Inspection on 09/12/08 for Highfield Residential Care Home

This inspection was carried out on 9th December 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 Residential Care Home 04/01/10

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Highfield Residential Care Home 3 St Marys Road Cromer Norfolk NR27 9DJ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Susan Golphin     Date: 0 9 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Highfield Residential Care Home 3 St Marys Road Cromer Norfolk NR27 9DJ 01263511421 01263879166 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Sterling Care (UK) Ltd Name of registered manager (if applicable) Mrs Elaine Flynn Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 20 The registered person may provide the following categories of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE Date of last inspection Brief description of the care home Highfield is situated in a residential area in Cromer and can accommodate 20 older people with dementia in 14 single and three double rooms of which 6 offer en-suite facilities. The home is a converted large family type guest house and has retained many of its original features. There is a discreet and enclosed garden area to the rear of the premises but there is no off street parking available. the fees range from £420£625 per week, depending on individual assessed needs. Information about the service Care Homes for Older People Page 4 of 25 care home 20 Over 65 0 20 20 0 Brief description of the care home including inspection reports and quality assurance survey outcomes are available through the management. Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced inspection was carried out over one day, approximately 7 hours in total.The report contains information from the Annual Quality Assurance Assessment document and information received by the Commission since the service was acquired by new providers Sterling Care (UK) in January 2008. The responsible individual for the service Mr Kanapathipillai Thavapalasunderam and the registered manager Elaine Flynn were present on the day.During the course of the visit we looked at records relating to residents,staff and the running of the establishment. We also spoke to staff and residents and visitors to obtain their views about the daily life of the home. Care Homes for Older People Page 6 of 25 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 7 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents and their representatives are provided with comprehensive information about the home and the facilities provided. Good assessment processes ensure peoples needs can be appropriately and individually met. Evidence: The service is registered to accommodate older people with dementia and from the information seen and the practice observed on the day the service can demonstrate the capacity to meet residents needs well. Staff were observed showing a good knowledge and understanding of the care of people with dementia by their practical application and approach. They appeared confident and competent when assisting people to move or eat and happily encouraged people to socialise and involve themselves in their surroundings and the days activities. Care Homes for Older People Page 9 of 25 Evidence: Two residents seen on the day, although having lived at the home for many years said that they had visited the home prior to admission and this had helped them to make an informed decision about where they wished to live. Care Homes for Older People Page 10 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are safe procedures in place for the management and administration of medication and for people who may wish to retain control and responsibility for their own medication and health related activities. Residents who use this service receive excellent care and support that is delivered in a considered and flexible way. Evidence: Each resident has a personal care plan based on the information gathered during the assessment process. Three care files were seen on the day and gave a clear indication that peoples care and support is delivered in a flexible and consistent way. Where appropriate risk assessments have been undertaken and are reviewed as care needs change or may be indicated. One resident spoken to on the day said that they were aware of their care plan and added that the staff discuss their care needs with them from time to time. Another said that they live the lifestyle they want and everyone is helpful and considerate always. Staff were observed delivering quality care in a respectful and kindly way, and there was no sense of anxiety or agitation seen or Care Homes for Older People Page 11 of 25 Evidence: expressed from those residents with a recognised mental frailty. From the discussions with the management and staff on the day the service positively maintains and promotes residents health care needs and general well being. From the information provided a number of residents have specific continence needs and it is to the credit of the staff that this area of care is managed very well. It was said that the current resident group have a average range of needs and the manager accesses other health care professionals for specific advice or guidance and also promotes specialist training to ensure that any specialist requirements can be confidently met. The registered provider confirmed that new equipment has been installed recently including a stand aid and hoist. Staff have received training in the use of both mobility aids. Medication administration and storage is well maintained and is subject to regular audit and review.The records seen on the day and the procedure and recording process for returning medication to the pharmacy is in good order and well maintained. Care Homes for Older People Page 12 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are good procedures in place to ensure that the expectations of people using this service are met, and their personal preferences and choices are promoted. Evidence: Three residents were spoken to on the day who said that they are very happy with the care and support they receive and that whilst there is a routine to the day it is not rigid and their expectations about the home are met in a flexible and personal way. One of the visitors said on the day that they are made most welcome each time they visit and that the management and staff are hospitable and friendly and I have the highest regard for them all. The meals served on the day looked both appetising and well presented. The dining rooms are furnished in a pleasant and homely style. There is a menu on each table and the meals are served from a hot trolley directly to the table. Vegetables and accompanying foods to the main dish are served from tureens so that residents can help themselves or can be served by staff. Softened or blended meals are provided where required and staff were observed assisting people to eat in an unhurried and relaxed manner. The manager confirmed that residents dietary needs and nutritional intake is monitored and any changes or loss of appetite are noted and acted upon.Residents commented positively on the meals and choice of Care Homes for Older People Page 13 of 25 Evidence: dishes available and one said that they had seen the menu for Christmas day and were looking forward to the lovely lunch. Care Homes for Older People Page 14 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are good open systems in place for raising concerns and dealing with complaints. There are good safeguarding procedures in place that protect people using this service from abuse and self harm. Evidence: From the written information received from the manager and from the discussions with the residents and others on the day of the inspection there is a robust complaints procedure in place for the