Inspection on 06/02/07 for Highfield Hall Care Centre

This inspection was carried out on 6th February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Highfield Hall Care Centre 28/09/05

Highfield Hall Care Centre 28/04/05

Highfield Hall Care Centre 04/01/05

Highfield Hall Care Centre 17/08/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Highfield Hall Care Centre Grane Road Haslingden Rossendale BB4 5ES Lead Inspector Mrs Susan Hargreaves Unannounced Inspection 6th February 2007 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 Hall Care Centre DS0000022505.V323224.R01.S.doc Version 5.2 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 Hall Care Centre DS0000022505.V323224.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Highfield Hall Care Centre Address Grane Road Haslingden Rossendale BB4 5ES 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) 01706 222326 01706 219455 Highfields.Hall@ashbourne-homes.co.uk Ashbourne Homes Limited Mrs Carole Ann Ashburne Care Home 75 Category(ies) of Dementia - over 65 years of age (21), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (2), Old age, not falling within any other category (52) Highfield Hall Care Centre DS0000022505.V323224.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. 7. 8. The total number of service users within these categories not to exceed 75 (seventy five) Staffing for service users requiring nursing care will be in accordance with the Notice issued on 15 January 2002 Within the overall total of 75 a maximum of 25 service users requiring nursing care who fall into the category of OP. Within the overall total of 75 a maximum of 33 service users requiring personal care who fall in the category of OP. Within the overall total of 75 a maximum of 21 service users requiring personal care who fall into the category of DE(E). Within the overall total of 75, 2 named service users requiring personal care who fall into the category of MD(E). When any of the named service users are no longer resident in the home, the registration must be changed to reflect this. The registered provider must, at all times, employ a suitably qualified and experienced person who is registered with the Commission for Social Care Inspection as manager of Highfield Hall Care Centre. 28th September 2005 Date of last inspection Brief Description of the Service: Highfield Hall Care Centre is a two-storey purpose built care home in it’s own grounds. The home offers 24-hour care for up to 75 older people who require either nursing or personal care. There is also a separate dementia unit. Accommodation is provided in single en-suite rooms. Communal lounges and dining rooms are located on both floors. A passenger lift facilitates access to all areas of the home. There is an enclosed garden, which is easily accessible to residents. There is ample parking for staff and visitors. Highfield Hall is situated in the small town of Haslingden close to local amenities and public transport. The current fees charged at Highfield Hall are £324.50 to £560 per week. Additional charges are payable for hairdressing, papers, magazines and massages. A statement of purpose and service user guide was available to prospective residents and their relatives on request. Highfield Hall Care Centre DS0000022505.V323224.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A key unannounced inspection, which included a visit to the home, was conducted at Highfield Hall on the 6th and 7th February 2007. No additional visits have been made since the last inspection. Six comment cards were received from the relatives of residents expressing their overall satisfaction with the care provided. Fourteen residents completed a survey. Thirteen of these residents stated they always or usually received the care and support they needed. At the time of this inspection 71 residents were living at the home. A tour of the premises took place and staff files and care records were inspected. Members of staff on duty, residents and visitors were spoken to. Discussions also took place with the manager regarding issues raised during the inspection. What the service does well: What has improved since the last inspection? Following the last inspection care planning has improved. Care plans address all identified personal and healthcare needs. Appropriate risk assessments for nutrition and the development of pressure sores are in place. To prevent medication from deteriorating an air conditioning unit has been installed in the drugs room on the residential unit. This ensures that the temperature of this room does not exceed twenty-five degrees Celsius. Highfield Hall Care Centre DS0000022505.V323224.R01.S.doc Version 5.2 Page 6 Bathrooms have been to look homely with the addition of shelves, ornaments and artificial plants. All the bedroom doors on the dementia unit have been fitted with nameplates, doorknockers and imitation letterboxes to give the appearance of a front door. This discourages residents from entering other people’s bedrooms. On the dementia unit a sensory room with reclining chairs, coloured lights, mobiles, a lava lamp and reclining chairs has been created. Members of staff or visitors can take residents to this room to relax and listen to soothing music. Colourful collages using pebbles, feathers, shells and fabric have been made and were displayed on the corridors of the dementia unit for residents to look at and touch. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Highfield Hall Care Centre DS0000022505.V323224.R01.S.doc Version 5.2 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 Hall Care Centre DS0000022505.V323224.