Inspection on 26/04/06 for Highfield House

This inspection was carried out on 26th April 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Highfield House 24/01/09

Highfield House 25/02/08

Highfield House 15/12/05

Highfield House 22/04/05

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 Ms Lynne Bennett Unannounced Inspection 26th April 2006 10:30 Highfield House DS0000016465.V289232.R01.S.doc Version 5.1 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 DS0000016465.V289232.R01.S.doc Version 5.1 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 Adults 18-65. 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 DS0000016465.V289232.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Highfield House Address London Road Stroud Glos GL5 2AJ 01453 758618 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) Stroud Care Homes Limited Mr David Donald Harley Care Home 7 Category(ies) of Learning disability (7), Mental disorder, registration, with number excluding learning disability or dementia (3) of places Highfield House DS0000016465.V289232.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th December 2005 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 service including three named people with a mental health need. The home is situated close to the centre of Stroud and residents are able to access public transport easily. They also have access to an estate car. 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. People living there have single rooms and access to two large communal lounges and a kitchen/diner. There are substantial gardens which are tiered to the rear of the home. They attend a local day centre, a nearby college and work experience placements. Fees range from £1,100 to £2,200. Highfield House DS0000016465.V289232.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection took place in April 2006, including a site visit to the home on April 26th starting at 10.30 and finishing at 17.30. Discussions were held with six people living at the home, the registered manager and four staff. The care for three people was case tracked and this involved talking to them about the care they receive, reading their files, talking to staff about how their needs are met and observing them during the site visit. Person centred plans, service users’ files, staff records, health and safety documents and quality assurance audits were examined. A pre inspection questionnaire had been returned prior to the inspection. Regulation 26 and Regulation 37 records supplied to the Commission also contributed towards the inspection. Comment cards were received from three people living at the home and three relatives. Feedback was received from other professionals involved in the care of people living at Highfield House including a visiting psychologist. What the service does well: What has improved since the last inspection? The storage and filing systems for service users’ files and other information have been improved. Highfield House DS0000016465.V289232.R01.S.doc Version 5.1 Page 6 Most of the staff team are registered for NVQ Awards in Care. One person is nearing completion of their award. A new member of staff said there is an expectation that once the induction and foundation training is completed then staff will register to complete a NVQ Award in Care. 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 DS0000016465.V289232.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Highfield House DS0000016465.V289232.R01.S.doc Version 5.1 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 the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s Statement of Purpose and Service User Guide give prospective people moving into the home details of the services the home provides and a series of visits enables them to make an informed choice about whether they wish to live there. EVIDENCE: Stroud Care Homes has a comprehensive and robust admissions policy and procedure. This includes obtaining a full assessment of need from the placing authority and any other professionals involved in the care of the prospective service user. They complete their own assessment that includes visits to the person at their current placement and visits to Highfield House. Documentation for two people who moved into the home last year was inspected at the last inspection and found to be satisfactory. They have both had an initial review of their placement at the home with relatives and representatives from their placing authority. There are currently no vacancies at the home. Some statements of terms and conditions have been reviewed and others are being completed. This requirement will therefore be repeated. Highfield House DS0000016465.V289232.R01.S.doc Version 5.1 Page 9 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 the following standard(s): 6,7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care planning in the home is generally good promoting the development of skills and independence. Risk assessments encourage and support people living at the home to challenge and deal with problem areas in their lives. Good communication systems in the home enable staff to support people living there to make decisions and choices about their lifestyle. EVIDENCE: A person centred planning approach is used in the home with evidence of the involvement of people living there. One person said they had just had a meeting with their family, advocate and care manager. Records on their file indicated that they had been involved in the preparation for this meeting with their key worker