Inspection on 27/03/06 for Highfield Nursing Home

This inspection was carried out on 27th 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 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 07/06/07

Highfield Nursing Home 30/08/06

Highfield Nursing Home 26/08/05

Highfield Nursing Home 23/03/05

Highfield Nursing Home 30/09/04

Highfield Nursing Home 29/03/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Highfield Nursing Home 36-38 Bromley Road Catford London SE6 2TP Lead Inspector Barbara Ryan Unannounced Inspection 09:30a 27 March 2006 th 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 DS0000007027.V280695.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. Highfield Nursing Home DS0000007027.V280695.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Highfield Nursing Home Address 36-38 Bromley Road Catford London SE6 2TP 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) 020 8488 3970 020 8488 3970 lorna.lang@excelcareholdings.com Highfield Healthcare Ltd Mrs Yvette Elizabeth Owens Care Home 45 Category(ies) of Old age, not falling within any other category registration, with number (0), Physical disability (0) of places Highfield Nursing Home DS0000007027.V280695.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 45 patients, frail elderly persons aged 60 years and above (female) and 65 years and above (male) 31st January 2006 Date of last inspection Brief Description of the Service: Highfield is a care home with nursing for a maximum of 40 older service users, who are physically frail. The overall stated aim, shared with other homes run by the same provider, is that of offering care in a home from home setting, recognising and meeting individual needs. To this end, Highfield says that they strive to offer sensitive and conscientious nursing and personal care in a comfortable and safe environment. The home aims to deliver a service based on a thorough assessment of need, in collaboration with the appropriate health professionals and involving the users and their families. Recruitment and training would be targeted to ensure that staff are competent and committed. The registered provider is Highfield Healthcare, a company associated to an organisation called ‘Excelcare’, who runs over thirty homes in England. A director, to whom all the staff are ultimately accountable, directs the service. The day-to-day running of the home is delegated to a care manager, who works full time at the home and who leads a team of staff. Accommodation is provided in a large building, divided into three smaller units, one on each floor. There is a lift. Bathrooms and toilets are located on each floor. None of the bedrooms have en-suite facilities. Over 50 of places had been in shared (double) bedrooms, but this is changing with double rooms being used as single when vacancies arise. There is a large back garden, mostly laid to lawn, with raised flowerbeds and a rockery. The front of the premises is paved to allow parking for visitors and staff. The front and back doors are accessible to people in wheelchairs, with ramps being provided to enable access to the garden. The premises are located on a main road close to the centre of Catford. The area is served by public transport and has a selection of shops and a supermarket. Highfield Nursing Home DS0000007027.V280695.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out on 27th March 06 beginning at 9.30 and ending at approximately 5.40pm. The methods of inspection included a tour of the building, discussion with the manager, operational manger, activities organiser, one member of the nursing staff, 5 resident and 3 visiting family members, the inspection of five residents files and a spot check on resident’s cash held at the home. What the service does well: What has improved since the last inspection? What they could do better: The home needs to complete risk assessments with regard to residents with mobility difficulties that live in rooms that are accessed only via stairs. The home should replace the bubbling lino in room 14 and ensure that there is adequate comfortable seating in the room. The home should offer all residents a key to their room and should ensure that the appropriate locks are fitted to allow this, unless it is deemed unsafe to do so. The home should continue to explore opportunities to enable all residents who at present share a room to be able to have a single room unless they make an active choice to share. The home needs to find a means of ensuring that it reaches 50 of care staff achieving level 2 NVQ or are attending a course. The home should continue to support residents to access leisure and social activities that they choose and are appropriate to there needs. They should give information to residents and family around the use of cot sides. Highfield Nursing Home DS0000007027.V280695.R01.S.doc Version 5.1 Page 6 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 DS0000007027.V280695.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 Highfield Nursing Home DS0000007027.V280695.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): 2,3,4 Residents are issued with contract of terms and conditions, however these do not state the type of room and room number the person will occupy and the fees. The home has a policy of assessing residents prior to their admission and this is being done. EVIDENCE: Five files were inspected and all had contracts and terms and conditions. None seen had a room number or type of room i.e. shared or single. The fee was not on the contract; in addition some were not signed. All residents should have a room number on their terms and conditions, as well as the fees charged. This would be particularly important for residents who are self funding. All the files looked at had assessments. The home has a policy of inviting prospective residents and their family to the home prior to admission. At times the prospective residents do not visit but a member of their family has come instead. Hospital admissions have been less frequent since the last