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Admission procedures were thorough. A pre-admission assessment was completed for each resident prior to admission. EVIDENCE: The individual records of six residents were inspected. Each contained a detailed pre-admission assessment. A senior member of staff visited prospective residents in hospital or their own home prior to admission. These assessments provided important information for the care plans. Prospective residents or their relatives received confirmation in writing that their needs could be met at the home. Standard 6 is not applicable to this service. Highfield Hall Care Centre DS0000022505.V323224.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans contained detailed information relating to all aspects of care. Medication was well managed. Privacy and dignity was promoted for all residents. EVIDENCE: The individual care plans of six residents were inspected. These care plans identified the personal and healthcare needs of each resident and explained how these needs were met. Appropriate risk assessments had been carried out. Information about how identified risks were managed was also included in the care plans. Records relating to the care of a pressure sore for one resident included details of dressing changes and the condition of the sore. A written report about the care given to individual residents was completed during each shift. Highfield Hall Care Centre DS0000022505.V323224.R01.S.doc Version 5.2 Page 10 Care plans were reviewed monthly and up dated when the needs of the resident changed. Residents and their relatives were invited to attend a review meeting every three to six months or more often if necessary. Residents were registered with a GP and had access to other healthcare professionals. At the time of the inspection none of the residents were self-medicating. Registered nurses and appropriately trained care assistants were responsible for administering all medication. Records relating to the management of medication were seen to be up to date. Medication was stored correctly in each unit of the home. The temperature of these storage areas was checked and recorded daily. Controlled drugs were stored securely and a stock check was satisfactory. Personal care was carried out in private. Members of staff were observed attending to residents in a friendly and professional manner. Three members of staff explained in detail how they promoted privacy and dignity for all residents. One resident said, “The staff are lovely.” Highfield Hall Care Centre DS0000022505.V323224.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. An excellent range of leisure activities suitable for all residents were organised Visitors were welcomed into the home at anytime. The daily routine met the needs and preferences of residents. Menus offered variety and choice. EVIDENCE: An activities co-ordinator was responsible for organising a range of leisure activities and social events for the residents. These included, keep fit and gentle exercise, bingo, pets as therapy, massages, arts and crafts, murder mystery afternoon, singing and board games. Outside entertainers regularly visited the home. A quiz night was being organised for later in February to which relatives and friends were invited. The activities co-ordinator explained that she spent time chatting and dong hand massages with residents who needed nursing care and were unable to take part in communal activities. One resident said, “We’ve got a good activities organiser.” On the dementia unit a sensory room with reclining chairs, coloured lights, mobiles, a lava lamp and reclining chairs had been created. Members of staff Highfield Hall Care Centre DS0000022505.V323224.R01.S.doc Version 5.2 Page 12 or visitors could take residents to this room to relax and listen to soothing music. The bar room had been relocated to the ground floor of the dementia unit. This was also the designated smoking area for residents. A beer garden had been made in the corridor outside the bar room with garden furniture and an appropriate mural on the wall. A luncheon club was held twice a week in the bar room. Colourful collages using pebbles, feathers, shells and fabric were displayed on the corridors of the dementia unit for residents to look at and touch. Visitors were welcomed into the home at anytime. Local clergy regularly visited the home. One resident explained how he enjoyed the visits from ‘Churches Together’ when they sang hymns and listened to appropriate readings. Residents were encouraged to make decisions about their lifestyle and daily routine. One resident said she chose to go to bed at 7.30pm and get up at 8.00am. Residents were encouraged to personalise their rooms with photographs, ornaments etc. The meal served at lunchtime on the second day of the inspection was wholesome and appetising. The menus were varied and offered choice. A member of staff working on the dementia unit explained how the residents were shown the food available at mealtimes to enable them to make an informed choice. Lunchtime was unhurried allowing residents time to chat and enjoy their meal. Members of staff were observed assisting residents in a sensitive and patient manner. All the residents asked except two said the meals were good. Highfield Hall Care Centre DS0000022505.V323224.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints were taken seriously and investigated. Appropriate policies and procedures were in place to ensure the protection of residents at the home. EVIDENCE: A comprehensive complaints procedure was in place. Two complaints had been made to the home since the last inspection. Detailed records of the complaints, investigation and action taken were seen. Policies and procedures relating to the safeguarding of vulnerable adults were in place. This issue was discussed with five members of staff. They were aware of the procedure and said they would report any concerns immediately. Highfield Hall Care Centre DS0000022505.V323224.