CARE HOMES FOR OLDER PEOPLE
Highnam Hall Residential Home Park Avenue Hartlepool TS26 0DZ Lead Inspector
Bridgit Stockton Unannounced Inspection 8th May 2008 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 Highnam Hall Residential Home DS0000065270.V366006.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. Highnam Hall Residential Home DS0000065270.V366006.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Highnam Hall Residential Home Address Park Avenue Hartlepool TS26 0DZ 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) 01429 232068 01429 233715 Mr Matt Matharu Care Home 45 Category(ies) of Dementia (5), Dementia - over 65 years of age registration, with number (17), Mental disorder, excluding learning of places disability or dementia (5), Old age, not falling within any other category (45), Physical disability (5) Highnam Hall Residential Home DS0000065270.V366006.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. Five persons in the category DE above the age of 55 may be accommodated in accordance with the home’s Statement of Purpose Five persons in the category PD above the age of 55 may be accommodated in accordance with the home’s Statement of Purpose. Five persons in the category MD above the age of 55 may be accommodated in accordance with the home’s Statement of Purpose 21st June 2007 Date of last inspection Brief Description of the Service: Highnam Hall Residential Care Home is registered to accommodate up to 45 older people, including people with mental health needs. On the day of the inspection there were 29 people living in the home. Highnam Hall is a grade 2 listed building, which retains many of its original features. The home is situated in a quiet road overlooking a popular park and has lawned areas to the side and private car parking to the front. The home is owned by Mr. Matt Matharu, who also runs a number of other care homes in the area. From information provided by the manager of Highnam Hall, fees charged by the home range from £354 to £358 per week. Additional charges include those for hairdressing, chiropody and newspapers. Highnam Hall Residential Home DS0000065270.V366006.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The quality rating for this service is 0 star. This means the people who use this service experience poor quality outcomes. The purpose of this inspection was to assess the quality of the care and support received by the people who live at Highnam Hall Care Home. Also we were looking at what progress had been made by the home in meeting the requirements we had asked them to undertake following a random inspection that had taken place in March of this year. This had uncovered poor practice taking place which had put some vulnerable people at risk of harm. Currently the home is working very closely with Hartlepool Social Services and the Commission for Social Care Inspection to improve this situation. The methods I used to gather information included a visit to the home, conversations with the people who live there, their relatives, healthcare professionals and the staff. I looked in detail at the care and records of four people, examined other records and looked around the home. What the service does well: What has improved since the last inspection?
Highnam Hall Residential Home DS0000065270.V366006.R01.S.doc Version 5.2 Page 6 Since the random inspection that took place in March of this year an acting manager has been appointed to the home. She has already started to work on improving things at the home. At the last inspection we asked for the care plans to written in more detail, the manager has started this review and commenced re writing some of the plans. Eventually all of the care plans will be re written. Some staff have been trained in the protection of vulnerable adults, more staff are scheduled to undertake this training in July of this year. Other training and updates have also taken place in the moving and handling of people and also in infection control. Most of the homes policy and procedures need review to make sure they are suitable and appropriate for Highnam Hall. The manager has started to review these and make amendments; it is acknowledged that this may also take some time to complete. What they could do better:
The home undertakes pre admission assessments of people prior to them moving into the home. The documentation needs review to make sure it captures all aspects of a persons needs and aspirations. The manager needs to look at everyone’s care plan to make sure that they give clear guidance and directions to care staff about meeting people’s needs. Information about people must be accurate and up to date so people get the right care and support they need. The medication recording and administration systems need to be improved, to make them accurate and to assist with the auditing of stock. Staff need further training to make sure they follow the homes policies and procedures, to ensure they know how to deal with people’s medication properly and safely. It is now a legal requirement for all care homes to store controlled drugs in a cupboard that meets the specific legal requirements. The arrangements that are in place at the home do not meet this requirement. Complaints are not dealt with properly. It is important that if people make a complaint or raise concerns they are recorded properly and responded to appropriately by letter, so there is a record of how the complaint has been dealt with. The record should also detail what action if any the home has taken. The recruitment of staff was looked at. I found the home does not properly vet staff before they commence working at the home. In addition there was no evidence to suggest that staff where suspended or properly supervised whilst being investigated if an allegations of adult abuse was brought against them. This is bad practice and does not protect the member of staff or the vulnerable adult. Care staff roles and responsibilities need reviewing as they are currently also covering some domestic tasks in the home such as laundry, this means they spend less time supporting and caring for people. The home needs to look to recruiting a laundress.
