Inspection on 07/02/06 for Naomi

This inspection was carried out on 7th February 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Naomi 26/08/08

Naomi 15/12/06

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 Gary Bartlett Announced Inspection 7th February 2006 09:30 Highgate Hall DS0000023868.V273532.R01.S.doc Version 5.0 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.V273532.R01.S.doc Version 5.0 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.V273532.R01.S.doc Version 5.0 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 Vacant 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.V273532.R01.S.doc Version 5.0 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 11th July 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 DS0000023868.V273532.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was conducted by Gary Bartlett, Regulatory Inspector, who was in Highgate Hall from 9.30 a.m. until 3.15 pm. During that time the Inspector spoke with the residents, and some staff. Parts of the Home and some records were inspected. Comment cards were received from the residents. The men spoken with had a high regard for the staff and the programme. Comments included: • “Since being at Highgate Hall my life has been turned around. I owe my life and sanity to this house and programme...” • “I have the upmost respect for the staff and Kenward Trust, they have given me back my life. • “Thank you to each and everyone of you.” The Manager (designate) and staff gave their full co-operation and the Kenward Trust Director of Residential Projects was present for the inspection. What the service does well: What has improved since the last inspection? A revised Statement of Purpose was available and an updated Service Users Guide had been given to residents. Staffing numbers had been improved. Good progress had been made on enhancing the environment through decorating, replacement of some carpets and the deep cleaning of others. The boiler had been replaced and Legionella tests undertaken. There were now systems for monitoring the hot water temperatures at the baths. Monthly Highgate Hall DS0000023868.V273532.R01.S.doc Version 5.0 Page 6 resident/staff forum meetings had been inaugurated. Administration and recording systems had been reviewed and improved. 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. Highgate Hall DS0000023868.V273532.R01.S.doc Version 5.0 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.V273532.R01.S.doc Version 5.0 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 the following standard(s): 1, 2, 3, 4 and 5 Sound systems were in place for prospective residents to decide whether Highgate Hall was the right place for them. Robust pre-admission processes ensured, as far as was practicable, the Home could meet residents’ needs. EVIDENCE: The Manager (designate) said the Statement of Purpose was 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 were provided for each resident. 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 (designate) described how every resident was also provided with a signed contract that clearly indicated roles and responsibilities. The Manager (designate) had a clear understanding of the need to ensure, through a holistic pre-admission assessment, that Highgate Hall was an appropriate place for prospective residents. This ensured the project was best suited to the applicants and also protected the interests of the men already on the treatment programme. 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. Emergency admissions were avoided in the interests of all concerned. Highgate Hall DS0000023868.V273532.R01.S.doc Version 5.0 Page 9 Highgate Hall DS0000023868.V273532.R01.S.doc Version 5.0 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 the following standard(s): 6, 7, 8, 9 and 10 Residents’ individual needs were clearly recorded and reviewed through the care plan system. Residents had the opportunity to contribute their views and ideas with regard to the services at the Home. There were risk strategies and a very strong ethos of confidentiality to promote and protect residents’ welfare EVIDENCE: Each resident had an individual care plan that included risk assessments. They were regularly reviewed and additional reviews would be triggered by any change in a resident’s needs. Residents commented favourably on the value of staff support. Residents’ choices were 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 was now held each month. At these meetings residents had the opportunity to contribute their views and ideas with regard to the Highgate Hall DS0000023868.V273532.R01.S.doc Version 5.0 Page 11 services at the Home. Residents could talk openly with staff and were comfortable in addressing perceived problems within the group. Residents were encouraged to develop relationships with external groups that could be maintained after the completion of their programme. There was a very strong ethos of confidentiality within Highgate Hall that underpinned the service. It was agreed counselling records remained confidential and would not be inspected. Residents mentioned they were aware of the boundaries of confidentiality but also of the need and benefits of sharing experiences as part of group work. The records seen were stored in a secure area when not in use and were kept in a manner that was in accordance with current data protection legislation Highgate Hall DS0000023868.V273532.R01.S.doc Version 5.0 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 the following standard(s): 11, 12, 16 and 17 The service was effective in offering residents the opportunity for personal development and in enabling them to partake in appropriate activities. Residents’ rights and responsibilities were respected. The men enjoyed the meals. EVIDENCE: The daily routines of the Home were designed to promote the residents’ rehabilitation and it was an integral part of the programme for residents to develop and use practical life skills. The men spoken with confirmed they had ongoing access to counselling services and therapies. It was evident that the programmes were presented in an effective, validated and professional manner. Highgate Hall DS0000023868.V273532.R01.S.doc Version 5.0 Page 13 Staff spoke of how residents were strongly encouraged to adopt a routine work ethic as part of their rehabilitation. 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 was acceptable that the Home departed from Standard 16.3 in that bedroom doors were not fitted with locks. Residents said staff were courteous and respectful. Appropriate assistance and advice with finances was given. Residents said they had plenty to eat and that the meals were of good quality. The menus seen were varied and options were made available to suit preference. A staff member described how special dietary needs could be catered for. Hot and cold drinks were available throughout the day. Highgate Hall DS0000023868.V273532.R01.S.doc Version 5.0 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 the following standard(s): 18, 19, 20 and 21 The Home provided appropriate support for residents’ physical and emotional needs to be met. EVIDENCE: The Manager (designate) 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 was given in a manner that preserved residents’ privacy and dignity. Records seen indicated that residents had 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. The residents said they were all registered with the local surgery. The Medication Administration Record (MAR) sheets inspected had been completed appropriately. A list of specimen signatures of staff authorised to administer medication was now in place. Highgate Hall DS0000023868.V273532.R01.S.doc Version 5.0 Page 15 There was an older