Inspection on 29/08/07 for Highfield Nursing Home

This inspection was carried out on 29th August 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 Nursing Home 05/08/08

Highfield Nursing Home 07/08/06

Highfield Nursing Home 09/02/06

Highfield Nursing Home 13/10/05

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 Val Daly Unannounced Inspection 29th August 2007 09:30 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.V349939.R01.S.doc Version 5.2 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.V349939.R01.S.doc Version 5.2 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 Highfield@schealthcare.co.uk Southern Cross Care Homes Limited Mrs Susan Anne Archer 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.V349939.R01.S.doc Version 5.2 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. 7th August 2006 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. None 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. Cost of service at Highfield Care Home. On the date of this inspection the fees for care ranged from £415 for Residential Care to £503 for Nursing care. Highfield Nursing Home DS0000000174.V349939.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was a key inspection and was completed by an inspector over two days. As a key inspection, all of the key standards were examined. A tour of the home took place, residents records were examined, records including accidents, complaints and menus were looked at and five residents, three members of staff, the manager, deputy manager and administrator were engaged in discussion about living at Highfield Care Home. The Commission for Social Care Inspection sent a number of questionnaires to the home for residents to complete. Ten were returned from residents and relatives. Comments from residents and relatives include: • • • • • • • My relative is kept totally clean and well dressed. Wheelchair bound activities are limited. Meals are varied and well prepared. I have nothing but praise for the staff. It is a warm and friendly atmosphere. Friendly and caring staff. Variety of activities. What the service does well: The home employs an activity co-ordinator, who organises a variety interests and pastimes for the residents to join in with if they wish. There is a weekly programme of activities on display, offering, quizzes, crafts, dominoes, bingo, ‘remember when’, cold baking, pampering and entertainment. The co-ordinator was also following on an exercise programme with the residents, which had been commenced by a physiotherapist as a pilot scheme. Four of the residents spoken to said how much they enjoyed this particular activity. The home shares a minibus with some of the other homes in their organisation. The activity co-ordinator said she plans her outings ahead in order to book her dates for the minibus. Places visited included; Saltburn, Seaton Carew, Redcar, Beamish, Stewart Park, Strikes Garden Centre, Tockets Mill and also short outings to cafés and pubs. Resident’s bedrooms were comfortable and contained personal possessions making them homely and individual. Two of the residents interviewed said they had chosen the colour scheme of the walls and carpet when they had been re decorated. Four sets of care documentation were examined and they each contained an individual plan of care. The plans were evaluated monthly and then reviewed Highfield Nursing Home DS0000000174.V349939.R01.S.doc Version 5.2 Page 6 three monthly with relatives being invited to attend and make their comments on the plans and care given. The plans also contained a social profile of the resident, showing their likes and dislikes of food, hobbies and working years. Each plan also contained information on which activities the resident had participated in. The documentation also showed placement reviews take place six monthly or every three months if the resident has any skin pressure damage. 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. The summary of this inspection report can be made available in other formats on request. Highfield Nursing Home DS0000000174.V349939.R01.S.doc Version 5.2 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.V349939.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service have their needs assessed. EVIDENCE: Assessments are carried out prior to a resident moving into the home to ensure their needs can be met. The manager also carries out her own assessment, meeting with the prospective resident, either in his or her own home or in hospital. Four residents files were examined and they each contained the required information. One resident interviewed said that she had moved to the home to be nearer her family. Four other residents said that their relatives had chosen the home on their behalf. The home does not provide intermediate care. Highfield Nursing Home DS0000000174.V349939.