Highnam Hall Residential Home DS0000065270.V366006.R01.S.doc Version 5.2 Page 7 The acting homes manager has been in post for approximately four weeks she has been a registered manager of another home previously but needs to submit and application to the Commission for social care inspection so she can become the registered manager of Highnam Hall. The system for recording and administrating people’s personal allowances needs review. Proper accounting procedures need to be in place, money should not be held in a pooled account and people should have access to there personal allowance at all times. During the inspection we looked at some health and safety records. We saw that over several months a fault report on the fire alarm system. We asked the acting manager to put this fault right immediately as it could have potentially put people at risk of harm if there had been a fire at the home. She notified me the following day that this work had been carried out. We have made some requirements and recommendations following this inspection. You can read these in the main part of this report. 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. Highnam Hall Residential Home DS0000065270.V366006.R01.S.doc Version 5.2 Page 8 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 Highnam Hall Residential Home DS0000065270.V366006.R01.S.doc Version 5.2 Page 9 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): 3&6 Quality in this outcome area is good. People’s needs are assessed prior to admission to the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans I looked at showed that pre-admission assessments had been carried out before offering someone a place. A senior member of staff visits the person at home or in hospital to discuss their care needs. This is to make sure the home has sufficient resources and skilled trained care staff to provide the appropriate care. The documentation used for this needs to be reviewed to make sure it captures a true picture of people’s needs and aspirations. I spoke with some relatives who were visiting the home and they confirmed that their relative had been visited by a member of staff from the home and that they were given good information about the home and it’s facilities. They had also taken the opportunity to come and visit the home with their relative to see if it was suitable. They said ’we looked around several homes in the area, but we were really impressed with this place, we consider ourselves very fortunate to find such a nice home’
Highnam Hall Residential Home DS0000065270.V366006.R01.S.doc Version 5.2 Page 10 Social Services assessments are also available in the care plans, and the acting manager confirmed that she would also use this information in conjunction with her assessment to make a decision about a placement. The home does not provide intermediate care. Highnam Hall Residential Home DS0000065270.V366006.R01.S.doc Version 5.2 Page 11 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 &10 Quality in this outcome area is poor Care plans do not provide staff with enough detail to meet peoples identified health and personal care needs. This, coupled with poor practice in the storage and administration of medication puts some people at risk. This judgement has been made using available evidence including a visit to this service. EVIDENCE: I looked at four care plans in detail, to make sure that people’s health and personal care needs are being met in the way the person prefers and to help them maintain their health and well-being. The four care plans looked at, were not written in enough detail to ensure that people’s needs could be met. In most of the plans the daily evaluation/progress sheets was kept up to date and reported any changes to the persons care needs, however the actual plan of care was not altered to reflect these changes. Hartlepool social services are also aware of the shortfalls surrounding care plans and are working very closely with the home to get the plans re written to include detailed information and actions for staff to follow in meeting peoples needs. The acting manager has instructed staff on how to complete daily evaluations of care and
Highnam Hall Residential Home DS0000065270.V366006.R01.S.doc Version 5.2 Page 12 has also identified several members of staff to assist her in re writing the plans. During my visit I looked at how peoples medication was looked after by the staff at the home. Some staff were not following the medication policy and procedures of the home. Tablets were difficult to audit because there was not a record of what medication the home had received or what the existing stock balance was. Some staff had not signed the medication administration record to denote that medication had been administered. Controlled drugs are not stored correctly To reduce the risk of harm to people, I asked the manager to obtain further training for all staff that administer medication. She needs to make sure that staff are properly trained and are safe to handle people’s medication. During the inspection it was noted that there are several bunches of keys in circulation all for the medicine trolley/cupboard. This is bad practice, as one person on the shift needs to be solely accountable for the medication. I noticed that staff treat people with respect and maintain people’s privacy and dignity. One person said ‘the staff do their best. I could not manage without them, that’s for sure’. A relative said ‘staff are really kind and caring, they have a great understanding when it comes to looking after old people’. One person commented ‘the staff, they are superb, we could not ask for a better group of people’. Highnam Hall Residential Home DS0000065270.V366006.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14&15 Quality in this outcome area is good. The recreational and social needs of people are well catered for which enables them to make daily choices and promotes independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During my visit the atmosphere in the home was friendly and welcoming, with visitors coming and going throughout the day. Some people were enjoying chatting with each other; some were listing to music or else sat in their bedrooms reading or watching television. The home employs an activities organiser and there was a good choice of activities and social events offered should people want to take part. People told me they had a choice of what they did during the day, one person told me they ‘went for a snooze’, after lunch. Another person said ‘I do as I please; it’s very relaxed here. If I want a sleep in I have one’. Everyone said the food was good, and a choice of meals was offered. The menus were well thought out. I spoke to the cook, she was knowledgeable about peoples diet requirements and knew what people liked to eat and what portion sizes they preferred. If anyone needed extra supplements during the day, milkshakes, ice cream and fruit smoothies were some of the things offered. One person said ‘I eat very well, we get a nice choice, I have no complaints about the food’. People could either have their meals in the
