Inspection on 16/08/05 for Highfield Road

This inspection was carried out on 16th August 2005.

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 Road 11/05/07

Highfield Road 29/06/06

Highfield Road 26/01/06

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Highfield Road 29 Highfield Road Dartford Kent DA1 2JS Lead Inspector Eamonn Kelly Unannounced 16 August 2005 15:00 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 Road H56-H06 S64649 Highfield Rd V233637 160805 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Highfield Road Address 29 Highfield Road Dartford Kent DA1 2JS 1322 281833 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) DGSM Limited Miss Theresa Chambers Care Home 8 Category(ies) of Learning Disability (8) registration, with number of places Highfield Road H56-H06 S64649 Highfield Rd V233637 160805 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: The home provides accommodation and residential care for up to 8 people with learning disabilities. Each service user has a single bedroom (bedrooms are arranged over 3 floors). Twenty four hour supervision is provided. The premises are close to local facilities and to public transport. There is a carpark at the rear. The house is owned by Hyde Housing and leased to DGSM Ltd. The premises has a small patio area at the rear. The manager advises potential service users and their supporters that the premises are suitable for service users with good mobility. Highfield Road H56-H06 S64649 Highfield Rd V233637 160805 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection consisted of meeting with service users and members of staff. An inspection of the premises was made. Some of the home’s records were checked. A brief summary of the requirements and recommendations to be contained in the inspection report was given to the registered manager at the end of the inspection visit. Copies of the Commission’s booklet “Is the care you get the care you need?” were left at the home. What the service does well: What has improved since the last inspection? There has been some internal redecoration. New kitchen equipment has been bought. The lounge furniture has been replaced. New beds have been provided in 2 bedrooms and a further 2 bedrooms have been fully renovated. Following modernisation of the water distribution and heating systems in 2004, these have been tested and found to be effective. The manager is expanding the level of information contained in service user plans. Now that the uncertainty about the future of the home has been removed, the manager is addressing the need for adequate written preadmission information to be available. The home has adopted a more effective approach to maintaining adult protection procedures. Highfield Road H56-H06 S64649 Highfield Rd V233637 160805 Stage 4.doc Version 1.30 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 Road H56-H06 S64649 Highfield Rd V233637 160805 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Highfield Road H56-H06 S64649 Highfield Rd V233637 160805 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3, 4 & 5 Prospective service users and their supporters do not receive the levels of assistance that is required at admission stage from current pre-admission documents. However, prospective service users receive the levels of preadmission support that they need. EVIDENCE: The pre-admission information available for prospective service users and their supporters was assessed in outline. It was agreed with the registered manager that the current documents do not contain full information about the home’s services and facilities. The manager undertook to produce material that would be informative, accurate and applicable to 29 Highfield Rd. The manager also undertook to review the current personal contract for service users and to have a revised contract available for any new service users. The shortfalls in the current personal contract for service users were discussed with the manager and ideas were exchanged to enable the new document to comply more fully with the requirements of national minimum standards. The revised personal contracts should contain more specific information regarding the service provision for individual service users. The current contract is an amended version of the (Hyde Housing) tenancy agreement. Highfield Road H56-H06 S64649 Highfield Rd V233637 160805 Stage 4.doc Version 1.30 Page 9 A case tracking exercise (ie. assessment of the care needs of some service users) indicated that recently admitted service users received good support and advice before moving into the home. Their care and accommodation needs had been fully assessed. Highfield Road H56-H06 S64649 Highfield Rd V233637 160805 Stage 4.doc Version 1.30 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 & 9 Service users have opportunities for personal goals to be identified and to receive assistance in making decision about their lives. EVIDENCE: Service user’s care plan records checked during the inspection visit were an accurate reflection of the current care requirements of service users. The manager intends to extend the information contained in the records particularly in relation to recording reviews of service users health and wellbeing. There was evidence that considerable attention is given to helping service users to make decisions about how to spend their time and to avoid the development of very rigid routines. The examples of recorded outcomes of risk assessments supported this conclusion. Service users described aspects of their aspirations and goals. These were very diverse