Inspection on 22/04/05 for Highfield House

This inspection was carried out on 22nd April 2005.

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 24/01/09

Highfield House 25/02/08

Highfield House 26/04/06

Highfield House 15/12/05

Highfield House 07/09/04

Highfield House 05/04/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Highfield House London Road Stroud Glos GL5 2AJ Lead Inspector Lynne Bennett Unannounced Friday 22 April 2005 12:00 nd 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 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 D51_D03_S16465_HighfieldHouse_V223160_220405_Stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Highfield House Address London Road Stroud Glos GL5 2AJ 01453 758618 01453 767911 Linda.C.Hughes@btconnect.com Mrs Linda Hughes, Stroud Care Homes Limited Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr David Harley Care Home - Personal Care 7 Category(ies) of Learning Disability (7) registration, with number of places Highfield House D51_D03_S16465_HighfieldHouse_V223160_220405_Stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 07/09/04 Brief Description of the Service: Highfield House is a detached house with accommodation for seven adults with a learning disability who may display behaviour that challenges. The home is situated in Stroud and service users are able to access public transport easily. Highfield House is one of three homes owned and managed by Stroud Care Homes. The home is staffed 24 hours a day, seven days a week. Family and friends are welcome to visit the home at any time and service users can meet them in private if they wish to. Service users have single rooms and access to a large communal lounge, a smaller lounge and a kitchen/diner. There are substantial gardens to the rear of the home. The service users attend a local day centre, a nearby college and work experience placements. Highfield House D51_D03_S16465_HighfieldHouse_V223160_220405_Stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over five hours on a day in April 2005. Time was spent with four of the people living at Highfield House; verbal feedback was received from three people. The registered manager and people living at the home showed the inspector around the premises. The care for two people was looked into. This involved looking at their personal files, care plans, risk assessments and speaking to them and their key workers. Admission information for a person moving into the home in May 2005 was examined in some depth. Care plans and risk assessments for this person were also examined. Other records looked at included staff files for new members of staff and health and safety records. Three members of staff were spoken to as well as the registered manager. What the service does well: What has improved since the last inspection? The admissions process is being followed by the home. Full assessments are obtained and people moving into the home are invited for visits. People living at the home are able to give their views on whether they will get on with the new people. Care records for people living at the home are better and the manager will be monitoring these to ensure that they are reviewed regularly. The home has been redecorated and the laundry/kitchen refitted with new fixtures and fittings. Highfield House D51_D03_S16465_HighfieldHouse_V223160_220405_Stage4.doc Version 1.30 Page 6 Staff are having regular supervision sessions and there are also regular staff meetings in place, improving communication within the home. Training in Positive Response is provided by a trainer (the manager) accredited with the British Institute of Learning Disabilities. 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 D51_D03_S16465_HighfieldHouse_V223160_220405_Stage4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Highfield House D51_D03_S16465_HighfieldHouse_V223160_220405_Stage4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4 and 5. Prospective people moving into Highfield House are supplied with information about the home and how it will meet their needs. The admissions process provides the opportunity for prospective service users to meet other people living in the home enabling them to make an informed choice about the suitability of the service. EVIDENCE: The home presently has two vacancies. The organisation has a comprehensive admissions policy and procedure that it is following. Assessment information is obtained about people wishing to move into the home from a variety of sources. The registered manager makes visits to the homes of people considering moving to Highfield House completing an additional assessment. Visits are then arranged to the home including an overnight stay. If additional training needs are identified for staff then this is provided before the person moves to the home. There was evidence that prospective service users are provided with a copy of the home’s Statement of Purpose and Service User Guide. Draft care plans and risk assessments are prepared ready for a move to the home. It was evident that people moving into the home are involved in this process. They are also consulted about the colour scheme for their room and what furniture they require. Staff research and provide guidance about a range of appropriate activities. Highfield House D51_D03_S16465_HighfieldHouse_V223160_220405_Stage4.doc Version 1.30 Page 9 Notes kept for initial visits and stays provide evidence that prospective service users have the opportunity to meet with other people living in the home and their views are considered. This complies with requirements issued at the previous inspection. Each person living at the home has a statement of terms and conditions that gives clear information about what is provided by the home. Highfield House D51_D03_S16465_HighfieldHouse_V223160_220405_Stage4.doc Version 1.30 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 and 9 A clear comprehensive care planning system is being put in place providing staff with the information they require to meet the needs of people living at the home. Individual risk assessments encourage and support people living at the home to challenge and deal with problem areas in their lives. EVIDENCE: Comprehensive plans are in place for people living at the home. There were some inconsistencies in the quality of the plans examined. Most plans are being reviewed regularly and key workers provide a monthly