Inspection on 15/08/05 for Highfields Care Home

This inspection was carried out on 15th 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Highfields Care Home 02/03/07

Highfields Care Home 07/02/06

Highfields Care Home 15/03/05

Highfields Care Home 05/11/04

Highfields Care Home 19/02/04

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

CARE HOME ADULTS 18-65 Highfields Care Home Highfield Road Swadlincote Derbyshire DE11 9AS Lead Inspector Brian Marks Unannounced 15 August 2005 10.00am 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 Care Home C52-C02 S51271 Highfields V244590 150805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Highfields Care Home Address Highfield Road Swadlincote Derbyshire DE11 9AS 01283 224658 01283 224658 highfields@unitedhealth.co.uk United Health Limited 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) Hazel Elizabeth Ashmore PC Care Home only 5 Category(ies) of 5 places - LD Learning disability registration, with number of places Highfields Care Home C52-C02 S51271 Highfields V244590 150805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None stated Date of last inspection 15 February 2005 Brief Description of the Service: Highfields is a purpose built single storey building offering 5 places for adults with severe learning disabilities, and physical disabilities; its design specification had been set at a high standard and the quality of equipment, furniture and fittings is very high. This includes special beds, baths, hoists and other equipment and all bedrooms have access to en-suite bathrooms with integral overhead tracking to access between the two areas. Corridors and communal areas are extensive to allow for comfortable access for service users and staff. The home benefits from good support from outside professionls who advise the homes staff on a variety of care issues. Highfields was registered on the 24th September 2003, and is owned by United Health, a company based in Lincoln that specilaises in the operation of care homes for people with sever learning disabilities. Highfields Care Home C52-C02 S51271 Highfields V244590 150805 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 visit that took place at the home over a morning. Additionally, time was spent in preparation for the visit, looking at previous reports and other documents. At the home, apart from examining documents, care files and records, time was spent looking around the building and speaking to 2 of the staff who were on duty and to the manager. The residents were not able to verbally respond to the inspection but they were observed throughout the visit, being cared for by staff. Within the last 2 weeks before the inspection a fifth resident has been admitted to the home, joining the 4 long-established residents. What the service does well: Highfields provides a specialised service to people with complex learning and physical disabilities, and does so successfully, using staffing levels that are set very high allowing for good levels of individual care. . Although the home is a very large bungalow with wide corridors and doorways to allow for easy movement, it has been fitted out in a domestic style and staff have worked hard to create a family atmosphere. Staff work in very flexible ways and activities take place both inside and outside the home with each individual’s needs in mind. The home was purpose built with this type of resident in mind and, as noted above, the physical layout of the home has been designed to make their lives as easy as possible. Furniture, fittings and decoration are to a high standard, and additional specialist equipment has been provided, which helps the residents to be cared for safely and in comfort. All of the residents are wheelchair users and these have been supplied to suit their individual requirements. Staff at the home are very alert to any problems that occur with the equipment within the home and are supported by a good service company. During the visit staff were observed caring for the residents; they did this with sensitivity and a relaxed style, constantly using verbal prompts and encouraging responses from the person they were supporting. Staff have developed ways of understanding what the residents are wanting and help them to make choices about their lives. The staff group are committed to the job of resident care and the manager reported that although there have been vacancies recently, consistency in resident care has been maintained and the use of outside agency staff kept to a minimum. Highfields Care Home C52-C02 S51271 Highfields V244590 150805 Stage 4.doc Version 1.40 Page 6 Staff receive good levels of support from both their colleagues and the home’s managers and they are committed to the work and residents at the home and relationships were observed to be good. General management and administration are well organised and the home benefits from the services and advantages of a larger organisation that takes care to make sure its homes are running properly. What has improved since the last inspection? 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 Care Home C52-C02 S51271 Highfields V244590 150805 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 Care Home C52-C02 S51271 Highfields V244590 150805 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) 2 and 4 Staff care for residents in a planned and consistent way as soon as they move into the home, using information provided by a number of people. EVIDENCE: The care records of one of the residents was examined in detail and these contained a number of documents including assessments of the care and services she required, which were made as part of the admission and matching activity that occurred before she came to the home. The manager of the home, as well as staff from the school she was leaving, had carried out these assessments and allowed for a careful transition to her new accommodation. The records indicated that she had visited the home before the move was made permanent, which allowed for everyone to get to know her and to give her an experience of life at the home. The manager explained that this was normal procedure for