CARE HOME ADULTS 18-65
Highfield Court Stafford Road Uttoxeter Staffordshire ST14 8QA Lead Inspector
Jane Capron Unannounced Inspection 21st November 2005 9.45am Highfield Court DS0000004955.V267422.R01.S.doc Version 5.0 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 Court DS0000004955.V267422.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 Adults 18-65. 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 Court DS0000004955.V267422.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Highfield Court Address Stafford Road Uttoxeter Staffordshire ST14 8QA 01889 568057 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) Moorcourt Developments Limited Care Home 59 Category(ies) of Learning disability (59), Learning disability over registration, with number 65 years of age (1), Mental disorder, excluding of places learning disability or dementia (9), Physical disability (5) Highfield Court DS0000004955.V267422.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. MD(E)/PD(E) REGISTERED FOR 1 LD/PD REGISTERED FOR 2 LD/MD REGISTERED FOR 3 Date of last inspection 20th July 2005 Brief Description of the Service: Highfield Court provides care for up to 59 adults with a learning disability and/or mental disorder but in future is admitting only users with a learning disability. The home provides for a range of abilities. The accommodation is provided in bungalows for individual or small groups, (maximum six) of residents. There are ten staffed bungalows that cater for thirty residents. The other bungalows provide support flexibly according to the assessed needs of the service user although 24-hour staff support is provided to all residents and staff are available to support residents to attend to their personal care and health care needs. All bedrooms are for single occupancy. Most of the staffed units run as independent units cooking their own meals, doing their shopping and their own laundry. Most of the other residents either have their meals in the main dining room or have meals cooked for them and brought to their bungalows. Several residents in the unstaffed bungalows do their shopping, cooking and washing. There is a central laundry. The home has an activity centre although this is primarily used for the service users with a learning disability. The home offers some trips out and a few residents attend college in Leek. The home is situated in a rural location on the outskirts of Uttoxeter and is set in extensive grounds. The home has its own transport. Highfield Court DS0000004955.V267422.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place over two days. The inspection occurred over a 16 hour period and involved the lead inspector throughout and a second inspector, Yvonne Allen, on the first day. The inspection included discussions with a number of residents that lived both in staffed and unstaffed units, a number of staff and the manager and the Responsible Individual. Two visitors were also spoken to. The inspection included examining a range of the accommodation including bedroom accommodation and the activity rooms. A sample of residents’ documentation was looked at. The arrangements for the administration of medication was inspected. Since the last inspection a new Care Manager has been appointed and she is going through the registration process. The home has a new Responsible Individual who is working fulltime and is based on the site. Additionally the home had developed a training school with fulltime training staff. The home continues to work on an improvement programme to improve the standards within the home and whilst some improvements have been seen there continue to be a number of areas that require action to meet the necessary standards. Some of these have been outstanding for some time and further improvements must be seen within the next few months. Since the last announced inspection there have been additional visits made to monitor the service and to promote improvement. There has been one complaint made to the CSCI that was not able to be resolved. What the service does well:
All the residents spoken to liked living at the home. Residents in staffed accommodation, who were spoken to, stated that they got on well with the staff. They felt that they had opportunities to go out and were involved in such tasks as shopping, cooking, menu planning and going out to leisure and social activities. Residents were aware of how to complain and felt that any concerns they had would be listened to and addressed by the staff. The home maintained suitable records of complaints identifying how they had been addressed. Highfield Court DS0000004955.V267422.R01.S.doc Version 5.0 Page 6 The home’s medication system made sure that residents were having medication as prescribed. There were no gaps in the records and the staff that administered medication were trained. The home had an induction programme in place and staff were supported through this process both by staff and the training manager. What has improved since the last inspection? What they could do better:
Whilst there has been improvements there continue to be a number of areas where further improvement is needed in order for the home to meet the required legislation and standards. The home needed to complete an updated Statement of Purpose in order for prospective residents to be fully aware of the service the home offers.
