Inspection on 16/08/05 for Highfields

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 Good. 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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Highfields 05/06/06

Highfields 29/11/05

Highfields 28/09/04

Highfields 20/04/04

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Southfields

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

CARE HOME ADULTS 18-65 Highfields 1 Emily Jackson Close Eardley Road Sevenoaks Kent TN13 1XH Lead Inspector Paul Stibbons Unannounced 16 August 2005 09:30 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. Highfields H56-H06 S23950 Highfields V242042 160805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Highfields Address 1 Emily Jackson Close Eardley Road Sevenoaks Kent TN13 1XH 01732 465987 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) The Avenues Trust Limited Mrs Janet Winter CRH Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Highfields H56-H06 S23950 Highfields V242042 160805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users with learning disabilities may also have physical disabilities 2. Care of one Service User who has been diagnosed with Alzheimers Disease is restricted to one person whose date of birth is 07/07/1926 Date of last inspection 28 September 2004 Brief Description of the Service: The home was purpose built in 1995 to accommodate six service users with learning disabilities. Accommodation is single storey and consists of 6 single bedrooms with en-suite showers and toilets. All bedrooms have a TV point. Except for the assisted bathroom, bedrooms and communial areas are not connected to an emergency call system. Day space consists of a lounge and separate dining room. There is a small rear garden. The home is situated in a quiet residential area within walking distance of Sevenoaks town centre and main transport systems; there is limited on site parking. Highfields H56-H06 S23950 Highfields V242042 160805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection and lasted from 10.05 hrs until 15.00 hrs. The regulatory inspector conducting the inspection was Paul Stibbons. In the absence of the manager the shift leader Mr Henry McErlane assisted the inspector. Time was spent looking at various records and documentation and a tour of the building was undertaken. Three staff on duty were spoken with and also the manager, who returned before the inspection concluded. Due to the communication difficulties of some service users some judgements were made through the inspector’s observations, supported by staff members and records held in the home. What the service does well: What has improved since the last inspection? Since the last inspection staffing levels have improved, thereby reducing the need for bank and agency use. The home’s manager has completed her NVQ4 training and is awaiting certification. The home is currently undergoing redecoration. Highfields H56-H06 S23950 Highfields V242042 160805 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. Highfields H56-H06 S23950 Highfields V242042 160805 Stage 4.doc Version 1.40 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 Highfields H56-H06 S23950 Highfields V242042 160805 Stage 4.doc Version 1.40 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, Service users can make an informed choice of home based on a comprehensive assessment of need and information of how the home will meet those needs. EVIDENCE: The home’s statement of purpose has now been updated to show the change from NCSC to CSCI, an application for minor variation to registration must be made due to the age of two service users. One service user’s care plan was selected to view and it contained a profile of life history and a comprehensive assessment of needs with input from the multi-disciplinary team. There was a care support plan that clearly instructed the care team on procedures. Activity records demonstrated that the service user’s interests were supported in attending musicals and photographs and brochures in the service users bedroom further evidenced this. Health records showed that needs were monitored and reviewed with input from relevant professionals. Highfields H56-H06 S23950 Highfields V242042 160805 Stage 4.doc Version 1.40 Page 9 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, 8, 9, 10 Individual care plans reflect assessed and changing needs and a keyworker system ensures individual service users’ needs and personal goals are addressed. Service users are encouraged to maintain their independence within their capabilities. Their rights to confidentiality are promoted. EVIDENCE: Comprehensive care plans ensure that the staff team provides consistent care. Due to the level of learning disabilities within the home, participation in the day to day running of the home is minimal; staff encourage inclusion in food preparation and cleaning bedrooms etc. One keyworker demonstrated a good understanding of the service users’ personal interests and how he supported them; this was later confirmed in discussion with the service user and records within the care plan. Service users were observed to freely move around the home and one service user had a mobile call system that was promptly responded to when activated. Service user records were securely stored in the manager’s office with access only to authorised personnel. Highfields H56-H06 S23950 Highfields V242042 160805 Stage 4.doc Version 1.40 Page 10 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, 12, 13, 14, 15, 16, 17 Service users are encouraged to engage in appropriate leisure activities within the home and use amenities in the local community that meet their educational and leisure needs. Service users are able to receive visitors and maintain family contact Service users are offered a varied and healthy diet according to their choices. EVIDENCE: One service user was being supported to attend the local age concern facility during the inspection. Activity charts showed opportunities for service users to participate in various in-house activities including exercise, darts, video/DVD viewing and someone external to the home comes in with guitar/keyboard for singing sessions. One service user said how he particularly liked the Elvis Presley songs. Opportunities are arranged to attend 10-pin bowling and it was recorded in individual plans whether these opportunities were taken. One service user is a member of the local library and his keyworker supports him to use this facility. Several service users have been to Centre Parcs for a five-day Highfields H56-H06 S23950 Highfields V242042 160805 Stage 4.doc Version 1.40 Page 11 holiday this year and there have been other outings to places such as Bournemouth. Family contact is promoted and for one service user’s birthday his family and staff team arranged a day out at Brands Hatch where he was given a ride in a sports