CARE HOMES FOR OLDER PEOPLE
Highfield House Nursing Home 298 Park Lane Macclesfield Cheshire SK11 8AE Lead Inspector
Joan Adam Unannounced Inspection 3rd November 2005 09:00 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 Nursing Home DS0000018774.V263140.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 DS0000018774.V263140.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Highfield House Nursing Home Address 298 Park Lane Macclesfield Cheshire SK11 8AE 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) 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 Nursing Home DS0000018774.V263140.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 27th April 2005 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 Nursing Home DS0000018774.V263140.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced visit of the home took place over five and was carried out as part of the yearly inspection process. A tour of the home was carried out and care records, fire records and staff personnel files were inspected. The service history of the home and the previous inspection report were read in preparation for the inspection. A detailed pre-inspection questionnaire was completed by the manager and retuned to the CSCI office. Residents and staff were spoken to during the inspection. Three of the staff on duty and five residents were spoken with during the inspection. What the service does well:
Residents’ health needs continue to be met to a good standard at Highfield House and all of the people spoken with were satisfied with the care that they were receiving. The standard of the care plans at the home is good and regular reviews of the plans of care are undertaken. Residents spoken with felt that the home was managed and run to a satisfactory standard. A good variety of food is provided. The home has a regular group of staff that have worked there for some time and they are well aware of the needs and personalities of the residents in their care. Staff are friendly and attentive to the residents. Bedrooms are warm, clean and are well personalised with residents’ own possessions. Social activities at the home are individual and the residents spoken to are pleased with the way the home is run and the choices they can make. The manager at the home is experienced and competent. Highfield House Nursing Home DS0000018774.V263140.R01.S.doc Version 5.0 Page 6 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. Highfield House Nursing Home DS0000018774.V263140.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 DS0000018774.V263140.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): EVIDENCE: This standard was assessed and met at the last inspection. Highfield House Nursing Home DS0000018774.V263140.R01.S.doc Version 5.0 Page 9 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 and 9 Care plans at the home are detailed and address the changing care needs of the residents Medication is administered, recorded, stored and disposed of correctly to maintain the safety of the residents living at Highfield House. EVIDENCE: Four care plans were looked at and all contained detailed assessments of areas of need, such as mobility, falls, moving & handling, continence, pressure area & tissue viability, nutrition and general dependency. All were up dated and reviewed on a regular basis. Records were also made of support from, and visits by other health professionals such as GP’s. Appropriate risk assessments were in place. Resident choices were documented such as times of rising and retiring and likes and dislikes of food. 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. Some comments from residents such as “The staff are lovely. ” “The home is very organised and the staff know what they are doing.” “Staff always knock on my door and wait for me to answer before they come in.”
Highfield House Nursing Home DS0000018774.V263140.R01.S.doc Version 5.0 Page 10 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. Staff were observed in the routines of providing care and support. This was being done in a very respectful way. Medication recording, management and storage were inspected. Medicine Administration Records were examined and found to have been completed correctly. Medicines were stored and disposed of appropriately. Highfield House Nursing Home DS0000018774.V263140.R01.S.doc Version 5.0 Page 11 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): 14 The residents living at Highfield House can make choices about their daily lives. EVIDENCE: Residents choices are recorded in the care plan such as times of rising and retiring and what foods they like and dislike. Residents spoken with said that they can choose where they spend their day and who they spend their day with. Activities are based on individual choice and need and preferences are recorded in the plan of care. Highfield House Nursing Home DS0000018774.V263140.R01.S.doc Version 5.0 Page 12 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 Complaints at the home are dealt with in accordance with the complaints policy and residents and relatives know who to raise concerns with. EVIDENCE: These standards were fully assessed and met at the last inspection. There have been no complaints since the last inspection. Highfield House Nursing Home DS0000018774.V263140.R01.S.doc Version 5.0 Page 13 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): 26 The home was clean and did not have any unpleasant odours. EVIDENCE: The home was cleaned to a high standard and there were no unpleasant odours. Residents said that the staff are always cleaning and the home is always clean. Highfield House Nursing Home DS0000018774.V263140.R01.S.doc Version 5.0 Page 14 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): 29 The recruitment procedures at the home are robust to ensure residents safety. EVIDENCE: The records of two recently appointed staff contained two written references, one of which was from a previous employer, enhanced checks with the Criminal Records Bureau and a health record. New staff were provided with a formal induction that was in the form of a workbook which is based on TOPPS induction. Highfield House Nursing Home DS0000018774.V263140.R01.S.doc Version 5.0 Page 15 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): 33, 35 and 36 The management of the home listens to the residents and relatives maintains the safety of the residents living there. EVIDENCE: Individual choices are recorded in the care plans for all residents living at Highfield House. The home has a quality assurance system in place which incorporates the residents comments in the form of questionnaires which are sent out to residents and their relatives. Clear individual financial records are in place for all residents living at Highfield House. Informal supervision takes place on a daily basis by the trained staff however not all staff have had on going formal supervision.
Highfield House Nursing Home DS0000018774.V263140.R01.S.doc Version 5.0 Page 16 Accidents are recorded appropriately. The fire log was checked and staff training in fire safety has taken place and was recorded. Highfield House Nursing Home DS0000018774.V263140.R01.S.doc Version 5.0 Page 17 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 X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X X X X X X X X 3 STAFFING Standard No Score 27 X 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X X 2 X 3 Highfield House Nursing Home DS0000018774.V263140.R01.S.doc Version 5.0 Page 18 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 OP36 Regulation 18 Requirement All staff must have formal supervision. Timescale for action 31/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Highfield House Nursing Home DS0000018774.V263140.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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