Highfield Court DS0000004955.V267422.R01.S.doc Version 5.0 Page 7 Whilst progress has been made in the care planning and risk assessment processes there remained a number that were not in the new format. These must be completed to ensure that all the necessary information is available to staff for them to be able to fully support the residents. These issues have been outstanding for some time and must be addressed in the very near future. Improvements have been made in providing residents with activities but this still needs to be expanded to ensure that all residents have the opportunity to engage in a range of leisure and social activities and independent living skills. The level of community access for some residents continues to be low and the home needs to take action over this to ensure that residents have regular opportunities to go out of the home. These issues have been outstanding for some time and must be addressed. The staffing levels for the staffed units is able to meet the residents needs however the staff support for those residents living in unstaffed units needs to be reviewed to ensure the level is sufficient to ensure that these residents are receiving the necessary support to have all their needs met. The home is also using a high level of agency staff that affects the continuity of the service. The home needs to ensure that residents that self medicate have secure storage so they can store their medication safely. The home recruitment and selection procedures were not completely safeguarding the residents. There were examples where evidence was not available to confirm a staff member’s identity and the home could not evidence that every established staff member had had a satisfactory police check. These matters must be addressed immediately. Whilst improvements were seen in the training arrangements staff did require training in the area of adult protection. The home also was required to increase the number of qualified staff. The home had made progress in upgrading the accommodation but there continued to be a way to go to be able to provide all residents with a good standard of accommodation. The home was also required to ensure that suitable locks were fitted to bedroom doors where residents wanted this to ensure that residents’ privacy was respected. The home also must ensure that in icy weather that the paths are treated early in the morning to prevent them being a hazard to residents going to the communal dining room for breakfast. 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 Court DS0000004955.V267422.R01.S.doc Version 5.0 Page 8 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 Outcomes Statutory Requirements Identified During the Inspection Highfield Court DS0000004955.V267422.R01.S.doc Version 5.0 Page 9 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 the following standard(s): 1,2,3,4 The home is still in the process of completing its revised Statement of Purpose which when completed should clearly identify the service it able to provide thus providing prospective users and relaxant others with the necessary information to make a choice over whether the home can meet their needs. The home’s assessment process provided the necessary information to identify whether the home is able to meet a resident’s needs, wishes and aspirations. The staff had the necessary knowledge and skills to be able to meet the health and personal care needs of the residents however for some residents the opportunities for personal, social and educational devolvement was limited. EVIDENCE: The home has not yet completed its Statement of Purpose and at a recent additional visit this was required to be completed by 1 January 2006. The Responsible Individual was in the process of working on the revised version. The home did have a service user guide. The home had procedures in place to undertake assessments for all prospective residents. These were completed in addition to those undertaken by the Care Management Team of the local authority. The assessments covered the necessary areas.
Highfield Court DS0000004955.V267422.R01.S.doc Version 5.0 Page 10 The home has over recent months arranged for a number of reassessments for residents that were felt not to be having their needs met and a number have now moved to more suitable accommodation. The home has now become clear over the needs it is able to meet and therefore is in better position to be able to meet the needs of existing and future residents. The home has developed links with the local health care practice and relevant other professionals, including Occupational Therapists and staff from the psychiatric services. All new staff receive induction and the home’s training manager is developing a range of relevant training. Staff have received training in diabetes and epilepsy. For some residents the home was offering a good level of opportunities for personal development and social and leisure activities but for some residents these opportunities were less available. The home did not have the necessary knowledge to meet the needs of residents from ethnic minority cultures. Prospective residents and relatives were provided with the opportunity to visit the home prior to moving in. These visits could be for a meal, overnight or weekend stay. Residents recently admitted from a home, owned by the same company, that was closing were able to visit the home on several occasions before making the decision to move. All placements were subject to a trial period and placements were not made permanent until a review involving the residents had been held. Highfield Court DS0000004955.V267422.R01.S.doc Version 5.0 Page 11 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 the following standard(s): 