v233705 210605 stage 4.doc Version 1.30 Page 6 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 Care Home I52 s19425 highfield v233705 210605 stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Highfield Care Home I52 s19425 highfield v233705 210605 stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4 and 5. Information available to prospective service users is comprehensive and informative enabling a realistic decision about admission to be made. The atmosphere in the home is relaxed offering a welcoming environment to prospective service users. EVIDENCE: The home does not offer facilities for intermediate care. (Standard 6). An information file is available to potential service users and their representatives. This includes the Service Users Guide, the Statement of Terms and Conditions, information about fees and other contractual obligations, the Complaints Procedure and copies of previous Inspection reports. The manager personally visits and assesses all prospective residents to ensure that their care needs can be met at Highfield. Appropriate assessment records were seen to be being kept. All prospective residents are invited to visit the home and the majority do, but where this is not possible their families are encouraged to visit. The manager explained that the home hosts many visits from the relatives and representatives and several groups were being shown around the home on the day of this inspection. The home had four vacancies on the day of this inspection. Highfield Care Home I52 s19425 highfield v233705 210605 stage 4.doc Version 1.30 Page 9 All new residents are subject to a trial period, usually four weeks, after which a review is held to ensure that their care needs are being met by the home and to independently ascertain their views and wishes. All residents have a contract (a statement of terms and conditions) that gives details of their room, the fees payable, notice periods, the care and services that they will receive and the terms and conditions of their occupancy including their rights and obligations in the event of any breach of contract. The homes Statement of Purpose and the Service User Guide had been reviewed since the last inspection. Highfield Care Home I52 s19425 highfield v233705 210605 stage 4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9 and 10 Personal care and assistance offered to service users is of a good standard which meets their individual needs whilst maintaining dignity and respect. Care staff are unobtrusive and sensitive in their approach. Care plans are well maintained and were reviewed regularly ensuring changes to health and social care needs are recognised and met. EVIDENCE: The care plans examined whilst found to contain adequate information for purpose, could in some cases have contained better detail as to how the care needs could best be met with cross referencing of information and instructions where appropriate. Not all the plans had been signed by the service user or their relatives although their involvement was confirmed by the staff; a way of evidencing this involvement should be established. A system for regularly reviewing the plans was seen to be in operation but this did not encompass all the care plans and the detail of several noted omissions were discussed with the manager. The service users were complimentary about the care that they received and about the manner in which it was delivered. Highfield Care Home I52 s19425 highfield v233705 210605 stage 4.doc Version 1.30 Page 11 They confirmed that their health needs were met and said that if problems arose they would discuss these with the staff or manager, who were confirmed as always being very approachable and helpful. Staff were observed to be operating a knock and wait policy on entering residents rooms and to be giving the residents time and space to make their own decisions in a dignified manner. Highfield continues to benefit from the services of a retained Doctor who holds a weekly surgery in the home. The manager explained that as many of the residents originated from the local Ware area they were fortunate in being able to retain their original GP and the home thereby had close links with several of the local doctors surgeries. The home continues to use a monitored dosage system of drug administration and an examination of this system and of the MAR administration recording sheets found that they were being properly maintained. An appropriate risk assessment had been completed for the resident who self administers one item of medication herself. Highfield Care Home I52 s19425 highfield v233705 210605 stage 4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14 and 15. Where possible the home tries to accommodate everyone’s individual daily life and social activity preferences and feedback and suggestions are sought at regular intervals this promoting autonomy and choice. Visitors are welcome and many visit the home regularly. The home provides a varied and wholesome diet. EVIDENCE: The variety of the homes activity programme has been increased since the last inspection. Activity organising staff pay particular attention to the comments made by the residents during their resident meetings when a number of requests and suggestions for different activities were voiced. It is recommended that better records of these discussions and of the individual residents preferences and attendance at activities is recorded on their care plans. On the day of this inspection residents were seen to be enjoying an activity session held in the garden where an awning has been erected for the summer months. Staff and residents said how much they enjoyed being in the attractive