report summarising people’s needs and identifying any changes. One file examined indicated that care plans had not been reviewed for over six months, although an annual review had been held in January. The needs of this person have changed and care plans and risk assessments must be reviewed to reflect this. The manager is introducing a checklist for these files monitoring the records. This checklist was in place on one file examined and it was evident that the key worker had actioned comments made by the manager. This process when fully implemented will highlight shortfalls such as the one identified in this report. Highfield House D51_D03_S16465_HighfieldHouse_V223160_220405_Stage4.doc Version 1.30 Page 11 People living at the home said that they are involved in preparation for reviews and have good relationships with their key workers. Where appropriate people living at the home sign care plans and risk assessments. Risk assessments are in place minimising hazards to people living at the home. The format for these risk assessments is being changed. A sample of the new risk assessment was available for examination. Highfield House D51_D03_S16465_HighfieldHouse_V223160_220405_Stage4.doc Version 1.30 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13,14,16 and 17. A varied programme of social and recreational activities are scheduled that may occasionally be restricted due to access to appropriate transport. The home has made progress in the provision of meals enabling people living at the home to exercise choice and control over what they eat. EVIDENCE: People living at the home access a range of local facilities in Stroud as well as visiting Gloucester and Bristol. One person said they were going to a local pub on the evening of the inspection and another was meeting a friend for a meal in Stroud. One person said that a holiday had been planned for later in the year with a friend. On the afternoon of the inspection one person was supported by staff to go swimming. Staff indicated that at times activities might be prohibited because the home is using a small family car. Occasionally staff use their own vehicles. The organisation must review the provision of transport for the home in light of the two new people moving in and the needs of others living there. Some people living at the home are able to use public transport. Highfield House D51_D03_S16465_HighfieldHouse_V223160_220405_Stage4.doc Version 1.30 Page 13 A person living at the home produced a new low fat cookbook which people living at the home had been involved in developing from a range of recipes downloaded from the Internet. Another person said that this could be used to prepare the weekly menus, although it was evident that people living at the home do not have to use this cookbook if they prefer an alternative meal. Lunch on the day of the inspection was a toasted sandwich. One person chose an egg sandwich as an alternative. There was evidence that some people are being supported to learn activities of daily living. In addition to staff support, photographs are used as prompts. One person was involved in vacuuming carpets and another prepared drinks. Highfield House D51_D03_S16465_HighfieldHouse_V223160_220405_Stage4.doc Version 1.30 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 and 19. The healthcare needs of people living at the home are well met with evidence of multi disciplinary support on a regular basis. EVIDENCE: Clear healthcare records are being maintained for people living at the home. Appointments are noted and outcomes of these appointments recorded in individual notes. People living at the home have access to a full range of healthcare professionals and are supported at outpatient appointments. An initial assessment for a person moving into the home indicated that they would require the support of the local Community Learning Disabilities Team. This has not yet been put in place. The registered person must ensure that an agreement is reached with the team. Protocols and guidelines are in place for staff outlining how they should support people living at the home during times of distress or anxiety. A debrief protocol is also in place and staff are offered 1:1 counselling with a Psychologist employed by the home. Highfield House D51_D03_S16465_HighfieldHouse_V223160_220405_Stage4.doc Version 1.30 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23 There are vulnerable adults procedures in place, although training for staff could be more robust to ensure the protection of people living at the home. EVIDENCE: The registered manager is a trainer of Positive Response training accredited with BILD. He regularly reviews reactive strategies and monitors the performance of staff. Regular refresher training is provided for all staff and new staff complete Positive Response training during their induction. The organisation employs a Psychologist providing support to both people living in the home and staff. Staff spoken to were aware of the home’s confidentiality and whistle blowing procedures and their responsibilities in light of these. Staff said that they are confident that the registered person would challenge poor practice. Staff have not attended training in the Protection of Vulnerable Adults. Highfield House D51_D03_S16465_HighfieldHouse_V223160_220405_Stage4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,27, 28 and 30. The home provides comfortable, homely accommodation that reflects the personalities and lifestyles of people living in the home. EVIDENCE: People living at Highfield House have single accommodation with access to either a shower or bathroom. There are two comfortable and homely lounges. One lounge was being used to store two bikes belonging to service users. Alternative storage must be found for these. The laundry, kitchen and dining room had just been refurbished with new fittings, work surfaces and equipment. A paper towel dispenser must be fitted near the hand washbasin in the kitchen. New floors are to be fitted and the room is to be redecorated. Hallways throughout the home have been redecorated since the last inspection. The gardens to the rear of the property are terraced and handrails have been fitted to the steps leading to the top garden. A person living at the home showed areas of the garden that are being cultivated and said that there were plans to build a summerhouse in the top garden. Highfield