Inspection on 07/02/06 for Highfield Nursing Home

This inspection was carried out on 7th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 25/08/09

Highfield Nursing Home 08/09/08

Highfield Nursing Home 11/09/07

Highfield Nursing Home 17/03/05

Highfield Nursing Home 15/07/04

Similar services:

Abbey The

Snydale Care Home

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Highfield Nursing Home Scarthingwell Park Barkston Ash Tadcaster North Yorkshire LS24 9PG Lead Inspector Jo Bell Unannounced Inspection 7th February 2006 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 DS0000058827.V280266.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 DS0000058827.V280266.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Highfield Nursing Home Address Scarthingwell Park Barkston Ash Tadcaster North Yorkshire LS24 9PG 01937 557724 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) highfieldarchester.com Barchester Healthcare Homes Limited Mrs Mandy Jane Daniel Care Home 55 Category(ies) of Old age, not falling within any other category registration, with number (43), Physical disability (12), Terminally ill over of places 65 years of age (1) Highfield Nursing Home DS0000058827.V280266.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. All service users admitted in the category PD must (i) require nursing care and (ii) be over the age of 50 years The current service users (3) in the category PD but aged under 50 years may remain in the home. This condition will cease when the service users reach the age of 50 or leave the home. The current service user (1) in the category of PD aged under 50 years who is in receipt of respite care may continue to receive this service. One named Service User in the TI (E) category who requires nursing care. 13th September 2005 3. 4. Date of last inspection Brief Description of the Service: Highfield Nursing Home is owned by Barchester Healthcare Ltd. It provides nursing care for older people and care for individuals with physical disabilities who are over 50 years of age. The home is located near Barkston Ash approximately 5 miles from Tadcaster. It is set in its own extensive grounds with a view of the lake and trees for service users to enjoy. Highfield Nursing Home DS0000058827.V280266.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The 2nd unannounced inspection of the year took place on Tuesday 7th February 2006. The registered manager and the deputy were available to assist with the inspection which lasted for three hours. The eight remaining key standards were assessed and the previous requirements and recommendations were discussed. A tour of the premises took place and service user’s care plans and medication charts were examined. Staffing levels and training, along with the role of the manager were discussed. The Health and safety aspects of the home were also examined. Two of the eight Standards assessed were fully met. The home offers a good standard of care which was confirmed by the residents. Many activities take place and the home is situated in a picturesque location. What the service does well: 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 DS0000058827.V280266.R01.S.doc Version 5.1 Page 6 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 DS0000058827.V280266.R01.S.doc Version 5.1 Page 7 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): None of these Standards were assessed. (Standard 6 is not applicable) EVIDENCE: Highfield Nursing Home DS0000058827.V280266.R01.S.doc Version 5.1 Page 8 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8 & 9 Service user needs are met. However, more robust reviews need to be in place to ensure this continues. Service users are generally protected by the home’s medication procedure. EVIDENCE: Care plans were inspected. These contained an initial assessment which was detailed. Specific care plans were in place and risk assessments for moving and handling, prevention of pressure sores, use of bed rails and nutrition were in place. The home are in the process of reviewing the type of care plan in use. Whilst there is a lot of information available it is not in a user friendly format. Three nutritional assessments inspected had not been reviewed recently. The first persons assessment stated ‘on supplements and blended diet’ .No care plan was in place and the nutritional assessment was last updated in November 2004, with the Waterlow assessment (prevention of pressure sores) reviewed in August 2005. The Manager stated that some individuals had not been weighed for over a year because the scales had been broken but were now mended. Highfield Nursing Home DS0000058827.V280266.R01.S.doc Version 5.1 Page 9 The second person who was on a pressure relieving mattress had not had his Waterlow score reviewed since June 2005 and this was the last time he was weighed. Another person had a good moving and handling assessment in place and the Waterlow Score had been reviewed in February 2006. However, the nutritional assessment had not been reviewed since May 2004. In the care plan it stated that the resident preferred to have her door closed. This had not been reviewed and it was evident through observation and speaking with this lady that her door was kept open. This had not been reviewed. The home must ensure that all aspects of the care is reviewed and evaluated on a regular basis to ensure it continues to meet individual needs. The care plans confirmed that health professionals visit the home on a regular basis. The GP, chiropodist, care managers and specialist nurses al have links with the home. The accident book was inspected and whilst no serious accidents had occurred it was evident that only the front part of this form was completed. Staff must be clear on how to complete this form. For example the section ‘what action might have prevented the incident’ and ‘the root cause’ was not completed. Guidance from the providers should be obtained. The medication system was inspected. Staff have undergone training in aspects of this system and speaking with staff it was evident that they have a greater understanding of the administration of medication. The fridge temperatures were recorded daily and the controlled drugs register was well maintained with two staff signing when a controlled