Inspection on 28/10/05 for Highmead House

This inspection was carried out on 28th October 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

Highmead House 02/05/07

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 Mrs Judith Sansom Unannounced Inspection 28 October 2005 09:30 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.V261869.R01.S.doc Version 5.0 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.V261869.R01.S.doc Version 5.0 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.V261869.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th May 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. Highmead House DS0000012812.V261869.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission of Social Care Inspection is upon the outcomes for residents and their views of the service provided. The methodology of case tracking is used to find out if the care being provided to the residents is of an acceptable standard and meets their individual needs. ‘Case tracking’ involves the review of resident’s records, meeting with them and talking with the care staff who provide the personal care to the selected residents. The inspection also includes a review of the homes’ procedures and processes to ensure that all practices carried out by the staff protect the residents. The inspection process includes the collation of information from residents, relatives and visitors to the home. The manager submits a completed preinspection questionnaire. From these information sources an inspection plan is developed. The inspection in the home was carried out on an unannounced basis during the morning. The inspection process that included the preparation and inspection took approximately four hours. No requirements were placed at the inspection of May 2005, however discussion relating the recommendations took place as part of the inspection process. Residents were spoken with and a selected tour of the home undertaken. As part of the case tracking process a selection of relevant records were reviewed What the service does well: One aim of the home is to promote independence for the residents. The care staff by not automatically undertaking the resident’s personal tasks, but by encouraging the residents to maintain their own life skills achieves a high level of independence. Residents are empowered to take the local bus into the nearest town for shopping expeditions, to self medicate, to go out walking and to continue with their preferred religious observances and to meet with their doctor in private. Information is displayed in the home telling the reader how and who to contact should they want an independent advocate. Following a robust selection and recruitment process all new staff are taken through a detailed induction process that ensures that all staff are working towards promoting the individual aims and preferences of the resident. Detailed training, incorporating core and service specific issues, is provided through the year. The registered persons expect all staff to be involved in NVQ Highmead House DS0000012812.V261869.R01.S.doc Version 5.0 Page 6 (National Vocation Qualification) training. Currently 4 of the staff group have achieved and are working towards NVQ level 3. A wide and varied programme of activities is offered to all residents. The programme takes into account the personal preferences and interests of the residents. The home is located in extensive grounds that continue to give immense pleasure to the residents. Residents spoke of how lovely it was to walk in the garden in the summer evenings. One resident said ‘the staff were splendid in everything they did.’ That she blesses the day that she came to Highmead to live’. Another resident said ‘the staff bend over backwards to help, and are always very patient and kind. I have never heard them speak firmly to a resident even with those who are confused and forgetful.’ 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. Highmead House DS0000012812.V261869.R01.S.doc Version 5.0 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.V261869.R01.S.doc Version 5.0 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 care home The pre-admission process of all potential residents to the home is well managed thus ensuring that all new residents know what to expect when they move into the home. EVIDENCE: One resident said ‘she had stayed at two other homes for respite care, two weeks at a time and would not have wanted to stay at either permanently. So when deciding to come to this home was very unsure, but once she visited Highmead it just clicked, and she has been really happy since she moved in. Another resident said that she had visited the home before she made any decision to move in. She wasn’t rushed or pressurised but given time to make a decision. Highmead House DS0000012812.V261869.R01.S.doc Version 5.0 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): 9, 10 & 11 Care records have been improved upon since the last inspection and additional information is included within the documents. The revision of the care plan and risk assessment ensures that the individual needs of the residents can be met. EVIDENCE: In response to the recommendations of the previous report amendments and additions have been made to the care records. All information inter-links and incorporates the risk assessments. This piece of work is on going as not all care records have been amended with the additional