Inspection on 10/12/07 for Highfield House

This inspection was carried out on 10th December 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Highfield House 28/11/08

Highfield House 10/07/07

Highfield House 22/05/06

Highfield House 19/12/05

Highfield House 20/07/05

Highfield House 26/07/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Highfield House 28 Clifton Road Ashbourne Derby DE6 1DT Lead Inspector Helen Macukiewicz Unannounced Inspection 10th December 2007 09:00 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 House DS0000002118.V355257.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 House DS0000002118.V355257.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Highfield House Address 28 Clifton Road Ashbourne Derby DE6 1DT 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) 01335 342273 01335 346942 highfield.house@fshc.co.uk Grandcross Limited(wholly owned subsidiary of Four Seasons Health Care Ltd) Post Vacant Care Home 37 Category(ies) of Old age, not falling within any other category registration, with number (37) of places Highfield House DS0000002118.V355257.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th July 2007 Brief Description of the Service: Highfield House is a large detached period property, which has been extended to accommodate 37 older people. There is a large car park with a number of steps up to the home or a driveway for wheelchair users. An experienced person, who is currently awaiting registration, manages the home. The home is situated very close to the small town of Ashbourne. A copy of the last Inspection report was seen in the foyer. The weekly fees have changed since the last Inspection due to changes in funding by the PCT for health care. The fees range from £333.85 to £654.00. Extras include hairdressing, private chiropody, toiletries and any newspapers. Highfield House DS0000002118.V355257.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Inspection was unannounced and lasted 7 hours during one day. Computer held records of all contact between the Home and the Commission for Social Care Inspection since the last Inspection were referred to in the planning of this visit. During this Inspection discussion with people who use the service and their relatives took place. Time was spent in discussion with the Manager and staff. Four residents care files were looked at in detail and their care was examined to see how well records reflect care practices within the home. Relevant records belonging to the home were also examined such as complaints and staffing documents. A brief tour of the home took place including some bedrooms. An ‘expert by experience’ assisted with the inspection process. An ‘expert by experience’ is a person who, because of their shared experience of using services, and/or ways of communicating, visits a service with an inspector to help them get a picture of what it is like to live in or use the service. The ‘expert by experience’ was present for three hours and spoke with several residents and relatives. His findings are incorporated into the report. What the service does well: What has improved since the last inspection? Highfield House DS0000002118.V355257.R01.S.doc Version 5.2 Page 6 The way that care is recorded has improved, and there is more evidence in the documentation to show that residents and relatives get involved in the planning of care. One member of care staff who had been recently appointed was going to commence 21 hours as an activities co-ordinator after Christmas. There have been improvements to the way that complaints are managed. Residents said they had no complaints. One said they felt able to raise any issues as they arose through the residents committee. One relative said ‘if I have any complaints I see (named the Manager) – she sorts it out straight away’. Care plans showed that an assessment of need by the Occupational Therapist had taken place in relation to residents who needed specialist chairs that carry a degree of restraint. The Regional manager reported that there has been some expenditure since the last Inspection, including new specialist beds and lifting equipment, kitchen equipment, new bedroom carpets and small items of furniture. Planning had been approved for an additional conservatory. More qualified nurses and care staff have been recruited since the last Inspection. What they could do better: Some equipment to enable better monitoring of residents’ weight is needed. There were some gaps in recording of medications that had not been identified through audits. This was a requirement of the last Inspection in July 2007 that had not been met. It was observed that those less able to participate in activities were not supported to join in. Residents raised some minor concerns about the laundry service. There had been improvements made to staff recruitment since the last Inspection, although there were still some gaps in the required preemployment checks. Observations of care provided for 2 residents indicated that person-centred care was not taking place routinely by all staff. Highfield House DS0000002118.V355257.R01.S.doc Version 5.2 Page 7 One relative felt that there could be better supervision of one of the lounges by staff. An Inspector also observed that supervision in that area had been low on the day of the Inspection. 