service. One resident commented that the procedure had been revised and that copies are available in big print if needed. The procedure is also displayed on the noticeboard. One resident said that at the last residents meeting the manager had discussed the complaints procedure with them which was helpful and reminded everyone what to do if they have any concerns. There is a comments and concerns book sited near the entrance of the home so that visitors or families can make written comments about the service if they wish. The manager audits the information throughout the week and responds or acts on the details as may be necessary. It is felt that this approach offers everyone the opportunity to comment openly about the service. From the records maintained in the staff files and from the comments made during the Care Homes for Older People Page 15 of 25 Evidence: interviews, all the staff have received training in safeguarding adults and said that they felt confident about recognising and responding to any allegations or signs of abuse. One visitor commented that they thought the staff of the home are very professional and handle people in an appropriate way. Care Homes for Older People Page 16 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service provides a good homely environment that meets the needs of the residents. The infection policy and procedure in place ensures good hygenic standards and practice are maintained. Evidence: Since the change of ownership in January 2008 there have been a number of positive and practical changes to the premises. the changes have included redecoration of offices and some residents rooms. Carpets have been replaced in the hallway and corridors and service equipment in the kitchen and laundry has been replaced. A new telephone and computer system has been introduced and staff can access and use a new hoist and stand aid for moving and handling residents safely and in comfort. The Commission have been provided with a business plan itemising the progress and planned improvements for the service. To date the estimated timescales for completion for the improvements is on target and the management are to be commended for the proactive way in which the improvements are being implemented. A brief tour of the premises was undertaken on the day and all the areas seen were well maintained, clean and tidy and fresh smelling throughout. New laundry equipment Care Homes for Older People Page 17 of 25 Evidence: has been purchased and all laundry needs are now dealt with on site. The sitting and dining rooms offer a warm and homely setting and are furnished with suitable and appropriate furniture for the resident group. Three of the bedrooms seen offered good quality furnishing and decor and reflected each residents personal choices and style. Residents spoken to on the day were complimentary about the accommodation and said that it was a lovely comfortable place to live, and that their rooms were as they would wish them to be. One resident said that quite a few things had changed for the better lately and that included a nice new television. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are good recruitment processes in in place that protect the well being of the residents. Staff can demonstrate their commitment to achieving the best outcomes for residents. Residents receive a good service from well trained and experienced staff who can deliver care in a competent and professional way. Evidence: On the day of the inspection the staffing levels were appropriate and residents needs were being met competently and in a kindly way. One resident said that whilst they personally did not need a lot of physical help they could rely on the staff to respond to any request. They also said that that in all the years they had lived at the home they had never experienced anything other than kindness and courtesy from all the staff. Residents were seen being assisted to eat where needed and each resident was being attended to personally by a designated member of staff. Training is actively promoted and currently there are five care staff with NVQ 3 qualification and five with NVQ 2 and two staff with NVQ 4. During the discussions with staff it was confirmed that they are provided with skills for care induction, mandatory training including health and safety, moving and handling courses, as well as specialist training such as awareness and understanding dementia and safeguarding adults Care Homes for Older People Page 19 of 25 Evidence: training. Regular supervision sessions are in place and one member of staff said that there is plenty of options and opportunity to discuss issues or personal progress with the senior staff and manager. The manager monitors staff practice and performance through a written work book which is reviewed as part of the process that ensures residents care plans and personal support are in place and met. Other staff commented that the service has a good staff team and there is an open approach to dealing with problems and issues which is both reassuring and effective. Staff meetings are held on a regular basis and staff are encouraged to say what they think and have their say. Three staff files were seen on the day and contained the appropriate documentation to support good recruitment practice including the application form and interview notes and evidence of a criminal record check having being made prior to appointment. The manager commented that there will be a review of the staff files in 2009 to ensure that the information contained is still appropriate and up to date. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has a good management structure in place and best practice and standards are being promoted in the interests of the residents and staff. there are good processes in place for seeking the views of those using the service and acting on the outcomes. Evidence: The registered provider for the home was present at the inspection and was able to provide details of the current management, the changes and improvements made since acquiring the service and details of the long term business plan for 2009. As previously stated there have been a number of changes and improvements to the service, and there has also been a review of some of the main administration and management schedules as well as replacement and upgrade of equipment where necessary. there is an ongoing programme of redecoration and replacement and refurbishment of the premises. Care Homes for Older People Page 21 of 25 Evidence: Everyone seen on the day and spoken to made positive comments about the changes and improvements and said that the changes had made a considerable difference to the quality and standard of the home. Residents and relatives have been asked to complete the quality assurance survey forms for 2008/9 and the initial response is very positive. The outcome of the quality review has yet to be collated and the results made public. The manager stated that they have responsibility for managing some residents monies. These are small amounts to cover personal needs.The records seen on the day are well maintained with clear debit and credit entries and running totals. Two signatures are needed for all personal expenditures. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 3 It is recommended that the plan to review and revise the assessment and care planning to an electronic format for the service be carried out. It is recommended that the review of the care planning procedures to incorporate electronic format and recording should be carried out as soon as possible as planned . It is recommended that the management continue with the implementation of the business plan for the premises within the given timescales. 2 7 3 19 Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 25 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!