Inspection on 08/03/06 for Highfield House Residential Home

This inspection was carried out on 8th March 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 Residential Home 01/03/10

Highfield House Residential Home 18/09/07

Highfield House Residential Home 26/09/06

Highfield House Residential Home 14/12/05

Highfield House Residential Home 15/03/05

Highfield House Residential Home 20/12/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Highfield House Residential Home London Road Halesworth Suffolk IP19 8LP Lead Inspector Jane Offord Unannounced Inspection 8th March 2006 13:00 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 DS0000024415.V285883.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. DS0000024415.V285883.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Highfield House Residential Home Address London Road Halesworth Suffolk IP19 8LP 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) 01986 872125 01986 872125 www.bupa.co.uk BUPA Care Homes (CFCHomes) Limited Post Vacant Care Home 40 Category(ies) of Dementia - over 65 years of age (3), Old age, registration, with number not falling within any other category (39), of places Physical disability (2) DS0000024415.V285883.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 1 Care can be provided to three named service users with dementia (as detailed in the application for variation dated 12 April 2005). 14th December 2005 Date of last inspection Brief Description of the Service: Highfield House is situated close to the town of Halesworth in Suffolk. The home is owned by BUPA and is registered for 39 older people and 1 person with a physical disability. Highfield is not registered to provide nursing care. The home offers 32 single rooms and 3 double rooms, 28 rooms have en-suite toilet facilities and 12 have an en-suite bath or shower. Highfield House offers two lounges, one with a television and one quiet room and two dining rooms. The home is situated within extensive grounds, with a summerhouse, sensory garden, patio and terraced areas. The home has easy access to the shops and is on the local bus route. Mrs Deidre Coby has been appointed the home’s manager and is currently in the process of becoming the registered manager for Highfield with the Commission for Social Care Inspection (CSCI) DS0000024415.V285883.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit took place on a weekday between 13.00 and 17.00. The manager was available to assist with the inspection process throughout. During the inspection three residents’ files and care plans were seen together with a number of policies, staff training records, results of a recent residents satisfaction questionnaire and the complaints log. A medication administration round was observed and some of the medication administration records (MAR sheets) were inspected. A tour of the home was undertaken and several residents invited the inspector to visit their room. Some staff and some visitors were spoken with. The day of inspection was very cold and raining but the home felt warm and welcoming. The décor is attractive and furniture is appropriate to the age group. Corridors have a selection of interesting pictures on the walls. Residents were having lunch when the inspector arrived and there was a friendly hum of conversation from the dining room. What the service does well: What has improved since the last inspection? There was evidence in the files of pre-admission assessments taking place, which had been a requirement from the last inspection. There was also evidence that risk assessments were being completed with valid interventions. DS0000024415.V285883.R01.S.doc Version 5.1 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. DS0000024415.V285883.R01.S.doc Version 5.1 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 DS0000024415.V285883.R01.S.doc Version 5.1 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): 3, 5. People who use this service can expect to have their needs assessed prior to admission and be able to visit the home to see the service on offer before a final decision to enter is made. EVIDENCE: Files seen of recently admitted residents had documentary evidence of a preadmission assessment having been done. The assessment covered areas of care such as personal hygiene, mobility, diet, elimination, sleep, pain, wounds and pressure sores. Other things assessed were communication, mental state and orientation, personal safety and history of falls. Further information included the family situation, interests/hobbies/pets, religion, medication and past medical history. One resident spoken with said they had been unable to visit the home prior to admission as they were in hospital. However they had lived in Halesworth and knew of the home. One of their children had visited the home and made the arrangements on their behalf. DS0000024415.V285883.R01.S.doc Version 5.1 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, 8, 9. People who use this service can expect to have a plan of care to meet their needs but cannot be assured that all the assessed needs will be reflected in the plan. They can expect to be protected by the service’s medication policy. EVIDENCE: Each resident’s file seen contained a care plan that covered areas of care such as mobility, diet, personal hygiene, dressing/undressing, sleep, toilet needs and communication. When needed care plans included skin care and spiritual needs. There were a number of risk assessments for skin integrity, nutrition, moving and handling needs and