Inspection on 15/09/06 for Highfield Private Rest Home

This inspection was carried out on 15th September 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 Private Rest Home 11/09/08

Highfield Private Rest Home 24/01/06

Highfield Private Rest Home 01/08/05

Highfield Private Rest Home 03/11/04

Highfield Private Rest Home 21/05/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Highfield Private Rest Home 77 Seabrook Road Hythe Kent CT21 5QW Lead Inspector Michele Etherton Unannounced Inspection 15th September 2006 09:15 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 Private Rest Home DS0000023438.V306624.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 Private Rest Home DS0000023438.V306624.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Highfield Private Rest Home Address 77 Seabrook Road Hythe Kent CT21 5QW 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) 01303 267036 01303 261669 Mr David Leonard Wadmore Mrs Brenda Ann Wadmore Mrs Dallas Lorraine Morris Care Home 31 Category(ies) of Old age, not falling within any other category registration, with number (31) of places Highfield Private Rest Home DS0000023438.V306624.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th January 2006 Brief Description of the Service: The Home provides residential care for up to 31 Older People. The Home comprises detached premises, with gardens to the front and rear, and parking for approximately ten cars. The Home is situated a short drive from the nearest town, with shops, health centres, churches, a library and other facilities, and is short walk from the sea front. The service provided includes varying levels of assistance with personal care. The Homes ethos is to provide an environment, which is as relaxed and homelike as possible. A great emphasis is placed on encouraging Residents to remain as active and independent as possible, and a variety of activities are provided within the home to assist with this. Mr and Mrs Wadmore own the Home and the Registered Manager is Mrs Dallas Morris. Fees for this service range between £303 -£550 per week. Highfield Private Rest Home DS0000023438.V306624.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection-involved analysis of information and documentation received about the home including a pre-inspection questionnaire completed by the provider. The views of residents, relatives and Health and social care professionals have been sought through pre-inspection survey questionnaires, these are still to be returned and therefore have not be used in the production of this report. An unannounced site visit was also undertaken as part of the inspection process and took place on 15th September 2006 between 9:15 am and 4:10 PM. During the course of the site visit, a tour of the premises was undertaken and time was spent in speaking with and observing individual residents and staff. A range of documentation was viewed during the course of the visit including care plans, assessment information, MAR charts, complaints, accident records, the fire book, staff recruitment, training and supervision records. A meeting with the manager took place at the end of the site visit to discuss findings. One requirement for action to be taken and four recommendations for improved practice were made as a result of this visit. During the course of the site visit the inspector spoke privately with 10 residents and observed a number of others during a tour of the premises, four members of staff in addition to the manager were spoken with, his has been influential in the compilation of this report. The site visit highlighted that the home is maintaining a good standard of compliance within all outcome groups although a shortfall was identified in one key standard with action required. All residents observed presented as relaxed and settled, with some more vocal residents expressing positive comments about the home and staff, comments ranged from “staff are very good” “the night staff are marvellous”, “we are given a good variety of food” “The home has been very supportive to me” What the service does well: The home provides residents with information about the service. The home ensures it undertakes assessment of prospective residents and can meet their current and ongoing needs. The home provides a pleasant, comfortable and homely environment that is maintained to a good standard, is clean and safe. Highfield Private Rest Home DS0000023438.V306624.R01.S.doc Version 5.2 Page 6 The home ensures that a satisfactory level of staffing is maintained in the home. The home demonstrates a commitment to the development of staff. The home is supportive and enabling of residents maintaining independence and retaining control and choice in their day to day lives. 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 Private Rest Home DS0000023438.V306624.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 Private Rest Home DS0000023438.V306624.