Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 30/01/06 for Highfield Hall

Also see our care home review for Highfield Hall for more information

This inspection was carried out on 30th January 2006.

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 found no outstanding requirements from the previous inspection report, but made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

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

Whilst the home had only recently opened most of the residents had lived at a home owned by the same company. Residents spoken to were happy to move to the home and had the opportunity to visit the home before agreeing to move. Residents were able to choose their own bedrooms and to be involved in decorating and furnishing their own bedrooms. Many brought their own furniture with them. Relatives and a Social Worker spoken to complimented the home on the way that they had organised the transfer from the previous home causing as little disruption as possible and making the whole move a positive experience for the residents. Residents confirmed that they had plenty of opportunities to take part in social and leisure activities both within the units and in the community. Activities included regular trips out, shopping, attending the Gateway club, swimming and horse riding. The accommodation of the Hall and Abbey View particularly were of a high standard. Bedrooms were of a good size and all had ensuite facilities. Communal rooms provided suitable accommodation in which residents could relax and eat.

What has improved since the last inspection?

First inspection.

What the care home could do better:

There were some areas where that the home needed to address in order to achieve all the standards. Although support plans were in place the home needed to ensure that when additional needs were identified a support plans was put in place.There were also some areas that needed to have risk assessments developed to ensure that risks to residents were fully addressed. Whilst the home had developed a range of social and leisure activities for each resident there was scope for more residents to take part in educational activities. Although the records showed that the residents were receiving their medication and records were being kept the home needed to ensure that medication was administered for each resident separately and the records completed after each medication administered thus reducing the likelihood of any errors in administration. The home also needed to ensure that only staff trained in medication were administering medication The home still needed to implement a system for the individual supervision of all the staff. Although progress had been made there was a low number of staff trained to at least NVQ level 2. Record keeping was generally up to date but there were occasional omissions that the home needed to address.

CARE HOME ADULTS 18-65 Highfield Hall Highfield Hall and Court Stafford Road Uttoxeter Staffordshire ST14 8QA Lead Inspector Jane Capron Unannounced Inspection 30th January 2006 09:30 Highfield Hall DS0000065382.V282294.R01.S.doc Version 5.1 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 Hall DS0000065382.V282294.R01.S.doc Version 5.1 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 Hall DS0000065382.V282294.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Highfield Hall Address Highfield Hall and Court Stafford Road Uttoxeter Staffordshire ST14 8QA 01538 702977 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 Mr Lee John Bentley Care Home 21 Category(ies) of Learning disability (21), Physical disability (2) registration, with number of places Highfield Hall DS0000065382.V282294.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Kingston View - Six beds - Learning Disability (LD) Abbey View - Six beds - Learning Disability (LD) Highfield Hall - Nine beds - Learning Disability (LD) and Two beds Physical Disability Date of last inspection Brief Description of the Service: Highfield Hall is a care home for residents with a learning disability. The accommodation is provided in three adjoining units that make up two sides of a courtyard that provides parking. Opposite the home are offices, the company’s training school and the activity centre used by the residents at Highfield Hall and Highfield Court, another home on the same site. The Hall itself provides accommodation for nine residents with a learning disability although two also have a physical disability. The home is on two levels with four bedrooms downstairs and five upstairs. The home has all single bedroom accommodation which are of a good size and all have ensuite facilities. The home has a lounge with attached dining area, a small industrial style kitchen and a laundry. The home has a vertical lift. The residents in the Hall have ranging abilities but a number of high dependency care needs. They all moved together from a home owned by the same company that was closing. Abbey View provides accommodation for six residents. The accommodation provides single bedrooms with ensuite facilities. The home has a large lounge, a domestic style kitchen with a dining room adjoining it. The residents assist in running the home undertaking a range of daily living tasks including assisting with meal preparation. Kingstone View provides accommodation for six residents with varying dependency levels but all need regular supervision and support to undertake tasks. The home provides single bedroom accommodation, a lounge and a domestic kitchen with dining area attached. Both Abbey View and Kingstone View have their own small laundry facilities. There are grassed areas to the rear of all the units and all units share the services of an activity staff member. The home has the use of a mini bus. The aim of all the units is to encourage residents to be as independent as possible and to provide them with a full and varied lifestyle. Each unit has its own staff but all staff may work in each unit from time to time. There is one senior that has responsible for all the units on each shift. Highfield Hall DS0000065382.V282294.