Inspection on 06/09/05 for Highfield Resource Centre

This inspection was carried out on 6th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 Resource Centre 08/07/08

Highfield Resource Centre 29/05/07

Highfield Resource Centre 01/11/06

Highfield Resource Centre 10/01/06

Highfield Resource Centre 24/02/05

Highfield Resource Centre 01/09/04

Highfield Resource Centre 30/01/04

Similar services:

Snydale Care Home

Abbey The

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 Resource Centre Wawne Road Sutton on Hull Kingston upon Hull HU7 4YG Lead Inspector John Gregory Unannounced 6 September 2005 @ 8:00 am th 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 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 Resource Centre J54_s34522_Highfield Resource_v242182_240205_Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Highfield Resource Centre Address Wawne Road Sutton on Hull Kingston upon Hull HU7 4YG 01482 300300 01482 833588 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Kingston upon Hull City Council Heather Woods Care Home 30 Category(ies) of OP Old Age (30) registration, with number MD(E) Mental Disorder - over 65 (30) of places LD(E) Learning Disability - over 65 (30) DE(E) Dementia - over 65 (30) Highfield Resource Centre J54_s34522_Highfield Resource_v242182_240205_Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Those service users admitted to the home in any category other than OP must have a primary need similar to those in the category of Old Age. The home can provide care for 6 service users aged 60 - 65 years whose primary needs are those related to old age. Date of last inspection 24th February 2005 Brief Description of the Service: Highfield is a care home offering accomodation and personal care to 30 persons who are subject to a wide range of primary conditions and are experiencing difficulties associated with the aging process. The accomodation is purpose built over two floors that are joined by a passenger lift.The home is used for multiple functions such as long term and respite care,intermediate care and daycare. The service users rooms are all single and there are a good range of communal facilities available for long term residential service users. The accomodation is situated in the Sutton area of Hull near to some local facilities and some long distance from the city centre.It is built within large grounds with good car parking facilities. The home is owned by the local authority social services department and run with some assistance from the local health authority. Highfield Resource Centre J54_s34522_Highfield Resource_v242182_240205_Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over the course of one day in September 2005.Preparation for the inspection took one hour and the fieldwork six and a half hours. Only those standards that the CSCI consider as central to the care process were inspected and where there was action necessary from the last report. A sample of policies procedures and records relevant to the standards inspected were examined. Six service users files were examined two of which were case tracked and four staff files were examined. There was a brief tour of the accommodation. Four service users and five staff were interviewed in private. The manager and a senior member of the care staff assisted the inspection. The inspector would like to thank the service users staff and manager of Highfields for their time cooperation and hospitality on this inspection. What the service does well: What has improved since the last inspection? The service provider has met all the requirements and recommendations of the last inspection. Highfield Resource Centre J54_s34522_Highfield Resource_v242182_240205_Stage 4.doc Version 1.40 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 Resource Centre J54_s34522_Highfield Resource_v242182_240205_Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Highfield Resource Centre J54_s34522_Highfield Resource_v242182_240205_Stage 4.doc Version 1.40 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 standard(s) 3&6 All service users are assessed prior to admission. These assessments of service users were not well integrated into the homes care planning systems. The intermediate care facility lacks the range of facilities necessary for active rehabilitation and the care staff work in parallel to the health authority staff. This lack of multi-disciplinary teamwork will not assist service users in maximising their independence. EVIDENCE: On the files examined there was evidence of a preadmission assessment having been undertaken under the care management arrangements or in the case of intermediate care by nursing staff. The care plans developed by the home for service users did not relate directly to these assessments and in the case of intermediate care a plan for use by the care staff did not exist. Senior members of the care staff being involved in the assessment process could assist the integration of these two processes to ensure that the service users needs are fully met. Service users confirmed that their relatives visited the home prior to their admission. The intermediate care unit can accommodate four service users, three of Highfield Resource Centre J54_s34522_Highfield Resource_v242182_240205_Stage 4.doc Version 1.40 Page 9 whom are placed together in the home. The unit has facilities for the movement and handling of service users but has no designated facilities for the social rehabilitation of service users such as kitchen and lounge facilities. This will hinder the rehabilitation of service users. One service user was interviewed of the two service users on the unit at the time of the inspection. The individual was pleased to be on the unit for a longer period of rehabilitation following an operation in hospital. None of the care staff are designated to the unit or specialise in rehabilitative care. There was no evidence of any staff receiving training in rehabilitative processes. This does not make best use of the resources available to the