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Inspection on 08/11/05 for Highfield Care Home

Also see our care home review for Highfield Care Home for more information

This inspection was carried out on 8th November 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home continues to provide a warm caring environment where care needs are met in a homely and comfortable setting and where care is delivered in a calm and unobtrusive manner by experienced and qualified staff. Almost without exception the residents spoken with praised the efforts of the staff in providing them with the services that they required with care and kindness.

What has improved since the last inspection?

Since the last inspection improvements have been made to the detail as to how care needs should be met, recorded in the residents care plans. The arrangement and storage of files and policies and procedures in the office has been improved.

What the care home could do better:

The home could provide a better standard of internal decoration and provision of more modern new furnishings and fittings for the residents bedrooms. (Work to commence this internal make over for the home is planned to start in January 2006).Records of all personal items held for safe keeping on behalf of the resident must be maintained for protection of both the resident and staff.

CARE HOMES FOR OLDER PEOPLE Highfield Care Home 34-36 Hoe Lane Ware Hertfordshire SG12 9NZ Lead Inspector Mrs Jan Sheppard Unannounced Inspection 8th November 2005 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 Care Home DS0000019425.V263606.R01.S.doc Version 5.0 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 Care Home DS0000019425.V263606.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Highfield Care Home Address 34-36 Hoe Lane Ware Hertfordshire SG12 9NZ 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) 01920468976/467508 01920 485 728 highfield@fshc.co.uk Tamhealth Ltd, a wholly owned subsidiary of Four Seasons Health Care Lilian Nwamaka Ofondu Care Home 54 Category(ies) of Old age, not falling within any other category registration, with number (54) of places Highfield Care Home DS0000019425.V263606.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. This home may accommodate up to 10 older people who require personal care. This home may accommodate 54 older people who require general nursing care. 21st June 2005 Date of last inspection 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 DS0000019425.V263606.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second unannounced inspection of this inspection year and took place over one day when two inspectors spoke with the nurse manager and the other staff on duty. A number of residents, their relatives and other professional visitors to the home were also spoken with and care plans and records examined. Most residents were very complimentary about the care and services that were offered to them. Their relatives and other visitors without exception expressed their satisfaction. One visitor said “ I am amazed at the comfortable homely surroundings in this home and the helpful friendly manner of the staff, I am able to visit at any time and am usually served with refreshments.” The detail in this report reflects the findings at the time of this inspection but also takes account of comments made in the pre inspection documentation, questionnaires and also comments made by visitors and other professional stake holders in the home. Not all the standards have been examined during this second visit, as they were all covered during the previous inspection to which reference may be made. What the service does well: What has improved since the last inspection? What they could do better: The home could provide a better standard of internal decoration and provision of more modern new furnishings and fittings for the residents bedrooms. (Work to commence this internal make over for the home is planned to start in January 2006). Highfield Care Home DS0000019425.V263606.R01.S.doc Version 5.0 Page 6 Records of all personal items held for safe keeping on behalf of the resident must be maintained for protection of both the resident and staff. 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 DS0000019425.V263606.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Highfield Care Home DS0000019425.V263606.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3 Adequate information is available to prospective residents to enable them to make a realistic decision about admission to the home. New residents are only admitted following an assessment of their care and other needs by the homes manager or other appropriately trained senior member of staff. The home does not offer facilities for intermediate care (Standard 6) EVIDENCE: There have been no changes since the last inspection to the information pack, that is available for potential service users and their families. The care plans and other records of several recently admitted residents evidenced that the correct admission policies and procedures had been followed and residents and relatives spoken with confirmed that their admission had been handled sensitively and was carried out at a pace that enabled them to participate as far as they were able to and wished to do so. Highfield Care Home DS0000019425.V263606.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8 10 Adequate care plans are kept for all the residents. Records evidenced that care and health needs were being well met with assistance sought from doctors and other medical specialists promptly whenever needed. Care was seen to be being delivered by trained and experienced staff in an unobtrusive and sensitive manner enabling individual needs to be met whilst maintaining dignity and respect for the resident. EVIDENCE: The care plans examined were seen to give more detailed information as to how some particular needs were to be met than had been found during the previous inspection. Detail of the management plans for a particular behaviour, which could not be found during the inspection, was supplied by the manager on the following day. The location of this information in the individual files must be clearly known and accessible to all staff at all times. Where a resident has known and identified allergies the details of these should be prominently recorded on the front of their care plans. Highfield Care Home DS0000019425.V263606.R01.S.doc Version 5.0 Page 10 The care plans were found to be subject to regular review and to where ever possible contain evidence of the residents involvement with their compiling. Without exception the residents were complimentary about the care that they received and about the manner in which it was delivered to them. One resident told the inspector.” The staff are very kind and they wait for me to do as much for myself as I possibly can, they do not make me feel disabled or old, my privacy and dignity are always respected ”. Another recently admitted resident told the inspector that she sometimes had difficulty in getting some of the staff to understand her but that overall she was very happy with the care that she was being given and her visitor confirmed that this was the case. Highfield Care Home DS0000019425.V263606.