Inspection on 23/09/08 for Highfield House Residential Home

This inspection was carried out on 23rd September 2008.

CSCI found this care home to be providing an Adequate service.

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 Residential Home 14/09/09

Highfield House Residential Home 27/03/08

Highfield House Residential Home 13/03/07

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 17/12/2008.

CARE HOMES FOR OLDER PEOPLE Highfield House Sycamore Terrace Haswell Co. Durham DH6 2AG Lead Inspector Andrea Goodall Key Unannounced Inspection 09:30 23 September 2008 rd 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 DS0000068092.V369200.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 DS0000068092.V369200.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Highfield House Address Sycamore Terrace Haswell Co. Durham DH6 2AG 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) 0191 5261450 0191 5261450 Susan Burns Marion Burns Manager post vacant Care Home 25 Category(ies) of Dementia - over 65 years of age (25), Old age, registration, with number not falling within any other category (25) of places Highfield House DS0000068092.V369200.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th March 2008 Brief Description of the Service: Highfield House is a care home that provides personal care and accommodation for up to 25 people who are over 65 years old. The home is registered to provide care for older people and older people with dementia. This home does not provide nursing care. The home has been operating for about 20 years. The current owners purchased the home about 2 years ago and have almost fully refurbished it. Highfield House is in a pleasant rural location on the outskirts of Haswell village. The home is close to the local communitys resources, including a shop, pubs, club, post office, and health centre. The ground floor accommodation has a large lounge and separate dining room, with good access to a patio and lawned gardens. The majority of bedrooms, toilets and bathrooms are also located on the ground floor. The first floor has a small number of bedrooms and an additional bathroom, with both lift and stair access. Bedrooms are mainly single occupancy with the exception of one double room (which is not currently occupied). Ten bedrooms have en-suite facilities. The weekly fees at the time of inspection were £390.00 to £411.00 depending on care needs. Highfield House DS0000068092.V369200.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. Before the visit: We looked at: • information we have received since the last visit on 27th March 2008 • how the service dealt with any complaints & concerns since the last visit • any changes to how the home is run • the provider’s view of how well they care for people The Visit: An unannounced visit was made on 23rd September 2008. During the visit we: • talked with people who use the service, relatives, staff, the manager & visitors • joined residents for a meal and looked at how staff support the people who live here • looked at information about the people who use the service and how well their needs are met • looked at other records which must be kept • checked that staff had the knowledge, skills and training to meet the needs of the people they care for • looked around parts of the building to make sure it was clean, safe & comfortable • checked what improvements had been made since the last visit We told the provider what we found. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations – but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Highfield House DS0000068092.V369200.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? There have been improvements to the way assessment records are completed. This means that the home can decide whether a new resident’s needs can be met. There have been improvements to the way care records are kept. These are better at showing staff what people need and how staff should support them. There are now more activities for people, and more chances for them to go out. The providers have made lots of improvements to the house. These include: new flooring, chairs and tables in the dining room; redecorated and upgraded toilets and bathrooms; and new beds and chairs in bedrooms. All windows to bedrooms have been replaced. All the ground floor bedrooms now have patio doors so that people can go out into the sheltered garden when they want. All staff have had lots of refresher training over the past few months. Highfield House DS0000068092.V369200.R01.S.doc Version 5.2 Page 7 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Highfield House DS0000068092.V369200.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 DS0000068092.V369200.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): 1, 2 and 3. (NMS 6 does not apply to this service.) People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. Assessments have improved but do not include all the care needs of prospective residents, so it cannot be fully assured that peoples’ needs can be met here. EVIDENCE: Highfield House has been open for around 20 years and is a well-known resource in the local community. Before they move in prospective service users, or their relatives, are given an information pack called a Service Users’ Guide that tells them about the service at the home. There is also a copy of the Service Users’ Guide in the hallway for people to look at. Highfield House DS0000068092.V369200.R01.S.doc Version 5.2 Page 10 At this time there are three people who live at the home who have significant visual impairments so cannot read the information pack. Currently, information about the home is not available in another format for these residents, so their diversity of need is not met in this way. Most of the people