Inspection on 03/01/06 for Highfield House Nursing Home

This inspection was carried out on 3rd January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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.

Other inspections for this house

Highfield House Nursing Home 16/09/09

Highfield House Nursing Home 05/12/07

Highfield House Nursing Home 26/03/07

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Highfield House Nursing Home Highfield House Nursing Home 33 Queens Road Ryde Isle of Wight PO33 3BG Lead Inspector Janet Ktomi Unannounced Inspection 10:00 3 January 2006 rd X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Highfield House Nursing Home DS0000066320.V267838.R01.S.doc Version 5.0 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 Nursing Home DS0000066320.V267838.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Highfield House Nursing Home Address Highfield House Nursing Home 33 Queens Road Ryde Isle of Wight PO33 3BG 01983 811015 01983 811119 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) Scio Healthcare Limited Care Home 26 Category(ies) of Dementia - over 65 years of age (5), Physical registration, with number disability over 65 years of age (26), Terminally of places ill over 65 years of age (2) Highfield House Nursing Home DS0000066320.V267838.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th May 2005 Brief Description of the Service: Highfield House is a registered Nursing Home providing nursing care and accommodation for up to twenty-six older people. The home is situated on the outskirts of Ryde within a few minutes walk of the main shopping centre and facilities. There are good bus links to Ryde town centre and Newport with a bus stop located close to the home. The home offers a range of single and shared bedroom accommodation located on two floors accessible to all service users by a passenger lift. The pleasant rear gardens are laid mainly to lawn with flowerbeds and paths. The area to the front of the home has been converted to provide car parking. Scio Healthcare Limited has recently purchased the home. The home’s Matron/Manager has commenced the registration process with the Commission. Highfield House Nursing Home DS0000066320.V267838.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was the second unannounced inspection of this inspection year. Core standards not assessed during the first inspection were assessed along with additional core and non-core standards. The inspection lasted four hours and was undertaken by two inspectors. A tour of the building was undertaken and discussions were held with service users, visitors, Matron and the nursing and care staff on duty. The Scio Healthcare Limited responsible individual, Mr Kevin Dannatt was present for part of the inspection. Many of the service users living within the home were met during the inspection and those able gave their views about the service. All the service users stated that they enjoyed living at the home and liked the staff. Care and other records and documentation identified in the report were viewed. What the service does well: What has improved since the last inspection? Scio Healthcare Ltd now owns the home. All beds have been replaced with new height adjustable electric beds specifically designed for providing nursing style care. A new portable hoist has also been provided. As part of Scio Healthcare the home has access to the minibus and driver from another home within the group and a day trip has been organised for service users able to participate in external activities. Service users stated they had enjoyed the outing and the Matron confirmed that more trips would be planned. A variety of in house activities were organised in December as part of the Christmas celebrations. Highfield House Nursing Home DS0000066320.V267838.R01.S.doc Version 5.0 Page 6 The training co-ordinator for Scio Healthcare has now commenced working within the home and provides induction, mandatory and specialist training for nursing, care and ancillary staff. 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 Nursing Home DS0000066320.V267838.R01.S.doc Version 5.0 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 Nursing Home DS0000066320.V267838.R01.S.doc Version 5.0 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 the following standard(s): 1, 2, 3 and 4. The home will soon provide appropriate written information about its services and contracts. All potential service users are fully assessed prior to admission to ensure that the home is able to meet their needs. Service users’ health and social needs are met at the home. Standard 6 is not applicable, as the service does not provide intermediate care. EVIDENCE: The Matron and administrator stated that the home’s statement of purpose, service users’ guide and contract for service users was being re-written. The inspectors were shown the folders that will be used for service users’ guides that will be kept within each bedroom. It is expected that these documents will be similar to those of the other nursing homes owned by Scio Healthcare Ltd that meet the required standards. Once re-written the Matron will forward a copy of the new documents to the Commission. The pre-admission assessments and care plans for the most recent admissions were viewed. These all contained an assessment undertaken by the Matron or deputy prior to admission and included patient discharge/transfer information Highfield House Nursing Home DS0000066320.V267838.R01.S.doc Version 5.0 Page 9 from the hospital. Also seen were moving and handling assessments. One service user admitted four days prior to the unannounced inspection did not have a care plan. The named nurse for this service user was on duty during the unannounced inspection and explained that the care plan would be written the next day when the home had had the opportunity of fully assessing the service user’s needs and abilities. Care and nursing staff stated to the inspectors that they felt able to meet the needs of service users and that appropriate numbers of staff are employed to ensure needs are promptly met. Due to the level of disability it was not possible to talk with all