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first inspection, the home being registered at the end of September 2005. The inspection took place over a six and a half hour period. All the units were visited and discussions were held with residents, staff and the Care Manager. A discussion was held with the relatives of one resident. The inspection included sampling of support plans, medication and residents’ finances. The accommodation was inspected. A sample of staff files were examined as well as discussions over the level of training provided. Rosters were inspected. The home had a registered manager who is in the process of undertaking NVQ 4. There have been no complaints since the home opened. Most of the residents had moved to the home from a home owned by the same company that was closing. Many of the residents knew each other and knew a number of the staff that moved with them. All residents had been assessed by the local authority to ascertain their individual needs. Residents and relatives had the opportunity to visit the home before deciding to move. All residents had a support plan in place that covered residents’ health and personal care needs. Residents right to dignity, respect and choice were being promoted. The accommodation was suitable for the residents and was providing them with a comfortable environment that gave them suitable private and communal facilities. The Health and Safety of the premises was being maintained. Staffing levels were suitable to meet the needs of the residents and provided adequate staff to enable them to engage in a range of activities both in and out of the home. The home was using a number of agency staff whilst it recruited enough permanent staff members. The home provided all new staff with induction training and plans were in place to ensure staff received all the mandatory training. All staff were to have training in adult protection over the next month. Highfield Hall DS0000065382.V282294.R01.S.doc Version 5.1 Page 6 The home’s manager was registered with the CSCI and was undertaking NVQ level 4. The home had a system in place to monitor the quality of the service and to identify any areas for improvement. The home had suitable external management systems in place and the Care Manager received supervision from the company’s Director of Care. What the service does well: What has improved since the last inspection? What they could do better: There were some areas where that the home needed to address in order to achieve all the standards. Although support plans were in place the home needed to ensure that when additional needs were identified a support plans was put in place. Highfield Hall DS0000065382.V282294.R01.S.doc Version 5.1 Page 7 There were also some areas that needed to have risk assessments developed to ensure that risks to residents were fully addressed. Whilst the home had developed a range of social and leisure activities for each resident there was scope for more residents to take part in educational activities. Although the records showed that the residents were receiving their medication and records were being kept the home needed to ensure that medication was administered for each resident separately and the records completed after each medication administered thus reducing the likelihood of any errors in administration. The home also needed to ensure that only staff trained in medication were administering medication The home still needed to implement a system for the individual supervision of all the staff. Although progress had been made there was a low number of staff trained to at least NVQ level 2. Record keeping was generally up to date but there were occasional omissions that the home needed to address. 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 Hall DS0000065382.V282294.R01.S.doc Version 5.1 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 Hall DS0000065382.V282294.R01.S.doc Version 5.1 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): 1,2,3,4,5, The home provided the information needed for prospective residents and their representatives to be aware of the services provided by the home and for the staff to have the necessary information to decide whether the home could meet their needs. Prospective residents had an assessment and the opportunity to visit the home prior to a decision being made to move to the home. Residents and/ or their relatives were provided with a contract so that they were aware of their rights and responsibilities. EVIDENCE: The home had a Statement of Purpose that identified the service the home provided. These were seen prior to registration of the home. Each resident has been provided with a service