who live here are from the local area and chose the home because they were familiar with it. Some people already knew a few of the staff, and they felt that this made it easier for them to settle in. It also means that staff are familiar with the local community and the cultural needs of the people who come to live here. People receive a contract which outlines the fees that they pay and how their care is funded. Only one copy is kept and this is placed on the resident’s file so they or their relatives do not immediate access to it. The contracts are now out of date because of the change of management at the home and change of CSCI address. There have been improvements to the way assessment records are completed. These now show that the needs of prospective residents are assessed before they move in, so that the home can decide whether those needs can be met here. For the past 6 months the providers and senior staff have carried out assessments of all the residents, as well as prospective new residents. Care managers of the Social Services Department also carry out assessments of people needs before they move here. This information is also provided to the home. The home is registered to provide care for people with dementia in all 25 places at the home. At this time there are around 14 people living here with some degree of dementia care needs. However the assessment records do not include this area of need. This means that their dementia care needs are not being assessed and followed through onto a plan of care. Highfield House DS0000068092.V369200.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): 7, 8, 9 and 10. People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. Care records are improving but there are still gaps so the home does not sufficiently demonstrate that peoples’ care needs are fully met. EVIDENCE: Care plans are records that are used by all care services to show what sort of help each person needs and how staff will provide that care. Since the last inspection the providers and senior staff have worked very hard to improve the quality of care plans so that there is much better information for staff about how to support people in the right way. In a sample of care plans examined all were up to date and most showed individual people’s needs, and how these might be supported. However none of Highfield House DS0000068092.V369200.R01.S.doc Version 5.2 Page 12 the people who have dementia had this need included in their care plans, even though this may be their main reason for coming to live at this home. It was clear that many staff have worked here for some years. All staff who took part in this inspection were able to describe people’s individual dementia care needs in a respectful and knowledgeable way. However this good knowledge has not been included in the care plans, so new staff would not know how to support people with their specific dementia care needs, for example memory loss or challenging behaviour. One resident often tries to leave the building without supervision which would place that person at risk. The home has taken steps to reduce the risk and also uses diversion in a respectful and sensitive way to help the person. However there is no risk assessment or risk management plan in place to show why and how the home manages this situation. Care records do show that the home makes sure that people have good access to health care professionals whenever they need this. For example some people have input from district nurses, physiotherapy and psychiatric services. Discussions with relatives showed that they are kept well-informed of any change in health needs. One visitor said, “They always let me know if she has been unwell and they always contact the doctor.” At this time the home provides good care for one person who needs lots of support to eat meals, and to keep changing position throughout the day so that their skin does not become damaged. The home has made sure that the person has all the right health care advice and input (e.g. dietician) and has made sure they have the right equipment such as special mattresses. However none of these good care practices were recorded in the person’s care plan even though the home has taken the right action to help this person remain as healthy as possible. The home would support people to manage their own medication if they were assessed as capable and wanted to do so. At this time no-one looks after their own medication so the senior staff are responsible for this. They have had suitable training in ‘safe handling of medication’. The home receives people’s medication from a pharmacist in easy- -to-use blister packs. Medication is stored securely and administered in the correct way. Many people are prescribed painkillers for ‘as and when’ they require them. Some people are unable to say whether they need painkillers due to their dementia care needs, so staff use their good knowledge of those peoples’ individual behaviours and facial expressions to check whether they require the medication. However this knowledge is not currently recorded in the medication records so there are no guidelines for all staff to know when people might want this medication. Highfield House DS0000068092.V369200.R01.S.doc Version 5.2 Page 13 Throughout the inspection visits there were many instances of good practice where staff supported residents in a sensitive and encouraging way. For example, sitting with individual residents to provide support at mealtimes, and helping people with their mobility at the resident’s own pace. There are clearly very good relationships between residents and staff. One resident said “I couldn’t be in a nicer place. I didn’t want to give up my own home, bit I’m well-looked after here – and there’s always someone there to help me if I need it.” Another resident said, “I feel as if I’m really cared for here - they look after me very well.” Visitors and relatives also described the staff as “friendly”, “helpful” and “approachable”. Residents are supported with their personal appearance, so that they are smartly and appropriately dressed to their individual taste. A weekly hairdressing service is available at the home, which several residents use. Residents can use their own bedrooms for privacy whenever they wish. There are easy-to-use locks on the inside of most bedroom doors if residents do not wish to be disturbed. Highfield House DS0000068092.V369200.