falls. One resident had a risk assessment for falls and although low risk it still included some interventions to protect the resident. ‘Frequent observation of the resident and ensure appropriate footwear’. One file had a note that a red area had developed on the resident’s skin so a referral was made to the community nurse for advice. The community nurse attended and left the carers instructions together with an appropriate cream to apply. DS0000024415.V285883.R01.S.doc Version 5.1 Page 10 There was evidence that residents were weighed regularly and this was linked to the nutritional assessment. There were also records of hospital out patient appointments attended. Each file had the resident’s GP and contact details and a record of any allergies. The files of two residents recorded at the assessment that the resident expressed anxiety, one about entering the home and leaving their own home the other about needing to ask for help. Neither of these concerns was addressed in the resident’s care plan. One resident is registered blind but the care plan made no reference to any coping strategies they used such as, the way they liked their food to be placed on the plate so they could identify what they were eating easily. A medication round was observed. The carer washed their hands prior to commencing and locked the trolley every time they left it to administer medication. The water jug on the trolley was covered and there was a supply of clean medicine pots. Residents were asked respectfully if they wished to take their medication and sensitively helped when required. The MAR sheets were inspected and it was noted that each one had a photograph of the resident and no gaps were seen in the signature boxes. Records were kept of wasted medication that was taken for destruction by the pharmacist. The medication policy was seen and covered storage, receipt and disposal of medication. There were guidelines for homely remedies, covert administration and errors in administration. There was a procedure for administering Controlled Drugs (CDs) and the correct way of recording. The policy also contained guidelines for the management of oxygen in the home if a resident required oxygen therapy. There was an assessment for self-medication and this was seen in one resident’s file together with consent from their GP to allow the resident to self-medicate. The policy folder had a list of the signatures of those staff who had been trained to administer medication and certificates of the training they had attended. There was also a copy of the most recent audit done by the local pharmacist that stated they had found no problems. DS0000024415.V285883.R01.S.doc Version 5.1 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): 12, 13, 14. People who use this service can expect to have choice about the way they spend their time and be encouraged to maintain contact with family and friends. EVIDENCE: Some of the residents’ files seen had records of activities undertaken by the resident such as memory games, board games, a quiz, dominoes and helping to bake the Christmas cake. One record stated ‘Nxxx likes to come down to the lounge for Holy Communion’. During the day a number of visitors came to the home. Staff welcomed them and in many cases offered them a hot drink. Some visitors spoken with said ‘they always offer a tray of tea and some biscuits’. Residents’ files contained information about the next of kin and contact details. A visitor spending time with a friend said the friend had recently been very unwell but the staff had kept the family well informed and the son had spent a night at the home when the resident had been especially ill. Residents said they could choose how they spent their time. Staff were heard offering to escort residents from the dining room after lunch to their rooms or the lounge or conservatory. DS0000024415.V285883.R01.S.doc Version 5.1 Page 12 Residents also said they could choose how they received personal care, whether they had a shower or bath and whether they preferred help or not. The daily records of one resident noted that they had ‘declined a bath this evening’. One resident said they liked their room and enjoyed spending time alone in it. They had a large collection of books and videos and passed their time quite happily with them. Another resident said they had frequent visitors and had been out with friends on the previous day. DS0000024415.V285883.R01.S.doc Version 5.1 Page 13 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): 18. People who use this service can expect to be protected from abuse. EVIDENCE: The POVA policy was seen and contained guidelines compatible with the procedures issued under the Inter-Agency Policy compiled by the Vulnerable Adult Protection Committee, Suffolk. A requirement from the previous inspection was for all staff to receive POVA training. The training log was seen and showed all staff had had that training this year. Staff spoken with confirmed that and were able to describe action they would take in the event of there being concerns about an abusive situation. DS0000024415.V285883.R01.S.doc Version 5.1 Page 14 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): 21. People who use this service cannot be assured that there are sufficient functioning bathrooms to meet their needs. EVIDENCE: The home has 32 single rooms and three double rooms, 28 have en-suite toilet facilities and twelve have an en-suite bath or shower. There is a communal bathroom on the ground floor and three bathrooms on the first floor. On