and well kept gardens on sunny days especially as their sun lounge can get too hot especially in the afternoons (new blinds are on order for this conservatory area). Highfield Care Home I52 s19425 highfield v233705 210605 stage 4.doc Version 1.30 Page 13 Without exception the residents were very complimentary about the quality and variety of the food provided and said that this had improved considerably over the past year. The chef regularly sits to talk with the residents and attends their residents meetings to discuss their choices for the next period of menu planning and so that he is able to take note and respond to individual requests for particular dishes. Special diets are catered for. More attention could be given to the detail of the printed menu seen displayed in the entrance to the dining room which did not seem to reflect the complete detail of the variety of options available at any one meal. Highfield Care Home I52 s19425 highfield v233705 210605 stage 4.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 The home has a robust complaints policy and procedure, which is promoted in the homes literature available in the entrance foyer of the home. The home has policies and procedures concerning Adult Abuse and Whistle Blowing, which ensure that residents are protected from abuse, neglect and self harm. EVIDENCE: A copy of the complaints procedure is available to prospective and current service users. Reference is made to the Commission for Social Care Inspection. The service users spoken with had an awareness of this and expressed their confidence that the manager would deal competently if any matter of complaint needed to be bought to her attention. The two complaints made during the past year were noted to have been correctly handled and that the complainants had been satisfied with the outcomes. Staff spoken with demonstrated a good awareness of issues relating to Adult Protection and had recently undertaken training concerning this and the homes Whistle Blowing policy. No incidents relating to abuse have occurred since the last inspection. Highfield Care Home I52 s19425 highfield v233705 210605 stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,22,24 and 26 The home and its surroundings offer a pleasant, comfortable and safe environment for its service users. The home is clean and well maintained with spacious lounge and dining accommodation and bedrooms that are personalised thereby offering a homely, lived in feel. EVIDENCE: The residents bedrooms are all well personalised with photos ornaments and small items of furniture so have a homely lived in feel to them. Specialist furnishings and equipment have been provided to meet their particular needs and to maximise their independence. Items of furniture and other effects bought into the home are all subject to fire and safety checks. On the day of this unannounced inspection the home was found to be clean and tidy with no unpleasant odours. Residents spoke highly of the dedicated manner in which the house keeping staff maintain the cleanliness of the home and of the speed and efficiency with which their laundry is returned to them, “hardly anything ever gets lost and great care is given to the laundry of all our different items if anything is ever spoilt it is replaced.” Highfield Care Home I52 s19425 highfield v233705 210605 stage 4.doc Version 1.30 Page 16 The home is well maintained and benefits from having the services of a gardener handyman who is available to assist with immediate repairs and renovations whenever needed. Since the last inspection a number of improvement measures have been completed and new items purchased including better facilities for the storage of wheelchairs, the purchasing of a number of adjustable beds with more for delivery later in the year, another hoist delivered bringing the total to five, more fire door guards have been fitted to residents rooms, and new non slip wood type flooring laid in the dining area; all these measures ensure the smooth and safe running of the home. The manager explained that the home is about to undergo major works of redecoration, refurnishing and renovation particularly of the residents rooms and of the communal lounge and dining areas where the decorations although still quite acceptable are somewhat dated and in some areas have a tired appearance which is not of a standard that is acceptable to the company. It is recommended that a plan and time frame for these works is drawn up so as to ensure that the operation works smoothly with the least interference to the lives and comfort of the residents. Highfield Care Home I52 s19425 highfield v233705 210605 stage 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29 and 30. The home is run by a dedicated and well established staff team who are led by an experienced and qualified manager. The staff are appropriately trained to meet the needs of the service users and undertake training on an ongoing basis. The home is adequately staffed to meet the current needs of the residents. All staff have job descriptions and clearly identified roles and responsibilities within the home. EVIDENCE: All the staff spoken with were positive about their work and the increase in the training opportunities now offered to them. The manager explained that when she joined the home twelve months ago she found that prior to this only mandatory training had been available. Since then she has considerably increased the range of courses and training opportunities offered. All staff have a training needs profile compiled on an annual basis from which the overall training needs of the home are determined. NVQ level 2 is available for careworkers