Inspection on 20/07/06 for Highfield House

This inspection was carried out on 20th July 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 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 House 27/10/05

Highfield House 18/05/05

Highfield House 27/09/04

Highfield House 14/04/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Highfield House 4 Highfield Road Shanklin Isle Of Wight PO37 6PP Lead Inspector Annie Kentfield Unannounced Inspection 20th July 2006 09:30 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 DS0000012497.V295018.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 DS0000012497.V295018.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Highfield House Address 4 Highfield Road Shanklin Isle Of Wight PO37 6PP 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) 01983 862195 01983 866364 teresaihl@btconnect.com Island Healthcare Ltd Ms Teresa Shirley Cornelius Care Home 23 Category(ies) of Dementia - over 65 years of age (3), Old age, registration, with number not falling within any other category (23), of places Physical disability over 65 years of age (6) Highfield House DS0000012497.V295018.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home may accommodate one person aged 60 - 65 years of age for respite care. 27th October 2005 Date of last inspection Brief Description of the Service: Highfield House Residential Home is located towards the mid-point of Highfield Road Shanklin, a quiet residential street situated off Victoria Road. The property is a large Victorian house that has been extended and adapted to provide residential accommodation for 23 people under three registration categories, OP - Older Person, DE(E) Dementia (elderly) and PD(E) Physical Disability (elderly). A passenger lift provides easy access to both floors, although for those ambulant enough the stairs are reasonably wide and of a manageable gradient. The premises is well maintained and provides adequate communal facilities for the service users, including a large lounge and separate dining room able to comfortably seat all residents. The gardens are substantial and ramped access has been provided for ease and convenience. Off road parking is provided but spaces are often difficult to come by and occasionally difficult to negotiate. The current scale of charges is from £425 to £500 with additional charges for chiropody, toiletries, hairdressing and newspapers. Highfield House DS0000012497.V295018.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. In order to provide an overall quality rating for this service evidence was gathered from a number of sources including an unannounced visit to the home. Comments were sought from service users and relatives and from health and social care professionals. All comments received expressed overall satisfaction with the service provided. The visit to the home included a tour of the premises, discussion with service users, staff and the manager and inspection of some of the home’s records. What the service does well: What has improved since the last inspection? There have been improvements to the internal decoration of the home. Action has been taken to comply with previous requirements: Medication – A statutory requirement notice was issued in March 2006 because of errors in the dispensing and recording of medication. The manager has taken appropriate action and care staff have received accredited training, professional pharmaceutical advice has been sought, and the manager regularly reviews the medication policy and procedures to ensure that the home is complying with the relevant regulations. Service user finances – the finance director ensures that service users are regularly invoiced for any additional services received and any purchases made on service users’ behalf. Highfield House DS0000012497.V295018.R01.S.doc Version 5.2 Page 6 Recommendation to seek advice on providing hand washing facilities that meet infection control guidelines – paper towels and liquid soap are provided in shared facilities. Recommendation that locks on toilets and bathrooms are operational – mostly this has been carried out although one lock was not working at the time of the inspection, but has been noted by the manager. 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. Highfield House DS0000012497.V295018.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 House DS0000012497.V295018.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. The home does not provide intermediate care but can provide respite care if a room is available. No service user moves into the home without having a comprehensive assessment of their care needs. EVIDENCE: Records show that all service users moving into the home have had all care needs assessed and recorded. Feedback from community care professionals confirmed that the manager is very good at assessing care needs and is very clear about the level of care needs that can be met by the home. Highfield House DS0000012497.V295018.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 at least once during a 12 month period. 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 the available evidence including a visit to this service. Each service user has an individual plan of care that is regularly reviewed. Service users’ health care needs are being met. Action has been taken to improve the dispensing and recording of medication. Privacy and dignity are respected although more care must be taken to ensure that all bathrooms and toilets are lockable. EVIDENCE: Care plans are clear and detailed with information for care staff on the care to be provided. Staff have had a specific training session on falls risk assessments and this area of risk is clearly documented in the care plans. Highfield House DS0000012497.V295018.R01.S.doc Version 5.2 Page 10 At the time of the unannounced visit, all care records were being moved to a different location and it was noted that this storage needs to be made lockable and secure. One service user said that staff always respect how she wants support and care provided. Since the last inspection that identified some concerns with medication procedures and the subsequent statutory requirement notice that was issued in March of this – it is clear that the manager has taken these issues very seriously and action has been taken to meet the requirements. Only staff who have been appropriately trained are allowed to dispense medication. Training was updated in May of this year. Two staff have also done a BTEC training course in medication. In