CARE HOMES FOR OLDER PEOPLE
Highgate Nursing Home (The) Northgate House 12 Hornsey Lane London N6 5LX Lead Inspector
Ms Jill Marriott Unannounced Inspection 16th September 2005 10:00 X10015.doc Version 1.40 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 Nursing Home (The) DS0000010326.V250538.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 Older People. 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 Nursing Home (The) DS0000010326.V250538.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Highgate Nursing Home (The) Address Northgate House 12 Hornsey Lane London N6 5LX 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) 020 7281 3511 020 7281 8412 Goldsborough Limited Ms Susan Roberts Care Home 55 Category(ies) of Old age, not falling within any other category registration, with number (34), Physical disability (17), Terminally ill (4) of places Highgate Nursing Home (The) DS0000010326.V250538.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. For the provision of general nursing care for 34 people aged 60 years and over, some of whom may have dementia 1.2) 17 continuing care beds for people of all ages and 4 pallative care beds. The Staffing Notice 2. Date of last inspection 14/4/05 Brief Description of the Service: The Highgate Nursing Home provides care with nursing for up to 55 service users as follows; 34 beds for elder care 17 beds for continuing care. (18 ) 4 palliative care beds. (18 ) The purpose of the home is to provide 24-hour care with nursing to meet the identified needs of all service users. A range of services are available including Physiotherapy, Occupational Therapy, Dental Care and Chiropody other services can be supplied on request. The Highgate Nursing Home is owned by Goldsborough Limited. The home is situated in the London Borough of Islington close to shops and local amenities. Highgate Nursing Home (The) DS0000010326.V250538.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was the second statutory visit for the year 2005/6 the inspection was unannounced and took place at 12.00 on 16/9/05. The inspection took 5 hours. 23 standards were assessed. All standards were met. The environmental standards exceeded the minimum requirements. The two requirements made at the last inspection are now met. The inspector spoke with the head of care, four members of staff and four service users. The inspection included a tour of the home. The homes records, medication system and a selection of staff and service user files were made available during the visit. What the service does well: What has improved since the last inspection?
Highgate Nursing Home (The) DS0000010326.V250538.R01.S.doc Version 5.0 Page 6 The Highgate Nursing Home has an excellent record of inspection with very few requirements made. Two requirements and one recommendation made at the last inspection have been met. During this inspection no requirements have been identified. All members of staff are receiving regular supervision and each member of staff has received an appraisal of their work for this year. The call bell system is working well and calls are in general answered within a specific timescale. Service users who spoke with the inspector said they are happy with the support they receive. The home has developed the statement of purpose, which is now up to date. The Personal Best Programme developed for staff at the home gives clear guidelines about the aims and objectives of the home and what is expected of every person working there. Staff who spoke with the inspector said that their main aim was to provide a good standard of care and support for the service users, One, person said that the Personal Best Programme, helps them to think more about their role and helps them to offer more professional and sensitive service. 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 Nursing Home (The) DS0000010326.V250538.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Highgate Nursing Home (The) DS0000010326.V250538.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards (1) (2) (3) (4) (6) were assessed at this inspection All service users are given a range of information prior to moving into the home. All service users have a full needs assessment to ensure they can be cared for appropriately at the Highgate. EVIDENCE: The Inspector was given a copy of the up to date statement of purpose, which includes the changes to the registration of the home. Information seen during this inspection showed that the Highgate provides a range of useful and appropriate information for prospective service users prior to moving in. A contract stating the terms and conditions of the placement is agreed with and signed by each service user. Copies of contracts are kept on service users files. All referrals made to the Highgate are assessed by a qualified nurse usually the manager or the head of care. The assessment procedure is used to ensure the home can meet the needs of each prospective service user, and is used to form the initial care plan.