drug has been administered. The home have a robust medication policy and staff are aware of how to dispose of medication. The medication charts were examined, currently the home does not use the monitored dosage system which the home is addressing with the GP surgery. Staff had signed for medication administered and the correct code had been used if the drug was not given. The stock balance of medication had taken place, however errors had occurred when counting this. On six occasions the incorrect balance had been recorded. For example with Diazepam it stated there were 28 and there were 56, with Baclofen syrup it stated there was 230ml and in fact there was 1130 mls. All these errors had been corrected. However, appropriate action must take place when this has been identified and medication audits must take place on a regular basis. Highfield Nursing Home DS0000058827.V280266.R01.S.doc Version 5.1 Page 10 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): None of these Standards were assessed. EVIDENCE: Highfield Nursing Home DS0000058827.V280266.R01.S.doc Version 5.1 Page 11 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): None of these Standards were assessed. EVIDENCE: Highfield Nursing Home DS0000058827.V280266.R01.S.doc Version 5.1 Page 12 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): None of these Standards were assessed. EVIDENCE: Highfield Nursing Home DS0000058827.V280266.R01.S.doc Version 5.1 Page 13 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 & 30 Service users’ needs are met through competent staff in adequate numbers. EVIDENCE: The staffing levels in the home are adequate. Currently there are two registered nurses and eight carers on duty during the morning for forty two residents. This reduces to seven carers in the afternoon and evening. Overnight there remains two registered nurses and three carers. The duty rota for the week of the inspection confirmed the staffing levels. The Manager is aware that some members of staff work thirteen hour shifts, this is in the process of being reviewed. Residents spoken with confirmed that staff look after them well. Call bells are answered promptly and staff are competent in their roles. Barchester have a training academy and staff have access to a range of study days. Five out of twenty seven carers have completed an NVQ Level 2, and a further two are undertaking this. The home employs overseas staff who are working as senior carers but who are registered nurses in their own country. During the inspection it was evident that residents were well cared for. Staff undergo an induction programme which is equivalent to Skills for Care, this leads onto a foundation programme which may last for up to six months. The induction covers safe working practices, meeting residents needs and training specific to their new role. The deputy manager is in the process of reviewing the training and is aware that individual training and development files are needed for each staff member. Highfield Nursing Home DS0000058827.V280266.R01.S.doc Version 5.1 Page 14 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 & 38 The home is well managed and the welfare and safety of resident’s is promoted. EVIDENCE: The Registered Manager has recently completed her NVQ Level 4 in Management, evidence of this was available. The Manager is a registered nurse with experience in caring for older people and younger adults. She is aware of how to meet individual needs through the philosophy of the home. Staff spoken with felt the Manager was supportive and had a good understanding of the residents in the home, this was also confirmed when speaking with the residents. Health and safety in the home was discussed. There is currently one maintenance person employed, however this is due to be addressed shortly. The home have a property maintenance manual which incorporates ‘daily walk Highfield Nursing Home DS0000058827.V280266.R01.S.doc Version 5.1 Page 15 around’ of the home where specific areas are checked and monthly checks which are recorded. All staff undergo mandatory training which includes fire safety, moving and handling, infection control and adult protection. These records were examined. The fire alarm is tested every Friday which was recorded and the last evacuation drill took place on 19th January 2006. Records confirmed that the fire equipment was last checked on 2nd February and the emergency lighting checked on 13th September 2005. Certificates relating to legionella and a safety risk assessment of the home were in place. Water temperatures were within the expected parameters and detailed records were available for all aspects of health and safety. When touring the premises it was evident that areas were clean and tidy and apart from linen cupboard doors been left open no other issues were identified. Highfield Nursing Home DS0000058827.V280266.R01.S.doc Version 5.1 Page 16 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 1 10 x 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 x 17 x 18 x x x x x x x x x STAFFING Standard No Score 27 3 28 2 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x x x x x x 2 Highfield Nursing Home DS0000058827.V280266.R01.S.doc Version 5.1 Page 17 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard OP7 OP8 Regulation 15 15 Timescale for action Care plans must be reviewed and 07/03/06 evaluated on a regular basis. Nutritional assessments and 07/03/06 Waterlow assessments must be reviewed on a regular basis. A monthly medication audit must take place. Errors in stock balances must be addressed appropriately. 07/03/06 Requirement 3. OP9 13 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. 2. 3. 4. Refer to Standard OP8 OP28 OP30 OP38 Good Practice Recommendations Staff should be aware of how to complete the accident book correctly. 50 of care staff should have achieved an NVQ Level 2 Staff should have an individual training and development profile. The linen cupboard doors should be kept locked when not in use. DS0000058827.V280266.R01.S.doc Version 5.1 Page 18 Highfield Nursing Home Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 DS0000058827.V280266.R01.S.doc Version 5.1 Page 19 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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