Inspection on 02/03/07 for Highfields Care Home

This inspection was carried out on 2nd March 2007.

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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Highfields Care Home 07/02/06

Highfields Care Home 15/08/05

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 Steve Smith Unannounced Inspection 2 March 2007 09:30 Highfields Care Home DS0000051271.V329393.R01.S.doc Version 5.2 Page 1 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 Highfields Care Home DS0000051271.V329393.R01.S.doc Version 5.2 Page 2 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 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. Highfields Care Home DS0000051271.V329393.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Highfields Care Home Address Highfield Road Swadlincote Derbyshire DE11 9AS 01283 224658 NOT GIVEN highfields@unitedhealth.co.uk Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) United Health Limited Hazel Elizabeth Ashmore Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Highfields Care Home DS0000051271.V329393.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th February 2006 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, as has the quality of equipment, furniture and fittings. The Home offers special beds, baths, hoists and other equipment specific to individuals, and all bedrooms have access to ensuite bathrooms with integral overhead tracking to provide access between the two areas. Corridors are very wide and communal areas are extensive to allow for comfortable access for service users and staff. The Home benefits from good support from outside professionals who advise the Home’s 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 specialises in the operation of care homes for people with severe learning disabilities. The charge made for staying in the Home, depends on the level of learning disability and care needs a Resident may have. Currently the lowest fee charged is £1548.25 a week, and the current highest fee is £1668.60. Charges will depend on such issues as, whether one or two staff are required to meet the needs of a Resident, across how much of each day. Highfields Care Home DS0000051271.V329393.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place in just under 6 hours. Discussion could not be held with Residents, due to their disabilities, however, the care needs of two Residents were ‘case tracked. The Manager was interviewed, and two care staff were also interviewed. A number of records were examined, and the bedrooms of all Resident were looked at and all public areas of the Home were examined. The Commission’s pre-inspection questionnaire, sent to the Manager, and the Commission’s questionnaire sent out to all of the Residents, had been completed, and were available prior to the inspection. One Resident (their relatives) choose to complete the questionnaire. What the service does well: What has improved since the last inspection? Since the last inspection, in February 2006, the Manager had ensured that staff had been trained in Safeguarding Adults procedures. She has also ensured Highfields Care Home DS0000051271.V329393.R01.S.doc Version 5.2 Page 6 that all new staff provided proof of their identity and that she obtained two written references at the interview stage of recruitment. Training had been provided or was planned on Infection Control and Emergency First Aid. What they could do better: The Registered Providers needed to ensure that an up to date copy of the Residents Guide was made available to all Residents, including the legal changes made in September 2006. A summary was also needed of the environmental standards met by the Home in the statement of purpose and Residents Guide to the Home. The Manager should set up and chair formal 6 monthly reviews of care for each Resident. She should also ensure that each Resident’s file contained a confidential section. Some improvements were needed in the recording of information in Residents files, and an improvement was needed in staff behaviour when meeting Residents care needs. The Manager should include the detail of the cleaning tasks and catering duties Residents were to assist within the Residents Guide to the Home. The Residents statement of terms and conditions of residence also needed to be provided with the rules in the home on smoking and alcohol consumption. An improvement in the recording on the Medication Administration Record sheets was needed. Within the complaints procedure, Residents and relatives needed to be informed that they would not be victimised for making a complaint. The Manager was encouraged to obtain a copy of the Public Interest Disclosure Act of 1998. It was also suggested that she informed staff, in the staff’s procedures manual, that they could not benefit in any way from Residents wills. Some staff needed training in First Aid and in Food Hygiene to ensure that training was fully up to date. The Manager needed to obtain copies of the Management of Health and Safety at Work Regulations 1999, the Workplace (Health, Safety and Welfare) Regulations 1992 and the Provision and Use of Work Equipment Regulations 1992. She also needed to ensure that these were operational within the Home. Highfields Care Home DS0000051271.V329393.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. Highfields Care Home DS0000051271.V329393.R01.S.doc Version 5.2 Page 8 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 Outcomes Statutory Requirements Identified During the Inspection Highfields Care Home DS0000051271.V329393.