with Level 3 for all senior careworkers, a study day for nurses was held in June with another for careworkers planned for November. The homes training programme evidenced that since the last inspection as well as the mandatory core training subjects of health and safety, food hygiene, first aid, manual handling and fire awareness, special training courses including Adult Protection, Dementia and Challenging Behaviour, BTEC infection control (MRSA), medication administration, Communication skills, Continence Care, Accident incident reporting, COSHH training, Diabetes Care and Palliative Care have all been held. Highfield Care Home I52 s19425 highfield v233705 210605 stage 4.doc Version 1.30 Page 18 Whilst many of these courses are held in the home or at nearby college venues others are held in the company’s sister home at the other side of the county. Transport is arranged whenever possible but it is commendable to learn that some staff were willing to pay for their own transport rather than miss the training opportunity. The home is fully staffed with permanent staff and during the past year has only needed to recruit bank staff to join the team who are employed on an as and when needed basis. The recruitment records for these staff demonstrated that the correct recruitment procedures had been carried out thereby offering protection to the service users. Highfield Care Home I52 s19425 highfield v233705 210605 stage 4.doc Version 1.30 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,35,36,37 and 38. The home is run by a competent, professionally trained and experienced manager who leads a very stable and dedicated staff group who work very well together as a team and who promote the best interests of their residents at all times. Health and safety issues are given good priority by the staff and this provides a warm and caring environment where the residents seemed relaxed and happy. EVIDENCE: The manager communicates a clear sense of leadership within the home. Staff meetings are prearranged and appropriately recorded and these records whilst showing evidence of good staff participation and discussions concerning quality improvement areas within the home also demonstrated firm and clear management direction. Highfield Care Home I52 s19425 highfield v233705 210605 stage 4.doc Version 1.30 Page 20 Service users spoken with were almost without exception complimentary about the care that they receive and the manner in which it is delivered to them and seemed confident that any changes they may request would be listened and acted upon. Comments such as “this home is well run the staff really do their best to care well for us” were echoed by several visiting relatives. One favourably compared Highfield to the previous home where her mother had resided, she said “Mum settled in here very quickly she was made to feel very welcome as are we when ever we visit we are always offered refreshments. The staff are very attentive nothing is too much trouble for them and Mums every need is met.” Another daughter said “They (the staff) are excellent they always welcome me when I visit Mum, they bring us lunch so we can have it together in the lounge “ Staff spoke positively about their work at Highfield confirming that a good team spirit exists,” we all work together to make sure that everything gets done” that they have good training opportunities and receive regular supervision and management support. A number of the homes statutory records were examined and were found to be well maintained. Records relating to fire drills and safety checks, the minutes of the Health and Safety meeting held on 18th May, accounts concerning residents personal allowance monies held for safe keeping, risk assessments and health and safety records and Regulation 37 and 26 notifications were all found to be appropriately kept. The findings of a Quality questionnaire sent to residents and relatives in December 2004 gave a 94 rating to the home being well managed and delivering good care, 82 for tidiness and cleanness of the bedrooms, 87 reported that the staff were available and easy to talk to and 100 said that the home facilities suited them. Highfield Care Home I52 s19425 highfield v233705 210605 stage 4.doc Version 1.30 Page 21 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 x 3 x 3 x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 3 3 3 3 3 3 Highfield Care Home I52 s19425 highfield v233705 210605 stage 4.doc Version 1.30 Page 22 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. Standard Regulation None 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. Refer to Standard 7 Good Practice Recommendations It is recommended that the staff record more detail as to how care needs should be met and cross reference appropriate information on the residents care plans. Evidence of service user or their representative involvement should be maintained. More detailed records of the activities undertaken by each resident should be kept on their care plan. The menu should display all the choices available. The home should prepare a plan of action for the proposed interior renovations of the home to demonstrate how these will be achieved whislt ensuring the safety of residents and staff at all times. 2. 3. 4. 12 15 19 Highfield Care Home I52 s19425 highfield v233705 210605 stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Mercury House 1 Broadwater Road Welwyn Garden City AL7 3BQ 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 Care Home I52 s19425 highfield v233705 210605 stage 4.doc Version 1.30 Page 24 - 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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