Inspection on 29/06/06 for Highland House Retirement Home

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 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 25/04/07

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 Unannounced Inspection 29 June and 4 July 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 Highland House Retirement Home DS0000023450.V293932.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.V293932.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 Post Vacant 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.V293932.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 19 January 2006 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. In the information sent to the Commission prior to this inspection, fees were noted as from £325.00 - £425.00 per week. Hairdressing, chiropody and reflexology are available at the home but are not included in the fees. Highland House Retirement Home DS0000023450.V293932.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector undertook an unannounced site visit to the home. This took place over two days and in total lasted just over 10 hours. The proprietor had previously sent in a pre-inspection questionnaire with information about the home, staff and residents. Surveys had been provided for all residents and their relatives. No residents and seven relatives responded. Comment cards were sent to the care managers for the residents and three responded. General practitioners were sent comment cards and one responded, as did a Community Nurse. During the site visit the inspector spoke to residents and staff members and made observations of interactions between residents and staff. The inspector also walked around the building, invited by residents to see their rooms. The inspector also spoke to two visiting relatives. Various records were also examined. The owners, Mrs Walsh spent time talking to the inspector and providing information. Information from previous inspection reports was also used for this inspection. What the service does well: What has improved since the last inspection? What they could do better: There are some minor things to be done to improve the assessment and care plan process ie ensuring that no gaps are left and introducing some paperwork to identify any risks associated with nutrition or pressure ulcers. The training programme needs to be sorted out to identify what still needs to be provided and this is planned. Highland House Retirement Home DS0000023450.V293932.R01.S.doc Version 5.2 Page 6 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. Highland House Retirement Home DS0000023450.V293932.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 Highland House Retirement Home DS0000023450.V293932.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 (Standard 6 does not apply to this home) 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 needs will be assessed before moving in and that the home believes it can meet those needs. EVIDENCE: The pre-admission assessments for four of the residents were looked at during this inspection. Two of them had been assessed by the local authority responsible for placing them and two had been assessed by senior staff from the home. The homes own format is suitable for the task and contains appropriate prompts. There were a couple of gaps regarding dates and signatures and this was pointed out to Mrs Walsh who agreed to remind staff about this. This information is used to compile a care plan (see Standard 7). Highland House Retirement Home DS0000023450.V293932.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 area is adequate. This judgement has been made using available evidence including a visit to this service. Residents’ health, personal and social care needs are set out in an individual plan of care but they need to be improved to ensure that these needs are fully met. Residents are protected by the home’s policies and procedures regarding medication. Residents are responded to in a way that upholds their privacy and dignity. EVIDENCE: The records of five residents were looked at for this inspection. The care plan objectives are based on the assessments carried out prior to admission and shortly after admission and the document contains assessments under the following headings:- physical assessment and psychological assessment. There are more detailed sub sections which include risk of falls, skin integrity, mobility and eating and drinking. Screening with regard to pressure areas and nutrition could be improved to identify anyone at risk prior to a problem being identified. There is a section within the documentation which allows for a resident to indicate their awareness and understanding of their care plan. This Highland House Retirement Home DS0000023450.V293932.R01.S.doc Version 5.2 Page 10 was not always completed. The inspector advised that the home should strive to always encourage a resident or their representative to sign to indicate that they have been involved or consulted. If no one is willing to sign then staff should indicate this. The records seen showed that residents’ health care needs are met by the relevant professionals eg chiropodist, general practitioner, community nursing service, out patient appointments, dentists and opticians. Some areas within the care plan/assessment format for some people were not completed and this might cause confusion. It is recommended that no gaps be left. If a section is not relevant or information is not known this should be made clear by staff completing the forms. The home uses a monitored dosage system for administering medication. Storage is appropriate and there are policies and procedures in place. Staff who administer medication have received training. The general practitioner who completed a comment card said that residents’ medication was appropriately managed at Highland House and the community nurse also thought this. The inspector observed staff giving out medications in keeping with good practice. Within the individual records there is a section identifying what an individual likes to be called. The GP and community nurse, as well as the seven relatives who returned comment cards, said they could see residents in private. A portable telephone is available for residents to use in private. Residents spoken to said that staff were kind to them when helping with any aspect of personal care. They said that staff were polite and knocked on their doors. The daily records completed by staff contained a few comments which were neither respectful nor promoted dignity. Mrs Walsh had already identified this and was dealing with it. Most of the comments were appropriate and respectful. Highland House Retirement Home DS0000023450.V293932.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 area is good. This judgement has been made using available evidence including a visit to this service. Residents are satisfied with the routines and activities in the home and are supported to maintain contact with their friends and family. Residents benefit from wellprepared and appetising food. EVIDENCE: Residents spoken to and those who completed a survey 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 and occasional visiting entertainers. Residents confirmed that they can choose to join in or not as they please. There is a section within the care plan assessment for recording hobbies and interests that people had before they moved into the home but as noted under Standard 7, some of these documents were not always fully completed. There are no restrictions to visiting times. All seven of the people who returned comment cards said that they were always made welcome when they visited. The home is not involved in the management of any resident’s finances. 