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 House DS0000002118.V355257.R01.S.doc Version 5.2 Page 8 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 House DS0000002118.V355257.R01.S.doc Version 5.2 Page 9 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): Standards 1 and 3. Standard 6 does not apply. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People have the information they need to choose a home that will meet their needs. EVIDENCE: The manager confirmed that the information about the home (Statement of Purpose) had not changed since the last Inspection. Some of the information for the residents and relatives (Service Users Guide) had been updated. The brochure had more pictures of the home. One relative said they had read the latest Inspection report that was on display in the foyer. All care files seen contained an assessment of need. This included 2 residents who had recently admitted, one for 2 weeks respite. The Deputy Manager who was also a qualified nurse had undertaken these assessments. These were Highfield House DS0000002118.V355257.R01.S.doc Version 5.2 Page 10 completed prior to admission. There was also an assessment of need by Social Services in one file, which the Manager said had been received prior to admission. A transfer sheet was in place. All visitors felt they had sufficient information about the home to make a decision about whether it would meet their relatives’ needs. One said they chose the home ‘because everyone seemed happy’. Highfield House DS0000002118.V355257.R01.S.doc Version 5.2 Page 11 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): Standards 7-10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Most people receive the care they need in a private and dignified way although there is the potential for some care needs to be missed. EVIDENCE: Four residents care files were seen. All had an assessment of need. All the basic information required was in place. There was a care plan audit sheet in the records, this showed that the Deputy Manager was taking action to ensure records were clear and recorded all the necessary information. There was evidence that risk assessments in areas such as skin care, moving and handling and falls have been carried out. There were also regular documented reviews of these. There was documented evidence that a relative had signed each month to agree the content of one care plan. The other three were missing signatures Highfield House DS0000002118.V355257.R01.S.doc Version 5.2 Page 12 although in one file, there was documentation to suggest the home had made attempts to contact relatives. One resident’s records showed that they had lost weight in 2 months at the beginning of the year, but that they had not been weighed since. Monthly records show that they were unable to be weighed. The Manager said that there were no scales that were suitable to weigh this resident. She said she had discussed this with the Regional Manager, but not ordered them. This request was not recorded. Through her audits, the Deputy manager had identified that there was no care plan for concealing medications in food. She did confirm that she had spoken to the pharmacist about that. There was no evidence of this is the care records. The weekly audits of medication storage, training and administration were seen. These had been completed. There were some gaps in recording of medications that had not been identified through audits. Further examination of records showed that the system for checking records was based on random selection, which meant that there was the potential for not all records to be checked in a four-week period. This was a requirement of the last Inspection in July 2007 that had not been met. The Manager was asked to take immediate action to ensure this was addressed and that the resident concerned suffered no ill effects. A satisfactory response to confirm the action taken was provided to the Commission for Social Care Inspection within 24 hours by the Manager. There was evidence of liaison with care managers; G.P., Occupational Therapists and specialist community mental health teams in the community recorded in care files. There was also documentation to support that the Optician has visited them. There was a documented care management review on file. One visitor said that staff had acted upon a request for a specialist mattress straight away. Residents and visitors all confirmed residents had enough privacy, and that staff upheld their dignity and treated them with respect. One visitor said they felt their relative was well looked after, and always kept clean. They said ‘I can’t fault the care’. The need to uphold principles of dignity and self-respect were recorded in the care plans. The Manager said that a new specialist bath was being purchased; the funding has been allocated for this. The Regional Manager also confirmed this. Highfield House DS0000002118.V355257.R01.S.doc Version 5.2 Page 13 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): Standards 12-15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is opportunity to lead a stimulating and active lifestyle of peoples’ own choosing for the more able residents. Those who need more support have less opportunity to do so. EVIDENCE: A personal history sheet was completed in care