identifying their wishes and needs. Full records of these meetings are kept on their files. People living at the home sign their care plans and risk assessments. Staff confirmed that they have regular planning time to monitor and review care plans and risk assessments. They initial and record any changes to these documents on a monthly basis. They also produce a monthly summary. These were all in place on the files examined. Highfield House DS0000016465.V289232.R01.S.doc Version 5.1 Page 10 Staff are also asked to sign all care plans to indicate that they have read them. This is good practice. Reactive and management strategies are in place. The plans examined are being regularly reviewed and discussed with care managers. The signature of care managers on several documents verified this. Staff spoken with have a good understanding of the needs of the people they support. They acknowledge that consistency is important as well as the training they receive in Positive Response. Daily notes refer frequently to the use of de-escalation and diversion. Staff were observed supporting a person during the site visit using these techniques effectively. The registered manager said that he is very aware that it is important to ensure the right skill mix and gender of staff when drawing up the rota. This was evident on the rotas and on the day of the site visit. There are a number of restrictions in place at the home. The front door has always had a security keypad. There is now an additional mortise lock in place with a break glass nearby with the key. The reasons for this are to ensure the safety of a person living at the home who cannot access the community without supervision of staff and who is able to access the keypad. Since the last inspection the registered manager has consulted with the fire service who have agreed that this is satisfactory. A new fire risk assessment is being put in place. During the inspection staff frequently had to locate the door key from a member of staff to open the front door to people wishing to gain entry or people wishing to go out. Consideration should be given to finding a more appropriate security system for the front door. Should the person move from Highfield House it would be the expectation of the Commission that this lock is no longer used. Restrictions are recorded in care plans and risk assessments. On one file examined there was evidence that this has been done in a multi disciplinary forum. This is good practice. Staff clarified the use of restrictions such as locking the kitchen at night, a door alarm and monitoring the use of a mobile phone and computer with Internet access. Where restrictions are in place there was evidence on the files examined that people living at the home have signed their agreement to these being in their best interests. People were observed during the site visit being supported to make choices and decisions about their day, what they wished to do and where they wanted to spend their time. Daily diaries, communication books and staff handovers provide staff with the information they need to provide consistency and the assistance that may be needed to meet these lifestyle choices. People living at the home indicated in discussion and in their surveys that they are happy with the support they receive from staff. Risk assessments are in place that have developed from hazards identified in care plans. These are regularly monitored and reviewed. It is suggested that Highfield House DS0000016465.V289232.R01.S.doc Version 5.1 Page 11 some of the risk assessments developed in 2003 are revisited in light of improvements in the risk assessment process in the home. The content of some of these risk assessments is not as thorough and clear as more recent assessments. Highfield House DS0000016465.V289232.R01.S.doc Version 5.1 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 the following standard(s): 12,13,15,16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home have access to a range of local community facilities and activities providing opportunities for them to be involved in their local community and lead active lifestyles. Contact with family and friends is encouraged and supported. Staff support people living at the home to respect the rights and responsibilities of others by creating an environment that encourages people to express their needs and feelings. People living at the home are encouraged to maintain a healthy diet by giving them informed choice about the options available. EVIDENCE: Each person has an activity schedule that they draw up with their key worker. One person living at the home said that they are really enjoying their ‘new planner’. Staff indicated that these schedules are flexible according to the Highfield House DS0000016465.V289232.R01.S.doc Version 5.1 Page 13 needs and wishes of people living at the home. Daily notes indicate when an activity has been offered and refused. People living at the home described the activities and opportunities open to them. These include going to a local college and Smartworks where they are involved in field studies growing organic vegetables. On the day of the site visit one person went to the local college for a cookery class. They returned home with a fresh fruit flan saying that they really enjoy the class and are hoping to join a drama class. Another person has work experience at riding stables for which they are paid. Other people said they enjoy going swimming, playing golf, using the leisure centre and going for drives or walks. Several people went out