Inspection on 10/04/07 for Highgrove House

This inspection was carried out on 10th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Highgrove House 30/01/06

Highgrove House 08/07/05

Highgrove House 17/01/05

Highgrove House 30/07/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Highgrove House 32-34 Winchester Road Worthing West Sussex BN11 4DH Lead Inspector Mrs A Taggart Unannounced Inspection 10th April 2007 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 Highgrove House DS0000014565.V331806.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 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. Highgrove House DS0000014565.V331806.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Highgrove House Address 32-34 Winchester Road Worthing West Sussex BN11 4DH 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) 01903 230487 01903 203811 care@highgrove-house.net www.heaton-house.net Mr Clive Neil-Smith Mrs Sally Mary Neil-Smith Mr Clive Neil-Smith Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Highgrove House DS0000014565.V331806.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th January 2006 Brief Description of the Service: Highgrove House is a care home providing care and accommodation for up to twenty older people over the age of sixty-five. It is situated close to the town centre of Worthing, West Sussex with easy access to the seafront, shops and other amenities. The home is a two-storey, detached house with eighteen bedrooms all of which have en-suite facilities. There is a passenger lift to the first floor, which makes the home accessible to all residents. A large, well-maintained garden is available for residents use. Current fees are £455 to £630 per week Highgrove House DS0000014565.V331806.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. In preparation for the visit a pre-inspection questionnaire was sent to the manager of the home for completion, survey forms were sent to residents and comments cards to families and professionals. Twenty residents, ten relatives and one professional person responded and all made very positive comments about the home. The inspector read the last two reports and any other relevant correspondence or documentation relating to the home and an inspection document was completed. The unannounced visit was carried out at 9.15am and lasted for 4.5 hours. During this time the inspector spent time talking with residents and the staff on duty and observed staff practice. Four care plans were tracked, with any issues being discussed with the resident or staff team and daily records and accidents and incident records were also seen. A tour of the building was undertaken, during which time all communal areas and bedrooms were seen and residents said how happy they were with their private space. Lunch, the main meal of the day was seen being prepared and served and residents said they were happy with the food provided. Records for the running of the business were seen including the fire book, staff fire training records, maintenance records, insurance, gas certificate and electrical appliance tests and all were current and in good order. The medication system of recording and administration was assessed as were accident and incident reports. Four staff files were seen and all contained the required documentation. The Registered Manager, Mr Neil-Smith was present in the home and received feedback at the end of the visit. What the service does well: Highgrove House offers a comfortable, attractive and homely environment for the people who live there. Pre-admission assessments are carried out and a plan of care completed to ensure that the staff team have the information they need in order to care for the people they support. Residents say they have access to good healthcare facilities, enjoy a variety of activities and outings and receive good quality, home cooked meals. Residents, their families and a social worker that visits the home regularly were full of praise for the home’s manager and staff team and said that people are always treated with dignity, kindness and respect. Highgrove House DS0000014565.V331806.R01.S.doc Version 5.2 Page 6 Comments about the home from a visiting professional included “I feel that the residents are cared for in a professional manner, the home is spotlessly clean, the staff are always friendly and polite and never complain about the management. It’s a good home that I would put my Mum in” and from a resident of the home “ We are all very well looked after, the meals are very nice and the staff are very kind”. What has improved since the last inspection? 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. Highgrove House DS0000014565.V331806.R01.S.doc Version 5.2 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 Highgrove House DS0000014565.V331806.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1 2 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is good information about the facilities available in the home. Prospective resident’s needs are assessed, visits to the home encouraged and contracts of terms and conditions of residency agreed. EVIDENCE: There is current information available regarding the home in order to assist prospective residents in make a choice about living there. The people living in the home and their families confirmed that they were able to visit the home to see the facilities on offer. A comment from a person currently living in the home was, “I had two weeks trial before I moved in and decided to stay, I am very happy and love my room”. In order to ensure that the home can meet individual needs, pre-admission assessments are carried out and contracts of terms and conditions of residency agreed and signed. Highgrove House DS0000014565.V331806.R01.S.doc Version 5.2 Page 9 Highgrove House does not provide intermediate care. Highgrove House DS0000014565.V331806.