addition, the manager has asked a Consultant Pharmacist to advise on procedures and plans to arrange further training for staff at a later date. The inspection visit found that storage and recording of medication was satisfactory. However, it was observed in discussion with the deputy manager that the medication room is not ventilated and staff therefore tend to leave the door open for air. This may prove distracting for staff that are having to concentrate on dispensing and recording medicines. Discussion with care staff demonstrated that the home has a commitment to providing suitable training that meets the care needs of the service users. As well as training in all areas of safe working practice, there are regular sessions on specific issues such as oral hygiene, dementia awareness etc. The previous inspection made a recommendation that all toilets and bathrooms must be checked to ensure that locks are working and service users have privacy. This has been partly met although the tour of the premises found some locks still missing or not working. The manager confirmed that this would be addressed straight away. Highfield House DS0000012497.V295018.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12.13.14.and 15 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. Service users are offered a range of leisure and social activities including occasional trips and outings. Visitors are always welcome. Service users are encouraged to exercise choice and control over their lives. Service users said that the food in the home is good. EVIDENCE: The home offers day care for up to 7 older people each day and employs an activities co-ordinator – activities are on offer for both residents and day care service users. A pilot session of Tai Chi was recently offered and some of the service users said they enjoyed this. There are occasional arts and crafts sessions, music, slide shows, quizzes and games. Small outings can be arranged in the home’s own transport. Highfield House DS0000012497.V295018.R01.S.doc Version 5.2 Page 12 Staff said that communion or religious worship could be arranged if requested also that “we will try and arrange anything that residents want to do”. Service users are encouraged to take their meals in the dining room that is sunny, spacious and attractively and comfortably furnished, with doors opening onto a patio and garden. The chef said that the home aims to purchase as much organic meat as possible and provide a freshly prepared and nutritious diet that includes lots of fresh vegetables and fruit. All of the service users spoken to were happy with the menu and the food provided. Lunch was observed to be attractively presented and service users said it was good. The inspector was not able to engage with all of the service users due to varying levels of cognitive impairment. Some of the service users were happy to give feedback when asked and overall service users indicated that they have some choice in many aspects of the daily living activities in the home such as times of getting up or going to bed, spending time in their own room, joining in activities if they want to, choosing what to wear and what to eat. Highfield House DS0000012497.V295018.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is adequate. This judgement has been made using the available evidence including a visit to this service. There is a clear complaints procedure that is detailed in the information given to service users and their relatives when moving into the home. Care staff are aware of the need to protect vulnerable adults and training in adult protection awareness is regularly updated. The service is aware of their responsibility to refer employees to POVA (Protection of Vulnerable Adults) where there is evidence that the safety of a service user is at risk and the manager is currently awaiting the outcome of a POVA referral. However, recruitment procedures must be more thorough to ensure that checks against the POVA list are made for all new employees before they start working in the home. EVIDENCE: No complaints have been received. One service user spoken to said that they would feel happy speaking to some of the care staff or the manager if they were not happy with anything. Staff have access to policies, procedures and awareness training about protecting vulnerable adults. New staff are supervised until a satisfactory criminal record check is received, however, the manager must also ensure that new staff have been checked against the POVA list if it is absolutely necessary Highfield House DS0000012497.V295018.R01.S.doc Version 5.2 Page 14 for staff to start work before a satisfactory CRB/POVA check is in place. This is a regulatory requirement and failure to comply has the potential to put vulnerable service users at risk. Highfield House DS0000012497.V295018.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. The home environment is well maintained, attractive and comfortable. Consideration has been given to making the home and garden safe for service users who may be frail and confused. Apart from two bedrooms all areas of the home were clean, pleasant and hygienic. EVIDENCE: The home environment sympathetically incorporates some of the original features of this period house making the general appearance of the home well appointed, well decorated and comfortable. Service users have a pleasant paved area outside of the sitting room and dining room where they can sit in the sun or shade. There is also access to attractive and pleasant gardens that are safe and secure and secluded for service users. Highfield House DS0000012497.V295018.R01.S.doc Version 5.2 Page 16 The dining room is comfortably furnished with matching tables and chairs with sufficient space to accommodate any service users who use a wheelchair. Bedrooms are individually decorated and furnished and there is a commitment to decorating and refurbishing rooms as they become empty. A faint smell of urine was noticeable in two bedrooms although it was clear that housekeeping staff have been shampooing the carpet on a daily basis and every part of the room was clean. The manager is aware of this problem and will be taking steps to eliminate the unpleasant odours. Since the last inspection when there was an issue with fabric towels being used instead of paper towels – the manager has re-instated the use of paper towels in order to comply with current good practice for the control of infection. Highfield House DS0000012497.V295018.