6,7,8,9 The care planning process was ensuring that staff had the necessary information to be able to meet the needs of most of the residents and therefore further action was required to ensure information about all residents was fully available. The residents had opportunities to make decisions over their lives and to participate in aspects of life in the home providing them with more control and a more fulfilling lifestyle although there was scope for participation to be further developed particularly for those residents living in the unstaffed accommodation. Whilst the home had developed risk assessments there were some outstanding areas that needed risk assessments implementing to ensure that residents were appropriately supported and were not exposed to any unacceptable risks or unnecessary restrictions. Highfield Court DS0000004955.V267422.R01.S.doc Version 5.0 Page 12 EVIDENCE: The home had developed improved support plans that covered the necessary areas of need. These provided the necessary information for staff to have the information to be able to meet the individual needs of residents and had been developed with the involvement of the residents. However ten residents did not have the new support plans and for these residents all the necessary information was not available to staff. The level of decision making depended on the abilities of the residents however residents spoken to did state that they were able to make a range of decisions over their lives. Residents had the choice over when to get up and go to bed. The times for breakfast was flexible. The main dining room started providing breakfast around 8 am but all bungalows had items of food in their bungalows so could always have breakfast in their own bungalow at a time of their choosing. Residents that were able choose how to spend their time; some choosing to spend time in their bedroom, others choosing to be in the lounge in their bungalow and others spending time around the site including the communal area next to the dining room. Residents went shopping to buy clothes and personal items. Most residents had some opportunity to participate in household activities including shopping, cooking, and domestic tasks such as doing their laundry and cleaning their bungalow. Residents spoken to stated that the home had residents’ meetings for all residents and the home plans to develop this type of consultation. Residents in the staffed units tended to a higher level of involvement in day-to-day aspects of running their unit. All residents had been provided with questionnaires as part of the quality assurance checks. There was scope for further resident involvement in areas such as the recruitment of staff, and particularly for those in the unstaffed units in issues such as activities and menu choices. The home had developed a range of risk assessments and in the revised care plans these had been updated recently. There were some outstanding areas that needed to be risk assessed. Highfield Court DS0000004955.V267422.R01.S.doc Version 5.0 Page 13 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 the following standard(s): 12,13,14, Whilst some of the residents had lots of opportunities to engage in educational, leisure and social activities and regularly accessed the community having a full and varied lifestyle there were other residents that had less opportunities to undertake such activities. Residents lives were enhanced through the friendships they had made at the home and by the home’s flexible procedures for visiting by friends and relatives. The flexible routines encouraged residents to make choices over their daily lives. Highfield Court DS0000004955.V267422.R01.S.doc Version 5.0 Page 14 EVIDENCE: A small number of residents attended college and two of the residents undertook therapeutic work for the home. The manager reported that attendance at college had recently reduced due to funding issues at the colleges. Also the adult basic education that some residents had attended had ceased operating Residents in staffed units had staff available in the home to support residents to undertake a range of social, leisure and independent living activities both in the home and in the community. Some residents attended church. Most of these residents enjoyed a varied and full lifestyle. A number of residents accessed the community without staff support and went into Uttoxeter regularly. A number of residents attended the Gateway club but were only able to attend fortnightly due to the inability of the club to accommodate the high numbers wanting to go. The home had two fulltime activity staff that worked hard to provide a range of crafts, computer activities and trips out as well as supporting some residents to go shopping and to access the community. The activity staff also arranged a number of trips out and activities such as discos and parties within the home. Due to the number of residents wanting activities and needing support to access the community, the time that this could be achieved for some residents was limited. Residents spoken to enjoyed going to the activity centre and out on trips and would like increased time doing activities and would like to access the community more often. A number of residents had had a holiday this year. Some had been to the Isle of Wight, Pontins and Tenerife. Those that had had the opportunity to go had enjoyed themselves. Residents stated that part of the reason for enjoying being at the home was the friendships they had made with other people who lived there. They liked having opportunities for developing friendships and spending time with friends. The home was aware of issues relating to intimate relationships and were aware of the need to access services