as the group of service users have widely differing support needs. Some have moved to the home following the closure of a local supported living Highfield Road H56-H06 S64649 Highfield Rd V233637 160805 Stage 4.doc Version 1.30 Page 11 scheme. Some are able to visit locations outside the home unaccompanied. There was evidence that they were consulted about how they spend their time and about possible alterations to their routines. There were many indications that they are supported to take some risks as part of maintaining as independent a lifestyle as possible. Highfield Road H56-H06 S64649 Highfield Rd V233637 160805 Stage 4.doc Version 1.30 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 13, 14, 15 and 17 Service users are enabled to be part of the local community. Service users have appropriate and sufficient opportunities for personal development. EVIDENCE: Opportunities are available for service users to undertake paid or voluntary work. Members of staff help assist them to continue their education or training and to continue taking part in planned activities. Examples of activities followed by service users over the past 12 months were discussed. Each service user is helped to visit day centres, social education centres, shops, pubs and many venues. The home has the full-time use of a vehicle for helping service users to go shopping and for leisure activities. Transport facilities are provided by some day centres which service users attend. Highfield Road H56-H06 S64649 Highfield Rd V233637 160805 Stage 4.doc Version 1.30 Page 13 Some service users use the home’s clothes washing facilities as part of the process of encouraging them to remain independent. Some have front door and bedroom door keys to enable continuation of this independence. Some service users have very close connections with members of their families who visit regularly and take a close interest in their progress and wellbeing. As part of risk assessment and enabling service users to take assessed risks, the home continuously monitors their actual and potential vulnerability to events and people outside the home. Examples were discussed where this vigilance was justified. There was evidence that service users have meals in accordance with agreed menus, known choices and their nutritional needs or preferences. They have access to the kitchen to help with cooking. A copy of “Special Recipes: A Personal Collection of Low Protein Recipes” for people with phenyllketonuria (pku) was being used by a service user to choose meals from colour pictures and advice from a support worker. Highfield Road H56-H06 S64649 Highfield Rd V233637 160805 Stage 4.doc Version 1.30 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 & 20 There is commendable emphasis by the home in enabling service users to gain access to suitable healthcare services. EVIDENCE: Examples were discussed of how care centres on helping individuals judge what they can and can’t do for themselves. Service users have differing levels of care needs and staff intervention for the provision of personal care is carefully assessed and agreed in each case. Male and female members of staff are employed at the home and members of staff are aware of the procedures for providing sensitive and flexible personal care. Service users visit their GP in most instances. Care plan records indicated that service users have ready access to social and healthcare services. An epilepsy nurse provides training for members of staff (an alarm is situated in a service user’s bedroom to alert the (sleeping) member of staff on duty at night of potential difficulties). A monitored dosage system of medication system is used. Medication is stored securely and MAR (medication administration record) sheets seen were up-toHighfield Road H56-H06 S64649 Highfield Rd V233637 160805 Stage 4.doc Version 1.30 Page 15 date. The MAR sheet system was previously amended by the home to improve accuracy and reduce the chance of mistakes occurring. The social and healthcare needs of each service user were discussed in some detail during the inspection visit. It was clear that particular attention is given by the home to monitoring their health and to taking robust action where the corporate system (ie. the provider, social services and health service provision) lacked the means to co-ordinate suitable packages of care for service users. Highfield Road H56-H06 S64649 Highfield Rd V233637 160805 Stage 4.doc Version 1.30 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 The home has suitable and commendable measures in place to protect service users. EVIDENCE: The home has a complaints procedure (a précis will soon be prominently displayed). Members of staff receive training in dealing with Adult Protection situations. The home has itself referred some situations to Social Services under the KCC adult protection policy and procedures. These situations were discussed in some detail during the inspection visit. All members of staff have been checked under appropriate recruitment procedures (ie. references, application form, CRB/POVA check, probation, induction training, supervision). The home follows the Kent & Medway Policy for Adult Protection. Service users are confident in expressing their views to members of staff, visitors and day centre staff. The home has procedures in place for listening to the views of service users and their supporters and for taking expressed views into consideration. Highfield Road H56-H06 S64649 Highfield Rd V233637 160805 Stage 4.doc Version 1.30 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26, 27, 28, 