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is well maintained and provides a high standard of accommodation for the residents. Laundry facilities were appropriate for the size of the home. EVIDENCE: At the time of the inspection the home was clean, tidy, free from offensive odour and well maintained. Bathrooms have recently been made to look more homely by the addition of shelves, ornaments and artificial plants. All the bedroom doors on the dementia unit have been fitted with nameplates, doorknockers and imitation letterboxes to give the appearance of a front door. This discourages residents from entering other people’s bedrooms. To further improve the premises the first floor corridor was being redecorated. Matching bed spread, curtains, cushions and lampshades were gradually being purchased for all bedrooms. The ground floor entrance hall has also recently Highfield Hall Care Centre DS0000022505.V323224.R01.S.doc Version 5.2 Page 15 been redecorated and refurnished. The grounds and gardens were well kept and a secure garden area was accessible from the dementia unit. A visitor said, “ The home’s nicely decorated and always clean.” Laundry facilities were appropriate for the size of the home. An infection control policy was in place. Highfield Hall Care Centre DS0000022505.V323224.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels were appropriate to meet the assessed needs of the residents. Recruitment procedures were thorough. Training for all members of staff was actively encouraged. EVIDENCE: Examination of the duty rota confirmed that staffing levels were appropriate to meet the assessed needs of the residents. It was evident from discussion with members of staff and the manager that training was encouraged. This included induction training for new employees, moving and handling, basic food hygiene, health and safety, fire prevention, resident welfare, dementia awareness, first aid and management of medication. Seventeen members of staff (45 ) had an NVQ qualification at level 2 or above in care. In addition to this a further six members of staff were working towards NVQ level 2. The files of five members of staff appointed since the last inspection were examined. These files indicated that all the required pre-employment checks to ensure protection of the residents had been completed prior to appointment. Highfield Hall Care Centre DS0000022505.V323224.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has an experienced manager. Residents and their relatives were consulted about the quality of the care and services provided at the home. Appropriate procedures to safeguard the health, safety and welfare of residents were in place. EVIDENCE: The registered manager is an experienced nurse and has an NVQ level 4 qualification in management. She has recently completed intermediate health and safety and maintains an up to date knowledge of current practice by reading appropriate journals and using the Internet. Highfield Hall Care Centre DS0000022505.V323224.R01.S.doc Version 5.2 Page 18 The home has achieved the nationally accredited RDB star rating quality assurance award. They have been awarded five stars, the highest rating, for the standard of care and environment, three crowns for facilities and services and two wheelchairs for access and accommodation for wheelchair users. Resident’s meetings were held every three months. At these meetings all aspects of the care and services provided were discussed. The annual survey of residents and their relatives was carried out in September 2006. Records of transactions involving resident’s money were seen to up to date and accurate. Policies and procedures for safe working practices were in place. Fire alarms were tested weekly and emergency lighting monthly. A fire risk assessment was in place. This was reviewed annually. Fire drills took place monthly and a staff attendance record was kept. A member of staff who had been working at the home for several months said she had not received training in fire safety. The handyman carried out an inspection of bed rails every week. Records of this were available. He was also responsible for checking wheelchairs, window restrictors, hot water temperatures and the nurse call system. Records of the routine servicing of equipment were seen. These included an up to date gas safety certificate and evidence that the testing of small electrical appliances had taken place in December 2006. Although an up to date electrical installation certificate was not available arrangements have been made for the necessary checks to be carried out on 12 February 2007. The kitchen was clean and tidy. Records maintained by the cook included fridge, freezer and food temperatures. During the inspection members of staff were observed using an incorrect moving and handling technique. One member of staff explained how she used the inappropriate under arm technique when moving and handling residents. Safety notices were displayed in the home. Highfield Hall Care Centre DS0000022505.V323224.R01.S.doc Version 5.2 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Highfield Hall Care Centre DS0000022505.V323224.R01.S.doc Version 5.2 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 OP38 Regulation 23(4)(d) Requirement To ensure all members of staff understand how to promote the health and safety of residents training in fire safety must be provided. To prevent injury to residents and staff correct moving and handling techniques must always be used. Timescale for action 30/03/07 2. OP38 13(5) 30/03/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Highfield Hall Care Centre DS0000022505.V323224.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Care Centre DS0000022505.V323224.R01.S.doc Version 5.2 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. 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