CARE HOMES FOR OLDER PEOPLE
Highfield Private Rest Home 77 Seabrook Road Hythe Kent CT21 5QW Lead Inspector
Julian Graham Unannounced Inspection 24th January 2006 09:45 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.V266318.R01.S.doc Version 5.0 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.V266318.R01.S.doc Version 5.0 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.V266318.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 1st August 2005 Brief Description of the Service: The Home provides residential care for up to 30 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. Highfield Private Rest Home DS0000023438.V266318.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was unannounced and started at 09.45 and lasted around four hours. Most of the time was spent talking with the residents, including having lunch with them. All spoke very positively about the home. The cook and cleaner were spoken with and the deputy manager and a carer were interviewed privately. Staff were observed directly and indirectly as they were going about their work with the residents. Staff presented well. A visiting District Nurse and two relatives were spoken with. Time was spent with the manager looking at a small sample of paperwork and some parts of the premises were viewed. What the service does well: What has improved since the last inspection?
Staff are receiving more one to one supervision with the manager or deputy manager. They are also being given more opportunities to develop their skills and understanding through in-house training. The manager said that staff’s motivation to learn has increased as a result. Through support and instruction from the manager, senior staff are beginning to take on more responsibility in some areas of the home’s functioning. More opportunities are being given for appropriate exercise and physical activity, through the recent introduction of several weekly exercise sessions within the activities programme. A three monthly programme of Residents’ Meetings that involve all residents wishing to participate has been successfully introduced. This follows on from a number of comments made at the last inspection from residents wanting to be more involved in the decision making in the home.
Highfield Private Rest Home DS0000023438.V266318.R01.S.doc Version 5.0 Page 6 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.V266318.R01.S.doc Version 5.0 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.V266318.R01.S.doc Version 5.0 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): Not inspected on this occasion. The arrangements for admitting people to the home were noted as being good at the last inspection. EVIDENCE: Highfield Private Rest Home DS0000023438.V266318.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,10 Care planning remains at a very good standard. Residents’ health is promoted. Residents feel they are treated with respect. EVIDENCE: Previous inspections revealed that an excellent care planning system is in place, with regular and effective monitoring and review. A small sample was briefly viewed on this occasion, confirming these high standards. A wide range of needs and how these can be met are detailed in the care plans, including mobility, daily living and self-care, health care, and community living. One resident said, “My needs are met perfectly.” Residents said that the home always arranges appointments with the GP and other health care specialists like the optician and chiropodist, where this is necessary. Those residents, who are able to do this independently, are being enabled to do so. A visiting District Nurse spoke positively about the home, and said that any instructions given are always followed very well, and that she is notified appropriately when a need arises. Residents were looking very nicely presented, and said that staff are courteous, friendly and respectful. A staff member who was interviewed demonstrated good understanding of the principles of choice, privacy, respect and independence when describing how she would assist a resident in having a bath. On two occasions during the inspection, staff were observed not properly
Highfield Private Rest Home DS0000023438.V266318.R01.S.doc Version 5.0 Page 10 knocking and waiting for an answer before entering residents’ bedrooms. Otherwise, staff presented very well, demonstrating kindness, patience, understanding and good humour. Highfield Private Rest Home DS0000023438.V266318.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Opportunities for residents to have an interesting day are regularly given. Contact with relatives and friends is encouraged. Routines are flexible. The meals in the home are good offering both choice and variety. EVIDENCE: Residents confirmed that there are plenty of interesting things to do in order to keep occupied. Those not wishing to participate are free to do so. Activities include arts and crafts, games such as bingo and dominoes, and exercises. Trips out in the car are also offered regularly. Staff see the provision of social and recreational activities as an important part of their role. The two relatives spoken with on the day of inspection, said they are always made welcome and that their involvement in the care of their relatives is encouraged. Residents said that there no restrictions are made on how they lead their lives and that routines are flexible. Residents were full of praise for the meals provided in the home. They said there