Inspection on 21/07/05 for Highlands Residential Home

This inspection was carried out on 21st July 2005.

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

Highlands Residential Home 13/02/09

Highlands Residential Home 21/02/07

Highlands Residential Home 05/12/05

Highlands Residential Home 11/03/05

Highlands Residential Home 14/07/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Highland Residential Home Fitzgerald Road Woodbridge Suffolk IP12 1EN Lead Inspector Jill Clarke Announced 21 July 2005 at 10.00am 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 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 Residential Home I54-I04 S24416 Highlands V233111 050721 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Highlands Residential Home Address Fitzgerald Road, Woodbridge, Suffolk, IP12 1EN Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01394 386204 01394 386204 Lyn@highlands1.plus.com The Abbeyfield Deben Extra Care Society Mrs Lyn Ward CRH 24 Category(ies) of OP - For older people over the age of 65 years registration, with number 24 places of places Highland Residential Home I54-I04 S24416 Highlands V233111 050721 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 11 March 2005 Brief Description of the Service: Highlands is one of a group of care homes, which is affiliated to the National Abbeyfield Society Group and is responsible to a local management committee, the Abbeyfield Deben Extra Care Society Limited. Situated in a quiet residential area of Woodbridge, within walking distance of the town centre. Woodbridge offers a range of amenities which include restaurants, garden centres, shops, library, banks, post office, Riverside Theatre and swimming pool. Highlands provides care for 24 older people. The home is an adapted period house, which overlooks the Deben estuary. All areas of the home can be accessed by lift or stairs. Most of the bedrooms and living areas, including a large conservatory, have views over the homes well established grounds and gardens. There is limited car parking provided at the front of the home. The 24 single bedrooms are located on the first and ground floors, all have ensuite wash hand basin and toilet. There are communal toilets and bathrooms located close to the bedrooms. Communal areas include a large dining room and two lounges, all of which are decorated and furnished to a good standard. Highland Residential Home I54-I04 S24416 Highlands V233111 050721 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine announced inspection carried out over seven and a half hours on a weekday in July. Before the inspection, CSCI comment cards were sent out to the home for residents, relatives and visitors. This gave the chance for people (who did not have to give their name) to give their views on the level of service provided and make any comments. Six residents, and seven relative/visitors comment cards were returned. Information gained from comment cards has been included into this report. Time was spent in private with seven residents, to hear their views on what it was like living at Highlands. General feedback was also obtained during conversations with residents throughout the inspection. Time was spent with members of staff, which included the manager, assistant manager and three care workers. Records viewed included, care plans, preinspection questionnaires, complaints and abuse policies. Discussions during the day with people living at the home, identified that they preferred to be known as residents, rather than service users. This report respects their wishes. A tour was made of the communal accommodation and sample of two bedrooms, to check the condition of the décor, furniture and hot water temperatures. What the service does well: The home provides a good level of care within a homely environment. Residents felt the home was well run, and they liked the “kind” and “caring staff”. Comments from relatives included ‘It is a great relief to me to know that they are in good hands’. A regular visitor to the home stated that ‘the home could not be run any more efficiently - if it was a 4 star hotel’. Staff were approachable, and residents felt comfortable to raise any concerns or make suggestions. Residents are given a chance to voice their opinions, through residents meetings. Residents enjoyed the “good food” and have recently put forward their choices/ideas for the new menus. Highland Residential Home I54-I04 S24416 Highlands V233111 050721 Stage 4.doc Version 1.40 Page 6 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. Highland Residential Home I54-I04 S24416 Highlands V233111 050721 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Highland Residential Home I54-I04 S24416 Highlands V233111 050721 Stage 4.doc Version 1.40 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 standard(s) 1, 3, 4 and 5. Standard 6 is not applicable. People wishing to move into the home, can expect to be given a good level of information. They will be invited to visit, and have their care and social needs fully assessed. This will support the person, in identifying if the home can meet the level of support they are looking for. EVIDENCE: Two residents shared their experiences when they applied for a place in the home, which were