Inspection on 05/08/08 for Highfield Nursing Home

This inspection was carried out on 5th August 2008.

CSCI found this care home to be providing an Good service.

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 29/08/07

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 29/01/2009.

CARE HOMES FOR OLDER PEOPLE Highfield Nursing Home The Meadowings Yarm Stockton On Tees TS15 9XH Lead Inspector Val Daly Key Unannounced Inspection 5th August 2008 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.V369842.R02.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.V369842.R02.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.V369842.R02.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. 29th August 2007 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.V369842.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use the service experience good quality outcomes. This inspection was a key unannounced inspection and was completed by an inspector in one inspection day. As a key inspection, all of the key standards were examined. This was to check that the home meets the standards that the Commission for Social Care Inspection say are the most important for the people who use services, and that it does what the Care Standards regulations say it must. A number of records were looked at including assessments of people who use the service and plans of care, staff recruitment records, complaints and maintenance records along with the annual quality assurance assessment. Three people who use the service, two members of care staff, the cook, the administrator and the manager, were engaged in discussion about living at Highfield. The manager had completed an Annual Quality Assurance Assessment prior to the inspection. The AQAA is the services self-assessment of how they think they are meeting the National Minimum Standards. This information is received prior to the inspection and it is then used as part of the inspection process. On the day of the visit the manager provided the information and documentation required. The Commission for Social Care Inspection sent a number of surveys to the home for people who use the service to complete. Twelve were completed and returned. Comments received can be read within the report. This was a positive inspection; people were open and friendly and welcomed discussion about the home. The weekly fees for care ranged from £453 for Residential Care to £572 for Nursing care. Highfield Nursing Home DS0000000174.V369842.R02.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Resident’s finances and records were kept appropriately with signatures in place. However whilst people who use the service have access to their monies via the manager it is held in one bank account and not individually. Documentation showed that water temperatures are taken and documented monthly, however Health and Safety Executive requires that water temperatures for baths are taken and recorded weekly. Highfield Nursing Home DS0000000174.V369842.R02.S.doc Version 5.2 Page 7 Surveys are sent out annually to people who use the service, along with relatives to seek their views about life in the home and the service provided. However a report regarding the outcome of the surveys was not available for inspection and the information had not been shared with the home or the people who use the service. 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.V369842.R02.S.doc Version 5.2 Page 8 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.V369842.R02.S.doc Version 5.2 Page 9 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): 3&6 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: Three sets of documentation were examined. They all showed evidence of an assessment being carried out prior to the person moving into the home. On the day of the inspection a senior member of the nursing staff and the administrator visited a person in another care home to meet them and ensure their needs could be met at Highfield. The assessment documentation covered areas such as; a brief medical history, a physical and social assessment and a social profile. Once the person is admitted a more in depth assessment is carried out: body mapping, ulcer risk assessment, dependency, nutritional risk assessment, malnutrition, eliminating, falls, and oral health. The home does not provide intermediate care. Highfield Nursing Home DS0000000174.V369842.R02.S.doc Version 5.2 Page 10 Comment cards from people who use the service stated ‘The staff came to visit me at my own home first and then I came to visit Highfield. I was able to see my room and agree what furniture I could move in’. Highfield Nursing Home DS0000000174.V369842.R02.S.doc Version 5.2 Page 11 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. The principles of respect, dignity and privacy are put into practice. EVIDENCE: Three care files were examined and they each contained an individual plan of care. The plans were evaluated and reviewed regularly. The documentation also showed placement reviews take place six monthly or every three months if the resident has any skin pressure damage. Since the previous inspection a ‘Life Story Book’ had been introduced. Family and friends were encouraged to assist in completing them, often bringing in photographs of occasions important to the person. Information was also included following on from the life history on how the person likes to spend their day. There was evidence that the person’s health care needs were being met. Risk assessments were in place where needed, for one person, risk of falling, and use of a walking aid. The plans of care are agreed and signed by either the person who uses the service or their relative. Highfield Nursing Home DS0000000174.V369842.R02.S.doc Version 5.2 Page 