service users, however during a tour of the building the majority of service users were seen and all appeared happy and well cared for. Equipment such as new height adjustable electric nursing beds and hoists is provided. Service users spoken with stated that they felt their needs were met and that appropriate numbers of care staff are employed at the home. Visitors stated that they felt their relative’s needs were met and confirmed that they had been asked about care needs. A local GP visiting the home during the unannounced inspection stated that he felt that service users were well cared for and their health needs appropriately identified and met. Staff induction and training should ensure that nursing and care staff have the necessary skills to care for the service users. Highfield House Nursing Home DS0000066320.V267838.R01.S.doc Version 5.0 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 the following standard(s): 7, 8 and 9. All service users have individual care plans detailing how health, personal and social needs will be met. The Matron must identify a system whereby the involvement of the service user or their representatives in care planning may be clearly demonstrated. The home must consider purchasing a limited number of pressure relieving air mattresses for use by service users whilst awaiting the provision of equipment form the Health Trust. Medication is appropriately managed within the home, however the home must ensure that Medication Administration Records are fully completed. EVIDENCE: During the unannounced inspection four service user care plans were viewed. Service users have individual care plans compiled following admission from information gained during pre-admission assessments and from information gained during the first few days following admission. Care plans were seen to be updated by named nurses, generally monthly and if care needs change. The care plan details the nursing and care the service user requires to ensure all aspects of health, personal and social care needs are met. Within the care plans is information and risk assessments to cover moving and handling, Highfield House Nursing Home DS0000066320.V267838.R01.S.doc Version 5.0 Page 11 pressure areas, continence and falls. Service users spoken with were generally unaware that written records and care plans are held by the home although due to cognitive limitations not all service users are able to participate in planning their care. The Matron stated that where this is the case family members or representatives are involved in care planning. Care plans do not contain a space for the service user or their representatives to sign to confirm that they have been involved in planning their care. The Matron must identify a system whereby the involvement of the service user or their representatives may be clearly demonstrated. During a tour of the building pressure relieving equipment was seen in use around the home. The Matron, care plans and pre-admission assessments indicated that four service users had pressure injuries, which had developed in the home. All service users with pressure injuries are being appropriately managed and pressure injuries are improving. Care plans contain Waterlow pressure area assessments that were seen to have been updated at least monthly with details as to how service users at moderate or high risk would be cared for. Discussions with the trained nurse on duty and the Matron indicated that the home does not have its own pressure relieving air mattresses. Following assessment and identification of a service user being at high risk a request for the necessary equipment is submitted to the Health Trust, however there is often a delay of several weeks before the equipment becomes available. One service user with pressure injuries had no pressure-relieving mattress as this had been returned to the hospital for repair and the Matron was chasing its return. Service users are entitled to the provision of equipment from the Health Trust, however the home also has a responsibility to ensure that it has the necessary equipment to meet service users’ needs. The home must consider purchasing a limited number of pressure relieving air mattresses for use by service users whilst awaiting the provision of equipment from the Health Trust. The inspectors were able to talk briefly with a local GP who visits the home on a regular basis as a number of the service users are registered at his practice. The GP stated that the healthcare needs of his patients were recognised and appropriately managed by the home. The GP stated that he would recommend the home to a relative or friend in need of nursing care. Care plans contained records of GP visits along with those from chiropodists, visiting opticians, dentists and the continence nurse who undertakes assessments on behalf of the Health Trust for continence equipment. Highfield House Nursing Home DS0000066320.V267838.R01.S.doc Version 5.0 Page 12 The home has a policy and procedure for the administration of medications, with medication found to be stored in an appropriate locked facility. Records are kept in regard to all medications received into the home and administered by the qualified nurses. The inspector saw the arrangements for controlled medication, the storage and recording of which was found to be appropriate. Any unused medication is returned to the pharmacy for disposal. The inspector viewed the medication administration records for all service users. It was noted that on a number of records there were spaces where prescribed medications had not been signed as being administered. Medication Administration Records have a code sheet detailing the reason why a particular medication may not have been administered and this must be used whenever a medication is not administered. A blank box does not inform other nurses or medical staff if a medication has been given and not signed for or not given and why. Highfield House Nursing Home DS0000066320.V267838.R01.S.doc Version 5.0 Page 13 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 the following standard(s): 12 The routines of daily living and activities made available are flexible