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 – 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. Residents have good opportunities to make choices about their own daily routines so that they lead a lifestyle that matches their social and cultural needs. EVIDENCE: People are encouraged and supported to choose their own daily routines. Residents described how they lead their own lifestyle, such as going to bed when they want, choosing where to dine, and spending time in the privacy of their own rooms. One resident said, “I still do what I can for myself, but staff are always there to help me with what I can’t do.” Many residents commented very positively on the activities and entertainment that they enjoy at the home. Every fortnight an activities co-ordinator spends the day engaging people in activities at the home, and care staff also provide activities on a daily basis such as games and quizzes. Also every fortnight there is a ‘Motivator’ who visits the home to provide gentle exercises for the Highfield House DS0000068092.V369200.R01.S.doc Version 5.2 Page 15 people who live here. Many residents also talked about the singers and entertainers who had recently performed for them at the home. Residents do have some contact with the local community either through walks out to the local shop with staff or going out with relatives. Around six people go out every week to a tea dance at the local community centre where they enjoy the music and socialising with other people from the local area. Many residents and their visitors spoke proudly of a recent Garden Fair the home had arranged where the local community was invited to help them raise money for a heart charity. Visitors said they are made to feel very welcome in the home and described the atmosphere as “warm and cosy”. One relative said, “I’ve put my name down for a room here for myself!” Residents described the quality of catering here as “very good”, “we always have lovely meals”, and “we’ve got lovely cooks.” Residents are asked what they would like from the two main choices a couple of hours before each meal so that they can discuss their choice with staff. The choices of meals and drinks are also displayed on a whiteboard in the dining room for people to see. It is good practice that the home makes a vegetarian option for one resident, and that other diets are catered for, including diabetic and softened meals. The inspector joined residents for lunch, which was very tasty and appealing. The dining room is bright and cheerful, and tables were well presented with tablecloths, napkins and condiments. Some people prefer to dine in their own rooms and this is respected. A small number of people need to be physically assisted to eat their meal, and this was carried out in an engaging way by individual staff. Highfield House DS0000068092.V369200.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): 16 and 18. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People feel they have clear information so they would know how to make a complaint. The staff team have had suitable training so they know how to protect residents from abuse. EVIDENCE: The complaints procedure is in the Service Users Guide information pack, which is also available the hallway. All residents and their relatives who took part in discussions said that they would feel very comfortable about talking to the providers or staff if they had any “grumbles” or concerns about the service. It was clear from observations during this visit that the providers make themselves available to any visitors to the home. People felt that the providers are very approachable and were confident that they would deal with any matters they raised. For example, one relative said, “The owners are very nice. I feel I can talk to them about anything.” There have been no complaints received by the home or by CSCI since the last inspection. Highfield House DS0000068092.V369200.R01.S.doc Version 5.2 Page 17 The home endorses the local authority Safeguarding Adults protocols, and a copy of the process and a chart showing how to make alerts to the Social Services Department is in the main office for all staff to see. All staff have had recently had certificated training in the protection of vulnerable adults. Highfield House DS0000068092.V369200.