files that were seen. The Manager said that there was only one resident who has not had this recorded, although efforts have been made to contact the family. Residents’ records had a good personal profile and a care plan for social activity. One care plan referenced the need for a person-centred approach. Another care plan for someone with dementia included a person-centred approach and the need for social stimulation. There were photographs of a Halloween party that had been organised. One resident said there had been some Carol singing. A person employed for 4 hours/week was enthusiastic about providing stimulation for people living in the home and had organised some activities for the afternoon of the Highfield House DS0000002118.V355257.R01.S.doc Version 5.2 Page 14 inspection. It was observed that those less able to participate in activities were not supported to join in. One member of care staff who had been recently appointed was going to commence 21 hours as an activities co-ordinator after Christmas. The Manager said that this would enable a more structured approach to activities and allow more time for those needing more support to receive activities/stimulation. Although there were no organised activities on display during the Inspection, residents said they were usually advertised and this was due to the absence of the member of staff who usually wrote this on a board. A diary on the wall showed there had been 10 organised activities during November. Residents said they could order a daily newspaper and there was a range of reading material available. One resident said they had a talking newspaper and books delivered. The residents had their own committee responsible for fund raising. They organised an Xmas Fayre (the recent one raised £460.00), an Easter Fayre and a Summer Party. Funds raised were used to pay for entertainers, who visited the home, to provide an Xmas gift for all residents and also to provide a birthday gift for all residents. The staff had started to record the amount of time spent doing one to one activities with residents whose needs indicated this. However, these records were limited and did not support that extra time was being spent on some days. One relative felt that there was not enough stimulation in one of the lounge areas. Observations of this area during the Inspection showed staff interacting only as they went about their business rather than spending meaningful individual time with people. Residents said they were able to maintain contact with their families and several were looking forward to going out to relatives over Christmas. For those unable to go out, residents said that visitors would be welcome into the home. Residents said they have a flexible daily routine; they were able to get up when ready (up to a point). Staff go to individual rooms to help residents get up; this will result in varying times of rising but no one seemed bothered by this. Staff were observed to assist a resident to open their mail and read the message inside out to them. Some residents have telephones of their own; one relative stated that a telephone was available to residents when required. That phone would be brought to the resident and the home covered the costs of calls. There were mixed views about the laundry service. One resident described the laundry as ‘excellent’. However, one relative expressed concern about missing Highfield House DS0000002118.V355257.R01.S.doc Version 5.2 Page 15 items. Further comments from residents included wrong items left in rooms and a general problem with identification, clean laundry put back in rooms with no support to put it away. One resident said that the home caters for their special dietary needs well. All residents said they were happy with the lunch served on the day of the Inspection. Comments about the food more generally included ‘Excellent choice at breakfast. Bacon and eggs always available’, ‘always a choice at lunch’ and ‘Generally very, very good’. Some residents confirmed they could have meals in their bedrooms if they wanted. Highfield House DS0000002118.V355257.R01.S.doc Version 5.2 Page 16 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): Standards 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are kept safe in the home and their rights to complain are upheld by the homes’ procedures. EVIDENCE: The Commission for Social Care Inspection were aware of 3 safeguarding issues that were dealt with between the Home and Social Services during the Summer. There have been no further safeguarding issues since. Communication with Social Services suggests that these issues had been dealt with satisfactorily. All minor concerns were logged, action had been taken in terms of improving the way food and drinks are served. Complaints records showed the action that the manager had taken to resolve issues. 