Highnam Hall Residential Home DS0000065270.V366006.R01.S.doc Version 5.2 Page 14 communal dining area or else in the privacy of their bedrooms. The majority of people chose the communal facilities. Highnam Hall Residential Home DS0000065270.V366006.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16&18 Quality in this outcome area is poor People’s concerns and complaints are not always dealt with properly. People are at risk from lack of action taken by senior staff when an abusive situation takes place. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The complaints procedure is not robust and requires amendment. It is important that if people make a complaint or raise concerns they are recorded properly and responded to appropriately by letter, so there is a record of how the complaint has been dealt with. The record should also detail what action if any the home has taken. A random inspection was undertaken in March of this year following an anonymous complaint made to the commission. This inspection uncovered serious concerns surrounding the home failing to report safeguarding adult incidents to the Social Services Department, thereby placing people at risk of harm. This has led to social services carrying out monitoring visits to the home on a regular basis; to check the practice of staff and to make sure people are not at risk of harm. Previously we asked the home to provide training in the safeguarding of adults procedures. Some staff have received this, more staff training is planned for the latter part of the year when the rest of the staff team will attend. Highnam Hall Residential Home DS0000065270.V366006.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26. Quality in this outcome area is good. People live in a comfortable and homely environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All the bedrooms that I saw reflect the person’s individual preferences and taste. There is a programme of re-decoration for the bedrooms, as well as for the rest of the home. The bedroom doors all have locks, and there is a lockable storage space in the rooms. This means that people can keep their belongings private and secure. The home is fresh, clean and comfortable. Everyone who commented agreed that the home is always, or usually well kept. One visitor to the home said ‘ it’s always nice and fresh, there is never any nasty smells lingering when you come through the door’.
Highnam Hall Residential Home DS0000065270.V366006.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): 27,28,29&30 Quality in this outcome area is poor. Poor practice was seen in the recruitment of staff, and procedures for dealing with bad practice regarding staff are not robust and do not protect people living at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: I looked at a selection of staff files. They all included completed application forms and two written references. The files showed in some cases staff had not undergone an up to date criminal records bureau check of a POVA first check, before starting work at the home. Both of these checks should be carried out on staff before they start work. This is to make sure they are safe to work with vulnerable people. The criminal record bureau check are not transferable from care home to care home, lots of files had checks from other employers. Staff files were not kept up to date, letters and records of disciplinary meetings were not recorded on staff files, and there was no evidence to suggest that staff where suspended or properly supervised whilst allegations of adult abuse were investigated. Job descriptions need review in particular the night care assistant post; the most current one issued contained more domestic chores than care duties. Care staff also cover the laundry duties, and this takes them away from actual care duties, this needs to be reviewed.
Highnam Hall Residential Home DS0000065270.V366006.R01.S.doc Version 5.2 Page 18 Staff training is delivered by outside trainers and staff are now given time to attend training sessions. Some staff have completed a course in dementia awareness, and others are scheduled to attend the course later in the year. NVQ training in care continues with most staff either completed or else enrolled on the course. The new manager has commenced regular staff meetings and during the inspection a meeting was held. Care practices were discussed and care staff did raise issues regarding the completing of domestic duties such as laundry whilst on duty, saying that they did not have enough time to look after people and complete ironing. Highnam Hall Residential Home DS0000065270.V366006.R01.S.doc Version 5.2 Page 19 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35&38 Quality in this outcome area is poor Lack of leadership and a weakened management team has lead to some people being exposed to unnecessary risk to their health safety and welfare. This judgement has been made using available evidence including a visit to this service. EVIDENCE: An acting manager has been appointed to the home and has started to address some of the issues that had arisen from the random inspection that we did in March of this year. There are still however, areas that are of significant concern regarding people’s health, safety and welfare that need addressing. The home has policy and procedures for staff to work towards, however they are not personalized to the home, and they do not give quick and easy guidance to staff these all need review to make them user friendly and relevant.
