CARE HOMES FOR OLDER PEOPLE
Highfield House 2 Huncote Road Stoney Stanton Leicestershire LE9 4DG Lead Inspector
Helen Abel Unannounced Inspection 25th July 2007 10:30 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 DS0000001755.V347066.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 DS0000001755.V347066.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Highfield House Address 2 Huncote Road Stoney Stanton Leicestershire LE9 4DG 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) 01455 274331 08701325604 clough@btopenworld.com Mr Howard Clough Mrs Christine Joy Clough Mrs Christine Joy Clough Care Home 3 Category(ies) of Old age, not falling within any other category registration, with number (3) of places Highfield House DS0000001755.V347066.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The registered persons may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission are within the following category: Old age, not falling within any other category - Code OP. The maximum number of service users who can be accommodated is 3. 20th December 2006 2. Date of last inspection Brief Description of the Service: Highfield House is a large detached building situated in the village of Stoney Stanton in South Leicestershire. It provides a service for up to three older people in spacious yet homely surroundings. The home has a comfortable lounge, which leads into the dining area. There is also a large conservatory. The furnishings and décor of the home are in keeping with the period of the building. There is a large well-maintained garden, which also contains an aviary. The home also has ample parking space to the front of the building. The Proprietors of the home have three dogs. All bedrooms are for single occupancy and one is located on the first floor, which is accessible via a stair lift. Bedrooms are spacious and well equipped with en-suite facilities (toilet and wash hand basin). The fees for 2006/07 are £320 to £379. A copy of the last published inspection report is available from reception. Highfield House DS0000001755.V347066.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The primary method of inspection used was ‘case tracking’ which involved selecting two residents and tracking the care they receive through review of their records, discussions with them and with the care staff, provider/manager and observations of care practices. A plan was made prior to the visit in which available information from the previous inspection report, service history, annual quality assurance was summarised. The inspection was positive indicating good outcomes for residents What the service does well: What has improved since the last inspection?
No requirements or recommendations were raised from the last inspection. The provider/manager has spent resources on providing an additional patio and gazebo for residents and their family to use on summer visits. Introducing a large feature fountain and temple within the grounds and improving the landscaping and planting, maintaining the drive surface. Several windows have been replaced with double glazing. Highfield House DS0000001755.V347066.R01.S.doc Version 5.2 Page 6 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 DS0000001755.V347066.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 DS0000001755.V347066.R01.S.doc Version 5.2 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 & 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents do not move to the home without having their needs assessed and knowing that they will be met. EVIDENCE: Currently there are only two residents in the home and both care plans were viewed for the purpose of this inspection. Care plans showed that all residents had been assessed prior to moving into the home and that this assessment then informs the care plan. A new resident is due to enter the home and has already been to visit. They have viewed their bedroom, toured the home, met other residents and staff,
Highfield House DS0000001755.V347066.R01.S.doc Version 5.2 Page 9 and received a Statement of Purpose/Contract. Prior to this visit relatives and the prospective resident had viewed the homes website. The inspection report is made available at reception in the home. Highfield House DS0000001755.V347066.R01.S.doc Version 5.2 Page 10 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 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff pay attention to meeting the health and care needs of residents, which help residents to feel well looked after. EVIDENCE: The two residents living in the home care plans were viewed for the purpose of this inspection. Each plan set out in detail what the residents needs were and how they were to be met. Each plan provided information regarding risks and how to minimise them. Each plan provided evidence that health care professionals were in contact with the residents for all their health care needs this meant that they regularly saw opticians, chiropodists and GPs. Daily records are held and include comprehensive information about how the individuals welfare. All plans are reviewed monthly ensuring that changing needs are identified and plans are amended to reflect this. The registered
Highfield House DS0000001755.V347066.R01.S.doc Version 5.2 Page 11 provider/manager is reminded to ensure a regular weighing programme continues with records held. Currently only trained staff administer medication with training supplied by the community pharmacist. The procedures are followed ensuring that residents receive their medication at the times they need and according to the prescription. Medication records were examined and were all in order ensuring residents health needs are protected. Residents told the Inspector:“It’s very good here. Can’t grumble”, “Staff are very good, very helpful” and “It’s as good as home here, even better”. Highfield House DS0000001755.V347066.R01.S.doc Version 5.2 Page 12 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): 12-15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are enabled to have a good lifestyle in the home which meets their needs and expectations. EVIDENCE: Residents were observed drinking hot drinks and biscuits in the morning and watching television. Both residents told the Inspector what they liked about their home:“ The meals are very good. I have had no complaints. I am asked what I want and choose what I like. When my family come they are offered refreshments. I enjoy going to the shops in the wheelchair” and “ There is enough food, good variety, we do have choice. I like the gravy. I have lemonade in my glass in my bedroom at night. Staff are very helpful” Residents have access to films on Sky or from a large collection of videos. Staff reported a resident would play dominoes, cards and snakes and ladders. Information about residents interests were on their care plans, including their spiritual needs, however residents spoken with generally preferred staying at
