Inspection on 29/06/06 for Highgrove House

This inspection was carried out on 29th June 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 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 28/02/06

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Highgrove House Highfield Road North Chorley Lancashire PR7 1PH Lead Inspector Mr Patrick Rooney Unannounced Inspection 29th June 2006 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 DS0000065791.V299011.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 DS0000065791.V299011.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Highgrove House Address Highfield Road North Chorley Lancashire PR7 1PH 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) 01257 270643 Park Lane Healthcare (Highgrove) Limited Care Home 40 Category(ies) of Dementia (5), Old age, not falling within any registration, with number other category (40) of places Highgrove House DS0000065791.V299011.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of 40 service users to include: Up to 40 service users in the category of OP (Old age, not falling within any other category). Up to 5 service users in the category DE (Dementia). The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidelines which may be issued through the Commission for Social Care Inspection regarding staffing levels in care homes. 28th February 2006 2. 3. Date of last inspection Brief Description of the Service: Highgrove House is a 40 bedded purpose built care home for older people, a small number of whom have dementia, which is situated close to Chorley Town Centre and is easily accessible by public transport. The home is purpose built and provides all single room accommodation on two floors. One room is provided with en-suite toilet facilities, whilst the remainder are all fitted with vanity units. The home has a dining room and a lounge area on each floor, with a further communal area situated just within the reception area of the home. The homes gardens were easily accessible, secure and were furnished with a range of garden furniture. Fees for a place at the home are from £365. There are additional charges made for individual personal requirements such as hairdressing and chiropody. Highgrove House DS0000065791.V299011.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit and took place over the period of a full day on 29TH June 2006 and a part day on 5th July 2006. The inspector spoke to resident, staff and management. Records were examined and there was a full tour of the home. Questionnaires were given to residents and visitors. Doctors and social workers with residents in the home were also consulted. What the service does well: What has improved since the last inspection? Highgrove House DS0000065791.V299011.R01.S.doc Version 5.2 Page 6 The new manager has reviewed all policies and procedures ensuring they are up to date and relevant to Highgrove House. There is a more effective management team, which is providing a good lead in improvement of care. Staff support, training and supervision are all improving and provision has been made to promote training. The home has established links with Preston College and is being used as a centre for the assessment of NVQ training. Environmental standards within the home have been greatly 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. Highgrove House DS0000065791.V299011.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 DS0000065791.V299011.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome group is good. There are good pre admission assessments, which are thorough and identify care to be provided. EVIDENCE: The assessments of three residents were looked at and their care discussed with them. All had received a full pre admission assessment and a comprehensive care planning process had been introduced. Staff spoken to showed a good awareness of the needs of residents and are able to provide the correct levels of care according to the assessments. Highgrove House DS0000065791.V299011.R01.S.doc Version 5.2 Page 9 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): 7,8,9 and 10 Quality in this outcome group is good. The care planning process ensures residents health, personal and social needs are met and residents are treated with privacy and dignity. EVIDENCE: The new manager has been improving all the homes policies and procedures, including care planning. Care plans are thorough and cover all aspects of care needed. These provide staff with a good guide in carrying out their duties. Reviews are carried out monthly with residents or their representatives and where possible they sign the record. Risk assessments are carried out to ensure residents safety while at the same time ensuring that they have choice. From discussion with residents, staff and from observation it was felt that the right levels of care are sensitively provided. Residents were very positive about the care they receive and said that they are treated with kindness by staff. Their comments include. “Staff are always around in case I need any Highgrove House DS0000065791.V299011.R01.S.doc Version 5.2 Page 10 help”. “ They always get the doctor when I need one”. ”Staff are really nice and help me a lot”. “If I need anything I only have to ask and its done” Access to doctors, district nurses and other health care professionals is enabled and good records of such visits are maintained. Nutritional requirements are recorded and there is good liaison with the chef and residents. Medication records were looked at and apart from one misrecording in the controlled drugs register, records are well kept. Staff administering medication have not all received training in this, however arrangements are in place for all staff giving out medication to receive training. Highgrove House DS0000065791.V299011.R01.S.doc Version 5.2 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): 12,13,14 and 15 Quality in this outcome group is good. The homes routines are flexible and provide an environment where individual social, cultural and recreational needs can be met. EVIDENCE: Residents told the inspector that they are able to choose what they do during the day. Rising and retiring times are for them to choose, the inspector observed this to be the case. Residents were seen in their own rooms or taking part in communal activities in the lounge areas. One of the staff on each shift is responsible for arranging activities. Residents are consulted about what activities they would like during residents meetings. Information regarding past interests and hobbies are being included in the assessment