person living at Highgate Hall and the Manager (designate) described how there were regular reviews to ensure that their care needs could be met at the Home. These reviews were undertaken in liaison with the respective Care Manager and health care professionals. Highgate Hall DS0000023868.V273532.R01.S.doc Version 5.0 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 the following standard(s): 22 and 23 A complaints procedure was readily available to residents who felt their views were listened to and treated with due seriousness. There were robust systems to protect residents from abuse. EVIDENCE: There was a clear and effective complaints procedure which residents said they were aware of. They felt confident that if they had any concerns they would be listened to and acted upon by staff. The Home kept a record of all complaints, of the investigation and of what action was taken by the Home. These records were monitored regularly. There were policies and procedures designed to safeguard residents from abuse which were regularly updated and accessible to all staff. Staff were expected to attend training courses in the management of challenging behaviour. Residents described how they were supported in managing their benefits. Where cash was held on behalf of residents, detailed records were kept Highgate Hall DS0000023868.V273532.R01.S.doc Version 5.0 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 the following standard(s): Residents’ quality of life had been enhanced through continued improvements to the environment. The poor condition of the laundry could compromise residents’ health and safety. EVIDENCE: Residents said they found the Home to be comfortable and met with their requirements. The parts of the Home inspected were warm, generally clean and free from unpleasant odours. Good progress had been made on improving the environment through decorating, replacement of some carpets and the deep cleaning of others. The boiler had been replaced and Legionella tests undertaken. There were now systems for monitoring the hot water temperatures at the baths. Parts of the laundry wall and floor needed to be made good to improve infection control and provide a safer environment. There was some discussion about the possibility of converting the basement area to provide staff accommodation and re-designating the use of other rooms. In principle, the proposals would offer an overall improvement. Highgate Hall DS0000023868.V273532.R01.S.doc Version 5.0 Page 18 Highgate Hall DS0000023868.V273532.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34 and 35 Highgate Hall has an effective and well supported staff team. Robust recruitment processes ensured only appropriate people worked there. EVIDENCE: Residents commented favourably on the staff skills and understanding, saying: • “The staff here are very good.” • “You couldn’t ask for better staff.” • “They really value you.” • “They care.” Prospective staff were required to complete an application form, attend a formal interview and provide written references. They were invited to visit the Home prior to the interview. Applicants’ identity and employment histories would be checked. A formal interview system would be used that recorded the questions and answers given. POVA and Criminal Records Bureau checks were requested for all staff and volunteers working at the Home. A risk assessment was always undertaken in instances where the Home employed persons with a criminal record and took into account their integrity through an honest declaration of offences. There were systems for the monitoring of equal opportunities. Staff files could not be inspected as they were held at the Trust central office. Highgate Hall DS0000023868.V273532.R01.S.doc Version 5.0 Page 20 Staff had job descriptions that defined their roles and responsibilities and it was evident that the staff understood when it was appropriate to involve others with more expertise. The Manager (designate) stated that volunteers worked within clearly defined parameters. All employed staff were required to undertake a comprehensive induction programme. The Manager (designate) said that whilst the staff group predominantly had qualifications in counselling skills and personal care was not generally given, the Home continued to encourage NVQ training where appropriate. There was not always a staff member at the Home, particularly at weekends, although there was always someone contactable by telephone. Discussion with the men and records of a meeting indicated that residents would feel more comfortable if there was always a staff member present. The Manager (designate) stated this was under consideration. Highgate Hall DS0000023868.V273532.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 38, 39, 40, 41 and 42 The Home benefited from a Manager and staff who were motivated and had high expectations of the service to be delivered. The Home regularly reviewed aspects of its performance through a programme of self-review and consultations, which included the opinions of residents. EVIDENCE: The Manager (designate) had been at Highgate Hall for approximately one year and was soon to undertake the fir person interview with a view to being registered. During that year administration and management systems had been reviewed and improvements made. The Manager (designate) and staff were dedicated to the aims and objectives of Highgate Hall. It was apparent from discussion with residents and staff that the Manager gave a clear sense of direction and leadership. A staff member described the support given by the Manager (designate) as “brilliant”. Highgate Hall DS0000023868.V273532.R01.S.doc Version 5.0 Page 22 The Manager (designate) described how residents were asked to complete a questionnaire at the completion of their programme. Residents had been told about the planned inspection and invited to speak with the Inspector if they so wished. There were regular meetings between residents and staff. Policies and procedures were reviewed on a regular basis. Current maintenance certificates were inspected and seen to be satisfactory. Records of routine fire safety systems checks were seen and the Manager (designate) was aware of the necessity to ensure all staff had undertaken fire training/drills at the frequency recommended by Fire Safety Officers. The Manager (designate) spoke of their intention to request a visit from the Fire Safety Officer to assess current fire protection systems. Highgate Hall DS0000023868.V273532.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 4 3 3 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 2 LIFESTYLES Standard No Score 11 3 12 3 13 X 14 X 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Highgate Hall Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score X 3 3 3 3 3 X DS0000023868.V273532.R01.S.doc Version 5.0 Page 24 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 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. An action plan must be received by CSCI by the given timescale. Timescale for action 07/03/06 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 3 Refer to Standard YA28 YA33 YA42 Good Practice Recommendations It is recommended that the proposed changes in usage of the basement area and other parts of the building are implemented It is strongly recommended that there is always a staff member on duty at the Home. It is recommended that the intended refurbishment of the kitchen be implemented. Highgate Hall DS0000023868.V273532.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone 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 DS0000023868.V273532.R01.S.doc Version 5.0 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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