House D51_D03_S16465_HighfieldHouse_V223160_220405_Stage4.doc Version 1.30 Page 17 A bedroom for a new person moving into the home was being redecorated at the time of the inspection. There are plans to remove the window in this room and replace with a larger picture window. There are also plans to make alterations to the shower and toilet on the top floor. People living at the home have an inventory listing their personal belongings and furniture. This complies with a requirement issued at the last inspection. Highfield House D51_D03_S16465_HighfieldHouse_V223160_220405_Stage4.doc Version 1.30 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,34,35 and 36. Robust recruitment and selection procedures are in place ensuring the safety of people living in the home. Staff have access to a range of training providing them with the knowledge and skills to meet the needs of people at the home. EVIDENCE: A core team of experienced, skilled and trained staff supports people living at the home. New staff complete induction training and are observed in practice for the first six weeks. Core training is provided for new staff including Positive Response Training, fire, basic food hygiene and first aid. A new member of staff said that this training had been completed within the first six months as well as registration for a NVQ Level 3 Award. Staff spoken to say that the team are very supportive of each other and that communication within the home is good ensuring consistency of approach. These staff are aware of the needs of people living in the home. In particular they are able to explain how to support one person who may present with challenges to the service. They summarised care plans, risk assessments and reactive strategies. Staff spoke positively about the support that is available to them after an incident in the home. This may include a debrief with a manager, counselling with a Psychologist or discussion with colleagues. Highfield House D51_D03_S16465_HighfieldHouse_V223160_220405_Stage4.doc Version 1.30 Page 19 Files for new staff were examined and these contained information as required by Schedule 4 apart from evidence of identification. This must be obtained. Photographs are being requested for all staff so that they can be issued with an ID card. Copies of these will also be kept on file. It was evident that robust recruitment and selection procedures are in place. Staff confirmed that after induction there is a training programme in place for NVQ Awards in Care, refresher training and training specific to the needs of people living at the home. Staff said that they had just completed a course in Mental Health awareness and Autism/Aspergers Syndrome. Supervision schedules are kept indicating that they are being arranged every six weeks. The manager said that he has been monitoring staff being supervised with team leaders. Staff said that they are receiving regular supervision sessions and attend staff meetings on a monthly basis. Agendas are displayed in the office and minutes produced for those staff who cannot attend staff meetings. Staff said they make a commitment to attend at least nine staff meetings each year. Highfield House D51_D03_S16465_HighfieldHouse_V223160_220405_Stage4.doc Version 1.30 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38 and 42. The registered manager has a clear developmental plan for the home that promotes the rights and best interests of people living there. Systems are in place ensuring that the home provides an environment promoting the welfare and safety of people. EVIDENCE: Staff spoke positively about the registered manager, saying that he is accessible and is promoting good communication between staff. Staff said that he would take action against poor practice. There is an improvement in the quality of recording and systems in the home; the registered manager has developed these. He is completing a Registered Managers Award at Level 4 and has become a trainer in Positive Response accredited with BILD. Environmental and fire risk assessments are in place and being reviewed. COSHH data sheets are kept for hazardous products that are stored securely. Fridge and freezer temperatures are recorded. Opened food in fridges was labelled with the date of opening. Temperatures of cooked meals are being Highfield House D51_D03_S16465_HighfieldHouse_V223160_220405_Stage4.doc Version 1.30 Page 21 taken and recorded. A member of staff is being trained in health and safety and will be responsible for monitoring key health and safety issues. Highfield House D51_D03_S16465_HighfieldHouse_V223160_220405_Stage4.doc Version 1.30 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 x 3 2 x 2 Standard No 11 12 13 14 15 16 17 x x 2 3 x 3 3 Standard No 31 32 33 34 35 36 Score x 3 x 2 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Highfield House Score 3 2 x x Standard No 37 38 39 40 41 42 43 Score 3 3 x x x 3 x D51_D03_S16465_HighfieldHouse_V223160_220405_Stage4.doc Version 1.30 Page 23 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. 2. 3. Standard 6 9 13 Regulation 15(2) 13(4) 16(2)(m) (n) Timescale for action Care plans must be reviewed 31 May regularly. 2005 Risk assessments for SW must 31 May be amended to reflect changes in 2005 need. The registered person must 31 July review the transport systems 2005 available to the home and ensure that it meets the needs of service users. The new service user must be 25 May referred to the CLDT. 2005 Alternative storage 31 May arrangements must be made for 2005 the bicycles. A paper towel dispenser must be 31 May provided near the hand wash 2005 basin in the kitchen. Evidence of staff identity must 31 May be kept on their files. 2005 Requirement 4. 5. 6. 7. 19 28 30 34 13(1)(b) 23(a)(m) 13(3) 17(2) Sch 4.6(b) 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. Refer to Standard 18(1)(c) Good Practice Recommendations Staff should attend training in the Protection of Vulnerable D51_D03_S16465_HighfieldHouse_V223160_220405_Stage4.doc Version 1.30 Page 24 Highfield House Adults. Highfield House D51_D03_S16465_HighfieldHouse_V223160_220405_Stage4.doc Version 1.30 Page 25 Commission for Social Care Inspection 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester GL3 4AB 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 D51_D03_S16465_HighfieldHouse_V223160_220405_Stage4.doc Version 1.30 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!