information One resident talked about how embarrassed she is when staff are providing personal care. The resident told the staff this, who has taken the initiative to undertake a risk assessment to enable her to have the minimum amount of help when she takes a shower. Another resident talked about how she undertakes all of her personal care and how sensitive and helpful the staff are. Highmead House DS0000012812.V261869.R01.S.doc Version 5.0 Page 10 Senior staff, which have received training from the local pharmacist, undertake the administration of medication to the residents. The deputy manager undertakes the responsibility of the stock control of all medications. One resident self medicates and takes the responsibility of administering her own medication. A detailed risk assessment is detailed within the care records, and the senior staff review the situation on a monthly basis. The resident talked about how this makes her feel that she is in charge of her own life. A lockable facility in her bedroom is used to store her medication in. The homes’ policy and procedure that guides staff in the actions to take when caring for a person who is terminally ill is very detailed and sensitive, and takes the staff step by step through the processes. The action expected by staff focuses on the needs of the resident, their preferences and the inclusion of their loved ones at this difficult time. This policy and procedure when followed by staff, gives assurance that all residents can be treated in a very individual and sensitive manner. Highmead House DS0000012812.V261869.R01.S.doc Version 5.0 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 & 15 Resident’s individuality is considered most important in the life of the home. The customs in the home take into consideration each resident’s own expectations and preferences resulting in fulfilled lives whilst they live at Highmead. EVIDENCE: Residents spoke very positively of how they are encouraged to ‘do their own thing’. Two residents who have become friends, take themselves off on the bus to Kettering for shopping trips, or go for walks. One resident talked about how important her religious faith is to her and how she goes to the mid week and Sunday services. Every opportunity is taken to rekindle previous experiences and abilities. This has been proved very beneficial when taking residents with dementia to the local market. The resident is encouraged to identify the fruit and vegetables, taking them to be weighed and then purchasing them. These actions have opened up paths of communication which otherwise may be lost. From conversations there were many examples of how the residents are encouraged to maintain links with ‘the outside world’. Highmead House DS0000012812.V261869.R01.S.doc Version 5.0 Page 12 Comments about the meals in the home were very positive, and the residents confirmed how much they enjoy the food and how it couldn’t be bettered. Although there is a set menu an alternative is offered, and the cook knows the resident’s individual likes and dislikes. The day starts with a cup of tea being served to the residents followed by breakfast. This meal can be taken in the resident’s own rooms. The residents are encouraged to meet together in the dining room to take their main meal. However if a resident chose to eat in their own room or if they were poorly then staff would serve the meal to the resident in their own room. All dining room tables are nicely decorated, and are placed in two dining areas of the home. Residents said how much they enjoyed going to the dining room for dinner. The meal served during the inspection looked appetising; residents clearly enjoyed eating this meal. Staff were in attendance should any resident require any help. Highmead House DS0000012812.V261869.R01.S.doc Version 5.0 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): 16,17 & 18 Detailed policies and procedures relating to complaints and the Protection of Vulnerable Adults are in place that affords protection to all residents living at Highmead. EVIDENCE: The management of the home are proactive in informing any visitors to the home and resident living in the home of the steps to take if they are unhappy about anything that is happening in the home. Residents were confident that should they have reason to grumble or complain the management team would always listen and take the appropriate action to put the wrong right. The commission has not received any complaints about the home since the last inspection. The deputy manager advised the inspector that the necessary documents requesting postal votes and the update of the electoral role were sent to the council the previous week. If a resident chooses to see a legal representative or advocate in privacy, other than their own bedroom, there are sufficient small rooms available for such meetings. Displayed in the home are the details outlining whom to contact if an independent advocate is required. There is a detailed procedure for staff to follow in the event of an allegation or suspicion of abuse occurs. The procedure has been separated into two sections. The latter one details ways in which staff can identify possible abuse Highmead House DS0000012812.V261869.R01.S.doc Version 5.0 Page 14 with residents who have dementia, and who may be unable to explain for themselves. The document is well written and informs the reader of the necessary steps to take. Since the last inspection