user guide that fully outlines the rights and responsibilities of the home and the residents. This shows the room a resident occupies and identifies where it is on a map. Part of the service user guide is in pictorial form having a photo of the manager, the responsible individual and a copy of the complaints procedure in a pictorial form. There was scope for further development of document in a more user-friendly format. Highfield Hall DS0000065382.V282294.R01.S.doc Version 5.1 Page 10 The residents were subject to an assessment prior to any placement being offered. This identified the individual needs of the residents. For residents in the Hall and Abbey View the home was registered to take the specific residents who had previously been living at another care home owned by the same company. Kingstone View residents that were admitted when the unit was part of Highfield Hall registration were subject to a review both by the local authority and the home staff. The assessments included the areas of health and personal care, occupational and educational needs, communication needs as well as social and family contacts. Compatibility with other residents was considered as part of the admission process. Most of the residents have moved to the home from another care home and some staff moved with them so there was knowledge of the individual needs of the residents. The support plans identified the communication needs of the residents and the home had involved speech therapists to look at these issues. The home has also developed links with other professionals with the Care Manager visiting health professionals prior to the home opening. The home was in the process of transferring to locally based health care services. The home provided relevant staff with training in autism to aid them to respond to the needs of a specific resident. Staff spoken to were aware of the individual needs of the residents. The home does have a number of recently recruited staff and there are programmes in place for their induction and to receive the necessary training. Prior to the residents moving to the home all visited the unit and had the opportunity to choose their bedrooms. Relatives that wished were involved in providing furniture and soft furnishing. One relative spoken to stated that they visited the home prior to any decision being made over admission and that this was the home they wanted their relative to move to although they had been offered others to visit. The placements were supported by local authorities and residents or their representatives were provided with a contract. The home ‘s service user guide identified residents and the home’s rights and responsibilities and this was signed and agreed with residents or their representatives. Highfield Hall DS0000065382.V282294.R01.S.doc Version 5.1 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 home had developed support plans that provided the information for staff to provide a service that met their needs. The home had some procedures in place for supporting residents to make decisions and to participate in aspects of running the home but there was scope for further development. A range of risk assessments were in place to protect the residents but there were some omissions and risk assessments needed to be reviewed. EVIDENCE: Sampling of files in all units showed that individual support plans had been developed. These covered the health and personal care needs of residents as well as communication needs, social needs; dietary needs and needs relating to occupational issues. Some aspects of the support plans were not up to date and related to their previous placement. Files showed that support plans had been internally reviewed since the home opened but there were some aspects of the support. The home had a key worker system in place. Highfield Hall DS0000065382.V282294.R01.S.doc Version 5.1 Page 12 There was scope for support plans to be in more user-friendly format. Plans were in place to meet any specialist needs of residents. The level of participation and decision-making depended on the individual abilities of the residents. Residents in Abbey View were very involved in the day-to-day decisions relating to their own lives and relating to aspects of the running of the home. They decided on such issues as meal planning, how to spend their time, whether to attend college, whether to join in with activities and go on day trips. They were involved in deciding how to spend their money. The unit had good resident participation being involved in meals preparation, food shopping, domestic tasks around the home including vacuuming and keeping their bedroom clean and tidy. Discussions took place over the planning of activities. In the Hall and Kingstone View the dependency levels of the residents was generally greater and in Kingstone View the residents were supported by staff to undertake a number of household tasks. They went out shopping and were involved in choosing activities they wanted to undertake. Within the Hall the level of decision-making and participation for most of the residents was lower. The cook in conjunction with the staff had developed the menus but these did tale into account the likes and dislikes of the residents and a choice was always provided. Resident swishes were taken into account when planning activities and trips out. One resident spoken to stated that he wished