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): 19, 24 and 26 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The home is clean, warm, comfortable and safe and the continuing decorative improvements means that people live in well maintained accommodation. EVIDENCE: Since the providers took over this home about two years ago they have made significant improvements to the standard of decoration and to the maintenance of the building. These improvements have continued since the last inspection. All bedroom have had replacement windows fitted. The bedrooms on the ground floor have also been provided with uvpc patio doors so that residents have easy access to the sheltered, secure gardens at the back of the house. Highfield House DS0000068092.V369200.R01.S.doc Version 5.2 Page 19 All bedrooms have been provided with new beds and armchairs. The flooring in the dining room has been replaced with attractive, good quality, non-slip laminate flooring, and new chairs and tables have been provided. A further ensuite has been built in another bedroom so there are now 10 rooms with these private facilities. The providers also have plans for further improvements including new flooring to the main lounge and upgrading toilets and bathrooms. It is evident that the providers have invested a lot of money, time and effort into improving the accommodation in a way that values and respects the people who live here. One relative said, “They have really smartened the place up. The bedrooms are lovely and have good views of the garden.” The home has one double room which is currently unoccupied. In discussions it was clear that this room would only be used by people who actively wanted to share a room, for example a married couple. The providers also confirmed that another room would be made available for them to use as a private lounge. All but two of the bedrooms have thumb-turn locks on the inside of the door so that people can choose to be private when using their rooms. People are also offered a key on admission, if their capabilities allow, so that they can lock their door when out of the room. Currently one resident has a key to their bedroom. Bedrooms are decorated to a good standard and many have been highly personalised by the people who live here. One resident said, “It’s very cosy here. We’re warm and comfortable.” There is a good range of toilets and bathrooms for people to use, particularly in the central part of the home. There are laminated signs and pictures to help people find their way to toilets which is helpful for people with memory loss. In several toilets there are boxes of protective gloves and continence pads on display, which does not support the dignity of the people who live here. The standard of cleanliness and odour control is very good. Residents and their visitors described the home as “always spotlessly clean.” The home has a wellequipped laundry room, but there are gaps to the flooring in this room. The providers confirmed that work to replace the flooring and provide a new washbasin has been arranged for the near future. Highfield House DS0000068092.V369200.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): 27, 28, 29 and 30. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The home provides competent, well-trained, suitable staff to ensure that the people who live here are protected from harm or abuse and that their needs are met. EVIDENCE: The staff team comprises a deputy manager, six senior care staff, eight care staff, two catering staff, one housekeeping staff, a maintenance staff and a part-time administrator. (At this time the providers also carry out a number of roles within the home and both have experience in care services.) On the day of this visit there were 18 people living here. The staff rota allows for up to 3 care staff throughout the day and 2 staff at night. The providers felt that these are satisfactory levels to meet the number and needs of the current residents. At this time care staff also carry out laundry tasks and also heat and serve the teatime meal. In spite of these extra duties, there was good staff presence in the lounge throughout the day and evening, and good staff support for residents at mealtimes. All catering, care and housekeeping staff have up-todate training in Food Hygiene and Infection Control. Highfield House DS0000068092.V369200.R01.S.doc Version 5.2 Page 21 Only one staff (the manager) has left since the last inspection and no new staff have been appointed. The manager’s post is advertised and candidates are to be interviewed in the near future. The home’s recruitment policies and application forms show that the providers are equal opportunities employers. In discussions and in their written procedures the providers are very clear about the need to follow robust recruitment practices such as taking up all clearances and checks before any new staff are employed. Six staff have achieved a care qualification called NVQ 2 and four more care staff are currently training towards this. Three senior staff have achieved NVQ 3 and two more staff are training towards this. This is very good practice as it means that, in the near future, 100 of the care staff team will have a professional care qualification. Training records and discussions with staff show that since the last inspection the providers have ensured that all staff have good training opportunities. For example all staff have had updated health and safety practices such as moving & assisting and emergency first aid. The home has good arrangements with two training agencies to provide specific training to groups of staff at the home. This means that staff can learn as a team and do not have to travel outside the area for their training. The home is registered to provide all its places to people with dementia care needs. At this time all care staff have attended a one day Dementia Awareness course. Some staff have also previously had more in-depth training in dementia care through a local college. Highfield House DS0000068092.V369200.