and care planning process. There are regular contacts with the community and church visitors and clergy are made welcome. Relatives and friends visit and are able to have privacy during their visits, they also are able to take residents out. Entertainers visit regularly and there are board games and simple exercises arranged with staff. Highgrove House DS0000065791.V299011.R01.S.doc Version 5.2 Page 12 The home has a four weekly rotating menu in which there are always choices available. A full time chef is employed who is fully informed about individual needs and special diets. He arranges residents meetings to discuss menus and includes their favourites. Every afternoon residents are asked what they would like for tea. All food is freshly cooked on the premises and includes fresh vegetables and fruit. Residents said that they enjoy the food they receive. Highgrove House DS0000065791.V299011.R01.S.doc Version 5.2 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): 16 and 18 Quality in this outcome group is good. There is a policy and procedure for dealing with complaints, which ensures complaints or concerns are listened to and acted upon and that residents are protected from abuse . EVIDENCE: All policies and procedures have been reviewed by the new manager and are more focused. The complaints procedure is available to all residents and their families, it is contained in the service users guide and is on notice board in the home. Residents said that they are able to raise issues of concern with the staff and manager. Adult abuse procedures including a whistle blowing policy were seen, these provide good guidance to staff. Staff spoken to were aware of the procedures and said they would certainly report any matters of concern to the manager. Staff are being provide with training in the protection of vulnerable adults. Highgrove House DS0000065791.V299011.R01.S.doc Version 5.2 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): 19 and 26 Quality in this outcome group is good. Major refurbishment taking place has significantly improved the environment homes cleanliness. EVIDENCE: The home has undergone extensive redecoration and refurbishment. Rooms have been redecorated and new carpets fitted. New furniture has been provided both in resident’s rooms and in public areas, all residents now have a lockable facility in their rooms. New shower rooms have been provided and baths have been fitted with new hoists. New laundry and kitchen equipment has been fitted. Residents have been impressed with the improvements and said the whole atmosphere is much better. Infection control policies have been updated and are more effective. The home was observed to be clean, hygienic and pleasant. Highgrove House DS0000065791.V299011.R01.S.doc Version 5.2 Page 15 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): 27,28,29 and 30 Quality in this outcome group is good. The homes policies on staffing the home and recruitment ensure resident’s needs are met. EVIDENCE: Duty rotas were viewed and showed that there are always sufficient staff on duty who are sufficiently skilled and experienced to meet the needs of residents. A new induction process has been introduced, which covers the National Care Standards. Currently there are below 30 of staff are qualified to NVQ 2 however plans are in place to ensure the 50 level is reached. A training matrix has been produced to ensure staff receive training in various aspects of caring for the elderly. A partnership has been entered into with Preston College to ensure all staff are enrolled for NVQ training in September. The home has been designated as an assessment centre for NVQ training. The homes recruitment processes were looked at and staff files examined. Application forms are completed and references from previous employers obtained. Criminal Records Bureau clearances are applied for. Two staff are currently working following POVA first clearances having been obtained. Staff in these circumstances should only work under supervision until the full CRB clearance is received. Highgrove House DS0000065791.V299011.R01.S.doc Version 5.2 Page 16 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): 31,33,35 and 38 Quality in this outcome group is good. There is good progress in establishing effective management of the home which has ensured better application and review of policies and procedures. EVIDENCE: There is a new manager in post who has applied for registration. She has had a good deal of experience and has previously been the registered manager of two nursing homes. Since taking up post there has been extensive reviewing and updating of policies and procedures. The home is accredited with ISO 9001 status and has an annual assessment regarding this. Resident’s views are valued and a six monthly residents survey has been implemented. Residents meetings are also held, the chef was at the time of the inspection arranging for a residents meeting to discuss menus. Highgrove House DS0000065791.V299011.R01.S.doc Version 5.2 Page 17 Staff on duty were seen separately and confirmed that they receive good support and supervision. Lines of accountability are clear and staff felt able to approach the manager with any concerns. Records regarding resident’s personal allowance were examined and are well kept. Health and safety is taken seriously and all safety checks are carried out regarding fire, emergency lighting, the electrical system and all electric items in use. Fire, health and safety, Basic Life Support and moving and handling training is planned to ensure all staff are updated on these issues. Highgrove House DS0000065791.V299011.R01.S.doc Version 5.2 Page 18 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 X X 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Highgrove House DS0000065791.V299011.R01.S.doc Version 5.2 Page 19 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. 1. 2. 3. 4. Refer to Standard OP9 OP9 OP9 OP29 Good Practice Recommendations 50 of care staff should hold NVQ Level 2 The controlled drugs record should be maintained correctly Staff administering medication should have accredited training in this. Staff with only a POVA first clearance should work supervised until the full CRB clearance is received. Highgrove House DS0000065791.V299011.R01.S.doc Version 5.2 Page 20 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ 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 Highgrove House DS0000065791.V299011.R01.S.doc Version 5.2 Page 21 - 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. 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