certain foods and these had been put on the menu. There was scope for the home to develop the level of decision-making and participation by the residents. The files showed that the home had developed a range of individual risk assessments but there were some areas such as bathing, accessing the community that were not covered and risk assessments needed to `be reviewed. Highfield Hall DS0000065382.V282294.R01.S.doc Version 5.1 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): 11,12,13,14,15,16,17 The home provided residents with the opportunity for development through involvement in independent living tasks and promoting social and communication skills. Residents benefited from being involved in social and leisure activities and from regular community access but there was scope for more residents to be involved in educational opportunities. The homes’ routines were quite flexible enabling residents to make choices and to have some control over their lives. Residents’ lives were enhanced through maintaining meaningful relationships with family and friends. The meals at the home provided residents with choice and a variety. Highfield Hall DS0000065382.V282294.R01.S.doc Version 5.1 Page 14 EVIDENCE: Residents were being provided with opportunities to develop through being involved with a range of independent living tasks. Residents had plans in place to meet the communication needs of residents and specialist services were involved to aid staff to have more effective communication with residents. Residents are encouraged to develop social skills through their relationships with other living in the units. The home had the services of a fulltime activity staff member and each resident was provided with time with the activity unit. This may be in small groups. This time was spend undertaking an activity that was of the residents choice of one that staff were aware of resident enjoyed. The residents had access to an activity room where they could undertake art and crafts and a range of games. A few residents attended college in Leek one day a week. All the residents had good access to the community. The home had use of a mini bus and a car and the use of this was divided between the units with all residents had the opportunity to have at least two trips out a week. Files showed that residents went out regularly. One resident stated that he went out with his key worker on a one to one basis. Another resident sat Abbey View stated that they went to do food shopping at a supermarket in Uttoxeter. The residents went out to do individual shopping and for social trips out. A number of residents went to the Gateway club. Several residents went swimming and horse riding. Within the home there were a range of arts and crafts taking place and one resident was playing dominoes. One resident in the Hall chose to spend a lot of time in his room and had a range of electronic equipment as well as a large TV. Each unit had its own lounge with TV and video. The Hall had a Valentine party planned. The home was in the process of planning holidays for the residents. Most residents maintained contact with family members. Visits by relatives to the home and by residents to family members occurred regularly. Several residents went for regular weekends to family members. Discussions with relatives visiting Abbey View confirmed that they had been fully involved in their relative’s move to the home and were in regular contact with the home when they visited to collect and return their son from weekend visits. They reported that they were very happy with the service provided and that they were made welcome when they visited. They felt their son had settled and was happy to return to the home. A number of residents had friends in other units and in Highfield Court, another home on the same site. They went to visit these friends. Highfield Hall DS0000065382.V282294.R01.S.doc Version 5.1 Page 15 All the units had relaxed routines but this was more evident in Abbey View where residents were more able. A resident stated he could get up and go to bed when he wanted. He said that he had tasks to undertake such as making his bed and helping lay the table but felt able to decide where to spend his time, either in his bedroom or in the lounge or dining area. Service users that were able were provided with a key to their bedroom. There may be scope for some residents to have a front door key. The home was a no smoking home and the resident that smoked did so in a specifically erected building in the garden. The Hall had a small industrial type kitchen and employed a cook. This unit had a four-week menu. This had been developed by the cook and staff taking into account residents’ preferences. There was always a choice provided. Meals were served in the conservatory off the lounge that was used as the dining room and for activities. There were no residents needing specialist diets but some did need assistance with eating and this was outlined in the support plans. Meals were taken within a time framework but there were no definite mealtimes. Residents in Kingstone View and Abbey View had more involvement in the meal process. They were more involved in menu planning and in meal preparation. The residents were involved in doing the food shopping and staff were responsible for cooking the meals. Meals were provided at a time that fitted in with the residents’ schedules but the main