8 formal complaints since the last Inspection were recorded in the Homes’ complaints log. A response was recorded to the complainant from the Regional Manager. There was no evidence to suggest that any of the complainants were still dissatisfied. Training records showed that all but the newest members of staff had received training on Customer care, which the manager stated includes recognising and handling complaints and concerns. Highfield House DS0000002118.V355257.R01.S.doc Version 5.2 Page 17 Minutes of monthly residents/relatives meetings that had been held were seen. These meetings were also used as a forum for people to raise their concerns. There was evidence in the minor complaints log that issues raised in these meetings had been recorded and action had been taken. There was also a record of a separate relatives meeting where people had also been able to raise concerns. Residents said they had no complaints. One said they felt able to raise any issues as they arose through the residents committee. One relative said ‘if I have any complaints I see (named the Manager) – she sorts it out straight away’. The Homes’ training records showed that most staff had received safeguarding training; the remainder were booked to attend this in January 2008. There was a copy of Four Seasons Adult Protection policy in the Managers’ office as well as copies of local authority procedures. Where asked, staff knew these were available. Staff also confirmed that they had safeguarding training and described appropriate action to a range of scenarios. Care plans showed that an assessment of need by the Occupational Therapist had taken place in relation to residents who needed specialist chairs that carry a degree of restraint. There was evidence that the relatives had been asked for consent, but one had not been acquired at the time of the Inspection. Consent for use of bed rails by a relative had been documented. Highfield House DS0000002118.V355257.R01.S.doc Version 5.2 Page 18 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): Standards 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in an environment that meets their needs. EVIDENCE: Where seen, residents’ bedrooms were light and airy, well decorated and had pleasant views. Residents had their own TV’s and telephones (some large number versions). One resident said they could have brought more of their own furniture in but chose not to. Family photographs were on display. Residents said that when availability allowed, requests to change bedrooms had been possible. The Regional manager reported that there has been some expenditure since the last Inspection, including new specialist beds and lifting equipment, kitchen Highfield House DS0000002118.V355257.R01.S.doc Version 5.2 Page 19 equipment, new bedroom carpets and small items of furniture. Planning had been approved for an additional conservatory. All areas appeared clean and tidy. The laundry was seen. This contained the necessary facilities and equipment for safe laundering of clothes. Highfield House DS0000002118.V355257.R01.S.doc Version 5.2 Page 20 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): Standards 27-30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Competent staff, in sufficient numbers care for people although well being could be affected by insufficient recruitment and training. EVIDENCE: More qualified nurses have been recruited since the last Inspection. The most newly employed member was due to commence the week of this Inspection. At that point the current Deputy Manager was going to have some supernumerary hours each week so that she could provide monthly clinical supervisions with qualified staff, monitor care and also provide support to nursing staff. A dependency monitoring scale was seen, the Manager said this is used to adjust staffing levels. This is done along with the Regional Manager each month. Staffing rotas were seen. Following a successful recruitment drive, these showed that 6 staff covered the mornings and occasionally one extra staff supports the early morning period. The Manager stated that from the 17th December 7 staff will be provided during the mornings. During the afternoons, 5 staff were planned and 3 on nights. From 25th December 2007 6 in the afternoon/evenings would be provided. The staffing numbers on the rota included qualified staff. Highfield House DS0000002118.V355257.R01.S.doc Version 5.2 Page 21 The Manager stated that 53 of Care staff had NVQ 2 qualifications or above. One was due to complete and another to start in the next 3 months. Three staff recruitment files were checked for the latest staff employed. There had been improvements made since the last Inspection. The following information was missing from 2 files: A statement of the persons’ health was missing from 2 files, and a personal statement about criminal convictions from another. All had a POVA first or CRB check on file. A trainer for Four Seasons was present during the Inspection. She was undertaking a day long course on Dementia, including person centred care. She was knowledgeable about the subject. Records showed that 8 staff members were undertaking the course and that 3 of the senior staff had already done this. Observations of care provided for 2 residents indicated that person-centred care was not taking place routinely by all staff. The Manager stated that she was reviewing the key workers to ensure that those who have received the training are those supervising care for residents with higher level needs. Training records also showed that staff had received mandatory training in areas such as food hygiene, moving and handling and first aid. More fire training was due to take place on the week of this Inspection. The training records showed that all staff would then have