Inspection on 25/04/07 for Highland House Retirement Home

This inspection was carried out on 25th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Highland House Retirement Home 29/06/06

Highland House Retirement Home 19/01/06

Highland House Retirement Home 04/10/05

Highland House Retirement Home 24/01/05

Highland House Retirement Home 27/09/04

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 Highland House Retirement Home Littlebourne Road Canterbury Kent CT3 4AE Lead Inspector Christine Lawrence Key Unannounced Inspection 25 April 2007 11.00 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 Highland House Retirement Home DS0000023450.V335062.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. Highland House Retirement Home DS0000023450.V335062.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Highland House Retirement Home Address Littlebourne Road Canterbury Kent CT3 4AE 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) 01227 462921 Mrs Marian Walsh Sue Page appointed as manager, not yet registered. Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places Highland House Retirement Home DS0000023450.V335062.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspections 22 January 2007 (Random) 29 June 2006 (Key Unannounced) Brief Description of the Service: Highland House is a residential care home for 28 older people. The home is on a main road between Canterbury and Littlebourne. It is set back from the road with large grounds and plenty of space for car parking. Canterbury has two mainline railway stations. There is a bus service which passes the home. Prospective residents will be given a copy of the Statement of Purpose and a Service User Guide on request. Copies of the latest report from the Commission for Social Care Inspection will also be made available at the home. Information provided at this inspection (25/04/07) stated that the current fees were from £395.00 - £465.00 per week. Hairdressing, chiropody and reflexology are available at the home but are not included in the fees. Highland House Retirement Home DS0000023450.V335062.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced. During the site visit I spoke to the owner, Marian Walsh and the new manager. Other staff were observed interacting with residents and carrying out their duties. I spoke to various of the residents in their own rooms as part of my tour of the building, and while sitting in the lounge area. Staff records and care plans for residents were examined as were other records regarding training and health and safety. I also had the opportunity to speak to a visiting relative. Mrs Walsh provided written information at the time of the inspection about the home and the people who live and work there. Information relating to some complaints (including some sent anonymously) was also used to inform this inspection. What the service does well: 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. Highland House Retirement Home DS0000023450.V335062.R01.S.doc Version 5.2 Page 6 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 Highland House Retirement Home DS0000023450.V335062.R01.S.doc Version 5.2 Page 7 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): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. New residents can be confident that the home will assess their needs before they are admitted to the home, to ensure that those needs can be met. EVIDENCE: The new manager, has devised a new more detailed pre-admission assessment form. This form is detailed and covers a range of needs and background information. This has recently been used for a person coming into the home for respite care. The new manager informed us that this format will be used for all future admissions. She confirmed that a copy would be kept on an individual’s record. Some records were looked at for people who already live at the home and they contained examples of information being sought from the placing authority such as Kent Social Services. Highland House Retirement Home DS0000023450.V335062.R01.S.doc Version 5.2 Page 8 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 adequate. This judgement has been made using available evidence including a visit to this service. Residents will benefit from having improved individual plans of care which identify how their health and care needs are to be met. They will be better protected by the home’s improved procedures for dealing with medication and they can be confident that they will be treated with respect for their privacy. EVIDENCE: Six individual records were looked at during this inspection. Five of these have been reviewed and updated into a new format, which better reflects residents’ needs and therefore should provide an improved basis for care to be delivered. The manager explained that she has two more care plans to change over to the new format. The new format is much more detailed than previously. Risk assessments specific to individuals are included within the care plan format. There is information for staff regarding a range of identified care needs and how to meet them. Highland House Retirement Home DS0000023450.V335062.R01.S.doc Version 5.2 Page 9 Within the individual record there is a section noting any GP visits and any other health care professional involvement such as hospital appointments, opticians, chiropodists and community nurses. Some pressure relieving equipment is in use as identified for some individuals. There is a weekly ‘exercise’ session (seated exercises) which residents can join in. One resident said that she really enjoyed these sessions. The new manager has instigated improvements to care plans and procedures. These changes are quite recent and other improvements are planned and these all should be monitored by the manager and the owner to