29 & 30 The premises are suitable for the needs of service users who benefit from good kitchen, lounge, dining room facilities and bedrooms. The premises are, however, best suited to people with few mobility difficulties. EVIDENCE: The premises are generally suitable for its stated purpose as a residential care home. Hyde Housing (the owner of the building) has replaced the central heating and plumbing system. Redecoration has taken place and some bedrooms have been fully refurnished. The patio area at the rear has not been maintained as an amenity for service users (development of this small area has been promised for about 2 years). A wall at the rear is also potentially dangerous and must be repaired without further delay by the owner of the building. In view of the need for service users to travel to the (sleeping) support workers locked door at night, the manager agreed to assess the need for extending the call alarm system to bedrooms. Highfield Road H56-H06 S64649 Highfield Rd V233637 160805 Stage 4.doc Version 1.30 Page 18 Bedrooms meet service user’s needs. Each bedroom is furnished to a reasonable standard. There are sufficient WC, bathroom and shower facilities. The premises were clean and hygienic during the inspection visit. There is a laundry room is used under supervision by some service users. COSHH (safety for storage of chemicals and cleaning materials) assessments have been made. There are no specific environmental adaptations or disability equipment. Any such equipment would be provided if a service user review determined a need. The home has reasonable communal facilities and bedrooms (on 3 floors) have proved suitable for service users over many years. Potential service users and their supporters are advised of the limitations of the premises for use by people with some physical disabilities. Highfield Road H56-H06 S64649 Highfield Rd V233637 160805 Stage 4.doc Version 1.30 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) x These standards were not assessed on this occasion. EVIDENCE: Highfield Road H56-H06 S64649 Highfield Rd V233637 160805 Stage 4.doc Version 1.30 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37 & 38 Service users benefit from a well run home. EVIDENCE: The registered manager is a registered nurse with experience in the care of people with learning and physical disabilities in residential and clinical settings. She has achieved a DMS (Diploma in Management Studies). The manager submits reports to the CSCI under Regulation 24: these reports are comprehensive. Some alteration to the format of the reports is being considered by the manager to enable them to be strategic and less detailed. The manager will now have the benefit of inspection reports each month (under Regulation 26). The registered responsible person for the service (Mrs L Woodward) has delegated this task to the services manager who will make the visits and submit the reports. This is part of the commitment of the provider to quality assurance measures to enhance service provision for service users. Highfield Road H56-H06 S64649 Highfield Rd V233637 160805 Stage 4.doc Version 1.30 Page 21 During this inspection visit there was a positive atmosphere and service users were generally at ease. They spoke well of life at the home and some outlined plans for the future. Highfield Road H56-H06 S64649 Highfield Rd V233637 160805 Stage 4.doc Version 1.30 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 3 3 2 Standard No 22 23 ENVIRONMENT Score 3 4 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 1 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 x 3 3 3 x 4 Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Highfield Road Score 3 4 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 x x x x x H56-H06 S64649 Highfield Rd V233637 160805 Stage 4.doc Version 1.30 Page 23 NA 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 1 Regulation 4&5 Requirement The registered person shall produce a written guide to the care home... The current guide is acknowledged but the improvements discussed are necessary to enable prospective service users and their supporters to obtain specific and objective information about the homes services and facilities. The premises..sound construction and kept in a good state of repair externally and internally. The boundary wall at the rear must be repaired to ensure that service users are not exposed to its potential collapse. Timescale for action 15/10/05 2. 24 23 (2) (b) 01/10/05 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 5 24 Good Practice Recommendations Revised personal contracts should contain more specific information regarding the service provision for individual service users. The rear patio area should be developed as a safe and H56-H06 S64649 Highfield Rd V233637 160805 Stage 4.doc Version 1.30 Page 24 Highfield Road 3. 24 useful amenity for service users. This is particularly important in the absence of a garden at the premises. It is recommended that, as service users on the 3 floors must make their way to the locked door of the room where the (sleeping) support worker is based at night, the call bell system is extended to all bedrooms. Highfield Road H56-H06 S64649 Highfield Rd V233637 160805 Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection The Oast Hermitage Court Hermitage Lane Maidstone Kent ME16 9NT 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 Road H56-H06 S64649 Highfield Rd V233637 160805 Stage 4.doc Version 1.30 Page 26 - 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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