meal was usually taken in all units at lunchtime and a snack type tea provided. Supper was provided and snacks were available throughout the day. Weight of residents was being monitored but the home had no support plan in place for one resident who was on a weight reduction programme. Highfield Hall DS0000065382.V282294.R01.S.doc Version 5.1 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 The home was meeting the health and personal care needs of the residents. The system for the administration of medication needed to ensure that all medication was administered individually and that only staff trained in the safe handling of medication were administering medication. EVIDENCE: The health and personal care needs of the residents were identified in their support plans. They identified the actions needed by staff to ensure these needs were being met. Areas such as nail care was fully documented and residents were noted to have received this care. Plans were in place to ensure that residents received dental and eye checks. Observation within the Hall showed that staff were treating residents with respect and that staff were aware of the individual likes and dislikes of the residents. Residents were all suitable dressed in age and weather appropriate clothing. Times for getting up were flexible. Highfield Hall DS0000065382.V282294.R01.S.doc Version 5.1 Page 17 All the residents were registered with a local GP practice and the manager had visited the GP to develop the necessary links with them. Records and discussions with staff confirmed that the home had involved relevant health care specialists and staff within one had received training to look at more appropriate ways of meeting the needs of one resident with autism. The home had a procedure for the administration of medication and this was completed by the senior on duty. Sampling showed that suitable records were being completed and medication was being stored in lockable cabinets. The home had the facility to administer controlled medication. All except one senior had had comprehensive training in the safe administration of medication. A pharmacy check had been completed and another one was due in February 2006. The home does need to ensure that all medication is administered individually and that each record is immediately signed following an individual having their medication. Highfield Hall DS0000065382.V282294.R01.S.doc Version 5.1 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 The home had a satisfactory complaints procedure that was presented in a suitable format. Whilst the home had adult protection and financial procedures in place the residents were not yet being fully support by staff trained in this area of the work although this was planned to take place over the next month. EVIDENCE: The home had a complaints procedure that was in a pictorial form. The home had a book to record complaints. The home had received no complaints since it had opened. Residents spoken to said that if they had any concerns they would raise them with staff and felt that the staff would sort them out. The home had a procedure for responding to allegations on abuse. The staff had not received training but information was available to show that training was to be provided in the next few weeks. The home had procedures in place for the recording and managing of residents’ finances. Residents’ money was kept securely in locked cupboards and residents’ monies was kept individually. Sampling showed that records were being kept and receipts obtained to support expenditure. The sampling did show that in one case that the records did not fully correspond with the money held due to a failure to record adequately. Highfield Hall DS0000065382.V282294.R01.S.doc Version 5.1 Page 19 The home had plans in place identifying any behavioural issues and the staff spoken to were aware of how to respond to incidents. The home had a no physical restraint policy and some staff had been trained in non physical intervention techniques. Highfield Hall DS0000065382.V282294.R01.S.doc Version 5.1 Page 20 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): 24,25,26,27,28,29,30 The home provided residents with comfortable accommodation that afforded residents the opportunity to mix with others and to have privacy in their bedrooms. The home’s cleaning and hygiene systems provided residents with an environment that was clean and had procedures in place to control the risk of the spread of infection. EVIDENCE: The home was made up of three separate units and were located on a large site close to another unit, Highfield Court. The site is located about half a mile outside of Uttoxeter in a rural setting. Some residents are able to walk to Uttoxeter and there was a pub within a fifteen-minute walk. Access to shops and community resources for most residents is by the home’s transport. All the units face a courtyard that is used as a car park. The rear faces a wooded field part of which residents are involved in making into a garden with seating. The Hall and Abbey View are newly opened and provide a good standard of accommodation. All bedrooms are of a good size with some being very large. Highfield Hall DS0000065382.V282294.R01.S.doc Version 5.1 Page 21 All these bedrooms have ensuite facilities some having their own bath, toilet and basin. Kingstone View has been open for approximately two years and was previously