Inspection on 11/07/05 for Naomi

This inspection was carried out on 11th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Naomi 26/08/08

Naomi 15/12/06

Naomi 07/02/06

Naomi 25/01/05

Naomi 09/11/04

Similar services:

Prinsted

Elizabeth House

Kenward House

Boons Park

Winthrop Hall

Life Works Community Ltd

Turning Point

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

CARE HOME ADULTS 18-65 Highgate Hall Rye Road Hawkhurst Cranbrook Kent TN15 4EY Lead Inspector Gary Bartlett Unannounced 11 July 2005 13:10 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. Highgate Hall H56-H06 S23868 Highgate Hall V223217 110705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Highgate Hall Address Rye Road Hawkhurst Cranbrook Kent TN18 4EY 01580752179 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) Kenward Trust CRH Care Home 9 Category(ies) of Alcohol depend past/present (9) registration, with number Drug dependence past/present (9) of places Highgate Hall H56-H06 S23868 Highgate Hall V223217 110705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service Users with drug and/or alcohol dependency may also have mental health difficulties 2. No of service users must not exeed nine persons Date of last inspection 25 January 2005 Brief Description of the Service: Highgate Hall is part of the Kenward Trust with the administrative base at Kenward House.. A range of support services is offered by the Trust. Highgate Hall is a large detached house in the centre of the village of Hawkhurst and stands in a quarter of an acre of garden. It is registered for 9 service users and provides all single bedrooms, one of which has an en-suite facility. The home is located close to shops, churches, post office, pharmacy and bus station. There are facilities for car parking at the front of the building. The garden is available for service users. The nearest main line station is 5 miles away. Highgate Hall in used as a first stage home for male service users who require rehabilitative care under a medium term programme in three months blocks. Highgate Hall H56-H06 S23868 Highgate Hall V223217 110705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission was represented by Gary Bartlett and Paul Stibbons, Regulatory Inspectors who were in Highgate Hall from 1.10 p.m. until 3.30 p.m. During that time the Inspectors had the opportunity to speak with 3 residents and some staff. Parts of the Home and some records were inspected. The focus of the inspection was to assess progress made to meet notified required and recommended actions in the last inspection report, gaining evidence against standards from records, observation and discussion. What the service does well: What has improved since the last inspection? What they could do better: The Home must comply with current legislation and be able to supply residents with an accurate Statement of Purpose and Service Users’ Guide. Failure to do so may result in enforcement action. Highgate Hall H56-H06 S23868 Highgate Hall V223217 110705 Stage 4.doc Version 1.30 Page 6 The planned refurbishment to the kitchen would benefit residents and promote better food hygiene standards there. 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. Highgate Hall H56-H06 S23868 Highgate Hall V223217 110705 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 Highgate Hall H56-H06 S23868 Highgate Hall V223217 110705 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 and 4 Residents were provided with information about the service at Highgate Hall but the Home continued to fail to provide an accurate Statement of Purpose and Service Users Guide as required by legislation. Comprehensive pre-admission processes and the opportunity to visit the Home prior to admission ensured, as far as was practicable, the Home could meet residents’ needs. EVIDENCE: Residents were given clear information about the purpose, duration and requirements of the programme. However, as at previous inspections, there was not an accurate Statement of Purpose on the premises and residents were not provided with an up-to-date Service Users Guide as required by legislation. The Inspectors advised the Manager (designate) that continued noncompliance could result in enforcement action being taken by the Commission. The Manager (designate) described how referrals to the Home came from a variety of sources. The rules of the programme and inherent restrictions were thoroughly explained to prospective residents and then re-iterated at the time of their admission. Staff used a detailed form in assessing how best the prospective residents’ needs could be met. A medical assessment was part of the process in view of the high risk of medical complications following Highgate Hall H56-H06 S23868 Highgate Hall V223217 110705 Stage 4.doc Version 1.30 Page 9 withdrawal. Considerable assessment was made of the residents’ motivation and how this would be sustained. It had been established at previous inspections that specialist needs would be met with support from relevant specialists and clinical guidance. Staff were encouraged to attend training programmes that included courses in matters of specialist care. There was a sound understanding of the need to cater for the preferences of specific ethnic minorities and to communicate with residents in such manner that they could understand. Prospective residents were able to visit the Home and they would be telephoned the following day to discuss their possible admission. Sometimes assessments were conducted off-site, for example at prisons or in their domicile. The Home did not accept emergency admissions. Highgate Hall H56-H06 S23868 Highgate Hall V223217 110705 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) These Standards were not inspected EVIDENCE: Highgate Hall H56-H06 S23868 Highgate Hall V223217 110705 Stage 4.doc Version 1.30 Page 11 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) 13, 14 and 15 The range of educational, recreational and social activities offered enhanced residents’ lives. EVIDENCE: A resident described how they were able to use