12 Policies and procedures are in place for the ordering, receipt, storage, disposal and administration of medication. For people wishing to manage their own medication a risk assessment and management process was in place. Since the previous inspection senior carers had achieved competency in administering medication following their training in the safe handling of medication. Another medication trolley had been purchased and senior carers administer medication to those people who do not require nursing care. Comment cards from relatives and people who use the service stated ‘We have hairdressing and manicures once a week, which adds to our well being’. Another comment was’ My mother is well cared for at Highfield’. Highfield Nursing Home DS0000000174.V369842.R02.S.doc Version 5.2 Page 13 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 for twenty hours a week over five days. There is a monthly programme of activities organised, which is on display on the notice board. People who use the service may join in with activities such as; arts and crafts, painting, dominoes, games, quizzes, pamper days, gentle keep fit, bingo and watching films. On the day of the inspection a number of people were joining in with a quiz in one of the lounges. People who use the service also enjoy outings in the company’s mini bus to Saltburn, Preston Park, Seaton Carew, a shopping centre nearby or driving out into the local countryside. Entertainment is also organised throughout the year. Within the care documentation the activities co-ordinator completes an individual weekly record of what the person joined in with. Comment cards form people who use the service stated’ We have a range of activities but I only go to some of them’. Another comment was ‘There are Highfield Nursing Home DS0000000174.V369842.R02.S.doc Version 5.2 Page 14 activities arranged but my family member is not well enough to partake. Staffs do try to involve her but not much success’. Friends and family are welcome to visit at any time and a relative confirmed this was the case during an interview. She said she was always offered a drink during her visits and sometimes stayed for a meal as well. Religious services take place in the home and residents are able to receive communion if they wish. The menu is nutritionally analysed and showed that a variety of food is offered to people who use the service and more alternatives are available. People are given choices by staff prior to the meal being served. During discussion with the cook she said she meets people as they move into the home and gets to know their likes and dislikes and any special needs they have. The majority of people in the home eat their meals in the dining areas but they are able to eat in their rooms if they wish. Comment cards from people who use the service stated ‘The food is good. I am a vegetarian and they cater well for me’. Another comment was ‘I enjoy my meals’. Highfield Nursing Home DS0000000174.V369842.R02.S.doc Version 5.2 Page 15 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): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People know how to complain and the home has an appropriate procedure in place. Training for staff in adult protection has taken place, keeping people who use the service safeguarded. EVIDENCE: Three people interviewed said that they would be comfortable speaking to a member of staff if they had any concerns. Comment cards from relatives and people who use the service stated ‘I can always speak to the home manager. She is always available when I have needed her. Another comment was ‘If I have a problem I have spoken to the matron who is very approachable. She has dealt with the matter, but not often I hasten to add’ The home has a complaints policy and procedure in place. There had been one complaint made to the home since the previous inspection. Documentation was in place to show that the complaint had been investigated and the manager was awaiting a response from the complainant. The home has a whistle blowing policy and an adult protection policy in place. During discussion with staff interviewed they were clear about reporting any suspected abuse. Two of the members of staff interviewed said they were completing a course in adult protection. Another person had only recently been employed and she was waiting to attend the next course although she was fully aware of adult protection as part of her induction. Highfield Nursing Home DS0000000174.V369842.R02.S.doc Version 5.2 Page 16 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 Highfield is comfortable, homely and well maintained. EVIDENCE: A tour of the home was carried out. People’s bedrooms contained personal possessions and were comfortable and homely. A relative interviewed said she had been involved in choosing the colour scheme and the carpet in her family member’s bedroom. Since the previous inspection a cabinet had been removed from the foyer and replaced by two armchairs, where people liked to sit and watch the comings and goings in the home. There was a new shower room for the people who use the service. In one of the bathrooms the dark wood skirting and door had been painted white, which lightened the room. The home was very clean and tidy without any odours. However the dark wood décor in communal areas and bedroom doors gives the home a dated and tired appearance. Highfield Nursing Home DS0000000174.V369842.R02.S.doc Version 5.2 Page 17 Comment cards from people who use the service stated ‘It is a very clean home, rooms and beds etc, always clean clothing at hand. Credit due to the cleaning and laundry staff’. A relative commented there was often a smell of urine especially in the area approaching the dining room’. Another comment was ‘I feel the home could be modernised with each person having their own toilet’. Highfield Nursing Home DS0000000174.V369842.