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 and 10 Quality in this outcome area is Excellent. This judgement has been made using available evidence including a visit to this service. There is good information in place to guide the staff team to the needs and wishes of the people they are supporting. Care plans are regularly reviewed and updated and medication is well managed EVIDENCE: For each resident living in the home there is a comprehensive plan of care in place to guide the staff team to the needs of each individual they are supporting. Residents and their families said that they had been involved in the process. The care plans of five people who have recently been admitted to the home were seen and all had been fully completed with information gained from the pre-admission assessment. Plans contain background information, likes and dislikes, hobbies and interests and details of healthcare needs. Risk assessments were also in place and recent reviews of the plans had been undertaken. The people living in the home said that they were always treated with dignity and respect, comments included, “ We are treated with kindness and respect”, Highgrove House DS0000014565.V331806.R01.S.doc Version 5.2 Page 11 and from a family member, “ Respect and good care is given at all times. Residents seem to be very happy to live here and support is given to their every need. Records show that the home works with a variety of healthcare professionals including local doctors and district nurses and a chiropodist visits every six weeks. The people living in the home said that their healthcare needs were well met and some people confirmed that they accessed their own GP independently. A resident said, “ There are two members of staff on duty at night and we can ring for a drink at any time. The staff are always respectful and care for my health needs well. I couldn’t wish for a better home to live in”. The home uses local pharmacy to supply medication and a monitored dose system is in place. Medication is safely stored in a locked cupboard in the office and Medication Recording Sheets were current and in good order. The home’s manager Mr. Neil-Smith said that further training from the pharmacist is due to take place in the near future and at that time the system will be reviewed. For residents who self-administer, risk assessments should be extended to include an ongoing monitoring process. Highgrove House DS0000014565.V331806.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 and 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. A variety of activities are in place to ensure that residents have opportunity for stimulation and interest, visitors are made welcome and good quality, fresh home cooked meals are provided. EVIDENCE: The home provides a variety of activities to ensure that there is stimulation and interest for the people living there. Tai Chi is offered every Thursday, exercises on a Saturday morning, visiting musicians are provided every two weeks and a monthly non-denominational service is held. Some people also have visits from their own vicars or priests. During the visit one person told the inspector that they played the piano every morning after breakfast, people were going out for walks or reading and a staff member was helping a lady with her knitting. Some people said it was very important to them to keep their independence and one person said they really enjoyed the large print books provided by the local library, changed on a monthly basis. There was a relaxed, happy atmosphere in the home and the staff on duty had one to one time to spend with people. Highgrove House DS0000014565.V331806.R01.S.doc Version 5.2 Page 13 Visitors are made welcome at any time, one person commented, “My visitors are always made welcome and offered refreshments as you would do if in your own home. They can also stay for a meal if they want”. Menus show that a variety of fresh, home cooked meals are provided and individual choices are recorded. Lunch, the main meal of the day was roast beef, Yorkshire pudding, roast potatoes cabbage and parsnips with fruit crumble and custard to follow. People were very complimentary about the food and one person commented, “ The food is good, we get a roast twice a week and I especially enjoy it when we get prawn cocktail for starters. I also like the fact that we can be served meals in the garden in good weather”. One person said they would like it recorded that cooking facilities could be improved by a large kitchen being provided. Highgrove House DS0000014565.V331806.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people living in the home and their families can be confident that any complaints and concerns will be treated seriously and acted upon and the homes procedures are designed to protect residents from risk of abuse. EVIDENCE: There is a complaints procedure in place, a copy of which is placed on the notice board in the home. No formal complaints have been recorded but residents and visitors said that they would feel confident in making a complaint. Comments included, “ If I had a complaint I would go to Mr. NeilSmith, he is really helpful and sorts out any problems for me” and “ Never needed to make a complaint but would feel confident to do so”. Some of the staff team have attended protection of vulnerable adults training and a further session is booked for the near future. There are POVA guidelines in the home and the staff on duty were aware of their responsibilities should they suspect any abuse had taken place. All said that they would report any concerns immediately. Highgrove House DS0000014565.V331806.