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5, 6 The overall quality of this outcome group is good. This judgment has been made using available evidence including a visit to the service. Prospective residents are provided with appropriate information about the home. An assessment of their needs is undertaken to ensure these can be fully met. The home does not provide an intermediate care service EVIDENCE: Four residents files viewed at the site visit, provided evidence that a pack of information is provided to residents and or their families about the home at admission, the information pack includes the user guide, statement of Purpose, contract, etc. Full and detailed assessment information was noted on those files viewed both from health and social care professionals and assessments undertaken by the home manager. Highfield Private Rest Home DS0000023438.V306624.R01.S.doc Version 5.2 Page 9 Some residents spoken with could recall their admission and confirmed that someone from the home had visited them prior to their coming to live at the home. The manager demonstrated an awareness of the limitations of the home in supporting some residents with ongoing deterioration in health, and could evidence that appropriate interventions had been sought to seek more appropriate placement or additional support in those cases. “if you get in somewhere and settle, it’s the best thing for you” Residents also confirmed that either they or their families had visited or known the home prior to their admission. The home offers occasional respite if a vacancy occurs in a long-term bed, but are not resourced to provide an intermediate care service. Highfield Private Rest Home DS0000023438.V306624.R01.S.doc Version 5.2 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): 7,8,9,10 The overall quality of this outcome group is good. This judgment has been made using available evidence including a visit to the service. Residents support plans are detailed, reflecting needs and aspirations. Residents are supported and enabled to have access to routine and more specialised healthcare appointments. The management of medication within the home is undertaken in a safe manner; this could be improved upon in some areas. The privacy and dignity of residents is upheld and they feel well treated by staff. EVIDENCE: During the course of the site visit 10 residents were spoken with, three in private and the rest in small groups, observations were also made of other residents and staff interactions with them. Four case files were selected for case tracking. Care plans were found to be informative and detailed, with evidence of routine review and updating. Highfield Private Rest Home DS0000023438.V306624.R01.S.doc Version 5.2 Page 11 Behaviour issues were noted on one file and the manager discussed strategies in place to manage this, these strategies are not recorded within the care plan or file and this may lead to them being applied inconsistently by staff (see standard 18). The home is encouraging of residents retaining skills and independence and facilitates opportunities for them to exercise control in their day to day lives by supporting them to self medicate where able to, travel independently outside of the home etc, risk assessments are in place for these activities. “I look after my own medication, I’ve been assessed for it” “One of the other residents goes out shopping and she gets me things if I want them” “I use the kitchen and make tea, I could use the fridge but there is nothing I want to put in it” Files viewed provided evidence of routine health care appointments and checks, residents spoken with confirmed access to dentists and other healthcare appointments. The home actively seeks interventions by health care professionals where needed e.g. continence, district nurse service etc, and this was evident on files viewed. Medication Administration Records (MAR) sheets were reviewed; these are satisfactorily completed with handwritten entries being signed and dated, one sticky label was noted on the MAR sheet and this was discussed with the manager who will discontinue this practice as it is liable to error, and this is a recommendation. Residents and staff would benefit from: the development of individualised medication profiles to ensure staff and the resident are fully aware of what medication is being given for and its potential side effects to aid observations etc, the development of individualised PRN guidelines to ensure consistency of administration would also improve the safety of administration, and these are recommendations. Discussion with staff’ indicated an understanding of how to manage medication errors, but clarity is needed within the medication procedure as to where such incidents are recorded and this is a recommendation. Receipt of meds were noted on MAR sheets, the home uses a medication dosage system(MDS) in addition to bottles and boxes, the manager institutes an informal audit of medications not provided within the MDS system, staff’ and residents would benefit from a more formalised system of auditing being introduced, to reduce further the risk of medication dosage errors occurring and this is a recommendation. Highfield Private Rest Home DS0000023438.V306624.R01.S.doc Version 5.2 Page 12 Discussion with residents indicated an overall satisfaction with their general daily routines and the manner in which they are supported, they spoke positively of the staff and observation of staff and resident interactions indicated discreet support is offered to residents as needed with staff observed speaking in a respectful but friendly manner to residents at all times during the site visit. Highfield Private Rest Home DS0000023438.V306624.R01.