Inspection on 27/03/08 for Highfield House Residential Home

This inspection was carried out on 27th March 2008.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Highfield House Residential Home 14/09/09

Highfield House Residential Home 23/09/08

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 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Highfield House Sycamore Terrace Haswell Co. Durham DH6 2AG Lead Inspector Aileen Beatty Key Unannounced Inspection 27th March 2008 10:00 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.V362313.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.V362313.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 Mrs Marion Burns Position 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.V362313.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th March 2007 Brief Description of the Service: Highfield House is a care home providing personal care and accommodation for up to 25 people who are over 65yrs of age. The home is registered to provide care for older people and older people with dementia. Highfield House is in a pleasant location on the outskirts of Haswell village. The home is close to the local communitys resources, including shops, pubs, club, post office, community health centre and other amenities. The ground floor accommodation has a large lounge and separate dining room, access to 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. Nine have en-suite facilities. Fees at the time of inspection were £304.00 to 398.00 Information is available in the home including inspection reports. Highfield House DS0000068092.V362313.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 0 star. This means the people who use this service experience poor quality outcomes. Before the visit: We looked at: • Information we have received since the last visit on 4th December 2006. • 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 views of people who use the service & their relatives, staff & other professionals. The Visit: An unannounced visit was made on 27th March 2007 During the visit we: • Talked with people who use the service, relatives, staff, the manager & visitors. • Looked at information about the people who use the service & how well their needs are met, • Looked at other records which must be kept, • Checked that staff had the knowledge, skills & training to meet the needs of the people they care for, • Looked around the building/parts of the building to make sure it was clean, safe & comfortable. We told the proprietor what we found. What the service does well: The home is very clean and well maintained. It is a pleasant environment for residents to live in. Meals are cooked to a high standard and a good range of alternative choices is available. Bedrooms are nicely personalised and homely. Residents say that they are happy with the care and facilities provided in the home. “Couldn’t ask for better”. Highfield House DS0000068092.V362313.R01.S.doc Version 5.2 Page 6 A lovely enclosed garden area is available for residents to use and some rooms have a veranda with views of the well-established and maintained garden. What has improved since the last inspection? 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.V362313.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 DS0000068092.V362313.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): 2 and 3. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Satisfactory contract information is usually available. Inadequate information is provided before and during admission. EVIDENCE: The last inspection identified that the contracts did not contain all of the required information. These have been updated and now contain this information including a breakdown of fees. Some out of date contracts are still held in the office, which could accidentally be given to new residents. The contracts viewed on the files of some residents had blank spaces where the information that needs to be added manually had not been completed. Most were not signed so there was no evidence that these had been seen and agreed to by residents or their representative. Highfield House DS0000068092.V362313.R01.S.doc Version 5.2 Page 9 Four care files were read. None contained sufficient information to demonstrate that an adequate assessment had been carried out before admission, or to inform initial care plans (which were not in place). Some information was available but patchy and incomplete. Some details upon admission were completed, partially completed or incomplete. Highfield House DS0000068092.V362313.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 and 10 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Care plans are of a very poor standard and mean that residents’ needs cannot be adequately met. Residents are generally treated with respect and have their privacy respected. EVIDENCE: In many ways, residents in the home are well cared for. Most residents spoken to say that they feel well cared for and family members present during the inspection also felt that the care was good. What is crucial to the safety and wellbeing of residents is the careful monitoring of health needs, and a consistent approach from staff instructed to care for them. The way that this is achieved is through effective care planning where care needs are identified by assessment, a care pan is written to address identified needs, and regularly reviewed to ensure it remains up to date and relevant. Of the care records examined, one person had no care plans at all, another had some scant information and two had some care plans that were lacking detail and Highfield House DS0000068092.V362313.R01.S.doc Version 5.2 Page 11 contained some out of date information. Physical assessments were also out of date and the plans in place were not evaluated correctly. At the last inspection it was identified that safe procedures for the use of bed rails were not being followed. Since then, the home no longer uses metal bed rails and has purchased two foam adaptations to prevent people from falling out of bed which don’t pose the same safety risk of entrapment. It is clear that there are some very caring staff in the home who know the residents well. Daily records are good, detailing