registered as part of Highfield Court. This provides all single bedroom accommodation and bedrooms of an adequate size. Abbey Court and Kingstone Court have similar resources. They have a lounge, a domestic kitchen with a dining area off. The seating in Kingstone View would benefit from being replaced. They have a bathroom and a shower room. There are adequate toilet faculties. The bathroom in Kingstone View is in the process of being upgraded. Both units have a small laundry room The Hall is on two floors with a vertical lift. The Hall has a large lounge with a conservatory that is used as a dining room and for activities, off the lounge. The home has a bathroom and shower room downstairs and a bathroom suitable for use with a hoist upstairs. The home has a laundry downstairs. The Hall has a small industrial type kitchen. The Hall also has an office downstairs and a small staff room/ medication room. The hall carpet would benefit from cleaning. All bedrooms provided suitable furniture although Kingstone View did not provide as high a standard of accommodation as the other units although it is able to meet the needs of the residents. Bedrooms throughout the units were lockable. There may be scope for some residents to have front door keys to their unit. Two residents in the Hall used wheelchairs when out of the home and these were available. The Hall had a vertical lift that had been serviced prior to the home opening. Residents that needed it had equipment in their bathrooms and the upstairs bathroom had the facility for a hoist. The home had access to a minibus with a tailgate. The Hall had its own domestic staff member who was also responsible for checking on the cleaning and hygiene in the other units. She was aware of issues relating to the handling and storing of hazardous of substances. All staff received training in infection control as part of their induction training. Staff reported that the home provided adequate supplies of gloves and aprons. All the homes appeared to be clean and tidy. All the units had their own laundry facilities and these were adequate to ensure that the residents’ laundry needs were met. Highfield Hall DS0000065382.V282294.R01.S.doc Version 5.1 Page 22 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): 31,32,33,34,35,36 Whilst the home had adequate staffing levels the home needed to recruit enough permanent staff to reduce the reliance on agency staff. The home’s recruitment processes were ensuring that staff had the necessary pre employment checks providing residents with protection. Whilst residents were being supported by staff that received induction the home needed to increase the number of staff that were suitably qualified. In order to provide residents with a staff group that was fully supported and supervised the home needed to develop it supervision system. EVIDENCE: The staffing levels provided adequate staff to meet the needs of the residents. Within the Hall there were three staff on duty including one senior care worker who also had responsibility for Abbey View and Kingstone View. This responsibility entailed oversight of those units and administering medication in all three units. The Hall also had a domestic and a cook. At night there were two staff on duty. Highfield Hall DS0000065382.V282294.R01.S.doc Version 5.1 Page 23 At Abbey View there were two staff on duty during the day and one staff member at night. At Kingstone View there were three staff on duty during the day, one staff member providing 1:1 support to one resident. There was one staff member on duty at night. The staff at both Abbey View and Kingstone Unit undertook domestic and cooking tasks. All permanent staff were provided with job descriptions and contracts. At the time of the inspection the home was in the process on recruiting staff and had a number of staff that were undertaking their induction training. The units were relying on a number of agency staff but although not permanent staff they had worked at the home for some time and did know the residents. The home hopes to reduce this reliance on agency staff. Observation of some of the permanent staff showed them to be motivated and keen to provide a good service. Relatives spoken to stated that they felt the staff were providing a good service and were always welcoming when they visited. Staff had received relevant training in specific conditions such as epilepsy and autism. Plans were in place for all staff to receive training in adult protection issues. The Care manager had developed links with health care professionals prior to the opening of the home. The home did have a low level of staff trained to at least NVQ level 2 but four staff were in the process of doing the qualification. All new staff undertook induction training that included training in health and safety, moving and lifting and infection control. The training unit was looking to develop a range of relevant training for the staff. The Care Manager had set up staff meetings for the staff including the night staff and was in the process of setting up a system for the individual supervision of all staff. The home had access to the company’s training unit and the training officer had responsibility for ensuring that staff completed their induction training. The unit was in the process of developing a centralised system for maintaining the records of staff’s training. The home operated the