Highfield House DS0000001755.V347066.R01.S.doc Version 5.2 Page 13 home. Staff confirmed trips to the local shops in a wheelchair would only take place when the weather was warmer. Staff confirmed resident’s visitors come regularly and at any time, they are able to see them in their bedroom or lounge or conservatory. Residents confirmed they receive regular phone calls from relatives on the portable phone. The registered provider/manager confirmed relatives have access to protected passwords and can access the website and see current pictures of their relatives. Staff were observed cooking a chicken and broccoli morney and plum cobbler and custard with all fresh ingredients. Staff confirmed freshly cooked meat and fish dishes are prepared every day and appeared appetising and nutritious. There is a dining room overlooking the garden for residents to take their meals. There are three dogs in the home belonging to the registered provider/manager. A resident said, “The dogs are very patient. I love dogs” The new resident soon to live at the home has confirmed a liking for dogs. A grey parrot lives in the home and in the warmer weather sits outside in the garden in a gazebo for the residents to see and hear. An aviary is also situated at the rear of the garden. Highfield House DS0000001755.V347066.R01.S.doc Version 5.2 Page 14 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 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected by procedures and good staff awareness regarding complaints and safeguarding from harm. EVIDENCE: The Commission for Social Care Inspection (CSCI) has received no complaints about this service since the last inspection. Residents spoken with said that they would raise any concerns and felt confident they would be dealt with quickly. A copy of the complaints procedure is available in every bedroom. The registered provider/manager spoke of closely checking with new residents and relatives, over the settling in period to make sure everything is going well and to make any necessary changes. Information regarding local procedures on Safeguarding Adults are available in the office. The provider/manager is active in the Care Homes Association and is aware of his responsibilities in protecting residents from abuse. Highfield House DS0000001755.V347066.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 23 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a comfortable living environment. EVIDENCE: The home was well maintained. Residents spoken with said that they felt the home was clean and comfortable. The garden was very well maintained with mature trees and attractive border plants, and a private area with seating for residents to sit in the warmer weather. The main hallway displays black and white photographs of present and past residents and is an attractive feature. There is an upstairs room dedicated for the hairdresser’s fortnightly visits to attend to the residents. Highfield House DS0000001755.V347066.R01.S.doc Version 5.2 Page 16 Resident’s bedrooms were personalised with their possessions and items of furniture. Resident name plaques are displayed on bedroom doors. One resident’s bedroom had an odour. The laundry facilities are suitable to meet the needs of the residents. Highfield House DS0000001755.V347066.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from well trained staff who are able to meet their needs. EVIDENCE: Staff rotas confirmed staff hours exceed those recommended. This is good practice. The registered provider/manager is involved in providing care in the home supported by other staff. Staff were observed interacting with residents in a caring and kind manner. Training records show that staff are provided with up to date training and that the registered provider/manager keeps up to date with changes in care practice. One staff member holds a nursing qualification. The registered provider/manager first aid training needs to be updated. There are no new staff employed in the home since the last inspection. However recruitment records were still checked and meet all the required prerecruitment checks. Highfield House DS0000001755.V347066.R01.S.doc Version 5.2 Page 18 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 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from living in a well managed home. EVIDENCE: This is a small home and the registered provider/ manager is a husband and wife team. They are very experienced in running care homes and as previously mentioned are active in East Midlands Care. They are aware of the conditions associated with aging and provide guidance and information to staff. The provider/manager follows the East Midlands Care Quality Assurance Scheme and report being open to ways to develop the service. The provider/manager and staff make sure the home is run properly, keeping residents safe.
Highfield House DS0000001755.V347066.R01.S.doc Version 5.2 Page 19 Residents’ monies were stored appropriately and records showed what money had come in and what it had been spent on. The Inspector suggested an identified resident signs for transactions around their own money. This will help maintain the individual resident’s independence and autonomy, and minimise risk of financial abuse. Records were seen of staff training and mandatory training is completed at regular intervals. No accidents have been recorded since the last inspection. Information around death of residents has been sent to the Commission for Social Care Inspection (CSCI) in line with the required reporting procedures. Highfield House DS0000001755.V347066.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 2 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 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 x x x 3 x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Highfield House DS0000001755.V347066.R01.S.doc Version 5.2 Page 21 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. Standard Regulation Requirement Timescale for action 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 OP26 Good Practice Recommendations One resident’s bedroom presented with an odour. It is recommended regular cleaning of the carpet takes place to eliminate unwanted odours and provide a more pleasant environment. The registered provider/manager first aid training needs to be updated in order to provide the most current first aid to people living in the home. To further maintain the identified residents independence and autonomy, they could sign their own financial transactions for their money held by the home. This will protect the interest of the resident. 2 3 OP30 OP35 Highfield House DS0000001755.V347066.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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
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