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. Highland House Retirement Home DS0000023450.V293932.R01.S.doc Version 5.2 Page 12 Personal items were seen in some of the rooms viewed. The daily records and the handover book used by staff between night and day shifts provided information that showed that residents go to bed and get up at the times they prefer. The inspector observed a meal. The food looked and smelt appetising. The home has facilities to grow some of its own vegetables and two residents told the inspector that they particularly liked that. The menus seen showed variety and although there are choices and options at teatime, there is only one option at lunch. Mrs Walsh said that residents’ personal dislikes are known and alternatives would be provided if necessary. The inspector advised that the home acquire a copy of the Commission for Social Care Inspection’s publication “Highlight of the Day?” for further information and guidance about mealtimes. Residents who completed surveys also expressed satisfaction with the food at Highland House. The meal observed was relaxed and some residents sat at the table relaxing after the meal. The dining room is a pleasant, area but also includes the staff workstation at one end which takes up some space. At the previous inspection Mrs Walsh explained that she planned to make changes sometime this year. This is still her plan. Highland House Retirement Home DS0000023450.V293932.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 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. 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. Three of the seven people who completed relatives comment forms indicated that they were not aware of the complaints procedure. This may be because of various reasons for instance they might not have had sight of the Service User Guide, but it is recommended that the home ensures that all relatives and visitors are made aware of the procedure. An example was noted of how a complaint was dealt with appropriately. Mrs Walsh informed the inspector that there are policies and procedures relating to adult protection, physical intervention/restraint, aggression towards staff and whistle blowing. Staff spoken to confirmed their understanding of their responsibilities to protect residents. A copy of the Kent and Medway policy and procedures is kept at the home. Appropriate criminal record bureau checks are carried out for all staff. There are also policies and guidance relating to residents’ money, financial affairs and safekeeping of valuables. There are no policies/procedure regarding racial harassment or equal opportunities/diversity. Although induction training includes reference to adult protection (and three staff have received other training) and there are specific Highland House Retirement Home DS0000023450.V293932.R01.S.doc Version 5.2 Page 14 policies and procedures, it is good practice to underpin this with training/instruction for staff. Highland House Retirement Home DS0000023450.V293932.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 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 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 but Mrs Walsh has plans to make some improvements. This includes the dining room as noted under Standard 15. The garden and building are both 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 laundry is situated away from the main building. The laundry area was satisfactory except for the hand washing facilities. This was discussed with Mrs Walsh who was organising a correction to this by the end of the inspection. Highland House Retirement Home DS0000023450.V293932.R01.S.doc Version 5.2 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): 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. Residents have sufficient staff to care for them. Residents are protected by the recruitment procedures. Some more training should be provided to ensure that staff are as competent as possible. EVIDENCE: Six of the seven relatives who completed comment cards said that they thought there were always sufficient staff on duty. The care managers, GP and community nurse who completed comment cards said that there was always a senior member of staff to speak with. A rota is used to indicate who is on duty at any time and the role they carry out. There are staff employed for food preparation, cleaning and the laundry. There are two waking night staff and at least three staff on day shifts. There are also administrative staff and a human resources person. Two members of staff have National Vocational Qualifications in care at level 2 and one of these has also gone on to complete a level 3. The records of five members of staff were examined and showed that the home’s recruitment procedure includes 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. Highland House Retirement Home DS0000023450.V293932.R01.S.doc Version 5.2 Page 17 Although some people have received training for various things there is a need to plan for more. Induction training takes place and is recorded. The human resources person is recently back in post and there are plans for her to review the current training and identify shortfalls and plans for the future. She is aware of the new Common Induction Standards and will be looking to ensure that any in house work with staff is in keeping with them. Highland House Retirement Home DS0000023450.V293932.R01.S.doc Version 5.2 Page 18 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, 35 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents benefit from living in a well run home which safeguards their financial interests. Residents’ helath, safety and welfare is mostly promoted and protected. EVIDENCE: The owner, Mrs Walsh, currently takes day to day responsibility for the home. She is supported by a head of care, a senior and the human resources person. Mrs Walsh has owned and operated Highland House for many years. She is currently undertaking the level 4 NVQs necessary for achieving the registered managers award. Mrs Walsh explained that she prefers not be involved with any finances of residents. These are managed by families or local authority representatives. Highland House Retirement Home DS0000023450.V293932.R01.S.doc Version 5.2 Page 19 Secure facilities are available to store valuables if necessary and a record is kept of this. 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. With the exception of the hand washing facilities in the laundry (see Standard 26), no obvious health and safety issues or hazards were observed during this inspection. Highland House Retirement Home DS0000023450.V293932.R01.S.doc Version 5.2 Page 20 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 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X X 3 X X 2 Highland House Retirement Home DS0000023450.V293932.R01.S.doc Version 5.2 Page 21 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 OP30 Regulation 18 Requirement The planned programme for training (care), including NVQs should be prioritised and progressed. A report should be sent to the Commission detailing this plan As above for training re health and safety Timescale for action 15/08/06 2 OP38 18 15/08/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 Refer to Standard OP7 OP8 OP18 OP31 Good Practice Recommendations There should be no gaps within the assessment and care plan documentation. There should be a screening tool or risk assessment for nutrition and pressure ulcers in place for each resident. More training regarding adult protection should be provided for staff As the person in day to day control, the owner should complete NVQs level 4 (Care and Management) Highland House Retirement Home DS0000023450.V293932.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 Highland House Retirement Home DS0000023450.V293932.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. 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