ensure that they fully meet residents’ identified health and personal care needs. A new drugs trolley has been purchased. Four staff have had guidance from the dispensing pharmacist on the new monitored dosage system now in place. The new manager said that she plans to access more in depth training for those who administer medications. The medication administration records were properly completed. The new manager has instigated some reviews of medication. The policies and procedures relating to medication have been reviewed and amended where necessary. Residents spoken to during this visit said that members of staff spoke to them politely and their privacy was maintained. I observed the staff on duty to be considerate and patient towards the people they were caring for. Highland House Retirement Home DS0000023450.V335062.R01.S.doc Version 5.2 Page 10 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 good. This judgement has been made using available evidence including a visit to this service. Residents can be confident that their preferences will be responded to and that they will be enabled to maintain contact with friends and family. Residents will be encouraged to make choices and they will benefit from nutritious food. EVIDENCE: Residents spoken to said that they thought there were enough things to do in the home. One person said she enjoyed the exercise sessions. There is bingo, singing along to music sessions, ball games, a weekly craft session and occasional visiting entertainers. There was a special entertainment on the day of this inspection to celebrate a resident’s 100th birthday. Residents confirmed that they can choose to join in or not as they please. There are no restrictions to visiting times. Residents and visitors said that visitors are made welcome. Mrs Walsh said that residents could bring in personal things for their own rooms although if this was furniture it had to be agreed in advance. Personal items were seen in the rooms viewed. The daily records provided information that showed that residents go to bed and get up at the times they prefer. The new pre-admission form contains a section about Highland House Retirement Home DS0000023450.V335062.R01.S.doc Version 5.2 Page 11 choices and preferences. The new manager said she would ensure this is completed for all new admissions. I observed a meal during this visit. The food looked and smelt appetising. The home has facilities to grow some of its own vegetables and residents told the inspector that they particularly liked that. The menus seen showed variety and choices are now available for lunches as well as at teatime. The meal observed was relaxed and some residents sat at the table relaxing after the meal was finished. The dining room is a pleasant area and residents were using the mealtime for socialising. Copies of menus are given to residents to keep in their rooms. Highland House Retirement Home DS0000023450.V335062.R01.S.doc Version 5.2 Page 12 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 adequate. This judgement has been made using available evidence including a visit to this service. Residents and others can be confident about complaints being dealt with appropriately. Staff members existing abilities to protect residents will be enhanced by training and clarification of written procedures. EVIDENCE: The home has a complaints procedure which includes a commitment that any complaint will be responded to within 28 days. Residents spoken to said they knew who to speak to if the were unhappy. Mrs Walsh agreed that the recent experiences regarding complaints made to Kent County Council and the Commission for Social Care Inspection, as well as the current adult protection investigation, had highlighted for her the need to ensure that everybody, including herself should be fully aware of the appropriate procedures for reporting incidents both within and external to the home. Policies and procedures are currently being reviewed by the new manager to make sure that they are easily understood and are relevant to Highland House. Further adult protection training is planned. Highland House Retirement Home DS0000023450.V335062.R01.S.doc Version 5.2 Page 13 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 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from living in an environment which is safe, well maintained, clean, pleasant and hygienic. EVIDENCE: Highland House is located between Canterbury and Littlebourne. It is suitable for its purpose. Some redecoration of rooms is being undertaken at this time. The garden is well maintained and there are facilities for residents to spend time outside in sunlight. There are no outstanding requirements from the fire safety officer or the local authority environmental health department. The home was clean at the time of the inspection and there were no inappropriate odours. Residents expressed satisfaction with the cleanliness. A cleaner and a laundry worker are employed at Highland House. The new manager said that she plans to recruit another cleaner. The laundry is situated Highland House Retirement Home DS0000023450.V335062.R01.S.doc Version 5.2 Page 14 away from the main building. The laundry area is satisfactory. All staff are currently undertaking ongoing training in infection control with an outside trainer. Highland House Retirement Home DS0000023450.V335062.