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15. The home provides a varied and wholesome diet prepared in a manner and in quantities that are appropriate for the needs and abilities of each individual resident. Visitors are welcomed in the home at any time and many were seen to be visiting during this inspection with several offered refreshments and others taking lunch privately in a separate quiet room with their relatives. The home offers a varied activity programme with both group and individual activities planned to try to meet all individual needs and tastes. EVIDENCE: The variety of the homes activity programmes was seen to have further increased since the last inspection and that regular summaries of activities undertaken are recorded on the residents care plans. A number of activities were observed during this inspection including an afternoon bingo session and a current affairs discussion with some residents during their morning reading of their newspapers. Without exception all the visitors and relatives spoken with during this inspection were very complimentary about the home and the services provided. Highfield Care Home DS0000019425.V263606.R01.S.doc Version 5.0 Page 12 Lunch was served during this inspection and was seen to be attractively presented with different sized plates used according to the portion sizes required by the individual residents. Residents spoke appreciatively about the meals provided commenting that alternatives were always made available if they asked if the menu for that day did not appeal to them. Lunch was seen to be taken in a leisurely and relaxed manner with considerable talk and laughter amongst the residents. For other residents who required help with feeding this was seen to be done appropriately with staff chatting to individual residents and allowing them to eat at their own particular pace. Highfield Care Home DS0000019425.V263606.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 The home has a robust complaints procedure and follows the Adult Protection procedures as set out in the Hertfordshire County Council joint agency guidelines EVIDENCE: A copy of the complaints procedure is available to prospective and current service users. Reference is made to the Commission for Social Care. Several residents spoken with were aware of their right to make a complaint but most said that they would first discuss any problems with the homes manager or with other senior staff whom they described as all being very approachable. The two written complaints that had been received since the last inspection were seen to have been dealt with according to the homes procedure and within acceptable time limits. Staff confirmed that they had received training on adult abuse and they were aware of the literature concerning the Hertfordshire Adult Protection Procedures. There have been no reported incidents concerning abuse since the last inspection. Highfield Care Home DS0000019425.V263606.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 25 and 26 Highfield Home provides its residents with a safe and comfortable environment with surroundings that are pleasant, homely and safe. The home is clean and well maintained. Equipment and facilities are provided to meet the individually assessed needs of the service users. The home is to be refurbished internally with new redecorations and furnishings; this work is to commence in January 2006. EVIDENCE: The residents occupy mostly single rooms which are well personalised and comfortably furnished with specialist furnishings and equipment provided to meet their individually assessed needs. Many of these bedrooms are to be redecorated and refurbished as part of a major make over plan for the home these works to commence in the New Year. The CSCI must be sent an action plan, including risk assessments, concerning how the home will operate during these refurbishment works. Highfield Care Home DS0000019425.V263606.R01.S.doc Version 5.0 Page 15 On the day of this unannounced inspection the home was found to be clean and tidy with no unpleasant odours. One visiting District Nurse when asked how she found the home commented on its relaxed ambience and the friendliness of the staff and said, “This is the only home that I have visited where I have never experienced unpleasant smells.” Highfield Care Home DS0000019425.V263606.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 and 30. The numbers of staff on duty on the day of this unannounced inspection tallied with the prepared staff rota and appeared to be sufficient to meet the needs of the residents. The homes records evidenced that all staff are appropriately trained and undertake an on going individually planned training programme designed to meet their particular needs. EVIDENCE: All the staff spoken with were positive about their work and the increase in the training opportunities offered to them. Staff confirmed that they are well supported by their managers and that a plan to meet their individual training needs is drawn up for them on an annual basis. The nurses spoken with confirmed that they were given good opportunities to attend training to extend and revise their professional knowledge and existing qualifications and the carers spoken with were either studying for N.V.Q’s or in the case of the most recently appointed new care worker was booked to commence this training in the new year. All staff spoken with were able to demonstrate a good understanding of adult protection procedures. It was noticeable that many of the staff have worked at this home for very many years, 15 and 18 years being mentioned to the inspectors and several of the staff commented on the fact that the staff team is very cohesive with both the long standing and the newer staff working well together as a team. Highfield Care Home DS0000019425.V263606.R01.S.doc Version 5.0 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33, 34 and 36. The home continues to be run by competent professionally trained and experienced manager who leads a very stable and dedicated staff team. Generally the residents interests and care are supported by the good maintenance of the homes records and procedures; although a full trail of signatures to support when a residents personal items are retained by the home in safekeeping could not be fully evidenced. EVIDENCE: Staff spoken with confirmed that they receive regular supervision and are well supported by the homes managers. One carer said there is always some manager or senior staff member about for me to ask if I am not sure about anything. Staff of all grades clearly worked well together for the benefit of the residents whose interests they appeared to be giving the highest priority at all times. Highfield Care Home DS0000019425.V263606.R01.S.doc Version 5.0 Page 18 One carer said to the inspector, whilst talking about the frailty and vulnerability of some of the residents, said “I always try to remember how difficult and demeaning it must be for a resident not to be-able to do even simple care task for themselves, and I try to make this situation as easy as possible for them”. The home maintenance of records and other documentation was generally found to be maintained in good order. One exception relating to items kept for a short period in the homes safe could not be fully evidenced in any easily accessible manner. The homes administrator discussed with the inspectors an improved procedure for this to give full protection for both the resident and the home. Highfield Care Home DS0000019425.V263606.R01.S.doc Version 5.0 Page 19 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 3 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 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 2 3 STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 2 x 3 x x Highfield Care Home DS0000019425.V263606.R01.S.doc Version 5.0 Page 20 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. 1 Standard OP34 Regulation 17(2) schedule 4(9) 13(4)(c) Requirement Residents personal items, which are held in safe keeping by the home, must be fully evidenced by a trail of records and signatures. An action plan including risk assessments concerning how the renovation works to the internal fabric of the home are to be managed must be submitted to the CSCI before the work commences in 2006. Timescale for action 08/11/05 2 OP24 31/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP7 Good Practice Recommendations It is recommended that to ensure better clarity details of the residents allergies should be noted in bold letters on the front of their care plans. Highfield Care Home DS0000019425.V263606.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire 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 DS0000019425.V263606.R01.S.doc Version 5.0 Page 22 - 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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