and varied to suit service users’ expectations, preferences and capacities. All standards in this section were assessed during the previous unannounced inspection undertaken in May 2005. EVIDENCE: Service users confirmed that the daily living routines within the home are flexible and that there is choice as to times for getting up/going to bed, what they eat and where they spend their time within the home. Breakfast times are flexible, with the main lunchtime and evening meals at set times. Staff, menus and service users confirmed that choice is available at all meals and that these may be taken either in the dining room, lounges or their own bedrooms as they wish. If service users do not want main meals at the usual times, meals and snacks are available at other times. Many of the home’s service users are too frail to enjoy external activities. The home has a visiting musician who plays the keyboards with home entertainment equipment (music and television) available in the lounges. A variety of seasonal activities was organised by the new Matron in December. These included three groups of carol singers from local schools, mince pies and mulled wine morning and a bran tub. As part of Scio Healthcare the home has Highfield House Nursing Home DS0000066320.V267838.R01.S.doc Version 5.0 Page 14 access to the minibus owned by another home within the group and a day trip has been organised for service users able to participate in external activities. Service users stated they had enjoyed the outing and the Matron confirmed that more trips would be planned. The new Matron intends to increase activities offered to service users. Highfield House Nursing Home DS0000066320.V267838.R01.S.doc Version 5.0 Page 15 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 the following standard(s): 16 and 18 Service users or their representatives are able to complain if they are unhappy with the service provided at the home. The Matron and other staff are aware of adult protection issues and would respond appropriately if they had concerns in relation to adult protection. EVIDENCE: The home has a policy and procedure for the investigation and resolution of complaints; this will be detailed in the new service users’ guide. Service users spoken with appeared happy to report any complaints and stated they would tell care staff, nurses or the Matron. Staff were clear that any complaints or concerns would be resolved or reported to the nurse in charge or one of the proprietors. None of the service users spoken with during the inspection had any concerns or complaints to report to the inspector. The complaints book was viewed and indicated there had been no complaints since the new Matron and Scio Healthcare took over the home. The home has an adult protection policy which links to the Isle of Wight Adult Protection policy and procedure, a copy of which was available in the nurses’ office. The home has appropriate policies for whistle blowing and gifts to staff. Discussions with the Matron showed that she had an understanding of adult protection issues and were clear about their responsibilities and actions that should be taken if abuse is suspected. The training co-ordinator showed the inspector records of adult protection training undertaken and planned for the home. Discussion with staff confirmed that they had received training about adult protection during both induction and NVQ courses and were aware of the actions they should take if they suspect abuse of a service user may have Highfield House Nursing Home DS0000066320.V267838.R01.S.doc Version 5.0 Page 16 occurred. The home encourages service users or their representatives to manage individual service users’ personal finances. Highfield House Nursing Home DS0000066320.V267838.R01.S.doc Version 5.0 Page 17 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 the following standard(s): 19, 22 and 26. The home is warm, clean and well maintained providing appropriate accommodation to meet service users’ needs. The home provides equipment necessary for service users but should consider purchasing a limited number of air pressure relieving mattresses for use whilst awaiting supply of these from the Health Trust. EVIDENCE: The home was not purpose built as a nursing home, however it has been extended and adapted over the years to provide a homely environment. When the inspectors arrived at the start of the unannounced inspection the responsible person for Scio Healthcare Limited, the new owners of the home, was touring the building with the new Matron to identify areas of the home which needed improvement or development to provide a more appropriate environment for the service users. The findings were discussed with the Matron later in the inspection. The Matron stated that the responsible individual is to identify options to provide a ramp to access two bedrooms currently accessed by two steps and to explore options to remove a steep staircase and provide en-suite facilities to the bedrooms either side. The responsible individual also Highfield House Nursing Home DS0000066320.V267838.R01.S.doc Version 5.0 Page 18 outlined the plans to extend the home to approximately forty beds. The home has outline planning permission and once definite plans are available will submit these to the Commission. The responsible individual confirmed that the development would be of the same high standard of extensions to their other nursing homes. Externally the rear garden is well maintained and provides a pleasant place for service users to sit when the weather is warm. Future plans will ensure the garden remains with improved pathways and access for service users. Since Scio Healthcare Limited became the new proprietors approximately two months prior to the unannounced inspection they have replaced all the nonheight adjustable beds within the home with new electric beds, which fully meet the needs of the home’s nursing care service users. An additional new portable hoist has also been provided. Liquid soap dispensers are now provided in all bedrooms as part of infection control systems. During a tour of the building pressure relieving equipment was seen in use around the home. As