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Current residents have sufficient staff to care for them. Residents are protected by the recruitment procedures. More training should be provided to ensure that staff are as competent as possible. EVIDENCE: There has been a high turnover of staff, mostly since last September. The current numbers are three senior carers, ten carers, one domestic and one laundry person. There are two cooks, two gardeners and a secretary. Rotas shown for recent weeks indicate that on most occasions there are sufficient people on duty but there have been problems in the past. The new manager agreed that these levels are sufficient for the current numbers of residents and the needs that have been identified but as numbers go up the staffing levels will need to be reviewed. Some shifts have been covered by agency staff when required. Written information provided by the new manager shows that three people have a national vocational qualification Level 3 and four people have Level 2. Two people are currently undertaking Level 2. There are plans to increase this number. Highland House Retirement Home DS0000023450.V335062.R01.S.doc Version 5.2 Page 16 The records of four members of staff were viewed during this visit. The recruitment procedures within Highland House include application forms, references, criminal record checks (and PovaFirst if required) and written terms and conditions of employment. Staff are given copies of the General Social Care Council’s code. Staff employed recently have also had telephone references. Training for some staff has been provided and more is planned. A staff training and development programme should be in place for the staff team as a whole and this should link with the individual training and development assessment for each member of staff (see also Standard 36). Highland House Retirement Home DS0000023450.V335062.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 36 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents will benefit from more settled management and staff supervision, allowing for responsibilities to be fully and consistently discharged. Residents’ health, safety and welfare is mostly promoted and protected. EVIDENCE: Mrs Walsh appointed the new manager and she took up her post towards the end of February. The new manager is qualified and experienced but has not yet applied for registration. She has been registered previously at another home. Mrs Walsh has been the owner of Highland House for many years and is currently being assessed for NVQ level 4. There are now three senior carers who have responsibilities for running shifts on a day-to-day basis but who also have specific areas of responsibility. This is a new management structure and Highland House Retirement Home DS0000023450.V335062.R01.S.doc Version 5.2 Page 18 will need to be monitored by the owner to ensure that it meets the needs of the home and the people who live and work there. The new manager intends to have regular seniors’ meetings. Some quality assurance work has been undertaken in the past, including seeking feedback from relatives and the new manager is introducing a system of meeting with residents on a regular basis for individual discussions about their satisfaction with the home. More needs to be done to ensure that the outcome of running the home in the best interest of residents is fully achieved and supported by systematically considering and monitoring success in meeting the aims and objectives of the home. There have been many changes to the staff team in the last six months or so and supervision has not always been provided. The new manager indicated her commitment to begin a programme of supervision for each member of staff which will link up with identifying training and development needs as noted under Standard 30. Some further training relating to health and safety is necessary and this will form part of the review being carried out as noted in Standard 30. A spot check on maintenance and service contracts showed them to be appropriate and up to date. Accidents are properly recorded in keeping with the Data Protection Act and the fire safety checks record was satisfactory. No obvious health and safety issues or hazards were observed during this inspection. Highland House Retirement Home DS0000023450.V335062.R01.S.doc Version 5.2 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 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 2 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X X 2 X 2 Highland House Retirement Home DS0000023450.V335062.R01.S.doc Version 5.2 Page 20 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 OP7 Regulation 14 and 15 Requirement The manager must audit the care provided by monitoring the effectiveness of the new care plan format and reviews of care. As above All policies and procedures relating to safeguarding adults must be reviewed to ensure they are robust and relevant to the home. The planned programme for training (care), including NVQs should be prioritised and progressed. The provider must monitor the new management arrangements to ensure they are effective. Procedures for monitoring that the home is run in the best interests of residents needs to be more systematic The provider must ensure that people working at the home are appropriately supervised. As above for training re health and safety. Timescale for action 31/10/07 2 3 OP8 OP18 14 and 15 12, 13, and 21 31/10/07 31/07/07 4 OP30 18(1) (a)(c) 12 (1) (a)(b) 24 31/07/07 5 6 OP31 OP33 31/10/07 31/10/07 7 8 OP36 OP38 18 (2) 18(1) (a)(c) 31/10/07 31/07/07 Highland House Retirement Home DS0000023450.V335062.R01.S.doc Version 5.2 Page 21 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP27 Good Practice Recommendations In order to facilitate the planning of the rota the guidance from the Department of Health (Residential Forum - Care Staffing in Care Homes for Older People) should be referred to. Highland House Retirement Home DS0000023450.V335062.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Highland House Retirement Home DS0000023450.V335062.R01.S.doc Version 5.2 Page 23 - 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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