Highgate Nursing Home (The) DS0000010326.V250538.R01.S.doc Version 5.0 Page 9 Care plans are kept on files and are monitored and reviewed monthly or more regularly if necessary. The Highgate does not provide intermediate services however service users placed for short periods of time are supported to maintain their independence as part of their care plan. Highgate Nursing Home (The) DS0000010326.V250538.R01.S.doc Version 5.0 Page 10 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standard (11) was assessed during this inspection The service users needs are known to the nursing and care staff. EVIDENCE: Each individual care plan seen includes a section, which details the wishes of service users and where appropriate relatives at the time of death. The inspector was told that not all service users wish to fill this in but the wishes of those who do are observed. The home has a clear policy relating to the death of service users, which ensures that service users are treated with care and dignity and families are treated with sensitivity and respect. Highgate Nursing Home (The) DS0000010326.V250538.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards (13) (14) (15) were assessed at this inspection. Service users are able to maintain contact with friends and relatives who are made to feel welcome. Members of staff know the service users likes and dislikes and enable individuals to exercise choice and control. A wide selection of appropriate food is available at the home throughout the day. EVIDENCE: The home has a visitor’s book, which is signed by all visitors. The inspector observed one visitor being welcomed by staff. All service users can receive visitors in their own rooms or in one of the various lounges throughout the building. Likes and dislikes are recorded on individual care plans. From discussion with staff and with service users it was evident that all service users are encouraged and supported to make choices. The inspector visited the kitchen the area was clean and hygienic. Fridge and freezer temperature are regularly record. The menu plan was seen and included a wide choice of foods daily. No complaints about food have been recorded since the last inspection. An environmental health inspection of the kitchen took place in November 2005 no further action was required
Highgate Nursing Home (The) DS0000010326.V250538.R01.S.doc Version 5.0 Page 12 Highgate Nursing Home (The) DS0000010326.V250538.R01.S.doc Version 5.0 Page 13 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards (16) (17) were assessed. There is a satisfactory complaints procedure in place that is accessible to service users, relatives and friends. The legal rights of service users are protected by the policies of the home. EVIDENCE: The complaints procedure forms part of the admissions information. The policy and procedure for making complaints is available in the service user handbook kept in each room. Service users who spoke with the inspector said that they had a copy of the information. One, service user told the inspector that he was aware of his right to an advocate for support if he wished. Service users are given information about the voting process and are able to choose to go to the polling station or vote by post. The inspector was told that service users rights are discussed at the beginning of the placement and are detailed in the service users handbook. Highgate Nursing Home (The) DS0000010326.V250538.R01.S.doc Version 5.0 Page 14 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards (19) (20) (21) (22) (23) (24) (25) (26) were assessed The environmental standards in this home are excellent. Service users live in a pleasant comfortable environment. EVIDENCE: The inspector toured the building and found it to be clean comfortable and free from offensive odours. There were areas of the home awaiting repair these repairs had been logged in the repair book. The inspector saw four service users rooms each room had appropriate furnishings and a selection of personal belongings including furniture, ornaments and photographs. All rooms have ensuite facilities and access to toilets and bathrooms throughout the building. One new shower room is being completed at present this is a walk in/wheel in shower room with a shower bed available for those who need it. Care plans show that assessed physical needs are met and that specialist equipment needed is identified and available for individual service users. Health and safety risk assessments are available in the home.
Highgate Nursing Home (The) DS0000010326.V250538.R01.S.doc Version 5.0 Page 15 The home has also just completed the redecoration of a small room on the lower ground floor for use as a medication room. The room means that staff will no longer have to carry medication from one floor to another. Highgate Nursing Home (The) DS0000010326.V250538.R01.S.doc Version 5.0 Page 16 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standard (28) (30) was assessed at this inspection Service users are supported by staff who are trained and competent to do their jobs. EVIDENCE: Approximately 14 members of care staff now hold an NVQ level 2 in care and 4 members of staff are working towards NVQ level 3. Member of staff who spoke to the inspector were aware of their individual roles and the content of their job description. Induction training has been developed to meet the NTO workforce training targets. Members of staff were able to tell the inspector about the principles of care and safe working practices. Individual training plans are being developed from the staff supervision and the appraisal system. Highgate Nursing Home (The) DS0000010326.V250538.R01.S.doc Version 5.0 Page 17 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standard (35) was assessed. Service users financial interests are safeguarded. Staff receive appropriate levels of supervision. EVIDENCE: Service users at the Highgate either take responsibility for their own finances or have family or advocates to support them. Where this is not possible an elected representative of the home is available for support. The home has had problems getting individual bank accounts for service users and one single account is used, however each person’s money is treated individually within the account and service users receive regular individual statements of their finances. Up to date details of accounts are available at the home. All service users have a lockable draw or cabinet in their room to ensure safety of personal possessions. Two staff supervision files were seen by the inspector supervision for staff has been regular since the last inspection.
Highgate Nursing Home (The) DS0000010326.V250538.R01.S.doc Version 5.0 Page 18 . Highgate Nursing Home (The) DS0000010326.V250538.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 X 3 HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 X 3 4 4 4 4 4 4 4 STAFFING Standard No Score 27 X 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 3 X X Highgate Nursing Home (The) DS0000010326.V250538.R01.S.doc Version 5.0 Page 20 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Highgate Nursing Home (The) DS0000010326.V250538.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Camden Local Office Centro 4 20-23 Mandela Street London NW1 0DU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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