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has vetting and recruitment practices in place. Staffs is trained and qualified and relevant information that safeguards people who use the service is in place. EVIDENCE: The rota showed that there were sufficient staffs on duty with a good skill mix. 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. However in two out of the three staff files examined the history of employment was not always fully explained and stated years rather than specifying months New staffs receive induction training using the Skills for Care Induction Standards. A member of staff interviewed confirmed she was working through the induction programme with a senior carer being her mentor. The manager had a training plan in place and since the previous inspection staff had undertaken training in; NVQ level 2, Health and Safety, COSSH, Food Hygiene, Moving and Handling and Fire Safety. Thirty staff were also working through a twelve week course for the protection of vulnerable adults. The manager said when this group of staff had completed the course a further fifteen would commence. Following this a course in infection control would be undertaken. At the time of the inspection more than 50 of the carers had Highfield Nursing Home DS0000000174.V369842.R02.S.doc Version 5.2 Page 19 achieved NVQ level 2 in care or above and a further three were registered to start the course. Comments from relatives and people who use the service stated ‘The care home provides a safe and comfortable environment where my family member enjoys her meals, which need to be fed to her. The staffs are always cheerful and patient and caring and do their best for the residents. They are good at liaising with relatives and call in the Doctor quickly if any problems arise. We have heard good reports about Highfield whenever it is mentioned. The rooms are always clean and clothing washed and ironed. The record keeping is extensive and well planned’. Another comment was ‘Staff could make sure residents are wearing co- ordinating clothes’. A relative commented ‘My family member is quite happy at Highfield and always tells me how lovely the carers are’. Highfield Nursing Home DS0000000174.V369842.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home regularly reviews aspects of its performance through a good programme of self-review, which include seeking the views of residents, staff and relatives. Finance systems are robust. EVIDENCE: The manager is qualified and competent to run the home. She is currently undertaking the registered managers award, to be completed by the end of September 2008. The manager carries out a monthly audit, which covers all the minimum standards. She also completes a monthly training report for the organisation. The area manager visits the home monthly and reports on many aspects of the home, the building, care records, health and safety and speaks to staff and people who use the service. Surveys are sent out annually to Highfield Nursing Home DS0000000174.V369842.R02.S.doc Version 5.2 Page 21 people who use the service, along with relatives to seek their views about life in the home and the service provided. However a report regarding the outcome of the surveys was not available for inspection and the information had not been shared with the home or the people who use the service. Staff meetings are held four times a year or more often if needed and minutes are kept. Meetings for people who use the service are held bi monthly. Three people interviewed felt that their thoughts and points of view were listened to by the manager. Resident’s finances and records were kept appropriately with signatures in place. People who use the service have access to their monies via the manager or administrator. Documentation showed that water temperatures are taken and documented monthly, however Health and Safety Executive requires that water temperatures for baths are taken and recorded weekly. The manager completes a number of health and safety checks. Records showed that fire drills are carried out monthly with an area of the home being evacuated. The manager also completes a summary of accidents, which are analysed monthly. Staffs receive regular training in Health and Safety and there is a full training plan in place. Highfield Nursing Home DS0000000174.V369842.R02.S.doc Version 5.2 Page 22 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 3 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 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 2 Highfield Nursing Home DS0000000174.V369842.R02.S.doc Version 5.2 Page 23 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 OP33 Regulation 24 (2) Requirement The results of quality surveys should be published and made available to people who use the service, relatives and other interested parties including CSCI. Hot water temperatures in baths must be taken and recorded weekly to ensure the safety of the people who use the service. Timescale for action 30/09/08 2. OP38 13 (c) 30/09/08 Highfield Nursing Home DS0000000174.V369842.R02.S.doc Version 5.2 Page 24 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 Within staff files, more information in the individual curriculum vitae’s regarding the dates of previous employment is needed. This will ensure the recruitment process protects people who use the service. The registered manager should complete the registered managers award. 2. OP31 Highfield Nursing Home DS0000000174.V369842.R02.S.doc Version 5.2 Page 25 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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. 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