unit. Interviews with staff confirmed that they are only asked to provide basic physical care for service users and there is no evidence of plans for their active involvement in the rehabilitative process, which is done by nurses and other medical ancillaries working in the community. There was no evidence of multi disciplinary teamwork or case review on this unit. This will not enable the rehabilitation of service users to be maximised. There was verbal evidence of a historical level of mismatching of service users needs to the intermediate care unit. This phenomenon may be reduced if the homes staff were involved in the assessment process. This combination of factors indicates that the best use of resources is not made on the intermediate care unit in order to assist service users to return home. Highfield Resource Centre J54_s34522_Highfield Resource_v242182_240205_Stage 4.doc Version 1.40 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 standard(s) 7,8,9&10 The care planning system for service users receiving long term care is basically sound, however much work needs to be done to improve the processes on the respite and intermediate care functions in the home. The health care in the home is good and the transactions of service users with care staff good with due regard being paid to their privacy and dignity. The process for the safe administration of medication protects service users. EVIDENCE: The case files of the service users receiving long term care were seen to be full with a discernible review and risk assessment process that kept the care for service users relevant to their needs. The care plans for those service users receiving respite care were sketchy with no evidence of short-term review to ensure that the care was kept relevant to their changing needs. Risk assessments for service users making use of the short-term facilities did not exist. These need to be undertaken to ensure service users are safe in the home. Service users on the short stay and intermediate care units were pleased with the facilities and staff in the home. Highfield Resource Centre J54_s34522_Highfield Resource_v242182_240205_Stage 4.doc Version 1.40 Page 11 There was written evidence confirmed by some service users that they have good access to the primary health care team and specialist facilities provided through the hospital service. The service provider has good policies and procedures for the administration of medication, which protect service users. The medication was audited and found to be basically in good order. It was noted that in one case the staff have chosen to treat one of the medicaments as a controlled drug. Highfield Resource Centre J54_s34522_Highfield Resource_v242182_240205_Stage 4.doc Version 1.40 Page 12 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 standard(s) 12,13,15 The level of stimulating activity in the home is variable and infrequent leading to service users on the short stay and intermediate care facilities being bored. There are unlimited facilities for contact with family and friends. The meals are well prepared, offer choice to service users and are uniformly appreciated. EVIDENCE: The written evidence of activities in the home showed a day-to-day reliance on watching television and listening to music as a form of activity for service users. One service user was able to describe occasional trips out to places of interest and some recreational games, which were enjoyed by a number of the long-term service users. All the service users using the short stay facilities said they were bored with no opportunities for stimulating activity. Service users were uniformly happy with the visiting arrangements with opportunities to have visitors at any time and in any numbers. One service user felt that a family party could be held in the bedrooms with no complaint. The menu was examined and seen to contain a good range and choice of food. The meals can be taken in the dining room; the small lounges, or in the person’s own room. The main meal was seen on the day of the inspection and was well presented and in good qualities. Service users uniformly expressed satisfaction at the choices quality and quantity of food on offer. Highfield Resource Centre J54_s34522_Highfield Resource_v242182_240205_Stage 4.doc Version 1.40 Page 13 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 standard(s) 16&18 The service provider’s complaint procedure is robust and service users are confident that their complaints would be listened to, taken seriously and acted upon. The service users are protected from. EVIDENCE: The service provider has a robust complaint policy and procedure. There had been three complaints since the last inspection that were dealt with appropriately. The service provider had records of many compliments having been received about the care and services on offer written by relatives and friends of service users. On interview service users were confident that had they need to complaint they were confident to do so and felt their complaint would be taken seriously and dealt with promptly. Staff were clear on their responsibility in the management of complaints. The service provider has a comprehensive policy and procedure for the prevention of abuse, upon which the staff have understanding and some training. The whistle blowing procedure was equally comprehensive but less well understood by staff. Highfield Resource Centre J54_s34522_Highfield Resource_v242182_240205_Stage 4.doc Version 1.40 Page 14 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 standard(s) 19 & 26 The service users live in an environment that is clean tidy well maintained and furnished in a domestic manner EVIDENCE: On a brief tour of the building it was noted that the home was clean tidy well decorated, furnished in a domestic manner with good personalisation in the service users rooms. It was noted that one of the baths that the temperature was on the edge of the safe range for service users. This may be a problem of adjustment of the temperature control valve. The