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1, 2 & 5. The quality in this outcome area was Good. This judgement was made using available evidence including a visit to this service. All new Residents moving to the Home were appropriately assessed prior to their admission, so that they and their families were reassured that their needs would be met. EVIDENCE: The Home’s statement of purpose and Residents Guide were reviewed during this inspection. Although both documents were very well constructed, the Resident’s Guide had not been updated with a summary of the physical environmental standards met by the Home. In September 2006, the details to be included within the Resident’s Guide where significantly updated by the government, but the Manager had been unaware of this change, and so the Guide was awaiting the necessary updates. However, the Residents Guide did contained information on how contact could be made with the Commission, the local Social Services Dept and local Health Authority. The Home received referrals of new Residents via the Care Management teams of Social Services Depts or Health Authorities from various places around the country. The Manager said that placing authorities always provided adequate information when Residents were placed in the Home, and this was seen when two files were reviewed. All new Residents were assessed by the Manager Highfields Care Home DS0000051271.V329393.R01.S.doc Version 5.2 Page 10 prior to the beginning of their placement, although no Residents were currently self-funding. All Residents had been provided with copies of the statement of terms and conditions of residency in the Home. Highfields Care Home DS0000051271.V329393.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7, 8 & 9. The quality in this outcome area was Good. This judgement was made using available evidence including a visit to this service. The Manager and staff ensured that Residents needs were met, allowing for their differing abilities and disabilities. EVIDENCE: To help assess Standard 6, the Residents Plan of Care, the records of two Residents were examined, for the purpose of case tracking. All of the basic information, concerning the Residents, was found to be in the files examined. Copies of the initial assessment completed by the Social Services Care Managers were available, and the Manager had completed her own initial assessment of needs for the Residents. There were also good care plans and risk assessments available in the records examined, providing staff with information to met the Residents needs. The files showed that good records of events affecting the Residents were kept. Entries were seen to be made at least 3 times a day, and Highfields Care Home DS0000051271.V329393.R01.S.doc Version 5.2 Page 12 included the detail of close work with health professionals, who regularly visited the Home. One of the Residents reviewed occasionally displayed aggressive or self-harming behaviour, which was appropriately addressed within the plan of care. The Residents formal reviews of care, to be undertaken on a six monthly basis, had not been completed. However, the Manager explained that she reviewed Residents needs at regular intervals, of approximately two to three months, which included contacting relatives by telephone, which was understandable given the considerable distances to relatives homes all across the country. The Residents records were easy to read and were detailed. The files were also well organised. The Manager was complemented on this very positive standard, although the files did not contain a confidential section. In the daily entries in one of the files examined a member of staff had written ‘Please Observe’, but staff had not responded to this request as no further entries were found relating to the issue to be observed. During the inspection a staff member was observed assisting a Resident while conducting a private conversation with another member of staff. During this time the staff member was observed to raise up the Resident’s head without explaining to the Resident what she was about to do. This was judged to be inappropriate behaviour and action by the two staff concerned. It was not possible to discuss Residents care needs with Residents due to their very profound disabilities, however, two staff were spoken to about Residents needs and the care provided for the Residents. Staff said that, if Residents were able, they were encouraged to indicate the clothing they wished to wear each day. They said that some Residents were also able to indicate whether they wished to go out, when staff gave them the choice. Certain Residents were also able to choose their food and drink, and to say whether they wished to take their medication. Staff said that the Residents were regularly taken out to visit, cinemas, public houses, were taken bowling, horse-buggy riding and ice-skating, with special equipment, and to a special hydro-pool, which was said to be much enjoyed. Occasional meals out were also said to be liked by some Residents. Staff were able to outline the ‘risk taking’ strategies required for these activities. The Manager said the Residents regularly helped, in a very limited way, with tasks in the kitchen, and that one Resident was able to help, to a degree, with cleaning tasks. Staff were regularly heard, during the inspection, to Highfields Care Home DS0000051271.V329393.R01.S.doc Version 5.2 Page 13 compliment and praise Residents for successfully carrying out tasks for their own benefit and for the home in general. Highfields Care Home DS0000051271.V329393.