is always a choice, and that alternatives can be provided when they want. One resident said he had mentioned to the cook that he would like a particular dish, and that this now features regularly on the menu. The cook attended a recent residents’ meeting to receive suggestions from residents. The meal on the day of inspection was hot, tasty and well presented. Residents said that they enjoyed it. Highfield Private Rest Home DS0000023438.V266318.R01.S.doc Version 5.0 Page 12 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): Not inspected on this occasion. EVIDENCE: Highfield Private Rest Home DS0000023438.V266318.R01.S.doc Version 5.0 Page 13 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): 19,20,21,24,,26 The standard of the environment is good, providing residents with a comfortable and homely place to live. EVIDENCE: During the course of meeting with residents to find out how they are experiencing life in the home, various areas of the home were viewed, including a wide range of communal sitting areas and a number of bedrooms. Good standards of decoration are being maintained, and bedrooms were inviting, welcoming and personalised. The home was very clean and odour free. In order to reduce the risk of cross infection, it is a requirement of this report that communal toilets, including the staff toilet, have paper towels in wall-mounted dispensers, and pedal bins. Highfield Private Rest Home DS0000023438.V266318.R01.S.doc Version 5.0 Page 14 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 Staff are well qualified and trained, and have a good understanding of residents’ care needs. Staffing levels are sufficient, but need to be kept under regular review, particularly in relation to afternoons and evenings. EVIDENCE: There are normally three or four care staff on duty in the mornings, with the manager and deputy, cook and domestic supernumerary to these numbers. This level of staffing would seem sufficient in that staff said they are not rushed in the mornings, and residents said that their needs are met well and promptly. In the afternoons and evenings, and until the night staff come on duty at 8 p.m, two care staff are on duty in addition to a cook and supper helper. Whilst there was no evidence to indicate that this is insufficient, it is recommended that these numbers are reviewed to ensure that there are sufficient staff on duty at all times to attend to the care and social needs of the residents. The review would need to take into account whether these numbers would be sufficient in the event of an emergency. All but one staff have either obtained a NVQ, are in the process of doing so, or are booked to commence the training shortly. This an achievement for the home, and is commended. This means that a staff team is caring for residents, which is well trained and competent to do their jobs. No care staff have left the home since the last inspection, nor been recruited. Good recruitment practice was noted at the last inspection.
Highfield Private Rest Home DS0000023438.V266318.R01.S.doc Version 5.0 Page 15 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): 31,36,37,38 Residents are benefiting from a well run home. EVIDENCE: The manager is qualified and experienced and is continuing to communicate a clear sense of direction and leadership to which staff and residents are responding positively. The manager is supported well by the deputy and senior staff, with staff demonstrating an awareness of their role and responsibility. Whilst quality assurance was not looked at on this visit, several residents commented on the usefulness of the Residents’ Meeting held in November. This meeting was open to all the residents, and is in addition to the meetings held by the Residents’ Committee, of which there are four resident members who represent the views of the residents as a whole. One to one staff supervision is being regularly provided. The accident book was viewed, and it was possible to cross reference any follow up action taken following accidents in residents’ care notes. Fire safety records are in good order, showing that the fire alarm system is being regularly checked and serviced, and that staff are
Highfield Private Rest Home DS0000023438.V266318.R01.S.doc Version 5.0 Page 16 being given regular opportunities to practice evacuating the building in the event of a fire. Highfield Private Rest Home DS0000023438.V266318.R01.S.doc Version 5.0 Page 17 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 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 x 3 3 3 X X 3 X 2 STAFFING Standard No Score 27 3 28 4 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X 3 3 3 Highfield Private Rest Home DS0000023438.V266318.R01.S.doc Version 5.0 Page 18 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 26 Standard Regulation 13 Requirement Paper towels in wall mounted dispensers and pedal bins to be provided in bathrooms and toilets. Timescale for action 24/02/06 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. 2. Refer to Standard OP10 OP27 Good Practice Recommendations Staff knock and wait for an answer before entering residents’ bedrooms. A review of staffing levels in the afternoons and evenings in relation to the needs of residents, to ensure that residents’ needs are met at all times. Highfield Private Rest Home DS0000023438.V266318.R01.S.doc Version 5.0 Page 19 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
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