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 20 23 24 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although the home provides a high standard of accommodation and is clean and hygienic, there are potential risks regarding residents wedging their doors open. EVIDENCE: Highgrove House offers an attractive and comfortable environment for the people who live there. There are well-furnished lounge areas, a dining room, large conservatory and an easily accessed landscaped garden, which residents said they especially enjoy. During the past year some refurbishment and redecoration has been carried out and the home was light and airy. There is a piano in the lounge that is regularly used by one resident and lots of books and magazines were around making the environment feel “homely”. Private bedrooms were all attractively decorated and had been personalised with furniture and belongings brought to the home by residents and people said they were very happy with their personal space. Recently two ensuite Highgrove House DS0000014565.V331806.R01.S.doc Version 5.2 Page 16 baths have been removed and replaced with showers to suit individual needs. Comments about the home from residents included, “I stayed for respite care and when I had the opportunity to come here and was able to bring my own things I decided to become a resident” and “The home is always fresh and clean and the garden is a joy to us. We are lucky to have a big, south facing garden and conservatories to catch the sunlight in winter. The home is spotlessly clean and decorated to a high standard”. During a tour of the building it was noted that some residents had wedged their bedroom doors open, which would put them at risk in the event of a fire occurring. This was brought to the attention of the manager who said he would address the situation immediately. A Requirement was made regarding this Standard. The home was clean and hygienic throughout. Highgrove House DS0000014565.V331806.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 29 and 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The people living in the home are supported by a committed kind and caring staff team and are protected by their being a robust recruitment process in place. EVIDENCE: Staffing rotas show that there are three carers, a cook and two domestic staff on the day shifts and at night there is one awake and one sleeping person. The manager’s hours are in addition to the rota. Residents and their families were full of praise for the staff team and said that they were committed kind and caring, many of the current staff team have worked in the home for a number of years and have good relationships with the people they support. Comments included, “The staff are excellent, in fact they are absolutely super”, “The staff here are always helpful, kind, cheerful and thoughtful” and from a social worker who visit the home, “Care staff are always smiling/happy when you visit. All are very polite to visitors and service users. You are always politely asked to sign the visitor’s book and anyone who walks into Highgrove is treated with great respect”. The staff on duty during the visit had time to spend with people on a one to one basis and there was a happy and relaxed atmosphere. Highgrove House DS0000014565.V331806.R01.S.doc Version 5.2 Page 18 There is a programme of training and development in place, over 60 of the staff team hold NVQ 2 or above, others are currently undertaking the award and the deputy manager is taking the Registered Manager’s Award. Courses recorded include mandatory training, risk assessment; dementia awareness and infection control and updates on medication and POVA are booked for the near future. There is a robust recruitment process in place, four staff files were seen and all contained the required documentation including current Criminal Bureau Checks and references. Highgrove House DS0000014565.V331806.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31 32 33 35 37 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is run by a capable and committed manager, the staff team are well supported and records are current and in good order. EVIDENCE: The home’s manager Mr. Neil-Smith is qualified, capable and committed and undertakes further training and development to update his skills and knowledge. The staff on duty, residents and families spoke highly of Mr NeilSmith’s management style and said that he managed the home in an open inclusive manner. A staff member commented, “ I have supervision with the manager. We have a very good supportive manager who works on site on a daily basis and so is aware of everything about the home”. A family member said, “ A high standard of care and support is always maintained at Highgrove House and the owners and staff team are always very attentive and respectful”. Highgrove House DS0000014565.V331806.R01.S.doc Version 5.2 Page 20 Most of the people living in the home either manage their own financial arrangements or are supported by legal advisors. A small amount of money is kept in the home on behalf of one resident. All transactions are recorded and when checked the records and amount was correct. The manager carries out an annual quality assurance process by sending out comprehensive questionnaires to residents and copies of these were seen during the visit. To ensure a more holistic view of the care provided, this process should be further extended to include families and professionals involved with the home. Records for the running of the business were seen including fire records and staff fire training, gas certificate and electrical appliance testing, the insurance certificate and maintenance book. All were current and in good order. As recorded earlier in this report one requirement was made regarding some bedroom doors being wedged open. Mr. Neil- Smith said that he had already gained quotes for fitting automatic closures in the home and would begin a programme of fitting them. This will be checked at the next visit. Highgrove House DS0000014565.V331806.R01.S.doc Version 5.2 Page 21 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 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 X X 3 3 X 3 STAFFING Standard No Score 27 4 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X 3 2 Highgrove House DS0000014565.V331806.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP19 Regulation 13 Requirement In order to ensure that residents are protected in the event of a fire occurring, the registered manager must ensure that risk assessments are completed for people who wish to keep their bedroom doors open and suitable automatic devices should be fitted. Timescale for action 30/05/07 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 Highgrove House DS0000014565.V331806.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Highgrove House DS0000014565.V331806.R01.S.doc Version 5.2 Page 24 - 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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