Inspection on 15/12/06 for Naomi

This inspection was carried out on 15th December 2006.

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

Other inspections for this house

Naomi 26/08/08

Naomi 07/02/06

Naomi 11/07/05

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 TN18 4EY Lead Inspector Ruth Burnham Key Unannounced Inspection 15th December 2006 09:30 Highgate Hall DS0000023868.V319059.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 Highgate Hall DS0000023868.V319059.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. Highgate Hall DS0000023868.V319059.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Highgate Hall Address Rye Road Hawkhurst Cranbrook Kent TN18 4EY 01580 752179 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) tthighgate@yahoo.co.uk Kenward Trust Trevor Robert Tomlin Care Home 9 Category(ies) of Past or present alcohol dependence (9), Past or registration, with number present drug dependence (9) of places Highgate Hall DS0000023868.V319059.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service Users with drug and/or alcohol dependency may also have mental health difficulties No of service users must not exceed nine persons Date of last inspection 7th February 2006 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. Fees are £505 pounds per week. Highgate Hall DS0000023868.V319059.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted by Ruth Burnham, Regulatory Inspector, who was in Highgate Hall from 9.30 a.m. until 3.00pm. During that time the Inspector spoke with the residents, and some staff. Parts of the Home and some records were inspected. The men spoken with had a high regard for the staff and the programme. Comments included: • “Being here is the best thing that has happened to me.” • “I am looking forward to Christmas here, it will be the best Christmas ever. • “The staff really understand.” A care manager was spoken to who was very impressed with the project and with the progress which his client had made whilst in the programme. The Manager and staff gave their full co-operation throughout the inspection. What the service does well: What has improved since the last inspection? Staffing numbers had been improved with the addition of staff accommodation in the basement, this provides on call cover at night. Good progress has been made on enhancing the environment through decorating, the laundry is due for completion at the end of January and the kitchen is being refurbished. Highgate Hall DS0000023868.V319059.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Highgate Hall DS0000023868.V319059.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Highgate Hall DS0000023868.V319059.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1-4 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. People who considering entering the project benefit from the sound systems that are in place to assist them to decide whether Highgate Hall is the right place for them. Robust pre-admission processes ensure, as far as was practicable, the Home can meet residents’ needs. EVIDENCE: People who live in the home are provided with detailed information before moving and provided with folders on arrival. The Manager confirmed that the Statement of Purpose is accurately descriptive of the aims, objectives, philosophy of care, services and facilities and terms and conditions of Highgate Hall and copies of the Residents Guide are provided for each resident, folders containing this information is in the residents rooms and residents confirmed that they have access to this. The men spoken with confirmed they had been made fully aware of the rules of the programme prior to coming to Highgate Hall. The Manager described how every resident is also provided with a signed contract that clearly indicates roles and responsibilities. The men spoken to described how they were able to visit the home before moving in and were able to talk to staff and other residents and share a meal Highgate Hall DS0000023868.V319059.R01.S.doc Version 5.2 Page 9 with them. The Manager has a clear understanding of the need to ensure, through a holistic pre-admission assessment, that Highgate Hall is an appropriate place for prospective residents. This ensures the project is best suited to the applicants and also protects the interests of the men already on the treatment programme. There is a sound understanding of the need to cater for the preferences of specific ethnic minorities and to communicate with residents in a manner that they can understand. Emergency admissions are avoided in the interests of all concerned. Highgate Hall DS0000023868.V319059.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6 - 10 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. People who come to live in the project benefit from clear care planning and risk assessment when they enter the home and it is clear that staff and management understand and respond to changing needs.. Residents have real opportunity to contribute to the decision making processes of the home. People who live in the home are protected through good risk management strategies and a very strong ethos of confidentiality. EVIDENCE: People who live in the home benefit from support from the committed and knowledgeable staff team, an initial care plan is recorded on admission which includes a risk assessment. It was clear through discussion with staff and management that the care of residents is constantly reviewed however this is not being documented satisfactorily. The management are currently in discussion about how to improve the documentation so that it is used as a Highgate Hall DS0000023868.V319059.R01.S.doc Version 5.2 Page 11 working document providing up to date guidance for staff in the home. Good daily monitoring records are kept individually. Residents said how much they appreciated the staff support. Residents’ choices are facilitated, where practicable, within the framework of the programme. The men described how they had the opportunity to make requests, ask questions and were reminded of the planned days activities. A resident/staff forum is held each month, and house meetings, weekly. At these meetings residents have the opportunity to contribute their views and ideas with regard to the services at the Home, they gave examples of how they had been listened to and their suggestions implemented. Residents said they can talk openly with staff and are comfortable addressing perceived problems within the group. Residents benefit from the support of staff and management to develop relationships with external groups that can be maintained after the completion of their programme. There is a very strong ethos of confidentiality within Highgate Hall that underpins the service. It has been agreed counselling records remained confidential and will not be inspected. Residents are aware of the boundaries of confidentiality but also of the need and benefits of sharing experiences as part of group work. The records seen are stored in a secure area when not in use and are kept in a manner that is in accordance with current data protection legislation Highgate Hall DS0000023868.V319059.