new people coming to the home. The records also included assessments of risk that her disability created in her life and of ways that staff helped to overcome or minimise those risks. There was a personal plan that described ways staff could best care for her and this was evaluated regularly to make sure that staff were continuing to work properly. From talking with the manager, progress by the residents is usually only made in very small steps, because of the nature of their disabilities. The home aims to provide steady stimulation of all the senses so that the residents do not suffer from the negative aspects of life in care such as boredom, lack of social contact and exclusion from community life. Improvements in the small areas Highfields Care Home C52-C02 S51271 Highfields V244590 150805 Stage 4.doc Version 1.40 Page 9 of life such as concentration, eye contact, vocalisation and direct response to the staff had been noted in those residents who had been at the home for an extended period. Highfields Care Home C52-C02 S51271 Highfields V244590 150805 Stage 4.doc Version 1.40 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 and 9 Detailed individual plans have been developed at the home so that support can be given consistently, and the welfare and safety of residents maintained. Most residents have poor verbal communication and staff have developed individual ways of understanding what they want from their lives at the home. EVIDENCE: Examination of care records indicated that residents have a detailed individual care plan, which included aspects of personal and health care activity put together from the assessments that had taken place. Because of the complex nature of the residents’ disabilities, these documents are wide ranging in their content and describe how staff are to care for them in some detail. This helps staff to care for them consistently and safely. Within the documentation there was evidence that the care plans are reviewed regularly – in some cases monthly but more usually every 2 months - and this indicated that support was being given in ways that were based on up-to-date information and further emphasised a consistent approach. The care plans were also linked to a number of health care records that staff maintained, such as the occurrence of epileptic seizures. These were important in making sure that problems with ill health are properly dealt with. Highfields Care Home C52-C02 S51271 Highfields V244590 150805 Stage 4.doc Version 1.40 Page 11 All of the residents have great difficulty with verbal communication, and the staff and manager described how they come to learn about what they want through the individual resident’s gestures, body language and sounds that they use. Although a lot of information is given by professionals with previous knowledge of the residents, the manager described how they have to re-learn this in some instances, because the resident reacts differently in different places. The care plans looked at included detailed risk assessments, which indicate key areas of concern and the ways in which staff can minimise or eliminate any problems in order to ensure individuals did not come to harm; they guide staff in safe ways of working. Examples of the problem areas covered included choking, hot drinks, wheelchair mobility and activities in the kitchen. Highfields Care Home C52-C02 S51271 Highfields V244590 150805 Stage 4.doc Version 1.40 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) 12, 13, 14, 15, and 16 Appropriate leisure activities are provided with high staff levels, allowing residents to develop and to lead more satisfying lives. Because of the capability of the group of people who live at this home Standard 12 does not apply. EVIDENCE: The manager reported that the daily routines of the home are centred around the residents and how they re reacting at any one time. Sometimes it is indicated that a late start to the day is required and activities fit around that. This was observed as residents arrived in the dining room for breakfast at different times. Residents were also observed within their rooms and in the main communal area, including the sensory room, and constant 1-to-1 attention was available to them during the visit. Staff used verbal stimulation to constantly reassure the residents and sensory stimulation was the basis of the day’s ‘routine’. Activities were outlined on individual programmes within the care documents, and 2 of the residents were out with staff during the visit. One resident was Highfields Care Home C52-C02 S51271 Highfields V244590 150805 Stage 4.doc Version 1.40 Page 13 observed enjoying loud rock music whilst other styles were heard later in the visit; staff reported that all had different tastes and these were responded to. During the inspection staff gave constant verbal reassurance to the residents, using adult language; the privacy of service users was respected by the closing of doors, particularly bathrooms. It had been agreed that formal structured activities such as day centres or college is not appropriate for these residents, and the individual activities programme examined described regular outings into the local community to shops and parks, and beyond to specific facilities such as garden centres and cafes. These are carried out with one or two staff, depending on circumstances, and are felt to be beneficial in giving the residents experiences that include, rather than exclude, them from normal social life. The manager also described 2 self-catering holidays away from the home that had been arranged for the 4 established residents earlier in the year. Records on the files examined indicated regular contact with family members and the manager confirmed that this was encouraged for all residents, although some had originated in regions of the country distant from the home. In order to assist this the staff had recently organised a Saturday barbecue and advocacy meeting to encourage family members to be involved with the running of the home. Highfields Care Home C52-C02 S51271 Highfields V244590 150805 Stage 4.doc Version 1.40 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 