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The overall quality of this outcome group is good. This judgment has been made using available evidence including a visit to the service. The activities programme in place would benefit from regular review to ensure the interests and needs of all residents are accommodated for. Flexible arrangements are in place to ensure residents maintain contacts with their families and the local community. Residents are enabled to exercise choice and control in their daily lives; they are provided with a varied and nutritious menu that reflects their input. EVIDENCE: Residents interests were noted on care plans. Some residents spoken with indicated there has been a dropping off of some activities, and thought that other residents not necessarily themselves would welcome more activities in keeping with their own interests, most of those spoken with indicated they were personally satisfied with their own personal routines and level of activities. Highfield Private Rest Home DS0000023438.V306624.R01.S.doc Version 5.2 Page 14 “Some people say there’s not much on, and I think they might welcome more activities, but there’s enough here for me” “It seems to be the same people who go on the outings, and they are usually the residents committee” The home has actively facilitated a residents meeting and a residents committee and activities is an area that is discussed regularly. Feedback from discussion with residents indicated that the current resident representatives may need to be supported to more actively seek feedback from the rest of the resident group to more accurately reflect and represent their views and interests around this area. And this is a recommendation. Residents confirmed access to visits from family and friends and arrangements for this are flexible, some indicated they access the local community either independently or in the company of home staff or relatives. A religious service is held in the home on a regular basis. Residents spoken with indicated that they actively make choices in their day to day routines, have brought in their own possessions, and exercise control of their own money or with the support of their representatives. The home provides a range of set weekly menus and residents indicated a good level of satisfaction in respect of the menu choices offered them. Residents confirmed that the cook will offer them an alternative if there is something they do not like. The cook attends resident meetings, and actively discusses menu choices with residents and accommodates their preferences where possible. Cold drinks were freely available to residents to help themselves and staff were observed offering drinks or encouraging the taking of drinks, staff were also observed providing support to a resident who needs help with feeding. Residents on the top floor have access to their own kitchen and in discussion confirmed they can make drinks and snacks if they wish and have been assessed as able to. “I know I would be able to have something different if I didn’t like what was on the menu” Highfield Private Rest Home DS0000023438.V306624.R01.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 The overall quality of this outcome group is good. This judgement has been made using available evidence including a visit to the service. The home is responsive to expressions of concern from residents who feel confident theirs views and concerns will be listened to and acted upon. Policies and practices within the home to protect residents from abuse would benefit from strengthening in some areas. EVIDENCE: The complaints record was reviewed and provided evidence that the home has responded well to recording minor concerns as well as more formal complaints, the level of recording indicates residents feel confident in expressing their views to the manager and or staff and feel listened to; this was confirmed in discussions with them. Staff spoken with individually and together indicated an overall awareness of adult protection issues, with some having attended formal training in this area. The home actively encourages all staff to undertake NVQ2 training and adult protection is covered within this course as well as initial induction, staff training records viewed at the site visit made it difficult to establish whether all staff have yet received adult protection training or would be doing so within the next few months (see standard 30) the home will need to ensure all staff receive formal training in this area within the standard training programme. Highfield Private Rest Home DS0000023438.V306624.R01.S.doc Version 5.2 Page 16 The home undertakes a robust recruitment procedure, to ensure prospective staff are competent and have the necessary skills to complement the existing team and support residents appropriately the current procedure would benefit from more active involvement by the manager in the selection process (see st 29) The home has implemented informal strategies for managing some resident behaviours; in order to ensure behaviours are managed consistently by staff it is recommended that behaviour management guidelines for specific residents should be drawn up and agreed by the relevant parties, with regular reviews as to their effectiveness. Highfield Private Rest Home DS0000023438.V306624.R01.S.doc Version 5.2 Page 17 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): 19,20,21,22, 23 24,25,26 The overall quality of this outcome group is good. This judgment has been made using available evidence including a visit to the service. Residents benefit from living in a clean, safe, comfortable and homely environment that is maintained to a good standard. EVIDENCE: During a tour of the premises all communal areas, a sample of bathrooms and toilets, the laundry and four resident bedrooms with their permission were viewed in addition to the gardens. The home was observed to be clean, tidy and odour free. On the day of the site visit the shaft lift was undergoing repair, residents were able to use stair lifts to the first floor. A ground floor bathroom is currently out of use awaiting a repair to a hoist, residents confirmed they were able to access other alternative wash areas. Highfield Private Rest Home DS0000023438.V306624.R01.S.doc Version 5.2 Page 18 The gardens are well maintained and residents confirmed they access them from time to time weather permitting, the maintenance man and a gardener are employed to ensure the gardens are kept in good order. Minor repairs around the home are undertaken by the maintenance person employed by the home, who confirmed access to a