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12 - 17 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. People who are living at the project benefit from the effective service which offers the opportunity for personal development and participation in appropriate activities. EVIDENCE: Daily routines of the Home are designed to promote the residents’ rehabilitation and it is an integral part of the programme for residents to develop and use practical life skills. The men spoken with confirmed they have ongoing access to counselling services and therapies. It is evident that the programmes were presented in an effective, validated and professional manner. It was good to meet a care manager who was visiting their client in the project for the first time and was very impressed with the project and the clear progress which their client had made whilst resident at the home. Highgate Hall DS0000023868.V319059.R01.S.doc Version 5.2 Page 13 People who live at the home enjoy access to a variety of leisure pursuits, the men spoken to said how much they had enjoyed the programme of activities since they had been at the project. One of the weekend staff organises outdoor pursuits which have recently included mountain biking at Bedgebury Forest , canoeing, rock climbing, bowling, walking and visits to places of interest. The men stated that their own religious beliefs were respected and there was the opportunity for worship should they choose. Due to the nature of the service provided at the Home, it is acceptable that the Home departed from Standard 16.3 in that bedroom doors were not fitted with locks. Residents said staff were courteous and respected their privacy. The men benefit from the assistance and advice that staff provide with financial issues. Residents said they have plenty to eat and that the meals are of good quality. The menus seen were varied and options are made available to suit individual preference. A staff member described how special dietary needs could be catered for. Hot and cold drinks are available throughout the day. Highgate Hall DS0000023868.V319059.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18 - 21 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. People who live in the home are provided with appropriate support to ensure that their physical and emotional needs to be met. EVIDENCE: The Manager said that it was one of the Home’s aims to ensure that personal care did not have to be given by staff although residents would be given advice about personal health and hygiene and that that this support is given in a manner that preserves residents’ privacy and dignity. Records seen indicate that residents had received additional support from health care professionals when required. The Manager spoke of the importance that the Home attaches to enabling residents to be as independent as possible in managing their health care and described how residents’ health was monitored. The residents said they were all registered with the local surgery. Highgate Hall DS0000023868.V319059.R01.S.doc Version 5.2 Page 15 The Medication Administration Record (MAR) sheets were examined at the last inspection and had been completed appropriately. A list of specimen signatures of staff authorised to administer medication is in place. There is an older person living permanently at Highgate Hall, the Manager described how regular reviews are carried out to ensure that their care needs can continue to be met at the Home. These reviews are undertaken in liaison with the respective Care Manager and health care professionals, it was agreed that an occupation health referral will be made to ensure that the facilities provided in the home continue to be appropriate for this person. Highgate Hall DS0000023868.V319059.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 - 23 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. People who are living at the home are free to offer comment and complaint; there is a complaints procedure readily available to them. There are robust systems to protect residents from abuse. EVIDENCE: People who live at the project benefit from the clear and effective complaints procedure which all the men spoken to were aware of. They felt confident that if they had any concerns they would be listened to and acted upon by staff. The Home keeps a record of all complaints, of the investigation and of what action was taken by the Home. These records are monitored regularly. There are policies and procedures designed to safeguard residents from abuse which are regularly updated and accessible to all staff. Staff are expected to attend training courses in the management of challenging behaviour. The men spoken to said that they are supported where they have to deal with the benefit system. Where cash was held on behalf of residents, detailed records are kept. Highgate Hall DS0000023868.V319059.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 27 - 30 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Residents’ quality of life had been enhanced through continued improvements to the environment. The imminent completion of work to improve the laundry will protect residents’ health and safety as will the planned work to improve the kitchen and bathroom. EVIDENCE: The men who live at the project benefit from a homely and appropriately equipped environment, they said that the home is comfortable and they are happy with the accommodation provided. The parts of the Home inspected were warm, generally clean and free from unpleasant odours. Good progress continues to be made on improving the environment through the ongoing programme of maintenance and decorating. There are systems for monitoring the hot water temperatures at the baths. Parts of the laundry wall and floor still need to be made good to improve infection control and provide a safer Highgate Hall DS0000023868.V319059.R01.S.doc Version 5.2 Page 18 environment, the manager confirmed that this work is due for completion at the end of January. The manager confirmed that the upgrading of the kitchen and much needed refurbishment of the bathroom will be completed in the first part of the coming year. The conversion of the basement area has been completed to provide staff accommodation which benefits the residents in that there is now a member of staff on the premises, on call in an emergency at night. Highgate Hall DS0000023868.V319059.