what has happened that day including visits from doctors etc. The daily records of a resident who had died suddenly were detailed. Some staff were observed to speak in a kindly but child like manner to residents, and also refer to the resident in front of them without including the resident in the conversation. Staff do not always provide adequate explanations about what they are doing. For example, staff were observed putting clothes protectors onto people without speaking to them or explaining what they were doing. Training in person centred care would highlight why this is important and help staff to communicate appropriately with residents at all times. Medication procedures were not followed on the day of the inspection. Medication for more than one person was being put into medicine pots and taken through to the lounge together. This increases the chance of administering medication to the wrong person, and goes against the homes own medication procedure. One hand written prescription sheet was not signed although there were few gaps in medication records, which appears to be an improvement since the last inspection. The care assistant on duty was able to describe the medication procedure including the ordering, receipt and disposal of medicines. There were no controlled drugs in the home on the day of the inspection. Some out of date medication was found in the cupboard and a large bottle with a hand written resident’s name on was found in the medicine cupboard. Staff on duty said that it contained liquid Paracetamol but there was no pharmacy label with the drug name dose or instructions for administration on the bottle. On the day of the inspection staff were observed treating the residents in the home respectfully. Residents were all smart in appearance and their privacy respected. Two residents were spending time quietly in their rooms and staff knocked before entering. Highfield House DS0000068092.V362313.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, 13, 14 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents have some access to social activities and family and friends are welcome. Most residents have some choice and control over their lives. The standard of meals is generally good. EVIDENCE: There has been some improvement in the availability of activities with the employment of an activities coordinator who visits one day a fortnight. It was confirmed that outside these times, staff do activities with residents. It was confirmed that residents are not taken out by staff, but are taken out by their families. Despite the improvements it was felt that there could be more focus on individualised activities relating to resident’s interests. A large enclosed garden is available which staff confirmed is used in summer. Social care plans are also inadequate and do not contain sufficient detail. Highfield House DS0000068092.V362313.R01.S.doc Version 5.2 Page 13 Visitors present during the inspection say that they are able to visit at any reasonable time. One commented that the home has improved significantly since the new owners took over. A good choice of meals and drinks are available. The white board in the dining room has various choices written on it. The choices of drinks are tea, coffee, fruit juice, and lemonade throughout the day, sherry and whisky is also available. The breakfast choice is cereal, porridge, toast, jam, bacon, egg, sausage, tomato, tea, coffee and juice. The kitchen has been recently re fitted and is clean and well organised. There is a two week menu in operation, and on the day of the inspection the inspector joined residents for lunch, which was very tasty and well presented. Residents enjoyed their meals. Some residents were assisted with their meals in the lounge and not given the opportunity to join others in the dining room. People were helped appropriately but pureed food was all mixed together in one bowl making it look unappetising. It is good practice to serve for example, meat, potato and vegetables in separate portions on a plate retaining the colour and taste of each. Highfield House DS0000068092.V362313.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 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is a satisfactory complaints procedure in place. Some safeguarding training has taken place so that staff know how to respond to adult protection concerns. EVIDENCE: A complaints procedure is in place and a record of complaints is held. It was noted however, that a member of staff had a note on their file regarding a complaint by a relative, yet this was not recorded in complaints record. Some staff have received training in safeguarding adults, but some staff did not have up to date training and this was being planned. The proprietor reported that there had been no adult protection issues since the last inspection. Highfield House DS0000068092.V362313.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 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is clean and tidy and well maintained which makes it a pleasant environment for residents to live in. EVIDENCE: The home is very clean and tidy and well maintained. Redecoration is ongoing but nearing completion. The lounge areas are bright and domestic in style, and bedrooms are nicely personalised and homely. There is large well-maintained garden, which is used by residents in good weather. There were some minor repairs requiring attention such as broken handles on vanity unit in en suites and some paint chipped but generally these are dealt with very promptly. Some en suite bathrooms look a little bare and would benefit from some corner shelves to personalise the space. Highfield House DS0000068092.V362313.R01.S.doc Version 5.2 Page 16 The home is also satisfactorily clean. There are no odour problems and bathrooms are kept to a hygienic standard. There is a good laundry area with industrial washing and drying machines. The laundry appeared well organised. There are still communal sponges in the home, which was pointed out at the last inspection as being unhygienic. Large numbers of towels are stored in the bathroom and recent infection control advice recommends that only towels to be used that day should be stored there. Highfield House DS0000068092.V362313.