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): 31, 33, 35 and 38. People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. There have been improvements to the way that the home is run but fire safety practices are not sufficient to ensure that residents are fully protected. EVIDENCE: Since the last inspection the manager has left the home. Over the past few months the two providers have taken responsibility for the day to day management of the home whilst advertising for a new manager. Both providers have many years experience of working in care services for older people, and one provider was previously the registered manager of a care Highfield House DS0000068092.V369200.R01.S.doc Version 5.2 Page 23 service for several years. There have been many improvements to the service since the last inspection and there are more improvements planned. Residents have opportunities to comment on the service, either individually or at Residents’ Meetings. It was clear that residents and relatives find the providers very approachable. The home has also used questionnaires to gain the views of relatives and there are plans to use questionnaires with care professionals. In this way the home aims to continuously review the service it provides. The home will support people to safely store small amounts of personal monies, if they request. Peoples’ monies are kept in individual wallets in a secure place, and transactions are clearly recorded and signed by two staff. However in a small sample of monies checked there was more money in the wallets than shown on the records. This had happened because monies had been deposited without being recorded immediately. All staff have had certificated fire safety training and all fire safety checks are carried out. However there has been no in-house fire instruction or drills so staff and residents have not had the opportunity to practice what they must do in the event of a fire. The maintenance staff carries out routine health & safety checks in the building, and overall the building was safe. However water temperature checks show that only a sample of baths or showers are checked each time. In this way it cannot always be ensured that all the baths meet the safe temperature of around 43°C. Highfield House DS0000068092.V369200.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 2 3 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 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 3 3 3 2 X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 2 x X 2 Highfield House DS0000068092.V369200.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP3 Regulation 14 (1) Requirement Assessments must include details of a prospective resident’s mental health or dementia care needs. Timescale for action 01/12/08 2. OP7 15(1) This is to ensure that the home is fully aware of that person’s needs before deciding whether those needs can be met at Highfield House. Care plans must set out the 01/12/08 specific dementia care needs of residents and must include detailed guidance for staff in how to support those needs. This is to guide staff in how to support people with their dementia care needs in a consistent, planned way. Where nutrition and skin integrity are primary care needs there must be specific care plans that set out those needs. There must be detailed guidance for staff in how to support those needs including a clear, coordinated approach involving care staff, catering staff and health care professionals. DS0000068092.V369200.R01.S.doc 3. OP8 15 (1) 01/12/08 Highfield House Version 5.2 Page 26 Monthly evaluations must report a meaningful assessment of the progress or change in need, and any action taken. This is to show how staff support people with their significant needs in a consistent, planned way, and to ensure that any changes in need are identified and acted upon. Staff must have in-house fire instruction and practice drills at regular intervals. This is to ensure that staff and residents are familiar with what to do in the event of a fire. 4. OP38 13(4)c & 18(1)c 01/12/08 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 OP1 Good Practice Recommendations Consideration should be given to providing information (such as the service users’ guide and complaints procedure) in an accessible format for residents who have visual impairments or reading difficulties, for example on cassette or CD. It would be better if contracts were updated to show the change in management at the home. Also consideration could be given to providing each person (or their representative) with their own copy of the contract. It would be better if each care need was set out on a separate care plan sheet, so that each specific need could be individually monitored for changes and progress. There should be a risk management plan to show what actions the home takes to support the person who attempts to leave the home. The nutritional assessments should include a code for the scores so that staff know what the outcome is of the assessment. DS0000068092.V369200.R01.S.doc Version 5.2 Page 27 2. OP2 3. 4. 5. OP7 OP7 OP8 Highfield House 6. OP9 7. OP21 8. 9. OP24 OP30 10. 11. OP35 OP38 There should be guidance for staff in the medication records about the signs individual people may show to indicate whether that they require ‘as and when’ painkiller medication. Boxes of protective gloves and continence equipment should be stored discreetly in toilets and bathrooms to protect the dignity of the people who live here and to support control of infection. Door locks should be provided to the two bedrooms that are currently without these. Arrangements should be made for the remainder of care staff to have more in-depth training in dementia care to support their care of the increasing number of people with dementia who live here. Any monies deposited or withdrawn from residents’ personal allowances should be recorded immediately so that the records always tally with the amounts held. Water temperature checks should be carried out to all the baths and showers to make sure that they all maintain a safe temperature for body immersion of around 43°C. Highfield House DS0000068092.V369200.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 DS0000068092.V369200.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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