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31 –35 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. People who live in the home benefit from the support of the effective and well supported staff team. Robust recruitment processes ensured only appropriate people worked there. Additional training is planned to ensure that the health and safety of residents is further safeguarded. EVIDENCE: All the men who live at the project were spoken to during the inspection and all praised the care, skills and understanding of staff and management. The manager confirmed that prospective staff are required to complete an application form, attend a formal interview and provide written references. They are invited to visit the Home prior to the interview. Applicants’ identity and employment histories are checked. Formal interview systems are used that recorded the questions and answers given. The manager confirmed that POVA and Criminal Records Bureau checks are requested for all staff and volunteers working at the Home and a risk assessment is always undertaken in instances where the Home employs persons with a criminal record taking Highgate Hall DS0000023868.V319059.R01.S.doc Version 5.2 Page 20 account of their integrity through an honest declaration of offences. There are systems for the monitoring of equal opportunities. Staff files could not be inspected as they were held at the Trust central office. Staff have job descriptions that define their roles and responsibilities and the examination of records and conversation with staff and management throughout the visit showed that staff understand when it is appropriate to involve others with more expertise in the care of people who live in the home. All employed staff were required to undertake a comprehensive induction programme with Kenward Trust, it was agreed that this should be expanded to include issues specific to the local situation at Highgate Hall. The Manager said that whilst the staff group predominantly had qualifications in counselling skills and training in personal care is not generally given, the Home continues to encourage NVQ training where appropriate. It was agreed that all staff will be provided with appropriate training in moving and handling and infection control as soon as possible. Highgate Hall DS0000023868.V319059.R01.S.doc Version 5.2 Page 21 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): 37 - 43 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. People who live at the Highgate Hall benefit from living in a well run home where their views are important. Their health and safety is promoted and additional staff training is planned in the New Year to further protect them. EVIDENCE: People who live in the home benefit from the experience and commitment of the Manager who has been at Highgate Hall for approximately two years and is now registered with the Commission. Since his appointment administration and management systems have been reviewed and improvements made and planned. The Manager and staff were dedicated to the aims and objectives of Highgate Hall. It was apparent from discussion with residents that they have confidence Highgate Hall DS0000023868.V319059.R01.S.doc Version 5.2 Page 22 in the management of the project. A visiting care manager was spoken to during the visit who was very impressed with the way in which the project is run and the way in which his client is being supported and has benefited from the programme. The Manager described how residents were asked to complete a questionnaire at the completion of their programme. The men who are living in the home were happy to talk to the inspector during the visit. The welfare of residents is promoted through effective policies and procedures which are reviewed on a regular basis, regular maintenance and safety checks of installations and equipment and staff training in safe working practices which the manager confirmed will include infection control and moving and handling in the New Year. Current maintenance and safety certificates were inspected and seen to be satisfactory. Records of routine fire safety systems checks were seen and the Manager was aware of the necessity to ensure all staff had undertaken fire training/drills at the frequency recommended by Fire Safety Officers, he is completing a risk assessment for the premises Highgate Hall DS0000023868.V319059.R01.S.doc Version 5.2 Page 23 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 3 2 4 3 3 4 3 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 3 25 x 26 x 27 3 28 3 29 3 30 2 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 4 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 3 3 3 3 3 x Highgate Hall DS0000023868.V319059.R01.S.doc Version 5.2 Page 24 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 YA30 Regulation 13(4) Requirement The registered person shall make suitable arrangements to prevent infection, toxic conditions and the spread of infection at the care home, in that the damaged walls and floor in the laundry must be made good. Refurbishment of the kitchen and bathroom must be completed. The registered person shall make suitable arrangements ensure that the persons employed by the registered person to work at the care home receive training appropriate to the work they are to perform; in that staff must be trained in the prevention of infection and safe moving and handling. Timescale for action 30/06/07 2 YA35 13(4) 28/02/07 Highgate Hall DS0000023868.V319059.R01.S.doc Version 5.2 Page 25 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 YA6 Good Practice Recommendations Once set up the care plan and risk assessment should be maintained, up to date, as a working document. Highgate Hall DS0000023868.V319059.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Highgate Hall DS0000023868.V319059.R01.S.doc Version 5.2 Page 27 - 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!