previously stated, discussions with the trained nurse on duty and the Matron indicated that the home does not have its own pressure relieving air mattresses with those seen being loaned to specific service users from the Health Trust. Following assessment and identification of a service user being at high risk a request for the necessary equipment is submitted to the Health Trust, however there is often a delay of several weeks before the equipment becomes available. One service user with pressure injuries had no pressure-relieving mattress as this had been returned to the hospital for repair and the Matron was chasing its return. Service users are entitled to the provision of equipment from the Health Trust however the home also has a responsibility to ensure that it has the necessary equipment to meet service users’ needs. The home must consider purchasing a limited number of pressure relieving air mattresses for use by service users whilst awaiting the provision of equipment form the Health Trust. The home employs domestic staff responsible for all domestic hygiene and cleanliness issues. On the day of the unannounced inspection the home was found to be clean, tidy and free from offensive odours. All WCs and communal bathing facilities were noted to have a supply of paper towels and liquid soap with guidelines available for staff around infection control and the use of chemical cleaners. Care staff informed the inspector that supplies of gloves and paper towels are held discreetly in all service users’ bedrooms. Liquid soap dispensers are now provided in all bedrooms. The training co-ordinator and her records confirmed that all nursing, care and domestic staff receive training in infection control. The home has a laundry located on the lower floor with industrial machines capable of washing to required temperatures and specifically employed laundry personnel. Highfield House Nursing Home DS0000066320.V267838.R01.S.doc Version 5.0 Page 19 Highfield House Nursing Home DS0000066320.V267838.R01.S.doc Version 5.0 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29 and 30. The home employs appropriate numbers of registered nurses, care staff and ancillary staff to meet the needs of service users. A comprehensive recruitment, induction and training programme should ensure that unsuitable people do not wok in the home and staff have the necessary skills required to meet service users’ needs. EVIDENCE: The Department of Health has yet to publish staffing guidelines for Nursing Homes. Staffing rotas confirmed the Matron’s opinion that the home provides sufficient staff numbers to meet the needs of service users. In addition to the nursing and care staff employed the home also employs catering, domestic, maintenance and administrative support staff. Service users spoken with during the inspection reported that staff were prompt in answering call bells and that they felt care staff had sufficient time to meet their needs. Staffing rotas seen during the inspection confirmed the Matron’s statement concerning staffing numbers. Care and nursing staff stated that there were adequate numbers of staff employed at the home to meet service users’ needs. The Matron and administrator described the home’s recruitment procedure that starts with adverts in local papers or via word of mouth. All potential employees complete an application form, involving full work history, two references, Criminal Records enhanced level and POVA check and health declaration. The Matron conducts interviews at the home. It is recommended that at least two people undertake all interviews and that a written record is Highfield House Nursing Home DS0000066320.V267838.R01.S.doc Version 5.0 Page 21 kept. Applicants are notified of the outcome of the interview by telephone. It is recommended that in addition to the telephone call a written notification of the outcome of the interview is sent to all applicants. All new employees have a three-month probationary period, full induction programme and terms and conditions of employment. The records in respect of the most recently appointed staff and a number of others were seen during the unannounced inspection and corresponded to the process described above. A copy of the employees’ handbook was provided to the inspector. In the case of qualified nurses their PIN numbers and registration details are confirmed with the NMC. The home is in the process of employing European qualified nurses as senior care staff. The documentation in respect of the first of these was viewed. The home uses an employment agency that ensures that staff employed from overseas have all the required documentation and permits to allow them to legally work in the UK. The new carer had only arrived in England the day prior to the unannounced inspection and although in the home and met briefly by the inspectors, was not interviewed during the inspection. The new carer confirmed that she was shadowing another carer. Scio Healthcare employs a qualified nurse with a background in nurse education to provide and organise training within the home. During the unannounced inspection the inspector was able to spend time with the trainer who showed the inspector the home’s training records and programme. This demonstrated that all staff receive induction and foundation training including an evaluation test following specific training such as fire awareness and infection control. Training is provided both individually and in small groups and also includes practical skills and supervised practise. Qualified nurses confirmed that they had attended update training to meet PREP requirements. Highfield House Nursing Home DS0000066320.V267838.R01.S.doc Version 5.0 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 34, 36, 37 and 38. The home’s management structure is appropriate for the size of the home. A plan to ensure all staff have regular supervision and an annual appraisal has been commenced. The home must ensure that all records within the home are fully maintained. The correct registration and insurance certificates must be displayed EVIDENCE: The home has been re-registered in October 2005 when Scio Healthcare Ltd purchased