to promote sexual health. Family and friends were able to visit at any reasonable time. Relatives spoken to felt welcomed when they visited the home and felt that they were kept in touch with changes and relevant issues relating to the care of their relative. Highfield Court DS0000004955.V267422.R01.S.doc Version 5.0 Page 15 The routines within the home were quite flexible. Residents in staffed accommodation were able to make decisions over when to have meals and to chose what they wanted to eat. All residents were able to spend time in their private bedrooms or in the communal areas in their bungalow or in the main communal dining room and social area. Residents were able to have their personal care needs met at a time of their choosing and those that needed little staff support residents that were able were consulted over how they wanted tasks completing. Highfield Court DS0000004955.V267422.R01.S.doc Version 5.0 Page 16 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 the following standard(s): 18,19,20 Residents receive personal support in the way they preferred and required and individual physical and emotional healthcare needs were well met. Residents were protected by the medication policies in place and supported to control their own medication where possible, although attention was required to the safe storage of medication where self medication was taking place. EVIDENCE: Discussions were held with two residents who shared a bungalow together. They described how much support and help they received from the staff at the home. This was confirmed on examination of the daily input records, which were stored in the lounge area. Staff had filled in records every day and when the two residents were asked if they received this help on a daily basis they confirmed that they did. Examination of the care plans relating to the two residents identified that their preferences and abilities were well documented. These had been promoted by the staff at the home and were evident through the tracking of the care delivered.
Highfield Court DS0000004955.V267422.R01.S.doc Version 5.0 Page 17 Residents’ choices were documented and upheld wherever possible in relation to daily routines and personal care. The two residents knew who their main carers were and spoke well of them. A key worker system was in operation and there was evidence of family involvement. One of the two residents was diabetic and she explained how she had to have a special diet, she particularly liked the diabetic cakes made by the kitchen staff. She said that the carers tested her blood sugar about three times per week and that she saw her GP, chiropodist and optician. She also told the inspector that she had recently received a flu jab by the practice nurse. Examination of her care plan and records of medical intervention confirmed the above. The resident also suffered from epilepsy and she stated that she no longer had fits as the tablets she takes has stopped these. Examination of her care plan and medication record identified that her epilepsy was now well managed. Medication Administration records (Mar Charts) were examined and these had been completed as required. The medication belonging to the two residents was stored in a locked cupboard in the bungalow and was administered by a senior carer trained to do so. The staff administering medication had received training prior to this but it is recommended that all staff who are responsible for this are given update training in medication. One resident was visited in his bungalow and he was self-medicating. There was a risk assessment in place in relation to this. When asked where he stored his medication it was identified that this was in his bedroom but was not locked up. As the resident shares his bungalow, it is required that this medication is kept locked up. Highfield Court DS0000004955.V267422.R01.S.doc Version 5.0 Page 18 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 the following standard(s): 22,23 Residents felt that their concerns were listened to and acted upon. Residents were protected from abuse by the systems in place although more staff training in this area was required. EVIDENCE: The residents spoken to said that if they had any concerns or complaints they would go to the Home Manager and had done so in the past. They were happy that these had been dealt with quickly and efficiently. The complaints procedure was noted and displayed in the residents’ information in the bungalows. This procedure was simple and clear and contained the details of the CSCI. The manager of the Home recorded complaints. A book was examined containing concerns and complaints. These had been documented along with the investigation and action taken, if any, as a result. Since the last inspection their had been one complaint made to the CSCI. This was looked into but was unresolved. When questioned, staff had some knowledge of the POVA procedure but required further training in this area to ensure that their knowledge of the local procedure was up to date. A sample of residents’ finances was examined. This showed that the home maintained comprehensive records and that expenditure was supported by receipts. Highfield Court DS0000004955.V267422.R01.S.doc Version 5.0 Page 19 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 the following standard(s): 24,25,26,27,28,30 The home was providing some of the residents with a good standard of accommodation but others needed their accommodation decorating and upgrading in order to provide them with a more homely environment. The home’s external communal areas were generally well maintained but the absence of action to address icy surfaces early in the morning was exposing residents to hazards. The residents