completed their mandatory training by January 2008. The Manager stated that staff training in challenging behaviour would be scheduled for early 2008. Two staff members confirmed they had received an induction to the home, that there was an induction booklet to work through and that they had been appropriately supervised. They also confirmed they had received mandatory training. Residents over lunch commented that staff were ‘very good’. Relatives were all happy with the attitude of staff and their commitment to the care of residents. One visitor said ‘my friend really looks forward to seeing their key worker’. One relative felt that there could be better supervision of one of the lounges by staff. An Inspector also observed that supervision in that area had been low on the day of the Inspection. Highfield House DS0000002118.V355257.R01.S.doc Version 5.2 Page 22 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): Standards 31, 33, 35, 36, 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is run in the best interests of the people living there so they are kept safe. EVIDENCE: The Manager had completed her required checks to apply to the Commission for Social Care Inspection to be approved as Manager for the Home. She said she intended to send these off by 14th December 2007. She said she has completed the Registered Managers Award and a qualification equivalent to the National Vocational Qualification level 4 in the past. Highfield House DS0000002118.V355257.R01.S.doc Version 5.2 Page 23 There was evidence that quality within the home was being monitored. Monthly relatives and residents meetings were recorded. Monthly audit sheets on care planning and dependencies were seen. A record of visits undertaken monthly by the Regional Manager were seen. The last report was dated 28.9.07. These showed that discussion with residents about their views of the home had taken place. They also provided some action points for the staff team in the home. There was recorded evidence that these action points had been addressed. Four seasons conducted a full customer satisfaction survey in October 2007. 50 questionnaires had been sent to residents and relatives. The Manager stated that she had been aware of the outcome and had been asked to comment on the findings and send a response to those who had been surveyed. The outcome report was seen. The Manager said she worked occasional weekend shifts and less frequently, night shifts. This was so she could monitor the home at different times of the day. She was supernumerary. Her hours of work were not identified on the staffing rota at the time of the Inspection. The system for managing resident’s finances hasn’t changed since the last Inspection. The home had acquired the advisory paper published by the Commission for Social Care Inspection on this subject, for reference. All residents and relatives were satisfied with the homes’ management of finances. The Manager said she received monthly supervision and this was documented. Care staff said they were regularly supervised and felt supported. All service records that were seen were up to date. Highfield House DS0000002118.V355257.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Highfield House DS0000002118.V355257.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? YES 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 OP8 OP9 Regulation 12(1)(b) 13(2) Requirement Suitable equipment for weighing residents must be provided. Medications administered must be signed for by Nursing staff to support service users are receiving the care and treatment they require. Previous requirement. There must be a regular programme of activities for residents who are not able to participate in organised group activity. Recruitment checks on staff must be undertaken prior to commencement of employment, this must be evidenced in staff files. To ensure that service users are safeguarded. Previous requirement. Staff must receive training appropriate to their role to ensure they are able to provide person centred care. Timescale for action 31/01/08 31/12/07 3. OP12 16(2)(n) 31/01/08 4. OP29 19(1)(a) and (b) and Schedule 2. 31/01/08 5. OP30 18(c) 28/02/08 Highfield House DS0000002118.V355257.R01.S.doc Version 5.2 Page 26 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. 5. 6. Refer to Standard OP7 OP9 OP14 OP18 OP27 OP31 Good Practice Recommendations Care plans should support involvement of residents and their relatives. Attempts to gain signatures to demonstrate this should continue. A care plan for concealing medications should be drawn up. Improvements to the laundry service should be made taking into account residents’ comments in this report. Efforts to gain written consent for use of the specialist chair should continue. Better supervision of all lounge areas should occur. The Manager should record her working patterns on the staffing rotas to support the amount of time she spends at the home and also her direct supervision of staff, and the home more generally. The Manager should register with the Commission for Social Care Inspection. 9. OP31 Highfield House DS0000002118.V355257.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 House DS0000002118.V355257.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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