maintenance book in which staff report repairs and concerns in respect of environment, and is on call for out of hours emergencies. Communal areas were furnished in a homely, comfortable and domestic style with a good quality mix of antique and more modern furniture, furnishings and décor were to a good standard. Two bedroom windows on the first floor were without window restrictors the provider indicated that this had been risk assessed and would be kept under review, the home were reminded that when assessing such arrangements consideration should be given within risk assessments as to whether other residents or visitors may be also be placed at risk. Bedrooms viewed were personalised to reflect the interests and tastes of their occupant. Residents spoken with expressed satisfaction with the accommodation and their own rooms, confirming that they were able to bring in personal possessions and small items of furniture from home and this had helped in enabling them to settle. “I was able to bring in lots of my personal possessions” “I like this room I have a lovely view from here”. Equipment to support the care of residents was noted throughout the home, residents confirmed they had access to call bells if they needed to use them. There are a satisfactory number of bathrooms and toilets and some residents have en-suite facilities. Those viewed were noted to be clean and in good order with appropriate equipment in place. The Home has addressed a previous requirement in respect of paper towels, and liquid soap in toilets etc. The laundry was in good order, staff had an understanding of managing soiled laundry and confirmed access to protective clothing when handling soiled laundry or undertaking some personal care activities. Highfield Private Rest Home DS0000023438.V306624.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 The overall quality of this outcome group is good. This judgement has been made using available evidence including a visit to the service. A satisfactory level of care and domestic staffing is in place to support residents. The home demonstrates and active commitment to a programme of qualification training for staff to support their overall competency. Robust recruitment procedures are in place to protect residents. The overall monitoring and provision of routine training for staff needs strengthening to ensure all staff have achieved basic core training and that this is routinely updated. EVIDENCE: Discussion with residents’ highlighted no concerns in respect of staffing levels, and in most cases indicated that staff responded within a short time of being called and were always available. Staff’ spoken with felt well supported and agreed that staffing levels in the afternoon had now improved. “Staff are very nice to me, the night staff are marvellous” Highfield Private Rest Home DS0000023438.V306624.R01.S.doc Version 5.2 Page 20 “the staff are very good” “Staff were very good although it was 5 am in the morning” The home had previously achieved an excellent level of qualified staff, recent staff movements have now reduced this to 58 , the home is committed to staff entering the NVQ2 qualification programme and seek to obtain funding and places. Staff work practices observed were good and supported that what they had learned was being put into practice. Three staff files were viewed, the content of files was compliant with schedule 2 and evidenced that all necessary checks and vetting are being undertaken and that a robust recruitment procedure is in place. Some recent issues in respect of recruitment of prospective staff have highlighted the need for consideration to be given to the active participation of the manager in the selection and interviewing stages of the recruitment procedure. Discussion with three staff during the site visit confirmed the homes commitment to NVQ2 training, and the support and encouragement they received to undertake this. During the course of interviews with staff it became evident that in one case a staff member who had been in place for more than one year had still not completed all mandatory core skills training, another staff member in post for less than 3 months confirmed they are currently undertaking induction using the new skills for care induction and the manager and provider indicated a good understanding and awareness of the new induction standards. It was highlighted from this discussion that new staff although undertaking moving and handling tasks have not received moving and handling training that includes a practical element as required within Health and safety legislation, it is a requirement that all care receive moving and handling training once undertaking care tasks as a matter of priority and the home must ensure this takes place within reasonable timescales, so as not to compromise the safety of residents or the individual staff member. A training programme is in place and some records of courses undertaken with attendance lists are maintained, the home does not routinely undertake skills scans of staff, develop individual training profiles and utilise this information to identify the gaps and training needs of the staff team; a staff training matrix is not in place. Current records held within the home are insufficiently clear to indicate whether all staff have completed mandatory basic skills training, what training needs they have both individually and as a team and when training updates are due. As a consequence, it is a requirement that the home can evidence that all care staff have received the appropriate basic induction and core skills training to ensure they are competent to support residents appropriately and safely. Highfield Private Rest Home DS0000023438.V306624.R01.S.doc Version 5.2 Page 21 