company’s recruitment and selection procedures. Sampling of the records showed that staff were subject to pre employment checks including POVA and CRB checks and two references were sought. Highfield Hall DS0000065382.V282294.R01.S.doc Version 5.1 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): 37,38,39,42,43 The residents were benefiting from a manager with relevant experience and who was in the process of undertaking the required qualification to effectively manage the home. The home was reviewing its performance through assessing a range of audits and through seeking the views of residents, relatives and professional visitors to the home. EVIDENCE: The home’s manager was registered by the CSCI as part of the registration of the home. He had sufficient experience of working with people in learning disabilities and knew most of the residents that moved into the home. He had started undertaking his NVQ level 4. He had also undertaken recent training in adult protection. The manager had an open approach and had daily contact with residents. Highfield Hall DS0000065382.V282294.R01.S.doc Version 5.1 Page 25 Although his office was based at the Hall he visited the other units on a daily basis and was observed interacting with residents in a relaxed manner and he was clearly liked by the residents. The home had residents and staff meetings. The home had implemented a system to review the quality of the service provided. This included a range of audits about the environment and about care practices. The home was also undertaking surveys of relatives and professional visitors to the home. Residents meetings were being held. The home was working to the company’s policies and procedures that had been reviewed in 2005. These covered the necessary areas. The home was maintaining a range of records required by the regulations. These included records relating to health and safety, care practices including medication and health services and inventories of residents’ belongings and their finances. There were some omissions in the recording of health care interventions although these had been undertaken. The home’s servicing records were inspected at registration and these were all in place and up to date. The home was undertaking the necessary fire prevention testing. Staff had programmes in place to ensure that staff undertook fire training, food hygiene and moving and handling. The home had trained enough staff in first aid to ensure there was a trained staff member on each shift. All staff completed some training in infection control as part of their induction training. The home had procedures in place for the safe storage and safe handing of hazardous products. The company main office was located on the same site and the Registered Individual worked on the site and provided the manager with supervision. The company had responsibility for financial budgeting and human resource planning. The Responsible Individual was involved in developing and over seeing the Quality Assurance system. The home had the necessary insurance cover in place. Highfield Hall DS0000065382.V282294.R01.S.doc Version 5.1 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 Standard No Score 1 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 2 33 3 34 3 35 3 36 1 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 2 LIFESTYLES Standard No Score 11 3 12 2 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 3 3 3 2 3 3 Highfield Hall DS0000065382.V282294.R01.S.doc Version 5.1 Page 27 Are there any outstanding requirements from the last inspection? N/A 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 YA6 Regulation 15 Requirement To ensure that support plans are implemented when there are new areas of need e.g. weight reduction programmes To complete risk assessments in respect of activities in which residents engage e.g. bathing, accessing the community, use of motorised scooter To investigate the possibility of more residents being involved in educational and fulfilling activities. To ensure that medication is always administered individually. To ensure that staff administering medication are suitably trained. To ensure that accurate records are kept of residents’ finances. To increase the number of staff suitably qualified To introduce a system for the supervision of staff. To ensure that records are kept up to date. Timescale for action 20/03/06 2 YA9 13(4)(b) 01/04/06 3 YA12 16(2)(n) 01/04/06 4 5 6. 7. 8. 9. YA20 YA20 YA23 YA32 YA36 YA41 13(2) 13(2) &18(1) (c)(i) 13(6) 18(1)(a) 18(2) 17(1)(a) schedule 3 01/03/06 01/04/06 01/03/06 01/06/06 01/03/06 01/03/06 Highfield Hall DS0000065382.V282294.R01.S.doc Version 5.1 Page 28 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 YA8YA71. YA16 YA24 YA6YA1 Good Practice Recommendations To look at methods of increased decision making and participation of those residents with specialist communication needs. To assess whether residents would be able to mange a front door key. To consider replacing the seating in Kingstone View and cleaning the carpet in the Hall To look at developing more information in a more user friendly format Highfield Hall DS0000065382.V282294.R01.S.doc Version 5.1 Page 29 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 © 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 Hall DS0000065382.V282294.R01.S.doc Version 5.1 Page 30 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!