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14, 15, 16 & 17. The quality in this outcome area was Good. This judgement was made using available evidence including a visit to this service. Links with the local community were good and supported and enriched Residents social opportunities. Varied meals were also provided to the satisfaction of all Residents. EVIDENCE: The two staff interviewed said that some Residents were regularly taken to their parents homes to visit and spend the weekend with them. Making links with the local community had not been easy for the Residents, given their level of disability. However, staff said that Residents regular trips to public houses, the cinema and to shops for clothing and food items had helped this. On all such visits staff were needed to assist with the transporting, both to the site and in moving Residents around in wheelchairs, as well as purchasing items for the Residents. To go out on these visit, Highfields Care Home DS0000051271.V329393.R01.S.doc Version 5.2 Page 15 Residents used the Home’s mini-bus, although the Manager said that on occasions taxis were also used. Two Residents enjoyed bird watching, and had been taken on bird watching trips, and had used part of their holidays to visit bird sanctuaries. The Residents in the Home were not able to choose the videos or C/Ds they watched. Staff had had to learn what each Resident preferred and to make such videos and C/Ds available for them. The Manager said that the Home arranged two holidays each year for Residents. One of these was a 5 day holiday taken during the week, and the second was a long weekend of 4 days. This was done so that Residents needs could be appropriately addressed and the routine of the operation of the Home was not disrupted for Residents over to long a period. During the previous few months Residents had had a trip to Blackpool and there has been a trip to a nature reserve. Staff and the Manager said that all Residents were visited by their relatives, which might occur on a weekly basis or at approximately 6 weekly intervals, dependent on the distant to the parents homes. One Resident was described as visiting home, himself, and staff accompanied him on the journey. Staff said that relatives write to Residents, and staff read the letters out to each particular Resident. They also said that they assisted with phone calls made by family members to the Residents. One member of staff said that the Manager intended to install a web-cam to one of the Home’s computers to allow a television link to be made between Residents and their families. When relatives called at the Home, they were encouraged to take their particular Resident out for a drive or a meal. The Manager and staff said that they always made sure that they knocked on Residents bedroom doors before entering, even though most Residents were not able to answer. During activities provided in the Home the Residents were able to choose to take part. This was done by Residents response to the proposed activity. A Resident was seen being taken away from a planned activity, due to his negative response to it. The opportunity to take part in household tasks, such as assisting in the kitchen and with cleaning tasks, was not included in the Residents Guide, although the Commission recommends this. The Residents contract also does not include the rules operated in the Home on smoking and alcohol consumption. Highfields Care Home DS0000051271.V329393.R01.S.doc Version 5.2 Page 16 A good range of meals was provided by the Home, which included the opportunity to have drinks between meals and to have a snack if chosen by the Resident. Staff said that they know which Resident likes and dislikes what meals. However, if a Resident shows a dislike for a meal previously enjoyed, then an alternative would be provided for that meal. Highfields Care Home DS0000051271.V329393.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 & 20 . The quality in this outcome area was Good. This judgement was made using available evidence including a visit to this service. Residents’ personal needs were well met, ensuring that their privacy, dignity and independence were maintained. The system of administering medication was good, and ensured Residents medication needs were met. EVIDENCE: Staff were able to say that they were taught to maintain Residents privacy and dignity at all times. An example of this was that Residents must always be assisted to change in complete privacy. To assist staff with the moving and handling of Residents each Resident was provided with their own slings to be used on the hoists available in the Home. Staff were able to say this was to ensure the comfort of Residents while using the equipment, and to aid in the prevention of pressure sores. Those Residents able to make a choice of what clothing to wear were encourage in this by staff providing alternatives, and asking the Residents to choose the item to be worn that day. Highfields Care Home DS0000051271.V329393.R01.S.doc Version 5.2 Page 18 The Manager explained that Residents made a choice concerning their favourite staff, and when possible the favoured member of staff would assist the Resident with any necessary tasks. Each bedroom was provided with an overhead hoist to assist with the transferring of Residents to their bathroom; the hoist track ran into the large private bathroom shared by no more that two Residents. The hoist was also used to transfer Residents into their wheelchairs and back to bed when necessary. Regular contact was maintained by staff of the Home with health service staff, such as physiotherapists and occupational therapists. Staff were able to say which Resident they were keyworker for, and what they did for the Residents while carrying out that roll. Each Resident was provided with at least an annual health check. However, health problems were identified at an early stage and a referral to the Resident’s Doctor was made. During the inspection the Medication Administration Record (MAR) sheets were examined and in general all was found to be very well managed and maintained. However, the following issue needed attention: Three medications for two Residents were found to have been left in the Nomad packs, despite the fact that the MAR sheet said that the drugs had been given. However, notes had been made in the Residents records to say that the drugs had not been taken. This suggested that staff were signing the MAR sheet before distributing the medication, rather than after doing so. Highfields Care Home DS0000051271.V329393.