inspection. Looking at dates of residents’ admission to hospital it was clear that some residents are Highfield Nursing Home DS0000007027.V280695.R01.S.doc Version 5.1 Page 9 being admitted to hospital and discharged very quickly, only to be re-admitted again shortly after. On one occasion a resident was discharged and readmitted the next day and die in hospital a day latter. The home must work with the hospital discharge team to ensure that the home continues to be able to meet the needs of service users discharged from hospital. Highfield Nursing Home DS0000007027.V280695.R01.S.doc Version 5.1 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): 7,10 Service users’ health, personal and social care needs are set out in a care plan, although further work needs to be done on risk assessments. Service users reported that they are treated with respect and their privacy is upheld. EVIDENCE: Five files were looked at and all had updated care plans. The home manager has introduced a weekly audit of all care plans, which she carries out. She has given key workers information around their role and responsibilities of this work. The care plans are reviewed monthly and there is an annul review with the funding authority. On the files looked at, all had a life history on file apart from one; there was a record that this was the residents family who where completing this. The home could write a little more on the care plans around goals and achievements, however it was acknowledged that for some of the residents, goals and achievements might be quite small and limited due to the degenerative nature of their illness. However, key workers should continue to work towards this. Some goals and achievement could be identified within the activities programme; these would need to be recorded in the care plan as well as the activities organiser’s files, which at present are kept on separate files. Highfield Nursing Home DS0000007027.V280695.R01.S.doc Version 5.1 Page 11 Only one of the files looked at had a consent forms for the use cot sides. The home must give information to residents and/or their family about the use of cot sides and the benefits and drawbacks of using them. The high percentage of male carers can at times make providing carers of the same sex difficult for the home. The home have made a commitment that they will ensure that male staff are always chaperoned by a female carer if they are providing personal care to a female residents. Ideally residents should be given a choice around who provides them with personal care. Highfield Nursing Home DS0000007027.V280695.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13,15 Activities and events do not currently take into account residents needs and wishes or the number of residents in more advanced staged of dementia. The home must ensure that the programme started is maintained and built on. They should try to have a new activities organiser in place as soon as possible. Residents are able to maintain contact with family and friends. They are able to access a healthy diet and culturally appropriate diet. EVIDENCE: The home had employed and activities organiser who had been in post approximately ten weeks prior to the date of inspection. A programme had been put in place which included art, exercise, hand massage and other activities. Plans were in hand to introduce a variety of other activities including cooking without heat, identifying a pet visiting scheme, picture bingo and various other activities. This person left the employment of the organisation on the day of inspection. This was a quite abrupt curtailing of the activities programme. The managing organisation needs to look at how to maintain the activities that are already set up until a new person is in post, to ensure residents are provided with some level of continuity. The home has a number of residents in quite advanced stages of dementia and the activities the home offer need to be appropriate to their needs. The home Highfield Nursing Home DS0000007027.V280695.R01.S.doc Version 5.1 Page 13 does have entertainers visiting at times and have had a visiting clothes shop recently. Visitors are made welcome and on the day of inspection there were a considerable number of visitors throughout the day. The home also has regular visits from representatives from the Church of England and the Roman Catholic Church for residents who wish to take communion. The residents are able to access a healthy diet; there is a choice of menu and African-Caribbean food is available. The chef said that they have a menu card to fill in, but quite often residents are not able to fill this in or would like something different on the day. The chef said that he would speak to residents and ask them what they want. He had been there many years and said he was familiar with residents’ preferences and was able to support them to have the choice of food they like. The chef will cook a birthday cake for residents on their birthday. The home ensure that fruit is available to residents who, due to their levels of dementia, may not be able to ask for fruit, but would like some if it was offered to them. The chef said that they bring a bowl of fruit out when serving meals. Highfield Nursing Home DS0000007027.V280695.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 The home has a complaints book and all complaints recorded in the book since the last inspection were dealt with appropriately. Staff need to have updated training with regard to the protection of vulnerable adults in order to ensure service users are fully protected from abuse. EVIDENCE: The home has a complaints book, which was looked at. There were three complaints entered in the book. All had been recorded and deal with. The home makes an entry for each day, and if there are no complaints they enter Nil. The home has a vulnerable adults policy and there have been two investigations since the last inspection. These have been dealt with by the adult protection coordinator for the borough. The managing organisation has employed a vulnerable adults worker on a short-term contract, who will be working with staff around issues of adult protection. The home have a whistleblowing policy and this was on display in the manager’s office. The last training provided around the protection of vulnerable adults was in October 05. Staff need to have some updated training around this issue. Highfield Nursing Home DS0000007027.V280695.