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Inspection on 27/04/05 for Highfield House Nursing Home

Also see our care home review for Highfield House Nursing Home for more information

This inspection was carried out on 27th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Resident`s health needs continue to be met to a good standard, and all of the people spoken with were satisfied with the care that they, or their relative, were receiving. Visitors are made welcome, and two residents` relatives said they are kept well informed and are involved in their care. Residents and relatives spoken with felt that the home was managed and run to a satisfactory standard. A good variety of food is provided. There is a stable staff group who have a positive attitude towards service users. Staff members were seen to interact well with the residents. The atmosphere in the home is cheerful and positive. The home has a competent and experienced manager.

What has improved since the last inspection?

Some bathrooms at the home have been recently decorated and new radiator covers have been fitted in the upstairs corridor.

What the care home could do better:

No areas for improvement were identified from the standards looked at during the inspection.

CARE HOMES FOR OLDER PEOPLE Highfield House 298 Park Lane Macclesfield Cheshire SK11 8AE Lead Inspector Joan Adam Unannounced 27 April 2005 9:00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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 F51 F01 S18774 Highfield House V223741 270405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Highfield House Address 298 Park Lane Macclesfield SK11 8AE Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01625 511519 01625 511519 Mrs Denise Moss Mrs Denise Moss Care Home 13 Category(ies) of Old age, not falling within any other category registration, with number (13) of places Highfield House F51 F01 S18774 Highfield House V223741 270405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 04/01/05 Brief Description of the Service: Highfield House is a detached stone built property enclosed privately behind a stone wall in 1/3 acre of mature gardens. It is situated within a conservation area ½ mile from Macclesfield town centre and is on a main bus route. It is a small, family run business and the proprietors live on site. The accommodation comprises of one lounge and one dining room, one single and six double bedrooms. One double bedroom is on the ground floor and the other bedrooms are on the second floor, accessed by a passenger lift or stairs. The home is staffed with Registered Nurses, carers, and domestic staff. Highfield House F51 F01 S18774 Highfield House V223741 270405 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit of the home took place over four hours. A tour of the home was carried out and care records, fire records and staff training files were inspected. The service history of the home and the previous inspection report were read in preparation for the inspection. Three of the four staff on duty, four residents, two relatives and a visiting GP were spoken with. What the service does well: What has improved since the last inspection? Some bathrooms at the home have been recently decorated and new radiator covers have been fitted in the upstairs corridor. Highfield House F51 F01 S18774 Highfield House V223741 270405 Stage 4.doc Version 1.30 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. Highfield House F51 F01 S18774 Highfield House V223741 270405 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Highfield House F51 F01 S18774 Highfield House V223741 270405 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 and 6 Good pre admission assessments are carried out before a resident is admitted to the home. The home is able to meet the assessed needs of individuals admitted to the home. EVIDENCE: Four residents’ care files were inspected. Each contained pre-admission assessments covering all aspects of personal care and any specialised care that might be needed for example physiotherapy and occupational therapy. One relative spoken with said that the manager came to see her mother before she was admitted to the home and that her mothers’ needs were discussed and agreed with her. Individual care plans had been produced on the basis of the pre-admission assessment. Highfield House F51 F01 S18774 Highfield House V223741 270405 Stage 4.doc Version 1.30 Page 9 A qualified nurse is available at all times to meet the continuing needs of those residents who require nursing care. Highfield House does not provide intermediate care. Highfield House F51 F01 S18774 Highfield House V223741 270405 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,10 The care plans seen address the changing needs of the residents. Residents at the home are treated with dignity and their privacy is respected. EVIDENCE: Four care plans were looked at and all were concise and detailed. These were based on the pre-admission assessments and were updated in response to the changing needs of the residents in respect of all aspects of health, personal care and social care needs. Risk assessments were in place for the use of bed rails and family members had signed these. Moving and handling assessments were also in place and these indicated the number of staff required to assist the resident and identified the type of equipment needed, if any. Four residents spoken with stated that they were happy with the care and attention they received at the home and felt that they are treated with dignity and their privacy is respected. All confirmed that staff are aware of their needs. Staff were seen to address the residents in a courteous manner. Staff spoken to were aware of the needs of the residents and of their likes and dislikes. Highfield House F51 F01 S18774 Highfield House V223741 270405 Stage 4.doc Version 1.30 Page 11 Two relatives spoken with stated that they were happy with the care provided at the home and that they are kept well informed about the health of their relative. One relative said that she “felt like a part of an extended family and always found the home to be warm and welcoming.” A GP who was visiting the home stated that “the home is lovely and well run.” Highfield House F51 F01 S18774 Highfield House V223741 270405 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,15 Residents can