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 & 23. The quality in this outcome area was Good. This judgement was made using available evidence including a visit to this service. Complaints made to the Registered Providers or Manager were appropriately addressed to meet Residents needs. The protection policies and procedures provided by the Registered Providers meant that Residents were well protected. EVIDENCE: The Commission had not received any notice of complaint since the last inspection of the Home in February 2006. The complaints procedure was provided in the Residents Guide, detailing that each complaint would be responded to within 28 days. However, the procedure did not state to Residents or their relatives that they would not be ‘victimised’ for making a complaint. The Safeguarding Adults procedure was seen. The Manager also had a Whistle Blowing policy and had the relevant information on the Dept of Health guidance ‘No Secrets’. However, a copy of the Public Interest Disclosure Act of 1998 was not available within the Home. The Manager said that all allegations and incidents of abuse would be followed up and action would, if necessary, be taken. She also said that any incidents of abuse by her staff would be passed on to the Protection of Vulnerable Adults register, but to date this had not been necessary. The policies and practices of the Home ensured that physical or verbal aggression by Residents was understood by staff and that staff would only intervene as a last resort to protect the Resident, other Residents or staff. Highfields Care Home DS0000051271.V329393.R01.S.doc Version 5.2 Page 20 The Home had satisfactory policies and procedures to deal with Residents money and financial affairs. However, the Manager said that the Home did not have a policy to inform staff that they could not benefit, in any way, from Residents wills. Highfields Care Home DS0000051271.V329393.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24, 25, 26, 27, 28, 29 & 30. The quality in this outcome area was Excellent. This judgement was made using available evidence including a visit to this service. The Home was very well maintained throughout, providing all Residents with a safe, and very comfortable environment in which to live. EVIDENCE: The premises of the Home were judged to be highly suitable for caring for Residents with learning disabilities, with ample space in corridors and all rooms. The Home provided a very safe and well maintained environment. Each Resident had their own bedroom. The bedroom space was well designed and laid out, usually to suit the needs of the Resident, and were provided with all the necessary furniture. All bathrooms were attached to Residents bedrooms, two Residents sharing a bathroom, with an overhead hoist system to allow access for each Resident, with assistance from staff. Highfields Care Home DS0000051271.V329393.R01.S.doc Version 5.2 Page 22 The domestic style kitchen was found to be appropriate, and the provision of a very large lounge and large dining area were very suitable for Residents needs. The lounge was provide with appropriate seating for Residents and staff, and allowed ample space for wheelchair access. The Home was well maintained throughout, and was very clean and hygienic. Highfields Care Home DS0000051271.V329393.R01.S.doc Version 5.2 Page 23 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 33, 34 & 35. The quality in this outcome area was Excellent. This judgement was made using available evidence including a visit to this service. Good levels of staffing were provided consistently within the Home to meet the needs of Residents. EVIDENCE: At the time of this inspection it was found that 53 of staff had at least a qualification of NVQ level 2 in Care, which was a satisfactory level of qualification for this Home. Staffing provided in the Home was compared with the details provided by the Residential Forum. This showed that during the three weeks of the 4th to the 19th of February 2007, the Home was providing more than sufficient staffing, for 5 Residents, when compared with the High Dependency level of the Residential Forum. These figures were calculated without the Manager’s working time included, as recommended by the Residential Forum. Therefore, suitable amounts of staff time were provided within the Home to meet Residents needs. Highfields Care Home DS0000051271.V329393.R01.S.doc Version 5.2 Page 24 The records of the last two staff employed at the Home were examined to see whether the Manager had obtained all relevant information about them. It was found that all information had been obtained. Staff induction and foundation training was provided for all new staff that came to work in the Home. All staff had been provided with Learning Disability Award Framework accredited training to assist them in underpinning their knowledge for progress towards achieving R/NVQs. Records of this training were seen. The Manager also said that all care staff were provided with at least five paid days training a year. All staff also had an individual training and development assessment and profile. Highfields Care Home DS0000051271.V329393.R01.S.doc Version 5.2 Page 25 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39 & 42. The quality in this outcome area was Good. This judgement was made using available evidence including a visit to this service. The Registered Providers ensured that the Home received monthly ‘inspections’ to check that Residents needs were being continually met. The Home’s quality assurance programme ensured that residents needs were continually