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, 32, 33, 35, 36, 38 The overall quality of this outcome group is good. This judgment has been made using available evidence including a visit to the service. The home benefits from the leadership of a well-qualified and informed manager who is committed to the development of the service and staff team to provide a good quality of life to residents. Systems for the quality assurance of the service are in need of further strengthening. The financial interests of residents are safeguarded. Staff’ are in receipt of appropriate and regular supervision. Policies and practices within the home safeguard and promote the health, safety and welfare of residents Highfield Private Rest Home DS0000023438.V306624.R01.S.doc Version 5.2 Page 22 EVIDENCE: The current manager is a qualified nurse and has achieved the required management qualifications she demonstrates a commitment to improvement and development of the service’, is supportive of staff development and has an awareness of latest developments in practice and regulation. The provider is present within the home most days but does not undertake day-to-day operational control. Staff and residents spoke positively of the manager and provider and found them friendly and accessible. Consideration should be given to reviewing the roles and responsibilities of the manager and provider to make clear lines of accountability and management responsibility for planning and innovation in supporting the development of the service. The manager indicated that staff meetings are held and staff spoken with confirmed this. Staff reported that they felt supported by the manager who they found approachable, the home undertakes residents surveys and individual and group consultations are undertaken by the cook with residents in respect of menus’. The home were unable to provide analysis of resident feedback and how this influences service development, overall quality assurance systems need strengthening, including the development of an annual development plan, that looks at overall service development and not environmental improvements exclusively, and this is a recommendation. The provider undertakes regular provider visits and copies of these reports are available to CSCI. Residents or their representatives are in control of resident finances, the home does not look after any monies on behalf of residents, although has systems in place to safeguard items of value for short periods if needed. Purchases are made on residents behalf are billed to the resident at cost. Staff reported they received regular supervision and records of this were noted at the site visit. The home has confirmed within the pre-inspection questionnaire that all necessary checks and servicing of equipment and services such as Gas and Electrical supplies have been undertaken within specified timescales. A review of the fire book revealed that routine tests and checking of fire equipment and systems and regular fire drills are occurring. The accident book indicated a low number of accidents per client and where there were indications of increasing falls the home were able to evidence that interventions had been implemented or would be in the near future. Highfield Private Rest Home DS0000023438.V306624.R01.S.doc Version 5.2 Page 23 Residents are generally safeguarded by the practices within the home, however, the home will need to strengthen its systems for monitoring staff training to ensure all staff have achieved a basic level of competence following induction and prior to commencing NVQ2 training. Highfield Private Rest Home DS0000023438.V306624.R01.S.doc Version 5.2 Page 24 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 3 3 3 3 3 3 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 4 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 X 3 Highfield Private Rest Home DS0000023438.V306624.R01.S.doc Version 5.2 Page 25 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 OP30 Regulation 18( c) 13(5) Requirement All care staff to receive moving and handling training once undertaking care tasks as a matter of priority. The home to evidence clearly through the development of a training matrix and individual staff training profiles that all care staff have received the appropriate basic induction and core skills training in addition to more specialist training needs to ensure they are competent to support residents appropriately and safely. Timescale for action 15/12/06 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 OP9 Good Practice Recommendations Home to discontinue use of sticky labels on MAR sheets. Home to develop individual resident medication profiles DS0000023438.V306624.R01.S.doc Version 5.2 Page 26 Highfield Private Rest Home and PRN guidelines Home to clarify within medication procedure where medication errors are to be recorded. A more formalised system of auditing of medications not within the MDS system to be implemented 2 OP12 Resident representatives to be supported to more actively seek feedback from the rest of the resident group to more accurately reflect and represent their views and interests in respect of activities Behaviour management guidelines for specific residents should be drawn up and agreed by the relevant parties, with regular reviews as to their effectiveness. Quality assurance systems need strengthening, the home need to more clearly evidence how residents views have influenced service development 3. OP18 4 OP33 Highfield Private Rest Home DS0000023438.V306624.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 Private Rest Home DS0000023438.V306624.R01.S.doc Version 5.2 Page 28 - 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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