exercise choice and control over their lives. Families and friends are welcomed into the home at any reasonable time. Residents have a good choice of meals which are wholesome and well presented and they enjoy them. EVIDENCE: Residents spoken with said that they could choose where and with whom they spend their time. An activities co-ordinator is not employed, however social activities are recorded in the care plan and these are addressed on an individual basis by the staff. Activities include reading, knitting, jigsaws, crossword and puzzle books. One staff member was observed reading a daily newspaper with a resident, another resident was doing a crossword and one was seen to be reading. An entertainer visits the home on a monthly basis for musical entertainment. There was a poster on the notice board advertising this event. One resident was being taken out to lunch by his son. Residents said that they are made a special fuss of on their birthdays. Highfield House F51 F01 S18774 Highfield House V223741 270405 Stage 4.doc Version 1.30 Page 13 A menu is in place at the home and residents said that the cook discusses meal choices on a daily basis. One resident had requested fish for lunch, which was not on the menu, a staff member was sent to the local shop to purchase some for her. All residents spoken with praised the meals. Those residents who required help with their meal were observed to be assisted by staff in a dignified and unhurried manner. Highfield House F51 F01 S18774 Highfield House V223741 270405 Stage 4.doc Version 1.30 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,18 A policy is in place to ensure that complaints are dealt with. Residents are protected from abuse. EVIDENCE: Residents and relatives spoken with said that they had no complaints and that they were aware of who to speak to if they were unhappy about any aspects of the home. A copy of the complaints procedure is available in the service user guide. A policy on the protection of vulnerable adults is in place and the inspector saw this. Members of staff spoken with confirmed that they were aware of the policy and the No Secrets guidance issued by the Department of Health. Staff have received training and this was recorded in the staff training files. CSCI have not received any complaints regarding the home. Highfield House F51 F01 S18774 Highfield House V223741 270405 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,22,25 The home provides suitable living space and facilities for the residents. EVIDENCE: The home was cleaned to a high standard with no unpleasant smells. Equipment is in place to enable the residents to maintain their independence, for example grab rails in corridors and toilets. The home has one single bedroom and six double rooms. All double rooms have screens to enable privacy and dignity of residents to be maintained whilst receiving personal care. Those residents spoken with who are in double bedrooms said that they were happy to share a room. The hot water within the home is tested and delivered at a safe temperature. The temperatures are recorded on a weekly basis. Highfield House F51 F01 S18774 Highfield House V223741 270405 Stage 4.doc Version 1.30 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,30 Staff members are meeting the needs of residents. Training is in place to up-date all staff in meeting residents care needs. EVIDENCE: Residents and relatives spoken to said that” nothing was too much trouble for the staff.” All staff members were seen to be polite and helpful towards residents and appear to communicate well with them. The home is friendly and welcoming. Induction training for new staff is to the recognised TOPPS standard. All staff have received essential training such as moving and handling and fire training during the last twelve months and this is recorded in the staff files. Staff have undertaken courses on infection control, basic care, nutrition in care setting, managing aggression and intermediate food hygiene. The staffing levels at the home are adequate to meet the needs of the residents. Trained staff are on duty twenty fours hours a day supported by care staff. Domestic and catering staff are also employed at the home. Duty rotas were seen and staffing levels were being maintained. Highfield House F51 F01 S18774 Highfield House V223741 270405 Stage 4.doc Version 1.30 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,38 The home is run and managed by a person who is fit to be in charge. The health, safety and welfare of residents are maintained. EVIDENCE: The owner manager of the home is a registered general nurse who lives on the premises and is registered with the Commission for Social Care Inspection. She has owned and run the home for a number of years and has previous experience of working and managing nursing homes. She was present on the day of the inspection. She confirmed that she has intends to complete the NVQ Level 4 in Management Award by the end of May 2005 as required by CSCI. Carers confirmed that fire, moving and handling, and food hygiene training is carried out. Highfield House F51 F01 S18774 Highfield House V223741 270405 Stage 4.doc Version 1.30 Page 18 The home has had a recent inspection by the fire officer the report of which was seen and no requirements were made. The home has a programme in place for on going maintenance of buildings and equipment. Residents and relatives spoken with said that the manager is approachable and easy to talk to. Staff said that they were supported and that their views were listened to. Highfield House F51 F01 S18774 Highfield House V223741 270405 Stage 4.doc Version 1.30 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x 3 x x 3 x STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x x x x x x 3 Highfield House F51 F01 S18774 Highfield House V223741 270405 Stage 4.doc Version 1.30 Page 20 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation NONE 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 NONE Good Practice Recommendations Highfield House F51 F01 S18774 Highfield House V223741 270405 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Address 1 Address 2 Address 3 Address 4 National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Highfield House F51 F01 S18774 Highfield House V223741 270405 Stage 4.doc Version 1.30 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!