to the local supermarket to help buy food on the day of the site visit. Others regularly use shops, pubs and cafes in Stroud. One person was looking forward to going out to the pub that evening. At previous inspections transport arrangements have caused concern. This was mostly due to the unreliability of the vehicle provided for the home. The registered provider has changed the arrangements for the maintenance and breakdown cover for the car. This appears to be satisfactory. An estate car is provided for their use but they also walk into the town and use local buses and the train. There is sufficient communal space for people living at the home to entertain friends or family. Feedback from relatives indicates that they are always made to feel welcome when they visit the home. People living at the home are also supported to visit their family with staff assistance if required. One person was recently supported to visit family in Weymouth. Daily diaries keep a record of contact with family and friends. People were observed during the site visit completing household tasks such as washing up, cleaning and helping with the gardening. People living at the home said that they have a rota for helping with household chores. Staff support was discussed at the handover for those people requiring assistance to complete these tasks. People living at the home have regular house meetings that are recorded. They receive feedback from the registered manager on any issues raised, although two people felt this could be done in a more formal manner (See Standard 22). Staff were observed enabling people living at the home to make decisions about activities of daily living. Communication between them and between the staff was positive promoting their rights and responsibilities. People living at the home described how they each choose a meal for the weekly menu that they are then expected to help prepare. Cookery books and recipes enable people to make an informed choice. Staff said that several people are becoming competent cooks. Menus are displayed in the kitchen. Highfield House DS0000016465.V289232.R01.S.doc Version 5.1 Page 14 On the day of the site visit lunch consisted of salad with cheese or chicken or sandwiches. People appeared to enjoy their lunch and commented that the food ‘is good here’. The evening meal was pork chops with potatoes and vegetables. Staff said that cakes are usually made at weekends and deserts are available if required. The house rules indicate that people living at the home must buy their own snacks. People living there and staff indicated that in reality this referred to sweets or treats. Fresh fruit, crisps and toast with an assortment of spreads were available during the day of the site visit and people were observed helping themselves to drinks. The kitchen is locked overnight to prevent people who may be at risk of self-harm accessing equipment or scalding themselves with hot water. This restriction is well documented. Several people have tea/coffee making facilities in their rooms so that they can have drinks during the night. The registered manager and staff indicated that the budget was sufficient to meet the needs of the household. Highfield House DS0000016465.V289232.R01.S.doc Version 5.1 Page 15 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 the following standard(s): 18,19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The way in which the people living at the home would like to be supported is clearly recorded and managed enabling staff to meet their personal care needs. People living at the home have access to a range of healthcare professionals making it possible to meet their physical and emotional health needs. Systems for the administration and control of medication are satisfactory although there is room for improvement to ensure that people living at the home are not put at risk. EVIDENCE: People living at the home said that they have key workers and one person has an advocate. Their routines were observed as being flexible and tailored to meeting individual needs. One person likes to sleep during the day and stays awake late at night. Staff respect this lifestyle choice whilst also making sure that they have opportunities for staff support to go out when they need it. Another person struggles with anxieties about future appointments. Staff give them ‘laminated sleep cards’which they use as a way of counting down to the date thereby helping them to manage their concerns. During the site visit the Highfield House DS0000016465.V289232.R01.S.doc Version 5.1 Page 16 person said this helped them and staff were observed planning to put this system into use. People are registered with a range of healthcare professionals and have access to the local Community Learning Disability Team. Full and comprehensive records are kept of appointments and the outcomes of appointments. This is good practice. Concerns were raised by members of the Community Learning Disability Team about a new person who had moved into the home from another placing authority. Arrangements had not been made with them prior to the move to Highfield House to provide a seamless service. As a result this person continues to receive support from their placing authority. Stroud Care Homes employ a counsellor to provide one to one counselling with people living at the home. Appointments were held on the day of the site visit. People living at the home said they look forward to these sessions. The counsellor said that the ‘staff team are thoughtful and helpful, following through any concerns.’ She also said that there is a good balance between confidentiality and encouraging open communication with people at the home and the staff team. The home has good systems in place for the administration of medication. Staff attend training in the safe handling of medication and the monitored dosage system. They are also assessed internally on an annual basis. This is good practice. The registered manager stated that they would be obtaining a recent copy of the British National Formula. Medication administration records were mostly satisfactory. Stock records are maintained for ‘as necessary’ medication. Staff need to ensure that handwritten entries are signed and should be countersigned by a colleague. The section on allergies should be completed even if to indicate there are none. The homely remedies list was put in place in 2003. This should be reviewed. Highfield House DS0000016465.V289232.R01.S.doc Version 5.1 Page 17 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 the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home feel listened to. An open atmosphere encourages them to voice concerns and make complaints. There are arrangements in place to protect people living at the home from the possible risk of harm and abuse. EVIDENCE: The complaints policy and procedure is available to all people living at the home with information about contacting the Commission for Social Care Inspection. The registered manager had received one complaint in the last twelve months from a person living at the home. This was dealt with and the outcome recorded on the person’s file. Concerns highlighted from the monthly surveys issued to people living at the home are dealt with in the same way. Letters from the registered manager to people raising the concerns were on their file with intended actions. Records of house meeting minutes also record concerns and action taken as a result. Concerns about the cleanliness of the environment, a broken toilet seat and the central heating have all been actioned and people living at the home informed about the action to be taken. People living at the home also have access to the Responsible Individual for the organisation during Regulation 26 visits when they will express any concerns they may have. A copy of the record of these visits is forwarded to the Commission each month. Feedback from relatives indicated that they are unaware of the complaints policy and procedure, although it is clearly displayed in the home. Highfield House DS0000016465.V289232.R01.S.doc Version 5.1 Page 18 Staff confirmed that they have recently attended training in the safeguarding of adults. Discussions with staff confirmed their understanding of their responsibilities in identifying, challenging and reporting suspected abuse. It is recommended that staff also access the ‘Alerters Guide’ training provided by Gloucestershire Social Services. Staff also attend Positive Response Training delivered by two registered managers of the organisation who are qualified trainers accredited with BILD. The registered manager said that physical intervention would only be used as a last resort. This was confirmed by discussions with staff and observation of their practice during the site visit. Robust financial records are kept for people living at the home. Receipts are numbered and cross-referenced with financial records that are checked and counterchecked daily. People have bank accounts and savings accounts. Bank statements are checked on a regular basis. Highfield House DS0000016465.V289232.R01.S.doc Version 5.1 Page 19 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 the following standard(s): 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Planned refurbishments and improvements to the home will provide people living there with a safe environment and a good standard of accommodation. EVIDENCE: People living at the home live in a comfortable, homely environment with access to spacious communal spaces. The kitchen/dining room is the focal point of the home but there was more noticeable use of the two lounges than had been seen at previous inspections. People were also enjoying the warm weather using the lower garden. There have been ongoing problems with the central heating system over the winter. There are plans for all people living at the home to go on holidays during July when extensive work will begin to replace the central heating system and to refurbish the ground floor toilet and second floor shower room. Parts of the house are in need of redecoration but this will all be completed at this time. Highfield House DS0000016465.V289232.R01.S.doc Version 5.1 Page 20 At the time of the site visit the home was clean and tidy. Personal protective equipment is provided for staff. Mops and buckets are colour coded. Water temperatures are monitored on a regular basis. Highfield House DS0000016465.V289232.R01.S.doc Version 5.1 Page 21 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. New staff with a range of life experiences complement an experienced and qualified staff team. Robust recruitment and selection procedures are in place protecting the people living in the home from possible abuse. The provision of training for staff is of a high quality providing a staff team who have the necessary qualifications to support people living at the home. EVIDENCE: New staff at the home spoke with enthusiasm and respect about the experienced staff team working at Highfield House. This was also reflected in comment cards from relatives referring to a ‘mature and experienced