home has a laundry on each floor that were hygienic with impervious walls and ceiling. Highfield Resource Centre J54_s34522_Highfield Resource_v242182_240205_Stage 4.doc Version 1.40 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29 &30 The home is staffed to provide a good level of basic care for a group of persons with problems associated with aging requiring long term care. However this staffing level and the training staff receive must be critically examined in order to ensure that all the needs of persons of multiple categories and high dependency levels can be met in the variety of forms of care that are on offer at the home. Issues related to this matter are commented on in all areas of this report directly related to service users care. The recruitment process needs some minor attention to detail. EVIDENCE: The rota was examined and based on four care staff working on the daytime shifts with two waking night staff. Two managing tiers, the most senior of which is supernumery; support this level of staff. There is a good level of support from ancillary staff. Whist this staffing level is appropriate if the home contained only service users with long-term care needs. It does not support the variety of designations and specialism declared in the homes statement of purpose and recommended for the specialism in the National minimum standards. Evidence is presented in previous sections of this report on this issue which indicates a shortfall in care needs of the short stay group of service users.. The service provider needs to critically examine the staffing level to ensure that all the needs of service users can be met. Highfield Resource Centre J54_s34522_Highfield Resource_v242182_240205_Stage 4.doc Version 1.40 Page 16 The staff confirmed the records that they were well trained in issues related to practical issues of care and some areas concerned with physical disability and service user protection. They confirmed that there is no training in areas related to rehabilitation, mental health issues or those concerned with learning disability. All these issues are either live for the current care of service users, or background issues of which staff need to be aware if they are to match the background needs of service users and registration categories with an appropriate level of skill. Service users commented upon the pressure to which staff are currently exposed due to some service users needing the attention of two staff for personal care. The service provider’s recruitment records were examined at a central point at a previous time and some records were to be kept in the home. There was no evidence of the staffs identity being kept on file. Highfield Resource Centre J54_s34522_Highfield Resource_v242182_240205_Stage 4.doc Version 1.40 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 The health welfare and safety of staff and service users are promoted in the home. EVIDENCE: The service provider has a robust policy procedure and set of records for issues concerned with health and safety, fire safety and the control of hazardous substances. Service users and staff expressed confidence in the health and safety arrangements in the home. Highfield Resource Centre J54_s34522_Highfield Resource_v242182_240205_Stage 4.doc Version 1.40 Page 18 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 x x 2 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 2 x x x x x x 3 STAFFING Standard No Score 27 1 28 x 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x x x x 3 Highfield Resource Centre J54_s34522_Highfield Resource_v242182_240205_Stage 4.doc Version 1.40 Page 19 no 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. Standard OP 27 Regulation 18 (1) Requirement That the service provider produce an action plan to ensure that having regard to the size of the care home,the statement of purpose and needs of service users and will ensure that at all times suitabley qualified competent and experienced persons are working in the care home in such numbers as are appropriate for the health and welfare of service users. The action plan to be submitted to the CSCI The service provider must obtain evidence of identity in respect of all persons working in the care home. Timescale for action 01/12/05 2. Op 29 19 Schedule 2 01/12/05 3. 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 Op 3 Good Practice Recommendations The homes staff should become involved in the preadmission assessment of all service users. J54_s34522_Highfield Resource_v242182_240205_Stage 4.doc Version 1.40 Page 20 Highfield Resource Centre 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. Op 3 OP 6 Op 6 Op 6 & 30 OP 6&7 Op 7 OP 12 Op 18&30 OP 19 Op 13 The service users care plans should be linked to the assessment Social rehabilitation facilities should be devloped for the intermediate care unit Specific care staff should be designated to or specialise in the work of the Intermediate Care unit Relevant care staff should training in rehabilitative techniques used on the intermediate care unit The service provider should develop multi disciplinary team work and short term review of service users on the intermediate care unit The service provider should develop care plans for service users on the respite and intermediate care units. The service provider must ensure that stimulating structured activities are made available for all service users. Staff should receive training in whistle blowing The service provider should ensure that the hot water temperature at points used by service users is at a safe temperature. The service provider should ensure that all staff recieve training in issues related to the multiple categories identified on the registration certificate. Highfield Resource Centre J54_s34522_Highfield Resource_v242182_240205_Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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 Resource Centre J54_s34522_Highfield Resource_v242182_240205_Stage 4.doc Version 1.40 Page 22 - 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!