car and the event was videoed for him. Two service users are supported to attend the local church when they wish. Lunch was observed during the inspection and the meal looked appetising and healthy. Communication with the service users gained limited response but they appeared to enjoy the meal and there was good interaction between staff and service users. Menus were inspected and demonstrated a varied and balanced diet. Highfields H56-H06 S23950 Highfields V242042 160805 Stage 4.doc Version 1.40 Page 12 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 Service users receive personal support in a respectful and dignified manner using appropriate equipment. Health needs are fully met by monitoring and referral to relevant specialists. Service users are unable to administer their own medication and are supported by competent staff and are protected by safe procedures. EVIDENCE: Staff were observed to treat service users in a respectful manner. Personal care was conducted in the privacy of their own rooms and it was observed that staff wore appropriate protective clothing. Care plans contained recording charts to monitor health needs and evidence of being reviewed by a multidisciplinary team. One service user plan showed a review of epilepsy medication and management on 09. 03.05 and dietician 13.07.05. Medication storage and recording was inspected and found to be safely stored and accurately recorded. PRN protocols were in place. A staff member was observed administering medication and was seen to follow correct procedures. Staff training files evidenced medication training to ensure competence for staff members and protection of service users. Highfields H56-H06 S23950 Highfields V242042 160805 Stage 4.doc Version 1.40 Page 13 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) 23 Service users are protected from abuse by the home’s policies and procedures and staff training on adult protection. EVIDENCE: Service users are protected from abuse by staff training on adult protection; viewing staff training files evidenced this. One recent new member of staff confirmed that the home requested two references and a CRB check before employing her. Service user cash boxes were seen securely stored in the office with an unbroken seal around each box. The shift leader explained that each time the seal is broken the transaction and contents has to be witnessed by two members of staff. Highfields H56-H06 S23950 Highfields V242042 160805 Stage 4.doc Version 1.40 Page 14 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 home provides a safe, comfortable and well-maintained environment. Service user bedrooms reflect their interests and lifestyles and benefit from private en-suite facilities. Specialist equipment maximises independence for service users. EVIDENCE: The home is fully furnished to a good standard and designed to appropriately meet the needs of the service users. The home is currently undergoing redecoration in the communal areas. Bedrooms are decorated to the service users tastes and personal possessions reflect the interests and lifestyles of individuals. Bedrooms all have en-suite facilities for the privacy of users and specialised beds where a need is identified. The bathroom has a purpose built bath and manual hoists are available where there is an assessed need. It was noted that equipment servicing was up to date. There is a set of seated scales for monitoring service user body weight. The room is spacious facilitating ample room for wheelchair access. The home has a comfortably furnished lounge area and a dining/day area that leads out through patio doors to the garden area. The garden area consists of a paved area with table and chairs and lawn enabling service users to sit out in warmer weather. There is a Highfields H56-H06 S23950 Highfields V242042 160805 Stage 4.doc Version 1.40 Page 15 laundry room and sluice facility with adequate equipment for the service. All bed linen and towels are colour coded for individual service users. Facilities and procedures were in place for infection control. Highfields H56-H06 S23950 Highfields V242042 160805 Stage 4.doc Version 1.40 Page 16 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) 32, 33, 35 A competent and effective staff team meets Service users’ individual and joint needs. EVIDENCE: There are three staff members on duty exclusive of the manager from 07.30 to 21.30 daily and one waking night staff. In addition there is a floating sleep night staff member to call on in an emergency. Recruitment for permanent members of staff should continue until full establishment is reached. Training files viewed evidenced appropriate training to enable staff members to competently fulfil their roles and responsibilities. Staff members were observed carrying out their duties in a competent and professional manner. Highfields H56-H06 S23950 Highfields V242042 160805 Stage 4.doc Version 1.40 Page 17 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, 41, 42 Service users benefit from living in a home that is run by a competent and qualified manager. The home’s policies and procedures ensure records comply with the Data Protection Act 1998. Health and safety of service users is promoted and protected within the home. EVIDENCE: The homes manager is a qualified RNLD and has recently achieved NVQ level 4 in management and the Registered managers award. Staff members spoken with said the manager was approachable and a source of advice. Records kept and maintained within the home were securely stored with access only to authorised people. Staff training files evidenced training in manual handling, first aid, food hygiene etc. Records were viewed relating to fridge/freezer and meat probe temperatures, all were legibly recorded. Highfields H56-H06 S23950 Highfields V242042 160805 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 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 x x Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x 3 3 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Highfields Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 x x 3 3 x H56-H06 S23950 Highfields V242042 160805 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 YA1 Regulation 4 schedule1 Requirement Application for a variation to registration must be made to the commission for the two existing service users over the age of 65 years Timescale for action By 25 September 2005 2. 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 33 Good Practice Recommendations Continue to recruit permanent members of staff to full establishment Highfields H56-H06 S23950 Highfields V242042 160805 Stage 4.doc Version 1.40 Page 20 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 Highfields H56-H06 S23950 Highfields V242042 160805 Stage 4.doc Version 1.40 Page 21 - 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. 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