Highnam Hall Residential Home DS0000065270.V366006.R01.S.doc Version 5.2 Page 20 The home holds some people’s personal allowance. The system for recording and administrating people’s personal allowances needs review. Proper accounting procedures need to be in place, money should not be held in a ‘pooled’ account and people should have access to there personal allowance at all times. It was observed during the inspection that one set of bedrails that were in use were not safe. They were loose fitting and the gap between the side of the bed and the rail was large enough to get a limb trapped and cause injury. The manager was asked to ensure that the rails fitted correctly. A written record should also be kept when bed rails are checked by staff to ensure they are still compatible with the bed and that they are safe to use. On the tour of the building all the fire extinguishers were not fitted to the wall brackets and were free standing, some had been used to prop open doors. This was brought to the attention of the maintenance person who then secured them back to the walls. Records of the fire alarm test were looked at. A fault on the system regarding the automatic opening of the front door when the fire alarm was activated had being recorded over several months; no action had been taken to repair the fault. This potentially put peoples lives at risk as in the event of a fire people would be reliant on a member of staff to open the front door with a key. The acting manager was asked to get this repaired immediately. Highnam Hall Residential Home DS0000065270.V366006.R01.S.doc Version 5.2 Page 21 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 1 8 3 9 1 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 1 17 X 18 1 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 1 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X X 2 X X 1 Highnam Hall Residential Home DS0000065270.V366006.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes No’s 1,2,3 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 OP29 Regulation 19 Requirement To ensure the safe recruitment of people coming to work at Highnam Hall, CRB (Criminal Records Bureau) disclosure checks must be carried out for all new staff. There must be care plans in place to guide staff in the individual support needs of each of the people who live here. These must include details of behavioural needs, risk assessments, and guidelines for staff outlining how these needs are to be managed. This is to ensure that staff provide consistent and safe support to people with behavioural needs, and to protect the safety of other residents. 3. OP22 13(4)(b)& (c) 13(7) There must be risk assessments in place regarding the limitation of a residents’ movement (e.g. use of bedrails). These must comply with Health & Safety Executive guidelines about the
DS0000065270.V366006.R01.S.doc Timescale for action 01/05/08 2. OP7 15 06/05/08 06/04/08 Highnam Hall Residential Home Version 5.2 Page 23 use of bed rails for people with dementia care needs. Risk assessments must: outline the justification for such limitation; demonstrate that the limitation is the best of all possible alternatives; include other relevant agencies; be signed by all parties; and be dated for ongoing review. This is to ensure the safety and welfare of the people who live here. 4. OP9 13 & 17 Schedule 3 For the health and protection of everyone at the home, all medication must be administered and recorded accurately. All staff that deal with peoples medication, have refresher training in the homes policies and procedures that surround medication systems. Controlled drugs must be stored according to current guidance and safe custody regulations. This provides the extra security needed for this type of medicine and will help to prevent loss or diversion. People who live at the home must have access to a clear and effective complaints procedure. All complaints should be reordered and the complainant responded to in writing. To make sure people are safe and to protect people from harm all staff who work at the home must be given training in the protection of vulnerable adults. The mechanism that automatically opens the front door on the activation of the fire alarm needs repairing immediately. 22/07/08 5. OP16 17(2) 22/07/08 6. OP19 13(6) 30/07/08 7. OP38 23 08/05/08 Highnam Hall Residential Home DS0000065270.V366006.R01.S.doc Version 5.2 Page 24 9. 10. 11. OP38 OP38 OP31 23 23 26 13 OP18 12 All fire extinguishers need to be secured to the wall. Fire doors must not be held open by any unauthorised means. Copies of visit records made by the area manger must be available for inspection at all times. The policy and procedure for the protection of vulnerable adults at the home needs review to demonstrate that proper safeguarding measures are in place to protect people when an allegation of abuse by a member of staff on a person living at the home has occurred. 22/07/08 08/05/08 22/07/08 08/05/08 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. Refer to Standard OP3 OP27 Good Practice Recommendations The pre assessment documentation needs review, to ensure it captures all relevant information about prospective service users. Overall staffing levels should be kept under review as occupancy levels rise. Highnam Hall has a number of floor levels and extension wings. When the home is full, and dependency levels are high, additional staff will be required. Additional domestic staff should be employed so that care staff are not undertaking laundry duties. It is recommended that the system in which peoples personal allowances is recorded is amended to ensure an audit trail can be carried out. People should have open access to there personal allowance at all times. Staff’s roles and responsibilities need defining. Job descriptions need review to reflect the actual duties required for the post. 3. OP35 4. OP30 Highnam Hall Residential Home DS0000065270.V366006.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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