and 20 Resident health and personal care needs are met, and they have access to outside health care professionals who help them to maintain goods standards. The management of medicines has improved since the last inspection and this is carried out safely and consistently through good recording and storage systems. EVIDENCE: All of the residents have high physical care needs and the care records indicated in some detail what staff needed to do to provide care consistently and safely. The home’s manager and staff manage all medication. All residents use a wheelchair inside and outside the home, and these are individually designed to the resident; additionally some of the residents have their own armchairs and additional equipment was provided in the bedrooms and bathrooms to help staff move residents and make life easier. Records also showed how outside professionals are able to help residents; a physiotherapist, dietician, occupational therapist and specialist consultant in rehabilitation had all been involved with the resident whose files were looked at. Records indicated that the health care of residents is properly managed and that they get good support from the local GP practice and have regular contact with the dentist and optician. There are no residents who manage their own medicines and systems operated by staff at the home were satisfactory. The previous CSCI inspection at the Highfields Care Home C52-C02 S51271 Highfields V244590 150805 Stage 4.doc Version 1.40 Page 15 home had been carried out by the pharmacy inspector and all the requirements made at that inspection have been carried out. These included a number of issues related to recording and storage practice, the checking of prescriptions and the use of occasional (PRN) medicines. All staff have received training in the administration of medicines. Highfields Care Home C52-C02 S51271 Highfields V244590 150805 Stage 4.doc Version 1.40 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) EVIDENCE: These standards were not specifically looked at at this inspection, other than to establish that the requirements from the last inspection regarding the amendment of the complaints procedure to indicate the timescale for response to complaints (Standard 22.4) and staff training in relation to ‘Adult Protection’ (Standard 23.1) had been completed. Highfields Care Home C52-C02 S51271 Highfields V244590 150805 Stage 4.doc Version 1.40 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, 29 and 30 The home is equipped, furnished and maintained to a good standard and offers homely and spacious facilities for residents to enjoy, as well as meeting their special physical needs. EVIDENCE: The home is newly built and, to allow for people with high levels of physical difficulties, was designed as a bungalow with wide corridors and spacious rooms. It was supplied, to a high standard, with equipment, furniture and fittings of a style that could be expected in an ordinary domestic setting, as well as being arranged with specialised equipment to meet the needs of the service users. This includes, tracking hoists between bedrooms and bathrooms, mobile hoists, individually designed seating and wheelchairs and special baths and toilets. There is also a much-used sensory room that assists with relaxation and specific therapeutic programmes. The home is near the town centre of Swadlincote and staff are able to get to local amenities on foot or using the home’s vehicle as required. Because the home is new there have been no maintenance problems to deal with; the manager described plans that were being made to start a redecorating programme to give the home a style that reflects the current group of younger residents. Highfields Care Home C52-C02 S51271 Highfields V244590 150805 Stage 4.doc Version 1.40 Page 18 Standards of cleanliness and hygiene at the home were high at the time of the visit and the residents were all well dressed in clean and appropriate clothing. The home has a well-equipped laundry and care staff are responsible for the personal laundry and bedding of residents. Highfields Care Home C52-C02 S51271 Highfields V244590 150805 Stage 4.doc Version 1.40 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) EVIDENCE: These standards were not specifically looked at at this inspection. Highfields Care Home C52-C02 S51271 Highfields V244590 150805 Stage 4.doc Version 1.40 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) EVIDENCE: These standards were not specifically looked at at this inspection, other than to establish that the requirement from the last inspection regarding fire safety training for staff (Standard 42.2) had been completed. Highfields Care Home C52-C02 S51271 Highfields V244590 150805 Stage 4.doc Version 1.40 Page 21 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 3 x x 3 x Standard No 22 23 ENVIRONMENT Score x x 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 4 x x x x 4 4 Standard No 11 12 13 14 15 16 17 x 3 3 3 3 3 x 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 Highfields Care Home Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x x x C52-C02 S51271 Highfields V244590 150805 Stage 4.doc Version 1.40 Page 22 Yes 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 Regulation Requirement There are no requirements to be made as a result of this inspection. Timescale for action 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 23 35 Good Practice Recommendations The registered person must ensure that all staff receive training in ‘Adult Protection’, and are aware of Derbyshire’s (statutory multi-agency) policy and procedures. The Registered Manager should ensure that training is provided for staff that links in with the Learning Disability Award Framework (LDAF). Highfields Care Home C52-C02 S51271 Highfields V244590 150805 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection South Point Cardinal Square Nottingham Road Derby DE1 3QT 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 Care Home C52-C02 S51271 Highfields V244590 150805 Stage 4.doc Version 1.40 Page 24 - 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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