very similar. This included an initial visit from people connected to the home. One resident said two people visited them from the committee, and the other had a visit from the manager and a member of the committee. Both residents found these visits “very informative”. They said they were asked about the level of support they wanted, their medical history, family links, social interests and why they wanted to move into residential care. They were given information booklets, and given time to read and ask any questions. The residents were pleased that they had a chance, in their own home to be able to ask questions, and not feel rushed. Highland Residential Home I54-I04 S24416 Highlands V233111 050721 Stage 4.doc Version 1.40 Page 9 One resident said that their family had looked at several homes on their behalf, before identifying Highlands to be the most suitable. The resident agreed with their selection, as they had previously visited the home. Both residents were invited to visit Highlands. They were offered lunch, and shown around the communal rooms, and the bedroom they were being offered. Time spent with the residents confirmed that they felt the home was able to meet their individual needs, and praised the level of care they received. The manager explained that anyone wishing to move into the home, would go through the following admission procedures: • Prospective residents are asked to complete an ‘Application Form’. Applicants already living in Abbeyfield housing are given first refusal. The form asks for brief details of their medical history and the reason for wanting to move into the home. They are also asked to say if they are looking to move into residential care soon, or in the future. Two members from the ‘admission committee’ visit the person in their own home. They give information on the highlands, and write a report on why the person wants to move into residential care, and the level of support required. The Manager may visit at this time, or closer to admission, to complete the home’s pre-assessment of physical and social care needs. With the person’s permission, a request is made to obtain a medical report from their Doctor. The prospective resident is invited to have lunch at the home, and spend the day meeting people living there. They are shown the bedroom on offer, if accepted; a date is arranged for their admission. If they were not happy with the bedroom, their name would remain on the waiting list, and offered a place another time. • • • • Residents felt the home’s admission procedure gave them a good insight into the home, was informative and allowed them to make an informed decision if they wanted to move in. Care files looked at, contained completed paperwork, showing the different stages of admission, and assessments undertaken. Highland Residential Home I54-I04 S24416 Highlands V233111 050721 Stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 and 10. People living at the home can expect to receive a good level of care, by staff that will respect their privacy and rights. EVIDENCE: Three residents spoken to during the inspection gave feedback on the level of care they received. The information held in their care plans, reflected the information given by the residents. Time spent with staff confirmed that they had a good understanding of the individual residents needs. Care plans gave staff clear guidance on how the resident wished to be looked after, and how much assistance they wanted. Staff write daily accounts of how the resident has spent their day, including any concerns or events that had happened, which other staff need to be aware of. This included Doctors visits, Hospital appointments or if the resident was feeling unhappy, the possible causes, and support given. Information obtained from residents before they moved into the home, forms the basis of the care plan. On admission residents are assigned a ‘Key Worker’, who work jointly with the resident and if applicable family, to complete a more detailed care plan. This included their likes and dislikes, Highland Residential Home I54-I04 S24416 Highlands V233111 050721 Stage 4.doc Version 1.40 Page 11 mobility, any identified risks, such as prone to falling, when they wish to have a bath and a pen picture of their life. Care plans held, showed signed statements to say that the plan had been ‘compiled’ jointly, with the signatures of both resident and member of staff involved. Residents confirmed that they had been involved in saying how they wanted to be looked after during the admission period. However they were not aware of reviewing its contents after that. Discussions with staff and paperwork seen, showed that the care plans were reviewed monthly, or earlier if required – but not always with the resident. Two residents had leg ulcers, which had been receiving treatment “for years”. One resident preferred to visit a clinic for treatment, rather than be visited at the home. The second resident during conversations, made it clear that they did not want any help from Health Professionals, and they would continue to manage their own treatment. This was being monitored by the home. Information supplied by the home before the inspection, and discussions during, identified that two residents had