Inspection on 13/10/05 for Highfield Nursing Home

This inspection was carried out on 13th October 2005.

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

Other inspections for this house

Highfield Nursing Home 05/08/08

Highfield Nursing Home 29/08/07

Highfield Nursing Home 07/08/06

Highfield Nursing Home 09/02/06

Highfield Nursing Home 01/03/05

Highfield Nursing Home 09/08/04

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

CARE HOMES FOR OLDER PEOPLE Highfield Nursing Home The Meadowings Yarm Stockton On Tees TS15 9XH Lead Inspector Lyn Burrell Unannounced Inspection 13th October 2005 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Highfield Nursing Home DS0000000174.V258262.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 Nursing Home DS0000000174.V258262.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Highfield Nursing Home Address The Meadowings Yarm Stockton On Tees TS15 9XH 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) 01642 781309 01642 780253 Southern Cross Home Properties Limited Mrs Margaret Atkinson Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40), Physical disability over 65 years of age (0) of places Highfield Nursing Home DS0000000174.V258262.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Within the 40 registered places a maximum number of 10 service users aged 60 years and above with PD may reside in the home. Three named individuals who are under the registered age category of the home are able to reside in the home for as long as they require and providing that their needs can be met by the home. A maximum number of 40 service users aged 65 years and above (OP) can be accommodated in the home. 1st March 2005 3. Date of last inspection Brief Description of the Service: Highfield care home can provide care of up to 39 older people. This includes providing both nursing and personal care. The home is purpose built and of single story. Non of the rooms have en-suite facilities however WCs and bathrooms are close to bedrooms and the lounges. There are 3 wings to the home with bedrooms and bathrooms, there is a quiet lounge diner at the end of the east wing and a lounge dining area at the south end of the home. A small lounge is in the middle of the home and has access to the enclosed patio. The patio has sturdy furniture for residents use when the weather permits it. Easy access to the home is from Yarm High street and is on a bus route situated on the edge of a housing estate. Shops are plentiful in the High St where residents can visit with family and friends. Highfield Nursing Home DS0000000174.V258262.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A positive inspection, whereby most of the National Minimum Standards inspected was met. The inspection lasted three and a half hours with one inspector; six residents and two relatives were interviewed. The registered manage resigned from her post in August 2005 and a new manager is now in post and has applied for registration with the CSCI. She has worked at the home for some time as the Deputy Manager. During this inspection discussion with residents took place, the inspector walked around the home, staff records and duty rotas were viewed, as were supervision records and the homes complaint policy. The inspector walked around the home and met residents. The home was clean, tidy and well decorated throughout. The six residents interviewed were very satisfied with the care they received. They said they felt happy and well cared for; their views are reflected throughout this report. Relatives who were visiting the home also confirmed the care given to the residents was very good. What the service does well: This home delivers a quality standard of care to the residents and provides a comfortable environment for the residents to live in. The ambience of the home is warm and homely, with good quality soft furnishings. All rooms are personalised with the resident’s belongings such as photos and ornaments. The staff are friendly and greet visitors in a positive helpful manner. Residents comments included:“ “ “ “ “ This home is an asset to the people of Yarm” The staff are all kind and caring” The staff will do anything for the residents” My meals have a special cover on them to keep them warm” The matron sorts out everything I need her too” Highfield Nursing Home DS0000000174.V258262.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 Nursing Home DS0000000174.V258262.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 Nursing Home DS0000000174.V258262.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): These standards were not assessed on this occasion. EVIDENCE: Highfield Nursing Home DS0000000174.V258262.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): 8,10 The staff at the home successfully support service users with their social, health and personal care needs in a way that treats them with respect and promotes their rights and privacy. EVIDENCE: All residents are registered with a local GP, and District Nursing and Macmillan nursing service is available on request. Other health care professionals include the optician and chiropodist. These services visit the home at regular intervals to ensure the resident’s receive a quality service that addresses their health care needs. There have been 3 accidents in the last 12 months that required medical attention; the causes were due to falls that sustained fractures to the hips. A system is in place to monitor people’s falls and hip protectors can be obtained on prescription if people are susceptible to falls. Risk assessments are completed foe any resident who is at risk of harming themselves. Highfield Nursing Home DS0000000174.V258262.R01.S.doc Version 5.0 Page 10 The nursing staff assess residents with a view to prevent pressure sores from developing. The most recent information shows there are three residents with breaks in their skin, two of these residents were admitted from hospital with sores. The home provides specialist equipment to help heal the tissue damage. During discussion with some of the residents they confirmed that the staff were kind and respectful towards them. The home was a happy place where the staff spent time with the residents. The staff assisting residents at mealtimes and also whilst they were carrying out there day to day work. Highfield Nursing Home DS0000000174.V258262.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): These standards were not assessed on this occasion. EVIDENCE: Highfield Nursing Home DS0000000174.V258262.