the home. Scio Healthcare Ltd have appointed a manager/Matron who is a Registered General Nurse and has the Registered Manager’s Award. The manager meets all the training requirements to achieve NMC Prep requirements and the training co-ordinator confirmed that any training needs identified for the manager would be accessed. The Matron was previously employed by Scio Healthcare Ltd at one of their other nursing homes as the deputy Matron. The Matron stated that she has a full job description. Scio Healthcare Ltd has appointed an administrator to support the Matron. The very Highfield House Nursing Home DS0000066320.V267838.R01.S.doc Version 5.0 Page 23 experienced deputy Matron employed by the previous owners remains in her post. During the inspection the management arrangements within the home were discussed and there are clear lines of accountability covering all groups of staff and management. During the unannounced inspection the inspector was able to talk to Scio Healthcare Ltd responsible individual, Mr Kevin Dannatt, who was clear about his responsibilities as the company’s responsible person. All levels of staff met during the inspection stated that they felt able to discuss any concerns or issues with members of the management team including the Matron and directors of the company. The registration process for the Matron is underway and should be completed in early March 2006. The home does not have an internal Quality Assurance process. Scio Healthcare Ltd has arrangements for Regulation 26 visits to be commenced by one of the company directors who is a qualified nurse and has previously managed a nursing home. Scio Healthcare Ltd and the Matron must identify an appropriate internal quality assurance and quality monitoring system based on seeking the views of service users or their representatives. The insurance certificate displayed in the nurses’ office stated the name of the previous providers. The administrator showed the inspector a letter from the insurance company confirming that the insurance had been transferred to the new proprietors. The home informed the inspector that a new insurance certificate would be issued once the existing certificate runs out in February 2006. The nurses’ office is not easily accessible therefore the insurance certificate must be displayed in a prominent position within the home. Financial viability of the proprietors was assessed during the registration process. The future developments of the home have been included in the proprietor’s financial planning. The Matron and training co-ordinator have commenced supervision sessions for some qualified nurses and care staff and over the next months will extend this to all staff. The Matron will supervise the qualified nurses with the training coordinator supervising the care staff. The Matron stated that supervision sessions will have a written record and the form to be used was seen. During the unannounced inspection a variety of records was inspected. These included care plans, risk assessments, Medication Administration Records, staffing rotas, recruitment and staff files. As already mentioned, there were gaps within the Medication Administration Records. The home is required to ensure that the Medication Administration Records are fully completed and that service users or their representatives sign care plans to confirm that they have been involved in the planning of their care. All records were found to be appropriately stored. The home is generally a safe place for staff, visitors and service users. Staff training records confirmed that staff receive induction and update training in moving and handling, fire safety, first aid, food hygiene and infection control. Highfield House Nursing Home DS0000066320.V267838.R01.S.doc Version 5.0 Page 24 The responsible individual has identified areas within the home that may present a risk to service users such as steps to two bedrooms and a staircase adjacent to two bedrooms and is considering options to improve these areas. The recruitment procedures within the home should prevent unsuitable people from working within the home. Highfield House Nursing Home DS0000066320.V267838.R01.S.doc Version 5.0 Page 25 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 3 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 2 X X X 3 STAFFING Standard No Score 27 3 28 X 29 2 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 3 X 3 2 3 Highfield House Nursing Home DS0000066320.V267838.R01.S.doc Version 5.0 Page 26 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7OP37 Regulation 12 (3) Requirement Care plans must show that the service user or their representative has been involved in the formation of the care plan. The home must consider purchasing a limited number of pressure relieving air mattresses for use by service users whilst awaiting the provision of equipment form the Health Trust. Timescale for action 28/02/06 2. OP8OP22 12 (1)(a) 28/02/06 3. OP9OP37 13 (2) Medication Administration 03/01/06 Records must be fully completed. The correct code must be used on all occasions when a medication is not administered as prescribed. Scio Healthcare Ltd and the 31/03/06 Matron must identify an appropriate internal quality assurance and quality monitoring system based on seeking the views of service users/representatives. 4. OP33 24 (1)(a and b) Highfield House Nursing Home DS0000066320.V267838.R01.S.doc Version 5.0 Page 27 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 OP29 OP29 Good Practice Recommendations Two people should undertake all job interviews and a written record of the interview should be made. Applicants should be notified of the outcome of interviews in writing. Highfield House Nursing Home DS0000066320.V267838.R01.S.doc Version 5.0 Page 28 Commission for Social Care Inspection Southampton, Portsmouth and Isle of Wight Ground Floor Mill Court Furrlongs Newport, IOW PO30 2AA 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 Nursing Home DS0000066320.V267838.R01.S.doc Version 5.0 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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. 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