would benefit from the dining room and social area being made more homely. The residents were in the main provided with satisfactory bedroom accommodation but the privacy of residents would be improved through the installation of locks to the bedroom doors. The home’s bathing and toilet facilities afforded residents privacy. The residents benefited from the home having procedures in place for the control of infections. Highfield Court DS0000004955.V267422.R01.S.doc Version 5.0 Page 20 EVIDENCE: The home was set in large grounds that were predominately laid to grass. Most of the bungalows were located around a grassed area. On the morning of the inspection the paths around the bungalows were icy and these were not treated until around 10 am meaning that residents were exposed to hazardous conditions when going out of their bungalows for breakfast in the main dining room. The home has refurbished a number of the bungalows and these provided a good standard of accommodation. The home had bungalows that continue to need refurbishment and the home has a rolling programme to upgrade all the bungalows. Residents were involved in deciding on how they would like their accommodation decorating. The home was involving professional occupational therapy advice for those with specific needs prior to refurbishing their accommodation. The home employed maintenance staff who undertook repairs. Bungalows were well heated and satisfactorily cleaned. The staff had access to gloves and aprons and were aware of procedures to control the spread of infection. All the bungalows had their own lockable front door and had a lounge with small kitchenette, bathroom and toilet. The bedrooms were of a satisfactory size and had satisfactory furniture. Toilets and bathrooms were lockable but bedrooms were not. In addition to the bungalows there was a communal dining room with social area attached that some residents chose to use. Smoking occurred in the social area outside mealtimes. The dining room and social area were not homely. The staffed bungalows and some of the unstaffed bungalows had their own washing machines and did their own washing. The home also had a large laundry which undertook the laundry of a number of the residents. The home employed a laundry assistant to undertake this laundry. This had the necessary laundry facilities and was able to wash laundry at disinfectant levels. Highfield Court DS0000004955.V267422.R01.S.doc Version 5.0 Page 21 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,35 The residents in the staffed accommodation had the necessary staffing levels to benefit from a good level of support however for some residents in the unstaffed units the staffing level did not provide enough support for regular access the community and to undertake a range of social and independent living activities. The home was using a high level of agency staff and therefore the continuity of care for the residents could be compromised. The staff recruitment procedure needed to be tightened up in order to ensure that residents were supported and protected. The staff training programme was being developed and, given a little more time, will ensure that the staff have all the required skills and expertise to meet the needs of the residents. Highfield Court DS0000004955.V267422.R01.S.doc Version 5.0 Page 22 EVIDENCE: The home had staff working in both the staffed units and supporting residents in the unstaffed units. The staffed units were suitable staffed to meet the needs of the residents. A number of bungalows had one staff throughout the day and night for two residents. These residents were generally receiving a good level of support to the residents and had the opportunities to be supported in the community. The 22 residents living in unstaffed units were supported by three care staff during the day. Some of these residents needed physical support as well as encouragement to undertake personal care tasks. This level of staff was unlikely to be sufficient to provide these residents with the support they needed both to undertake personal care tasks, domestic tasks and to access the community on a regular basis. Residents did have the use of two activity staff and were able to access the activity centre for limited periods a week. The activity staff also supported some residents to access the community but due to limited resources some residents access to the community and activities in the home was at a low level. The home was using a high level of agency staff. During the week of 20/11/05 39 shifts were covered by agency staff. This resulted from staff how had moved from the home that had closed deciding not to transfer to Highfield Court. The home was recruiting staff. The home’s recruitment and selection processes had improved with all recently employed staff having the necessary pre employment checks and undertaking an induction programme. Six employee files were examined in detail. References, employment history and other required information were in place but four out of the six files examined did not contain the required identification. It is a requirement that the required identification is in place as outlined under regulation 19 schedule. In addition the home was not able to demonstrate that all the staff who had been employed for sometime had been subject to a satisfactory CRB check. There was now a dedicated training manager in post who was in the process of organising the staff training and development programme. This was observed in the form of a training matrix and other documentation. There was now a designated training room and evidence of on going training sessions for staff. Staff had received training in the management of aggression and other pertinent training.