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care that people receive is based on their individual needs. Staffs need to ensure signatures are on individual reviews to show resident or relative involvement. The principles of respect, dignity and privacy are put into practice. EVIDENCE: Four sets of care documentation were examined and they each contained an individual plan of care. There was evidence to show that the plans were evaluated monthly and then reviewed three monthly with relatives being invited to attend and make their comments on the plans and care given. However in two out of the four reviews examined there were no signatures in place form either the resident or their relative. The plans also contained a social profile of the resident, showing their likes and dislikes of food, hobbies and working years, however more information is needed to meet social and leisure needs. A weekly report detailing how the residents spent their days was in place, however in three out of the four plans examined these were not up to date. Each plan also contained information on which activities the resident had participated in. The documentation also showed placement reviews take place six monthly or every three months if the resident has any skin pressure Highfield Nursing Home DS0000000174.V349939.R01.S.doc Version 5.2 Page 10 damage. There was evidence that the resident’s health care needs were being met. Risk assessments are in place where needed. Policies and procedures are in place for the ordering, receipt, storage, disposal and administration of medication. For residents wishing to manage their own medication a risk assessment and management process was in place. Qualified nurses administer medication and will continue to do so regarding residents who require nursing care. However senior care assistants have recently received training in administration and safe handling of medication. The senior carers were in the process of being supervised whilst administering medication to residents who do not require nursing care, to ensure competence before carrying out these duties on their own. This was confirmed in staff training records and during staff interviews. Residents interviewed said the staff always knocked on doors before entering and were cheery and helpful. Highfield Nursing Home DS0000000174.V349939.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use services are able to make choices about their lifestyle. A variety of food is offered. EVIDENCE: The home employs an activity co-ordinator, who organises a variety interests and pastimes for the residents to join in with if they wish. There is a weekly programme of activities on display, offering, quizzes, crafts, dominoes, bingo, ‘remember when’, cold baking, pampering and entertainment. The co-ordinator was also following on an exercise programme with the residents, which had been commenced by a physiotherapist as a pilot scheme. Four of the residents spoken to said how much they enjoyed this particular activity. The home shares a minibus with some of the other homes in their organisation. The activity co-ordinator said she plans her outings ahead in order to book her dates for the minibus. Places visited included; Saltburn, Seaton Carew, Redcar, Beamish, Stewart Park, Strikes Garden Centre, Tockets Mill and also short outings to cafés and pubs. A daily record of activities within the resident’s care is completed, which shows the activities they participated in. The manager said that representatives from religions visit individual residents and there is a church service held every two weeks in the home. Highfield Nursing Home DS0000000174.V349939.R01.S.doc Version 5.2 Page 12 The menu showed that a variety of food is offered to residents and more alternatives are available. However only one resident out of the five spoken to said they were aware of what was on the menu prior to the meal being served. A new menu had recently been started, which had been planned for older people and people with dementia in care homes. The menus were nutritionally analysed. The manager had made a few changes to the menu to suit resident’s preferences. Residents interviewed said they were satisfied with the meals and were aware they could ask for something different if they did not like food offered. Residents are able to eat their meals in the dining rooms or in their rooms as they wish. Highfield Nursing Home DS0000000174.V349939.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are able to express their concerns and have access to a robust effective complaints procedure, are protected from abuse, and have their rights protected. EVIDENCE: Five residents interviewed said that they would either speak to a carer or the manager if they had any concerns. The home has a complaints policy and procedure in place. This has been updated since the previous inspection and includes the Contracts and Commissioning department of the Local Authority. One complaint had been received in the previous twelve months. Records showed that the complaint had investigated promptly and there were written reports of action taken in place. Following the outcome of the investigation the complainant was asked if they were satisfied or not. The home has a whistle blowing policy and an adult protection policy in place. There was evidence in the staff training file to show that staff had received training in Adult Protection’. Three members of staff confirmed during interviews that they had received training and were aware of the procedure to follow in the case of suspected abuse. Highfield Nursing Home DS0000000174.V349939.