fallen several times. The manager said that they were (with the residents permission) going to ask their Doctor to make a referral to the Falls Clinic. It is hoped that the specialist staff would be able to give further guidance; on any actions staff could be take to reduce the number of falls. The manager had also obtained information on a new nutritional screening tool being introduced by the local hospital. The questionnaire helps staff to monitor resident’s weight, and seek further advice from the team if they are worried about residents losing or gaining too much weight. Discussions with staff identified that if they have any concerns that a frail resident may develop a pressure sore, from sitting or lying too long, they would take action to remove the risk. This would be undertaken by using pressure relieving mattresses and seat pads. It was suggested that all residents, although mobile were assessed on admission. This would identify any future risks, taking into account their medical and physical health, weight and skin type. The information could then be kept on file and reviewed when needed. For example, if they required long periods in bed following an illness. Highland Residential Home I54-I04 S24416 Highlands V233111 050721 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14 and 15. People living at the home can expect to be treated with respect and supported to have control over their lives. Meals served are varied, nutritious and well presented. EVIDENCE: Time was spent with four residents in the privacy of the enclosed conservatory. They were asked their views, which included what it was like living at the home, and if they would like to see any changes made. From the informative discussions, they were clearly happy living at the home, which they “could not fault”. When asked if they felt they, or the staff controlled how they were cared for. They said they “were free to get up when they wanted”, that “staff don’t talk down to us, we are all called by name – in return staff are respected”. Throughout the day staff were seen to address residents by Mrs, Miss, Mr or Reverend. They acknowledge residents whenever they walked past or entered a room, and included residents in any conversations. Both individual and group conversations held with residents throughout the day, showed that residents were supported to make their own decisions. For Highland Residential Home I54-I04 S24416 Highlands V233111 050721 Stage 4.doc Version 1.40 Page 13 example deciding if they wanted to attend the ‘talk and slide show on the Isle of Sky’ in the dining room that afternoon, or prefer to stay in their room. Residents were seen to ask the Manager to re-arrange or cancel appointments on there behalf. Relatives visited freely throughout the inspection, some residents went for a walk, whilst others met up in the conservatory for morning coffee. An invitation was given to join the residents for lunch. The atmosphere was relaxed, with staff and visiting member of the committee also joining the residents for lunch. Residents said that they preferred not having set places to sit. They said that they had their own individual napkin rings, and staff whilst putting “a fresh napkin in for each meal”, would place the holder at a different table/position each meal. Residents felt that this encouraged them to “mix” and stopped residents taking ownership, of a set place. They felt this also stopped any unnecessary friction, and was a “good idea” in promoting a friendly atmosphere. Residents described food as “very good”, “quantity and quality”, and menu’s always gave “variation & choice”. They said a “good alternate” was always offered, if they did not like the main meal. Lunch served was a selection of cold meats, mixed salad, jacket or Croquets potatoes, and potato salad. On the table were dishes of red cabbage and beetroot. Residents, sitting at the table confirmed that meals were always of a good standard, and well presented. Gooseberry Crumble and Custard, Yogurt or Fresh fruit followed the lunch. From the six residents feedback cards received, half felt the meals were good, where others indicated ‘only sometimes’. The Manager said at the residents meetings, some had asked for more herbs and seasoning to be used, whilst others did not want this. It was agreed, that all the residents would be asked to complete a ‘Menu Suggestion’ sheet, which they have been doing this week. Nineteen had already been returned, which gave a range of resident’s individual choices. The information would then be used next week, to produce new menus, and the residents asked to comment. Menu sheets viewed, showed that many of the residents had requested more fresh fruit. The manager said this had been already been introduced, with Fresh fruit offered as an alternative to dessert each day. Residents explained that for a trial period, they were being served their coffee and tea with their dessert, instead of after. This had been suggested at their residents meeting the previous week. Some residents felt that they were waiting too long for drinks to be served, as staff waited for people to finish their dessert. If the drinks were too hot, this led to a further wait while they cooled down. The residents at the table seemed to