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 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users are sometimes protected by the home’s recruitment practices and there are sufficient numbers of staff on duty. EVIDENCE: There are sufficient staff on duty in the home to care for residents safely. Most staff are trained to NVQ level 2 or above. The manager was not present during the inspection so a full inspection of training records was not carried out. Following the inspection, the inspector spoke to the proprietor who was carrying out a review of raining and booking training that is out of date or due for renewal soon. A copy of the training plan for the year will be forwarded to The Commission for Social Care Inspection. The files of two staff members were checked. One file contained all of the required checks and information. The other file belonged to a member of staff moved from another of the homes owned by the proprietors and updated checks were not carried out. All staff employed in the home must go through the application process again, as criminal records checks in particular, are not transferable between homes. Highfield House DS0000068092.V362313.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 and 38. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The home is sometimes run in the best interests of service users but some practices mean their needs may not always be met. Health and safety requirements met. EVIDENCE: The home manager has not yet been through the fit person process with CSCI. This involves an application and relevant checks being carried out. There is then an interview following which CSCI will determine whether the person is “fit” to manage a care home. Residents spoken to say they feel well cared for and there was some positive feedback from relatives. A concern during the inspection was the lack of Highfield House DS0000068092.V362313.R01.S.doc Version 5.2 Page 19 managerial responsibility for ensuring that care records and health assessments are up to date. This was a requirement at the last inspection and has not been met. A requirement relating the correct procedure for administration of medication has not been met. There are satisfactory procedures for holding residents money. At present many residents owe money to the home for toiletries and other items, as the home does not have access to the personal allowance of many people. This does not prevent the resident’s having access to toiletries or treats but they are subsidised by the home. Information about what residents are expected to pay for (such as hairdresser) is written into the terms and conditions for the home. The residents’ personal allowance is referred to as pocket money and it was suggested it might be more appropriate to refer to this as their personal allowance. There were no safety concerns identified during the inspection. COSHH data sheets (relating to hazardous substances) are available for all cleaning products used in the home. There is also evidence of regular electrical tests on small appliances used. Routine services are carried out on large equipment such as the lift. On the day of the inspection, there was a problem with the lift that resolves itself. The lift engineer was called out to check it anyway and there is a very good response time by the staff and engineers. Highfield House DS0000068092.V362313.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 X 2 1 X X X HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 1 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 3 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 Highfield House DS0000068092.V362313.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? YES 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 OP2 Regulation Schedule 3 Requirement Timescale for action 27/05/09 2. 3. OP3 OP7 4. OP8 5. 6. OP9 OP10 7. OP12 Ensure all details are completed on service user guide and statement of purpose when given to residents. OUTSTANDING 14 (1) Full assessment information must be available before admitting residents to the home. 15 (1) (2) Care plans must be completed for each resident and be sufficiently detailed, up to date, and evaluated regularly. OUTSTANDING 15 (2) (c) Health assessments must be carried out at regular intervals, recorded, and used to update care plans. 13 (2) Medication procedures must be followed to ensure that residents remain safe. OUTSTANDING 18 (1) (a) Staff should receive training in person centred care to help them to develop therapeutic communication techniques. 16 (2) Activities should be further (m) developed to meet the specific interests of residents and link to social care plans. All residents must have the opportunity for DS0000068092.V362313.R01.S.doc 27/05/08 27/05/08 27/06/08 27/05/08 27/07/08 27/07/08 Highfield House Version 5.2 Page 22 trips outside the home. 8. 9. OP15 OP16 16 (2) (i) Schedule 4 18 (1) (a) Pureed food must be attractively presented to residents. All complaints must be recorded to demonstrate what it was, and how it was dealt with by the home. . Provide evidence of safeguarding training that has been completed, and sessions planned. Remove communal sponges and provide staff with information regarding hygiene and infection control. The recruitment policy must be followed for all staff to protect residents. Provided CSCI with the training plan to demonstrate staff are trained and competent. 27/05/08 27/05/08 10. OP18 27/06/08 11. OP26 13 (3) 27/05/08 12. 13. OP29 19 18 (1) (a) 27/05/08 27/06/08 OP30 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP26 OP35 Good Practice Recommendations Towels are not stored in large quantities in the bathroom as they become damp, be there some time, and might be linked to the spread of infection. Use term personal allowance when referring to residents’ money, as pocket money sounds more appropriate for children. This will help staff to view residents as adults. Highfield House DS0000068092.V362313.R01.S.doc Version 5.2 Page 23 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.V362313.R01.S.doc Version 5.2 Page 24 - 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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