met. EVIDENCE: The Manager was appropriately qualified to manage the Home, having an NVQ level 4 qualification in Management and a Nursing qualification. The Home was visited, on a monthly basis, by a senior manager to oversight the operation of the Home, and to access the views/opinions on the operation of the Home by relatives of Residents and of staff. The Manager ensured that effective quality assurance measures were used within the Home. An annual development plan was provided together with a monthly audit reviewed by senior managers. The views of family and friends of Highfields Care Home DS0000051271.V329393.R01.S.doc Version 5.2 Page 26 Residents were obtained via an annual questionnaire sent out to all Residents’ families. The training required by the Regulations was examined. This showed that Moving and Handling training, Infection Control training, Fire Safety training and the provision of a trained qualified First Aider on every shift were all up to date. It was found that First Aid training was required by 3 staff and that Food Hygiene training was required by 9 staff. The Manager was also able to show, and staff interviewed confirmed, that training was also provided in Cerebral Palsy, Sensory Development, Epilepsy, General Health Care, Disability Discrimination, Whistle Blowing, Medication and a number of other issues. The questionnaire sent to the Manager by the Commission, prior to the inspection, showed that the Registered Providers and Manager had provided all policies and procedures required. It was found that while the Home had a number of Regulations available, it did not have information on the Management of Health and Safety at Work Regulations of 1999, or the Workplace (Health, Safety and Welfare) Regulations of 1992 or the Provision and Use of Work Equipment Regulations of 1992. The Registered Providers had provided risk assessments on the working conditions of staff; and had provided a written statement of the policy, organisation and arrangements for maintaining the safe working practices in the Home. The Manager was also able to confirm, and the records were seen, that all accidents, injuries and incidents of illness or communicable disease were recorded and reported to the relevant government bodies. She also confirmed, that with the assistance of the Fire Service, that fire safety notices were posted in relevant places around the Home. Highfields Care Home DS0000051271.V329393.R01.S.doc Version 5.2 Page 27 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 Standard No Score 1 2 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 4 26 4 27 4 28 4 29 4 30 4 STAFFING Standard No Score 31 X 32 3 33 4 34 4 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 2 X Highfields Care Home DS0000051271.V329393.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? No 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 5 Requirement The Registered Providers and Manager need to review the Residents Guide and update it in line with the legal changes that came into force in September 2006. Staff responsible for distributing medication must sign the Medication Administration Record sheets after medication has been given, not before. All necessary staff must be provided with mandatory training in First Aid and Food Hygiene. The Manager must ensure the services provided by the Home comply with the Management of Health and Safety at Work Regulations 1999, the Workplace (Health, Safety and Welfare) Regulations 1992 and the Provision and Use of Work Equipment Regulations 1992. Timescale for action 27/04/07 2. YA20 13 27/04/07 3. YA42 18 30/06/07 4. YA42 18 27/04/07 Highfields Care Home DS0000051271.V329393.R01.S.doc Version 5.2 Page 29 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 YA1 Good Practice Recommendations The Registered Providers should provide a summary of the environmental standards, detailed in Standard 1.1, and include these in the statement of purpose, and in the Resident’s Guide to the Home. The Manager should complete formal 6 monthly reviews of care with Residents. Those attending the review should include the Resident, where possible their relatives and representative, and staff from the home. Where Social Services Depts carry out annual reviews of care this could be one of the 6 monthly reviews. Residents files should contain a confidential section. When staff use the Residents record of events to ask other staff to carry out tasks, such as ‘Please Observe’ the task should be addressed on each entry following until the staff member requesting the task signs it off as no longer needed. Staff should not hold private conversations between each other in the presence of Residents, even when the Resident is profoundly disabled. When staff assist a Resident by physically moving them they should always explain what they are doing to the Resident. 3. YA16 The expectation that Residents participate in cleaning tasks and catering duties should be included in the Residents Guide to the Home. The Residents contract or statement of terms and conditions of residence should include details of the Home’s rules on smoking, alcohol and drug taking. 4. YA22 Within the procedure for making a complaint it should be stated that neither Residents or their relatives will be ‘victimised’ for making a complaint. Copies of this DS0000051271.V329393.R01.S.doc Version 5.2 Page 30 2. YA6 Highfields Care Home amendment should be placed within the Residents Guide. 5. YA23 A copy of the Public Interest Disclosure Act 1998 should be available within the Home. Staff should be informed that they cannot benefit in any way from Residents wills. Highfields Care Home DS0000051271.V329393.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 DS0000051271.V329393.R01.S.doc Version 5.2 Page 32 - 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!