the day of inspection one bathroom on the first floor was being used as a storage area with the bath full of boxes and other equipment in the room including a television set. The manager said the residents did not like using this bathroom on account of the sloping ceiling. A decision needs to be made about the use of this room and the water checks undertaken for safety and potential infection should be maintained while there is still functioning plumbing in the room. DS0000024415.V285883.R01.S.doc Version 5.1 Page 15 A further bathroom on the first floor had a Parker bath in it that was not emptying completely. This matter was brought to the notice of the manager who has subsequently provided CSCI with evidence that the matter was being dealt with and the maintenance person was awaiting a new part for the bath. However this reduced the number of usable communal baths in the home to two. Also in the Parker bathroom it was noted that the toilet seat was detached from the toilet and propped against the wall. DS0000024415.V285883.R01.S.doc Version 5.1 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 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): 30. People who use this service can expect to be cared for by staff trained to do the job. EVIDENCE: A requirement from the last inspection was that all staff should receive training in Protection of Vulnerable Adults (POVA). The training records seen showed that all staff had undergone that training this year. Staff spoken to confirmed they had had the training. Some staff had done training in 1st aid, infection control, basic food hygiene and a guide to supervision. In addition there was evidence of updating training in moving and handling, fire awareness and health and safety. New staff received an induction that meets the National Training Organisation (NTO) standard. DS0000024415.V285883.R01.S.doc Version 5.1 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 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, 38. People who use this service can expect to have their views sought about the service and have their finances protected by the financial management procedure in place however they cannot be assured that all areas of the home are maintained to a standard to protect their health and safety. EVIDENCE: As part of the quality assurance for BUPA the home had recently given all residents a questionnaire about the service they receive in the home. The manager said the results were better than last year. Fifty per cent of the questionnaires were returned and the results were generally in the ‘satisfied’ or ‘very satisfied’ brackets. There were questions on the environment, the food, staff attitudes and the care offered. Opinion was sought on the cleanliness of the home and any changes people wanted. DS0000024415.V285883.R01.S.doc Version 5.1 Page 18 The administrator who manages residents’ personal money was not available on the day of inspection. The inspector requested that they send to CSCI a flow chart and description of the management of residents’ money to ensure that the system will protect residents’ finances. This has been done and the documentary evidence shows the system is safe and offers an audit trail. During the inspection it was noted that the door to the laundry was wide open, on several occasions, with no member of staff present. The laundry is easily accessible to residents and has a notice on the door that says it must be closed when not in use. The automatic fire release mechanism on the door was broken and would not have functioned as a tin blocked it. The laundry contained a number of washing machines and dryers in a small area and was hot. The situation posed a potential fire hazard. DS0000024415.V285883.R01.S.doc Version 5.1 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 X X 2 X X X X X STAFFING Standard No Score 27 X 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X 1 DS0000024415.V285883.R01.S.doc Version 5.1 Page 20 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. 2. Standard OP7 OP21 Regulation 15 (1) 23 (j) Requirement Residents’ care plans must reflect their assessed needs. Any maintenance required on the Parker bath must be undertaken as soon as possible to ensure there are adequate bathing facilities functioning in the home to meet the needs of the residents. The toilet seat in the Parker bathroom must be replaced. The water checks in the bathroom used for storage must continue until the plumbing is disconnected. The laundry door must remain shut when no member of staff is in the room. The automatic release on the fire door to the laundry must be repaired or renewed. Timescale for action 31/03/06 31/03/06 3. 4. OP21 OP38 23 (j) 13 (4) (c) 08/03/06 08/03/06 5. 6. OP38 OP38 13 (4) (a) 23 (4) (c) (iv) 08/03/06 08/03/06 DS0000024415.V285883.R01.S.doc Version 5.1 Page 21 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 OP21 Good Practice Recommendations Consideration should be given to altering the use of the bathroom presently used for storage, provided the home could still meet Standard requirements for the number of facilities available to residents if the bath was removed. If that bath is included in the required numbers then it should be made functional again. DS0000024415.V285883.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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 DS0000024415.V285883.R01.S.doc Version 5.1 Page 23 - 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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