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 24, 26, The home offers a homely environment and residents generally have pleasantly decorated and personalised room. The home has a number of rooms that are only accessible via a small flight of stairs and is therefore not entirely suitable for residents with mobility problems. Service users do not have a key to their rooms. The home has provided suitable accommodation for staff whilst on their break. There are a small number of repairs to be completed. EVIDENCE: The home occupies a large Victorian house on a main road. It is pleasantly decorated and was in the process of having some further redecoration done on the day of inspection. The home has reduced the number of shared rooms and only three are still shared. The structure of the building makes some of the rooms inaccessible for residents with mobility difficulties who cannot climb stairs, as a number of rooms are accessed by a small flight of stairs with no lift access. Several of these rooms are now unoccupied. One of these rooms is occupied by two residents, one of whom is no longer able to mobilise. There is no hoist in the room due to issues with the stairs. One resident is being cared for in bed and Highfield Nursing Home DS0000007027.V280695.R01.S.doc Version 5.1 Page 16 the other, who uses a zimmer frame, needs support to access her room. She is at risk on the stairs without assistance and at risk when trying to mobilise in her room without her frame. The room has one window at the one end. The curtains to provide privacy when pulled also block access to a window in the room for one of the residents. The issues around this room were discussed with the home manager and the operational manager. It was acknowledged that one of the residents had been offered a room with wheelchair and hoist access, but had said that they did not wish to move to a vacant room. The other resident was not well orientated in place and it was difficult to judge her views on her accommodation. She was possibly unable to comprehend the risks involved in trying to leave her room without support or able to use the call system. A further fact that complicates the issue around moving residents in shared rooms to a vacancy single room is that some rooms are block booked by a borough and only a residents funded by that authority can been moved to it unless it is purchased from them by another funding authority. The home should carry out risk assessments of both the residents occupying this room and continue to work with the issues of providing accessible accommodation whilst taking into account residents and family wishes. Many of the rooms are not lockable by key and it would not be possible to offer the occupants of these rooms keys if they wanted them and could manage them. Some residents did have keys. The home must risks access and offer all residents a key and ensure that the locks are changed on doors were this is needed. There is a main sitting room and dining room on the ground floor. The sitting room has been divided to create several smaller seating areas. The home was clean and hygienic. There were some minor repairs needed to some of the floor tiles in two of the downstairs WCs. The flooring in room 14 is uneven and the lino is bubbling in some areas. The residents in this room have reduced mobility and this could put them at increased risk of falls. There was no armchair for one of the room’s occupants to use. Of the other residents’ rooms seen, these were pleasantly furnished, decorated. Some residents had personalised their rooms. One of the 1st floor bathrooms needed a more findable and easy to grasp pull cord to switch on the light. The last inspection required that the staff room needed to be made more suitable. The home has now provided a well-equipped room in the building at the bottom of the garden. This has easy chairs for staff and a well-equipped kitchen with kettle, toaster, fridge and microwave. The room looks on to the garden and is light and airy. Highfield Nursing Home DS0000007027.V280695.R01.S.doc Version 5.1 Page 17 The laundry was seen and there is some damage to the floor and bottom of the shelving where residents’ clothes are sorted due to water damage, this needs to be repaired. The manager and administrator’s office is situated in a part of the conservatory. This becomes uncomfortably hot at times and blinds are needed to screen people from the sun in this room. The home has a large pleasant garden, which is wheelchair accessible. There are several fruit trees, shrubs and flowerbeds. It was attractive and well maintained. Highfield Nursing Home DS0000007027.V280695.R01.S.doc Version 5.1 Page 18 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 The home has not achieved 50 of their care staff having or attending level 2 NVQ or above. The managing organisation needs to ensure that this is achieved. There were sufficient staff on duty to meet the needs of current residents. EVIDENCE: The home at present has 29 residents. On the morning of inspection there were two nursing staff and 4 carers on duty during the day and a rota that gave one nursing and 2 care assistants at night. The home needs to ensure that 50 of the care staff have NVQ level 2. This has not been reached and is at present approx 35 . The home manager explained that there are a number of staff who were recruited and worked at the home for several year who are not eligible to access free NVQ training. The home manager has discussed this with the training manager and at present no solution has been found. This was discussed with the operational manager and there will be consideration given to how this situation