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is adequate. This judgement has been made using the available evidence including a visit to this service. Generally, the home has a team of staff who are skilled and experienced and the level of staff turnover is fairly low. However, the home does not quite meet the recommended minimum of 50 of care staff that have the minimum qualification in care of NVQ level 2. As discussed in the Complaints and Protection section of this report – the recruitment procedures must be improved to meet the requirement for POVA checks. Recruitment records must also evidence that all staff including ancillary staff have satisfactory references and criminal record checks before starting work in the home. EVIDENCE: At the time of the unannounced visit to the home there were 3 care staff, 2 cleaners, cook and kitchen assistant, activities organiser, manager and deputy manager and the finance director in the home. This would appear to be sufficient to meet the needs of the 20 service users and additional day care users in the home. Highfield House DS0000012497.V295018.R01.S.doc Version 5.2 Page 18 Recruitment and training for staff is organised centrally by the provider company, and recruitment records for one new member of staff were not available in the home at the time of the inspection, as required. Records also showed that some new staff had started work before it was confirmed that they were not on the POVA list. The manager must also ensure that all staff in the home have satisfactory references and criminal record checks prior to employment, including ancillary staff. However, other aspects of recruitment were good and all new staff have a supervisor/mentor and follow a planned programme of induction There is ongoing training for all staff in the mandatory areas of health and safety and safe working practice. 10 of the 22 care staff have achieved at least NVQ level 2 in care, however, the National Minimum Standards expect at least 50 of care staff to have the minimum qualification and the manager should provide a plan of how this will be achieved. Individual discussions took place with some of the staff and it was evident that staff feel very well supported and there are regular formal supervision sessions, appraisals, and staff meetings. All staff have job descriptions and a copy of the General Social Care Council – Code of Conduct. Staff also said that senior staff were always available for informal supervision or to deal with a query. One member of staff said that they were encouraged to spend as much time as possible with the residents and they particularly enjoyed this aspect of their job. Highfield House DS0000012497.V295018.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 Quality in this outcome area is adequate. This judgement has been made using the available evidence including a visit to this service. The registered manager is qualified and experienced and has an energetic and positive management approach. There is a quality assurance process that combines internal quality inspections and audits and questionnaires to seek feedback from service users. The outcomes of the quality assurance process need to be made available to service users/relatives/care managers etc. Service users’ financial interests are protected. Generally, the health and safety and welfare of service users and staff are promoted, however, the manager must ensure that doors in the home are not held open with door wedges. Highfield House DS0000012497.V295018.R01.S.doc Version 5.2 Page 20 EVIDENCE: The registered manager has achieved the recommended minimum qualifications. It is the policy of the home that service users manage their own finances or have support from relatives or advocates. The manager looks after small amounts of personal monies for 3 service users. Other service users are invoiced by the home for services or purchases. The results of the quality assurance process were seen in the office of the home. In discussion with the manager and provider they said that they are looking for ways of sharing the quality assurance results with service users and providers. An ‘Open Day’ was arranged but was sparsely attended. One of the registered providers is responsible for health and safety and recently updated fire safety training. Health and safety issues are regularly given to staff to read in the monthly staff newsletter. Some doors were being propped open with wedges. The weather was particularly hot and service users wanted doors kept open. The manager is aware that this is a risk to fire safety and following the inspection confirmed by telephone that wedges had been removed. Advice should be sought from the Fire Safety Officer about fitting suitable self-closing door mechanisms. Highfield House DS0000012497.V295018.R01.S.doc Version 5.2 Page 21 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 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Highfield House DS0000012497.V295018.R01.S.doc Version 5.2 Page 22 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP18 Regulation 19 and Schedule 2 Requirement The manager must confirm that prospective new staff are not on the POVA list – before their employment is confirmed. (enforcement action will be taken if the manager does not comply) The manager must ensure that recruitment procedures are thorough. All staff must have satisfactory POVA and criminal record checks before employment is confirmed – including all ancillary staff. (enforcement action will be taken if the manager does not comply) The manager must advise the Commission how the home will achieve 50 of care staff with a minimum qualification in care (NVQ level 2 or equivalent). The manager must consult with the fire safety officer on all matters of fire safety and suitable equipment. Timescale for action 20/07/06 2. OP29 19 and Schedule 2 20/07/06 3. OP30 18 30/09/06 4. OP38 23(4) 20/07/06 Highfield House DS0000012497.V295018.R01.S.doc Version 5.2 Page 23 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. Refer to Standard OP10 OP26 Good Practice Recommendations The locks on toilet and bathroom doors should be operational. All areas of the home must be free from any unpleasant odour. Highfield House DS0000012497.V295018.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Southampton, Portsmouth and Isle of Wight Ground Floor Mill Court Furrlongs Newport, IOW PO30 2AA 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 House DS0000012497.V295018.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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