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The physical design and layout of the home enables people who use the service to live in a comfortable environment. EVIDENCE: A tour of the home was carried out. Resident’s bedrooms were comfortable and contained personal possessions making them homely and individual. Two of the residents interviewed said they had chosen the colour scheme of the walls and carpet when they had been re decorated. One of the lounges was in the process of being been changed into a sensory room with a projector and screen, which will have a relaxation bubble scene, fish or a calming lights effect. A member of staff had suggested the changes and fundraising had taken place to purchase the equipment. Since the previous inspection the treatment room had been re located and also a storeroom had been altered to make an extra bathroom. In two of the other bathrooms overhead tracking had been installed with a hoist. Two of the residents interviewed said they enjoyed a bath using the new hoist. Many of Highfield Nursing Home DS0000000174.V349939.R01.S.doc Version 5.2 Page 15 the residents were in the dining area having lunch, which looked appetising and was nicely presented. The garden and patio area had tubs of colourful plants and flowers. Some new garden furniture had been purchased to enable the residents to sit outside in the better weather. Maintenance certificates were in place and up to date. The home was clean and odour free. Highfield Nursing Home DS0000000174.V349939.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staffs in the home are in sufficient numbers to support the people who use the service; however further training is required for some staff in order to safeguard the residents. EVIDENCE: The home has a rota in place, which is flexible for the needs of the residents. There is a policy and procedure in place for the recruitment of staff. Staff records showed that the required information, references and CRB checks were in place prior to staff commencing work in the home. Since the previous inspection a new induction-training programme was in place, which runs alongside ‘Skills for Care’ induction programme. The home has a training plan in place and since the previous inspection staff had undertaken training in many areas such as NVQ 2, Adult Protection, Fire Safety, Moving and Handling, Palliative Care and Food Safety. Three Senior Carers had also undertaken training in safe handling of medication. It was noted that training is required for some of the staff in Food Safety, Health and Safety and COSSH. The manager said that this training would be arranged. At the time of the inspection four carers had achieved NVQ level 2 or above. A further eleven carers were working towards an NVQ. Highfield Nursing Home DS0000000174.V349939.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The management and administration of the home is based on openness and respect. Staff supervision needs to be up to date and further training is required for some staff in Health and Safety in order to safeguard the residents. EVIDENCE: The registered manager is a qualified nurse, competent and experienced to run the home. At the time of the inspection she was undertaking the registered managers award. The home has a ‘relatives surgery’ where the manager is available one evening a week for anyone who wishes to see her. This is to assist relatives who wish to see the manager but are unable to visit the home during the day. The regional manager carries out monthly visits and reports on many aspects of the home, the building, care records, health and safety and also has discussion with residents and staff. Surveys are sent out annually to residents to seek their views about life in the home. However feedback from the surveys is not Highfield Nursing Home DS0000000174.V349939.R01.S.doc Version 5.2 Page 18 given to the manager. Resident and staff meetings are held regularly and minutes are kept. Some of the staff requires training in Health and Safety. Since the previous inspection improvement had been made regarding formal supervisions for staff but more were required to keep them up to date. Highfield Nursing Home DS0000000174.V349939.R01.S.doc Version 5.2 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 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 X 2 Highfield Nursing Home DS0000000174.V349939.R01.S.doc Version 5.2 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. Standard OP7 Regulation 15 (1) Requirement Signatures must be in obtained from either the resident, or their relative when not possible to show resident involvement in the review of their plan of care. Training for some staff is required in Food Safety, Health and Safety and COSSH. This is required to protect the health, safety and welfare of the people who use the service. Timescale for action 30/11/07 2. OP38 18 (1) 30/11/07 Highfield Nursing Home DS0000000174.V349939.R01.S.doc Version 5.2 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 OP7 Good Practice Recommendations The manager should continue to work with staff to improve the collection of social profile information, which can then feed in to the completion of Care Plan 9. in meeting social, leisure needs. The weekly reports detailing how the resident spends their days should be kept up to date. The manager should continue working to achieve 50 of the care staff with NVQ2 in care. The registered manager should complete the registered managers award. The results of resident / relative quality surveys should be published and made available to residents / relatives and other interested parties including CSCI. The manager should continue to work to achieve supervision for care staff at least six times per year. Residents should be informed of the choices on the menu prior to the meals being served. 2. 3. 4. OP28 OP31 OP33 5. 6. OP36 OP15 Highfield Nursing Home DS0000000174.V349939.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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.V349939.R01.S.doc Version 5.2 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. 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