prefer the changes, although the Manager said that at least one resident preferred the old way, but Highland Residential Home I54-I04 S24416 Highlands V233111 050721 Stage 4.doc Version 1.40 Page 14 individual arrangements could be made, if the majority of residents wanted to keep to the new arrangements. The minutes of the residents meeting also gave their suggestions on outings they would like arranged for the summer. This included a meal at Felixstowe and an outing to Sutton Hoo. Residents who had previously been on these trips said they had “really enjoyed” the day, and look forward to going again. Highland Residential Home I54-I04 S24416 Highlands V233111 050721 Stage 4.doc Version 1.40 Page 15 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 standard(s) 16 and 18. The home has clear procedures in place to deal with complaints, and allegations or suspicions of abuse. EVIDENCE: The home’s complaint procedure is displayed on the resident’s information board. However it was noted to be the old copy, and not the one updated by the home, following a previous inspection. This was brought to the attention of the Manager, who will ensure the latest copy is displayed. Residents spoken said if they had any concerns, they would tell the “Matron” or “a member of staff”. The home has a copy of the Protection of Vulnerable Adults (POVA) Policy (June 2004), as well as their own company procedures, which had recently been updated. Recent events confirmed that the management knows what action to be taken when concerns are raised. One POVA referral has been made, investigated and resolved. Time spent with staff, confirmed their understanding of what is abuse, and their responsibility in reporting any concerns. Staff said that they had recently attended, training in identifying abuse. Highland Residential Home I54-I04 S24416 Highlands V233111 050721 Stage 4.doc Version 1.40 Page 16 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 standard(s) 20, 23, 24, and 26. People can expect a homely, clean environment, which is decorated and furnished to a high standard. This gives residents a safe and comfortable home to live in. EVIDENCE: A resident said when they first visited the home and chose the bedroom they wanted, they were given samples to choose, a new carpet, curtains and wall colourings. The manager confirmed that this was normal practice, unless the room had only just been re-carpeted. Residents also said that the bedrooms were empty, which enabled them to bring in their own bedroom furniture and possessions. The manager confirmed that the home would provide furniture, if the resident was unable to, but many preferred to bring in their own. Residents were pleased with their bedrooms, and could see why, once they moved into a room, they were unable to move to another room. They accepted this, and spoke about the “cost implications”, if residents kept moving around, having chosen a new carpet and curtains. One resident said Highland Residential Home I54-I04 S24416 Highlands V233111 050721 Stage 4.doc Version 1.40 Page 17 they “loved” their room, another said it was not a care home, but like “living in someone’s large private house”. When asked if the home was always kept as clean and fresh as it was during the inspection, residents said “yes”, and that the home never had any “unpleasant odours”. As part of the home’s on-going refurbishment plan, a new call bell system is due to be fitted in 4-weeks time. The call system will include moveable call boxes, which can be taken off the wall, and used by the resident anywhere in their room. There will also be separate call pendants, which can be used by residents when they are in the garden. The established gardens have views across the River Deben in the distance. Residents said they enjoyed walking, and sitting out in the gardens. One resident with sensory disability, had just come back with a carer, after “crushing” the lavender to release the smell. One resident had raised concerns on their comment card about the security of the home. Discussions with the manager identified that concerns had been raised over one of the external doors, which residents like to leave open in the summer. The crime prevention officer had visited, and staff took up their suggestion of growing a tall hedge. Unfortunately this spoilt the residents view of the river/gardens, and they asked for a section to be removed – which staff did. They are currently looking at other security measures, which will include a digital lock. Residents would be given the number to operate themselves. All communal areas viewed during the inspection, were decorated and furnished to a high standard. Highland Residential Home I54-I04 S24416 Highlands V233111 050721 Stage 4.doc Version 1.40 Page 18 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 28. People using the service can expect to be looked after by staff who have the skills, training and knowledge to support their individual care needs. EVIDENCE: Relatives/ visitors who completed the comment cards were asked if they felt there was always enough staff on duty. Two out of the seven relative/visitors asked if they felt in their opinion was there always enough staff on duty, had answered ‘No’. One relative had written that ‘I am told