Highfield Court DS0000004955.V267422.R01.S.doc Version 5.0 Page 23 Mandatory health and safety training was ongoing at the Home. Discussions identified a need for the induction training to be further developed to include POVA training. The home had made progress in supporting staff to undertake NVQ training but there was some way to go to ensure that 50 of staff had achieved the qualification. Highfield Court DS0000004955.V267422.R01.S.doc Version 5.0 Page 24 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 The recently recruited Care Manager has the necessary knowledge and skills to provide the residents with a well run home. The home’s quality assurance scheme will provide residents with a home that is subject to ongoing evaluation and review and provides the necessary information to develop and improve the service. EVIDENCE: Since the last inspection there has been a new Care Manager appointed and this manager is going through the registration process. The manager has the relevant experience and has been a Care Manager previously. She has the necessary knowledge and skills to be an effective manager. She has completed NVQ 4. Highfield Court DS0000004955.V267422.R01.S.doc Version 5.0 Page 25 The home has some quality checks in place and is in the middle of expanding this process. The home undertakes questionnaires of residents, relatives and professional staff who visit the home. The home had monthly checks on a range of environmental and care practice. The recently appointed Responsible Individual is taking an active role is assessing the quality of the service with a view to ensuring that the home develops and any issues of concern are quickly picked up. Highfield Court DS0000004955.V267422.R01.S.doc Version 5.0 Page 26 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 3 2 3 x Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 3 2 x Standard No 24 25 26 27 28 29 30
STAFFING Score 2 3 3 3 2 3 3 LIFESTYLES Standard No Score 11 x 12 2 13 2 14 2 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score x 2 2 2 3 x CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Highfield Court Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 3 x 3 x x x x DS0000004955.V267422.R01.S.doc Version 5.0 Page 27 yes 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 YA1 YA6 Regulation 4 6 Requirement To complete a current Statement of Purpose. Timescale for action 01/01/06 01/01/06 3 4 YA9 YA13YA12 5 6 YA20 YA35YA23 To complete the outstanding Care Plans (previous timescale not met) 13(3) To ensure that risk assessments cover the necessary areas of risk. 16(2)(m)&(n) To ensure that all residents have the opportunities to take part in sufficient educational, leisure and social activities and to have regular access to the community. 13(2) To provide residents that self medicate with a lockable facility. 18(1)(i)&13(6) To ensure that all staff have the necessary knowledge to undertake their role to safeguard residents from adult abuse. (Previous timescale not met) 01/01/06 01/01/06 01/12/05 01/02/06 Highfield Court DS0000004955.V267422.R01.S.doc Version 5.0 Page 28 7 YA24 23(d) & 12(4) 8 9 YA24 YA34 13(4)(a) 19 Schedule 2 10 YA33 18(1)(a) 11 12 YA32 YA33 18(1)(c) 19(1)(a) To provide the CSCI with an outline plan of the refurbishment schedule and to confirm that bedroom locks are to be provided for those residents that wish them. To ensure that the paths are not hazardous to residents To ensure that all staff are subject to a satisfactory CRB check and that the identity of staff is confirmed. To provided residents with continuity of care through the reduction of reliance on agency staff. To increase the number of staff qualified to NVQ level 2 To ensure there are adequate staff on duty at all times to ensure that all residents have the opportunity to have their needs met particularly relating to educational, leisure and access to the community. 01/02/06 23/11/05 01/01/06 01/02/06 01/03/06 01/12/05 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 4 Refer to Standard YA8 YA20 YA26 YA14 Good Practice Recommendations To look at increasing the level of participation by residents particularly those in the unstaffed units. To replace the current trolley used to transport medication. To consider ways of making the dining room/ social area more homely. To provide all residents with the opportunity to have a holiday
DS0000004955.V267422.R01.S.doc Version 5.0 Page 29 Highfield Court 5 6 YA20 YA35 To provide regular update training for staff in the administration of medication To implement training programmes using the learning disability framework Highfield Court DS0000004955.V267422.R01.S.doc Version 5.0 Page 30 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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