staff team’ and from visiting professionals. One member of staff has a NVQ Award. One member of staff is completing the induction and foundation award and all others are registered for their NVQ Awards. During the site visit a NVQ Assessor spent time with one of the members of staff who has nearly completed their award. Recruitment and selection records were examined for three new staff members. All information as required under Standard 19 and Schedule 2 was in place. There was evidence that where there are gaps in employment history Highfield House DS0000016465.V289232.R01.S.doc Version 5.1 Page 22 these are being obtained and references obtained from previous employers in care. This is commendable. The registered manager also said that people living at the home are involved in the interviewing of new members of staff. This is good practice. The registered manager must check whether the advocate and the psychologist visiting the home have CRB checks in place. Stroud Care Homes has a training schedule in place that provides an in house induction for all new staff followed by the induction and foundation award and then NVQ Awards in Care. Mandatory training is provided and refreshers put in place for all staff. A mixture of training providers are used including the local college, private training companies and open learning as well as some in house training. Each person has a training portfolio and copies of certificates are retained. One new member of staff with considerable experience in the care field spoke positively about the training programme and courses that had been made available to them. Their records confirmed attendance at a range of training events. Specialist training in mental health issues is provided. A range of booklets are being developed by senior staff providing access to information about specific conditions and issues affecting people living at the home. This is commendable. Highfield House DS0000016465.V289232.R01.S.doc Version 5.1 Page 23 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There has been considerable improvement in the quality of systems and records in place, enriching the lives of the people living at the home. They are benefiting from a consistent management approach to their care. Systems are in place ensuring that the home provides an environment promoting the welfare and safety of people. The home’s quality assurance programme involves people staying at the home in the review of services being provided. EVIDENCE: The registered manager is a qualified nurse and is completing the Registered Managers Award. He is a trainer of Positive Response training accredited with BILD. In order to maintain this accreditation he completes regular refresher training. Certificates of registration and insurance are displayed in the home. The registered manager is developing robust systems and processes within the home and monitoring the performance of staff through supervisions, staff Highfield House DS0000016465.V289232.R01.S.doc Version 5.1 Page 24 meetings and auditing records. He has consistently worked with the Commission to improve standards within the home. This was confirmed during the inspection. Quality assurance systems are in place which include the Regulation 26 visits by the Responsible individual. These involve people living at the home and staff. The Commission is supplied with a record of these visits. Each month people living at the home complete a survey. Copies were examined for April 2006 which included statements such as ‘I like the staff’, ‘I am happy’ and ‘the support I get is good’. Feedback is also asked for from visiting professionals. Two surveys were examined. Health and safety systems are in place to monitor the safety of fire equipment, electrical equipment, water temperatures and fridge/freezer temperatures. Staff complete mandatory training and refresher training scheduled when needed. The pre-inspection questionaire indicated that all necessary annual checks have been completed. Records in the home confirmed this. Highfield House DS0000016465.V289232.R01.S.doc Version 5.1 Page 25 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 Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 x LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 3 X Highfield House DS0000016465.V289232.R01.S.doc Version 5.1 Page 26 Yes 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 YA5 Regulation 5 Requirement Ensure contracts are fully completed (Some contracts have been reviewed. Timescale of 28/02/06 not met) Handwritten entries on medication administration records must be signed. Criminal Record Bureau checks must be in place for an advocate and a psychologist visiting the home. Timescale for action 30/06/06 2. 3. YA20 YA34 13(2) 19(10) Sch 2.7 31/05/06 30/06/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard YA7 YA9 YA20 Good Practice Recommendations Review the security system for the front door. Review the content and guidance in some of the risk assessments developed in 2003. Handwritten entries on medication administration records should be countersigned. A copy of the BNF should be obtained. The homely remedies list should be reviewed. DS0000016465.V289232.R01.S.doc Version 5.1 Page 27 Highfield House 4. YA23 Staff should attend training provided by the local adult protection team. Highfield House DS0000016465.V289232.R01.S.doc Version 5.1 Page 28 Commission for Social Care Inspection Gloucester Office Unit 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. 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