but cannot confirm that the bell is not always answered too quickly’. The manager said that they were having a new call bell system. The system records how long each call bell takes to be answered on a printout. This can then be checked to identify any problems, and take action to identify why there was a delay, and resolve it. Residents spoken with during the inspection felt there was enough staff on duty, although one felt staff were “generally busy” and said that staff did not always have enough time to do all their work. Staff spoken with felt that there was enough staff, but acknowledge that shifts and workloads would vary, depending if any residents were unwell. The manager confirmed the staffing levels are 4 carers in the morning, and 3 during the afternoon/evening. This gives a ratio of 1 carer to 6 residents in the morning and one to eight residents during the afternoon evening. Highland Residential Home I54-I04 S24416 Highlands V233111 050721 Stage 4.doc Version 1.40 Page 19 Residents completing the comment cards were asked if they felt ‘well cared for?’ all had answered ‘Yes’. This was also reflected during comments made during the day. Information supplied by the home showed that 9 care staff had completed their NVQ 2 training or above, with another two staff due to complete soon. Once completed, the home would have achieved having over 50 of staff with an NVQ 2 qualification. Discussions with staff and records viewed confirmed training undertaken by staff in the last twelve months. This included Foundation in Care, Safe Handling of Medications, Falls & Strokes, Elder Abuse and Manual Handling. Highland Residential Home I54-I04 S24416 Highlands V233111 050721 Stage 4.doc Version 1.40 Page 20 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) People can expect a well run home, where the residents interest are put first. EVIDENCE: Residents described the experienced manager as “charming – always has time to stop and listen”. They said the “office door was always open” and that the manager “doesn’t just sit in the office and lock the door – but is out and about”. During the day residents were seen to approach the manager to ask if they could undertake a task for them, such as drawing money out. Residents also commented that the Assistant Manager was “very good” and that they found all the “staff were helpful and approachable”. They felt comfortable to voice any concerns or make suggestions. One resident said that they had noticed the “friendly atmosphere” when they first visited the home, which helped them make their mind up. Highland Residential Home I54-I04 S24416 Highlands V233111 050721 Stage 4.doc Version 1.40 Page 21 Residents completing the CSCI comment cards were asked if they would like to be more ‘involved in decision making in the home?’. Two had answered ‘No’, three ‘Yes’ and one only ‘sometimes’. There were no further comments made saying how they would like to be more involved. Residents spoken to during the visit felt that they could make their own decisions. They said living within a community, they were aware that they also had to respect each other’s views. Minutes of the recent residents meeting were looked at. Several points had been brought up by the residents, which the manager said had or been or were being addressed. This included residents who lived on the first floor wanting their window restrictors removed, which would be done following a risk assessment. There were also suggestions for menu changes, when drinks are served and future outings. The CSCI poster giving notice of the inspection was displayed on the resident’s notice board. Five out seven relatives had said that they were aware of the inspection. This led to discussion with the manager that future inspections would most likely be unannounced. Highland Residential Home I54-I04 S24416 Highlands V233111 050721 Stage 4.doc Version 1.40 Page 22 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION x 3 x x 3 3 x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 3 x x x x x Highland Residential Home I54-I04 S24416 Highlands V233111 050721 Stage 4.doc Version 1.40 Page 23 No 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 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. Refer to Standard 7 Good Practice Recommendations Although residents are involved in developing care plans during admission, staff should encourage residents to jointly review its contents at regular interviews. This would remind residents what they have stated, and ensure that they have not changed their views since admission. It is recomended that all residents have a pressure area assessment undertaken on admission , not just those that have been identified at being at risk. This would give staff a base line to work from, if the residents physical care needs changed. 2. 8 Highland Residential Home I54-I04 S24416 Highlands V233111 050721 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection 5th Floor St Vincent House 1 Cutler Street Ipswich Suffolk, IP1 1UQ 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 Residential Home I54-I04 S24416 Highlands V233111 050721 Stage 4.doc Version 1.40 Page 25 - 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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