local facilities on a risk assessed and monitored basis. As the residents were a the home for the duration of the programme only, it was not practicable for them to be placed on the electoral role. Residents were encouraged to pursue their appropriate interests and hobbies. There were very firm rules regarding visitors to the Home to protect all residents’ interests and to try to safeguard their successful completion of their programme. Residents were fully aware of these rules prior to admission. Contact with families and friends was enabled within these parameters. Highgate Hall H56-H06 S23868 Highgate Hall V223217 110705 Stage 4.doc Version 1.30 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 and 21 Highgate Hall promoted residents’ independence and health care support. EVIDENCE: The Manager (designate) said that it was one of the Home’s aims to ensure that the personal care did not have to be given by staff although residents would be given advice about personal health and hygiene. This support was given in a manner that preserved residents’ privacy and dignity. Residents received additional support from health care professionals when required. The Manager (designate) spoke of the importance that the Home attached to enabling residents to be as independent as possible in managing their health care and described how residents’ health was monitored. Residents were all registered with the local surgery. There was an older person living at Highgate Hall and the Manager (designate) described how there were regular reviews to ensure that they were safe at the Home. Reviews were undertaken in liaison with the respective Care Managers and health care professionals. In the instance of an older resident it was evident the Home had liased closely with Social Services and a domiciliary care agency for the provision of personal care should it become necessary. Highgate Hall H56-H06 S23868 Highgate Hall V223217 110705 Stage 4.doc Version 1.30 Page 13 Highgate Hall H56-H06 S23868 Highgate Hall V223217 110705 Stage 4.doc Version 1.30 Page 14 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) These Standards were not inspected EVIDENCE: Highgate Hall H56-H06 S23868 Highgate Hall V223217 110705 Stage 4.doc Version 1.30 Page 15 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 and 30 The Home was comfortable and met with residents’ requirements. Residents’ quality of life had been enhanced through improvements to the environment. EVIDENCE: Those parts of the Home seen were warm, clean and free from unpleasant odours. The state of décor around the Home was generally good and there was an ongoing programme of redecoration. Residents and staff had benefited from the addition of separate office accommodation. This offered improved confidentiality. The previous office area had been converted to an additional room for group work. Residents said they found the Home to be comfortable and met with their requirements. Highgate Hall H56-H06 S23868 Highgate Hall V223217 110705 Stage 4.doc Version 1.30 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) These Standards were not inspected EVIDENCE: Highgate Hall H56-H06 S23868 Highgate Hall V223217 110705 Stage 4.doc Version 1.30 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) 42 The Home promoted residents’ health, safety and welfare. EVIDENCE: There was discussion about the necessity for recorded risk assessments to be made of any potential danger to residents through thermostatic control valves not being fitted to the hot water taps of baths or showers. The Manager (designate) described how it was still intended to refurbish the kitchen to improve the ergonomics and to better promote food hygiene standards. Maintenance certificates were not inspected on this occasion. Highgate Hall H56-H06 S23868 Highgate Hall V223217 110705 Stage 4.doc Version 1.30 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 4 3 3 x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x x x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 x x x x 3 Standard No 11 12 13 14 15 16 17 x x 3 3 3 x 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 Highgate Hall Score 3 3 x 3 Standard No 37 38 39 40 41 42 43 Score x x x x x 2 x H56-H06 S23868 Highgate Hall V223217 110705 Stage 4.doc Version 1.30 Page 19 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 1 Regulation 4 Requirement “The registered person shall compile a “Statement of Purpose” The registered person shall supply a copy to the Commission and shall make a copy available on request for inspection by every service user and any representative of a service user” This remained an outstanding requirement from previous inspections “The registered person shall produce a written guide to the care home”, in that the Service Users Guide must be updated where required. This remained an outstanding requirement from the previous inspection “The registered person shall ensure that unnecessary risks to the health and safety of service users are identified and so far as possible eliminated” in that recorded risk assessments must be made in respect of the vulnerability of service users where thermostatic control valves have not been fitted to hot water taps. Timescale for action To be completed by 15/08/05 if not sooner 2. 1 5 To be completed by 15/08/05 if not sooner 3. 42 12(1)(a) 13(4) To be completed by 15/08/05 if not sooner Highgate Hall H56-H06 S23868 Highgate Hall V223217 110705 Stage 4.doc Version 1.30 Page 20 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 42 Good Practice Recommendations It is recommended that the stated refurbishment of the kitchen fittings under consideration be implemented. This was being addressed but remained an outstanding recommendation from previous inspections Highgate Hall H56-H06 S23868 Highgate Hall V223217 110705 Stage 4.doc Version 1.30 Page 21 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 Highgate Hall H56-H06 S23868 Highgate Hall V223217 110705 Stage 4.doc Version 1.30 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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