a member of staff informed the senior staff of some serious concerns within the ‘whistle-blowing’ policy. The senior team took the necessary steps to protect all residents in the home and the issue has been resolved satisfactorily. Highmead House DS0000012812.V261869.R01.S.doc Version 5.0 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, 20, 21,22, 23, 24, 25 & 26 The redecoration and refurbishment programme has been maintained ensuring that the people living in the home have safe, comfortable surroundings. EVIDENCE: Residents are very proud and pleased with their rooms. They have the availability of locking their doors and lockable cupboards within their rooms. Their rooms are decorated to a high standard, and contain a wide range of personal possessions making the rooms personalised and homely. One resident said that she wished she had known before she moved in that she could bring her furniture with her, but recognises that she couldn’t have fitted it all in. Specialist equipment is provided for any resident who has an identified need. For example pressure relieving mattresses lifting and walking aids. There are raised toilets and bath seats for the orthodox style of bath. However there is a selection of showers and alternative form of bath for any resident to use. Highmead House DS0000012812.V261869.R01.S.doc Version 5.0 Page 16 All parts of the home are maintained to a very high standard, with the domestic staff maintaining very high standards of cleanliness and hygiene. Residents spoke positively of the laundry system. In that if they put their dirty clothes out one night it is returned the following day. The residents said that they had never had any of their clothes spoilt in the laundry. Highmead House DS0000012812.V261869.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 There is in place a robust selection and recruitment process that affords protection to the residents in the home. EVIDENCE: There is a stable staff group that is appropriately trained and equipped to undertake the care of the residents in the home. By the end of the month all staff will have received training in understanding residents with dementia. Training for al staff is ongoing, and 4 staff will have gained NVQ (National Vocational Qualification) level 3 very shortly. The deputy manager is constantly assessing the staff’s needs to ensure that the appropriate training is offered. The current selection and recruitment practices are robust, and files demonstrated that all necessary checks are undertaken prior to any potential employee being accepted onto the staff group. Through the induction training the staff are expected to read the homes’ policies and procedures. Through supervisions and staff group meetings these processes are discussed and reflected upon to ascertain whether any changes or improvements can be made. Highmead House DS0000012812.V261869.R01.S.doc Version 5.0 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, 32, 33, 35, 37 & 38 There is good leadership, guidance and direction to staff from the Registered Manager and the senior team that ensures the residents receive consistent quality care. EVIDENCE: The registered manager is very experienced in managing a care home and holds the appropriate management qualifications in management. The deputy manager has been delegated with number of areas of responsibility. Both the manager and deputy manager maintain a high profile in the home, and it is common practice for the management team to be present for seven days a week. There is always a management presence in the home during the weekends when relative and visitor numbers tend to increase. This practice enables the management team to directly engage with and support relatives. Highmead House DS0000012812.V261869.R01.S.doc Version 5.0 Page 19 The interaction between the management team towards the staff and residents is one of respect and value. The residents were very complimentary about the staff and the management team, and believe that they can talk to any of them with the confidence that they will listen. Some residents have chosen the home take on the responsibility of safe keeping their monies. The records were reviewed and were seen to be detailed and accurate. All transactions are open and transparent. The manager is not the appointee of any resident. Frequent and regular group staff meetings and formal 1:1 supervisions support staff. Staff are confident that they are able to talk to the management team and that their confidentiality will be maintained. All records reviewed confirm that the home is being run to an acceptable standard. Policies and procedures are pertinent and are written in a manner that can be easily understood by the reader. Highmead House DS0000012812.V261869.R01.S.doc Version 5.0 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 X 8 X 9 3 10 3 11 3 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 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X 3 3 Highmead House DS0000012812.V261869.R01.S.doc Version 5.0 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. 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. Refer to Standard Good Practice Recommendations Highmead House DS0000012812.V261869.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB 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 Highmead House DS0000012812.V261869.R01.S.doc Version 5.0 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!