Inspection on 02/05/07 for Highmead House

This inspection was carried out on 2nd May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Highmead House 28/10/05

Highmead House 12/05/05

Highmead House 11/11/04

Highmead House 29/06/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Highmead House 153 Finedon Road Irthlingborough Northants NN9 5TY Lead Inspector Irene Miller Unannounced Inspection 11:15 2nd May 2007 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 Highmead House DS0000012812.V327463.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. Highmead House DS0000012812.V327463.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Highmead House Address 153 Finedon Road Irthlingborough Northants NN9 5TY 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) 01933 650244 01933 653744 Mrs Gillian Waller Mrs Gillian Waller Care Home 32 Category(ies) of Dementia - over 65 years of age (5), Old age, registration, with number not falling within any other category (27) of places Highmead House DS0000012812.V327463.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th October 2005 Brief Description of the Service: Highmead is a privately owned residential care home providing personal care for up to 32 persons with old age over the age of 65 years. Within this total up to 5 persons with dementia can be provided with personal care. The home is situated approximately 1 mile outside of Irthlingborough in a quiet location. The grounds are extensive with a car park area to the rear of the building. The gardens are well maintained and are accessible for the residents of the home. Highmead offers mainly single accommodation over two floors with lift access to the 1st floor. Available for the residents are a number of communal areas including a conservatory. The interior of the home is maintained to a high standard. Currently the weekly fees range from £346 to £420. Highmead House DS0000012812.V327463.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is based upon outcomes for people living in the home and their views of the service provided. This inspection was a ‘Key Inspection’ that focused in the main on the key standards under the National Minimum Standards and the Care Standards Act 2000 and the Care Homes Regulations 2001, for homes providing care for older people. The primary method of inspection used was ‘case tracking’ which involved selecting three residents and reviewing the records in relation to their care needs. In addition discussions took place with residents, staff and visitors and general care practices within the home were observed. Three care plans were reviewed (a care plan sets out how the home aims to meet the, personal, health, social and emotional needs of the resident). Records in relation to staff recruitment, training, medication management, and quality assurance were reviewed. Based upon information gained from reviewing pre inspection information relating to the home the inspector spent approximately two and a half hours planning the areas to focus on at this inspection. The registered provider/manager Gillian Waller was available at the home on the day of inspection and the inspection took place over a period of approximately eight hours. What the service does well: Highmead House DS0000012812.V327463.R01.S.doc Version 5.2 Page 6 The management style of the home is supportive and the registered provider/manager has a presence in the home on a day to day basis. Quality Assurance is regularly audited and the views of the residents and visitors are sought to further improve on the service provided within the home. The staff recruitment and selection process is robust and staff are expect to be involved in NVQ (National Vocation Qualification) training ensuring that residents receive a high quality of care at all times. The staffing levels are high, and roles and responsibilities are clear, ensuring that staff can discharge their responsibilities fully. The internal and external environment of the home is pleasant and well maintained. 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. Highmead House DS0000012812.V327463.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 Highmead House DS0000012812.V327463.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 3 (standard 6 is not applicable to this service) Quality in this outcome area is good. Prospective residents can be assured that they will only move into the home once it has been established that the home can fully meet their care needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care records viewed demonstrated that full pre-admission assessments had taken place prior to admission, which had formed the basis of the personal care plans. Visitors spoken with confirmed that acting on behalf of their resident that they had been fully involved with the whole process of their admission. The statement of purpose and service users guide were available to view, there was some factual information that required amending regarding the Commission for Social Care Inspection, contact details. The registered Highmead House DS0000012812.V327463.R01.S.doc Version 5.2 Page 9 manager confirmed that the information would be amended and a copy of the homes statement of purpose would be forwarded to the Commission for Social Care Inspection. Highmead House DS0000012812.V327463.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7,8,9 & 10 Quality in this outcome area Good. The residents health and personal care needs are assessed however having risk assessment in place with particular attention to the prevention of falls may further protect the residents who are vulnerable in this area. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Many of the residents living at the home have the ability to communicate and express their needs and wishes and therefore the information within the care plans was not required to be written down in the finest detail, therefore there was sufficient information available for staff to follow. Moving and handling assessments were available within the care plans, which had identified were residents were at risk of falls. In discussion with staff it was established that some measures had been put into place to aim to reduce the risk of falls, such as changes to the layouts of bedrooms to reduce obstacles. Highmead House DS0000012812.V327463.R01.S.doc Version 5.2 Page 11 The home works closely with a falls co-ordinator based at Isbrook Hospital, however falls risk assessments were not available to document the hazards surrounding the individual residents that had been identified at risk of falling or the control measures in place to reduce the hazards to an acceptable level. Within the care plans there was information available of the involvement of other healthcare professionals such as chiropody and optical specialists and visits by their general practitioner. The homes medication was sample checked and in general well managed, the resident’s benefit from the home having good working relationship with the general practitioners that visit the home. There was an effective system in place to ensure that in the event of an emergency admission to hospital that resident’s essential medical information was readily available to pass on to which was up to date. Staff training on medication safety and management was provided, and staff confirmed that they were receiving medication through a distance-learning course through a local college. The medication policy had recently been reviewed and updated and was comprehensive in its content. Highmead House DS0000012812.V327463.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,14 & 15 Quality in this outcome area is good. Residents can be assured that they will be supported to exercise choice and control and lead the lifestyle that matches their expectations and preferences. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There was a programme of planned activities in place, and staffing levels were high to ensure that there was sufficient staff on duty to respond to residents social and emotional needs and to spend time with residents on a one to one and a group basis. There were opportunities for residents to engage in social, religious and cultural activities of their choosing, and residents spoken with throughout the course of the inspection said that they could spend their time as they choose, residents were observed to move around the home independently and to be spending time within their rooms and within the communal areas of the home. Opportunities were available for residents to participate in the day-to-day household activities if they wished, and individual hobbies and interests were Highmead House DS0000012812.V327463.R01.S.doc Version 5.2 Page 13 promoted, one resident had a sewing machine within their bedroom and enjoyed doing small upholstery and clothing alterations. Set visiting times were in place and relatives spoken with confirmed that the visiting arrangements were suitable to their needs, the registered manager said that the home could accommodate visiting outside of the set times if relatives had any problems fitting in with the arrangements. The kitchen was clean and tidy and food stocks were plentiful containing a good supply and variety of quality branded foods and there was a variety of fresh fruit available for residents to access. There was a set menu in place, however alternatives were available if a resident disliked what was on the menu and information was available within the kitchen on the residents likes and dislikes in terms of there dietary preferences. Highmead House DS0000012812.V327463.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 & 18 Quality in this outcome area is good. Residents can be assured that any concerns or complaints they may have will be taken seriously, listened to and acted upon by the manager and that they will be protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The complaints procedure was available in the front entrance of the home and within the homes statement of purpose and the service users guide. Since the last inspection visit no concerns about the home had been raised with the Commission for Social Care inspection and no concerns or complaints had been raised with the homes management. Information was available on independent advocacy services available should a resident wish to access this service. Training on the Protection of Vulnerable Adults (POVA) was available and staff spoken with demonstrated an awareness of resident protection from abuse. The home’s adult protection policies and procedures included guidance from the Northamptonshire’s Inter Agencies POVA (Protection of Vulnerable Adults) team. Highmead House DS0000012812.V327463.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19, 20 & 26 Quality in this outcome area is excellent. Residents live in a home that is pleasant, well maintained, clean and furnished to a high standard. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During a limited tour of the building the home was seen to be light and airy clean, hygienic and maintained to a high standard. The décor was traditional and in keeping with the period of the house. The garden was maintained to a very high standard. The communal areas were clean and furnished to a high standard with homely touches, there was good communal areas were residents could enjoy each other’s company and where residents could sit and enjoy the views to the immaculately kept garden. Highmead House DS0000012812.V327463.R01.S.doc Version 5.2 Page 16 The registered manager had supplied information prior to the inspection-taking place on the frequency of safety checks and the maintenance and upkeep of the home. An external fire consultant provides fire safety training for staff and carries out weekly fire system checks within the home. Bedrooms viewed contained personal items of furniture and electrical equipment such as TV’s, video and DVD players, Radios and CD players, personal paintings and photographs, one bedroom had a sewing machine, which the resident had brought with them. Many of the bedrooms enjoy pleasant views over the garden and thought and consideration had been put into place where bedrooms did not have a view of the garden, having window boxes and container plants in place. Residents spoke of their satisfaction with their bedrooms saying how much they liked living at the home and how pleased they were to live there. Within the bathrooms and en-suite facilities there were raised toilets and bath seats, and the showers and baths were adapted for use by all residents living in the home. The home employs a team of domestic staff who are committed to maintaining a high standard of cleanliness and hygiene throughout the home. The laundry was clean and well organised with effective procedures in place to prevent the risk of cross infection. The registered manager confirmed that refurbishment works were due to take place within the laundry later in the year. Highmead House DS0000012812.V327463.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27,28,29 & 30 Quality in this outcome area is excellent. Residents are supported by a team of staff who are trained and competent to carry out their roles and responsibilities to the full. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a loyal and committed staff team, many of whom had worked at the home for several years, the staffing rota demonstrated that the home works to a high staffing ratio and flexible working arrangements in place. Records were available of staff training that had been undertaken, such as health and safety, moving and handling, food hygiene, health and nutrition, medication, dementia care and training on NVQ (National Vocational Qualification) levels 1 and 2 in care is promoted and available to all staff. Three staff recruitment files were viewed, which contained all the necessary information to demonstrate that staff were fully vetted on recruitment and that ongoing training and support was provided. New staff undertake a detailed induction process that incorporates core and specific care needs. Through discussion with staff and observations of care practices it was evidenced that staff treat residents with respect and that their rights to choice privacy and independence were facilitated. Highmead House DS0000012812.V327463.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31,33,35 & 38 Quality in this outcome area is excellent. The resident’s health, safety and welfare is promoted and protected and management responsibilities are carried out to the full. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Discussion with the registered provider/manager demonstrated that the registered provider/manager has the skills, experience and knowledge to manage a home for older people. The deputy manager has been delegated with number of areas of responsibility and both the manager and deputy manager maintain a high profile in the home. In discussion with the staff, visitors and residents it was established that the style of management was open transparent and supportive, and all spoken with said that they could approach the manager at any time. Highmead House DS0000012812.V327463.R01.S.doc Version 5.2 Page 19 Staff confirmed that formal one to one staff supervision takes place regularly, and that they receive annual appraisals to access their performance and development needs, and that staff meetings are held. Quality Assurance reviews take place annually and include resident and relative’s satisfaction survey questionnaires. The result of the most recent Quality Assurance review, which was conducted in April 2007, was available to view. Records of money held on behalf of residents who are unable to handle their own finances were available and a sample check confirmed that transactions are open and transparent and well managed. The registered manager works hard to ensure that standards remain high and to further improve on the quality of care provided at the home. The administrative records available and the discussions that took place with residents, staff and visitors, evidenced that the registered manager promotes the health safety and welfare of residents and that, this philosophy underpins the care provided at the home. Highmead House DS0000012812.V327463.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 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 4 3 X X X X X 4 STAFFING Standard No Score 27 3 28 3 29 4 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 3 Highmead House DS0000012812.V327463.R01.S.doc Version 5.2 Page 21 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. 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 OP7 Good Practice Recommendations Risk assessments should be in place with particular attention to prevention of falls. Highmead House DS0000012812.V327463.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Text phone: 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 Highmead House DS0000012812.V327463.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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