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 in the home are handled objectively and openly with the manager and staff encouraging service users, their friends and families to offer comment on the services that are offered. Service users are confident that any complaints made would be acted upon. EVIDENCE: In the last 12 months there has been three complaints made to the home, two complaints were about hoisting equipment and one was from a resident about the food temperature. These complaints were dealt with by the home manager and involved the regional manager to the complainant’s satisfaction. The company policy for managing complaints is satisfactory, however policies and procedures don’t reflect the current provider details and not the previous organisation. The manager did confirm that the process of change is ongoing and all the policies will change to Southern Cross in the near future. Highfield Nursing Home DS0000000174.V258262.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): 19,23,24 25 The home is clean, well decorated and maintained. This can help promote a positive image for service users, and ensure they remain safe. All rooms in the home are single and meet the National Minimum Standards but they do not have en-suite facilities. EVIDENCE: The building was well maintained and in good decorative order. Recently there has been new carpets and flooring fitted in the home, this is part of an ongoing refurbishment plan, whereby the manager has a devolved budget that allows capital expenditure to be spent as she feels is necessary. The handyman keeps meticulous records that show when minor repairs have been done and also his monitoring checks that maintain safety in the home. Highfield Nursing Home DS0000000174.V258262.R01.S.doc Version 5.0 Page 14 Each resident’s room has equipment provided that will help with their care needs. During a time of redecoration residents are included in choosing colour schemes. A resident confirmed that she chose the colour scheme when her room was redecorated. One resident said she chose to have her own curtains and bed linen in her room and also had small items of furniture that she had brought from home. Rooms are bright and cheerful and individual, the residents that had a discussion said they “felt better having their belongings with them as it was a comfort”. Highfield Nursing Home DS0000000174.V258262.R01.S.doc Version 5.0 Page 15 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): 27,28,29,30 Staffing levels are sufficient to effectively meet the needs of service users living in the home. The deployment and number of staff on all shifts ensures that at all times service users are supported by an experienced group of staff, although this would be enhanced by more care staff achieving appropriate qualifications. The procedures for the recruitment of staff are robust and provide the safeguards to offer protection to people living in the home. A satisfactory training programme is in place for all staff to attend. EVIDENCE: There are 38 residents are currently living in the home 16 of them require nursing. There is 1 Registered Nurse on duty 24 hrs supported 6 carers during the morning, 5 carers each afternoon and evening and 3 carers at night. The dependency of the residents is monitored using a scoring system, this shows the current dependency of residents as being medium dependency with a few residents who are high dependency. When the home manager can demonstrate the high dependency needs of the residents she increases the staffing levels accordingly. Highfield Nursing Home DS0000000174.V258262.R01.S.doc Version 5.0 Page 16 Policies need to reflect Southern Cross as the organisation and not Highfield. The company can demonstrate their commitment to training and there is a central training plan which includes a range of subjects such as health and safety, basic food hygiene, fire training, first aid. Staff records are current and up to date. There are 16 carers employed at the home only 1 has NVQ, it is planned for the company to commence training in the near future. However the home will not achieve the 50 of care staff required to achieve NVQ 2 in care by December 2005. A robust recruitment system is in place and the records are well maintained. Each staff member has a personnel file that is kept in accordance with data protection. To ensure the residents are safe each employee completes an application form and explains any gaps in employment. Two references are requested by the manager, one of the references is from the previous employer. Photographic identification and birth certificates are copied and a criminal records check is sought at an enhanced level. Nurses personal identification numbers are checked with the Nursing & Midwifery Council to ensure they nurses are eligible to practice. Highfield Nursing Home DS0000000174.V258262.R01.S.doc Version 5.0 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): 31,36 At this time there is no Registered Manager in post. Staff are currently not appropriately supervised which assists in promoting and safeguarding the best interests of the resident’s. EVIDENCE: A new manager has been in post since 5 September 2005 and the CSCI is currently waiting for the application to be the Registered Manager to be submitted. All staff have a staged induction using the skills for life philosophy. A booklet is given to each new staff member to complete with their mentor. All staff should receive supervision at least 6 times a year this is currently not in place. This provides an opportunity for staff and managers to reflect on skills, competence and development of staff and improve the standard of care provided to service users. Highfield Nursing Home DS0000000174.V258262.R01.S.doc Version 5.0 Page 18 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 X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 X X X 3 3 3 X STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X X X 2 X X Highfield Nursing Home DS0000000174.V258262.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 Standard OP31 OP36 Regulation 9,10,25 18 Requirement The manager must be registered with the CSCI Staff must receive formal supervision at least 6 times a year Timescale for action 30/11/05 30/11/05 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 OP29 Good Practice Recommendations The policies and procedures must reflect the current organisation name and philosophies. Highfield Nursing Home DS0000000174.V258262.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Tees Valley Area Office Advance St. Marks Court Teesdale Stockton-on-Tees TS17 6QX 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 Nursing Home DS0000000174.V258262.R01.S.doc Version 5.0 Page 21 - 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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