can be resolved. A number of the staff that make up the night shift fall into this category; this situation is therefore at times quite concentrated at particular parts of the rota and does not always provide a range of skills mix. The night staff are also almost 50 male; this may at times pose problems for the home’s commitment to ensure that all male staff are chaperoned by a female member of staff when providing personal care to female residents at night. The home felt this was not an issue that had arisen, however it is Highfield Nursing Home DS0000007027.V280695.R01.S.doc Version 5.1 Page 19 possible that this could arise in the future. Highfield Nursing Home DS0000007027.V280695.R01.S.doc Version 5.1 Page 20 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): 35 The home manages the money it hold for residents appropriately. EVIDENCE: The home is not appointee for any residents. They do hold cash for some residents. There was a spot check on three residents’ cash and this tallied with the amount entered in the ledger. Receipts were kept with residents’ cash. There had been an incident of financial abuse since the last inspection; this resident managed their own money. The member of staff has been dismissed. Highfield Nursing Home DS0000007027.V280695.R01.S.doc Version 5.1 Page 21 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 2 3 2 X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 X 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X 2 X X 2 X 3 STAFFING Standard No Score 27 3 28 2 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X 3 X X Highfield Nursing Home DS0000007027.V280695.R01.S.doc Version 5.1 Page 22 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. Standard OP2 Regulation 5 (b)(c) Requirement The registered provider must update the terms and conditions issued to service users to include fees to be paid, type of room and room number. The registered person should ensure that comprehensive risk assessments are carried out with regard to the two residents with mobility difficulties that share a room with access via a flight of stairs with no lift access. The registered person must work with the hospital discharge team to ensure that the home can continue to meet the needs of service users who have been admitted and then discharged from hospital. The registered manager must ensure that male care staff are chaperoned by a female member of staff when providing personal care to female residents. The registered person should ensure that a second armchair is placed in the shared room identified. The registered manager should DS0000007027.V280695.R01.S.doc Timescale for action 30/09/06 2. OP7 13(1)(4) (c) 03/04/06 3. OP4 14(2)(b) 01/05/06 4. OP10 12 01/05/06 5. OP24 16(2)(c) 01/07/06 6. OP19 23(2)(b) 01/06/07 Page 23 Highfield Nursing Home Version 5.1 7. OP10 12(4)& 23 (2) 8. OP21 23(2)(n) 9. OP28 18(1)(c) (i) 10. OP19 23 (2)(b) 11. OP24 12(4)(a) 12. OP29 19(1)-(5) ensure that the lino in room 14 which is bubbling and making and uneven surface should be replaced. The registered provider must continue to take steps to ensure that the use of the premises does not impede residents’ right to privacy, dignity and choice being consistently upheld. (Previous timescale of 01/03/04 and 01/10/05 partially met) The registered provider must change the pull chord to the light switch to the 1st floor bathroom to make it easier to find and grasp. The managing organisation must ensure that they achieve a level of 50 of their care staff have trained to level 2 NVQ or undertaking the course. The registered person must ensure that the bottom shelving and floor in the laundry room that has been damaged by water penetration should be repaired or replaced. The registered person should ensure that all residents are risk assessed with regard to being safe to have a key to there room and all the are assessed as safe are offered keys and locks changed on doors that do no allow this at present. The registered provider must ensure that all statutory checks, to ensure suitability of staff, are conducted and inform the decision to appoint. To this end existing files must be reviewed and appropriate steps taken, if necessary, to ensure that the checks are consistent with the requirements and the home’s own policy. DS0000007027.V280695.R01.S.doc 01/08/06 01/07/06 01/07/06 01/08/06 01/08/06 01/07/06 Highfield Nursing Home Version 5.1 Page 24 (Previous time scale of 01/12/04 partly met – not inspected on this occasion) 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 OP18 Good Practice Recommendations That the effectiveness of the adult protection policy is reviewed by the home in relation to the calibre and expertise of the staff team, the support they receive and the resources available. To this end the following should also be considered: - How the premises support staff in promoting dignity and privacy. - The turnover of home managers and regional managers. - The expertise of care staff and the training provided. - The hours worked and other conditions of work for care staff. That the home maintain and build on the activities programme in place, that provide activities that are appropriate for all residents including whose who have degenerative cognitive conditions. The home should install blinds in the office used by the manager and administrative officer which is situated in a part of the conservatory and can be uncomfortably hot on occasions. That the home when asking residents or there family to give their consent for the use of cot sides should be given information around the use of cot sides that included the benefits and draw backs associated with them. 2. OP12 3. OP38 4. OP7 Highfield Nursing Home DS0000007027.V280695.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection SE London Area Office Ground Floor 46 Loman Street Southwark SE1 0EH 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 DS0000007027.V280695.R01.S.doc Version 5.1 Page 26 - 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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