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Inspection on 22/08/05 for Highpoint Lodge

Also see our care home review for Highpoint Lodge for more information

This inspection was carried out on 22nd August 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Highpoint Lodge has managed to maintain a stable staff team with the owners working alongside staff. A family atmosphere exists whereby people feel relaxed within a professional setting. Service users indicated that they were happy with the care provided. The registered providers stay abreast of professional developments and adjust policies and procedures accordingly. Staff benefit from `in-house` training packages. Staff and service users informed the inspector that the registered providers were most approachable and always listened to concerns or ideas.

What has improved since the last inspection?

The home continues to provide a good standard of care and all concerned have to work hard to maintain this position. The inspector spoke with 3 staff during the course of the inspection and was impressed by their enthusiasm and support of one another. The total number of staff now in possession of an NVQ has reached 75%. On going maintenance and decoration of the home keeps the premises in good order. The overall appearance of the home and the grounds is maintained to high standards.

What the care home could do better:

Based on the areas inspected at this unannounced inspection, it is the opinion of the inspector that the home is being operated to satisfaction at this time.

CARE HOMES FOR OLDER PEOPLE Highpoint Lodge 69 Molesworth Street Wadebridge Cornwall PL27 7DS Lead Inspector Mike Dennis Unannounced 22 August 2005 09:30 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. Highpoint Lodge D52-D04 S9182 Highpoint Lodge V234134 220805 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Highpoint Lodge Address 69 Molesworth Street Wadebridge Cornwall PL27 7DS 01208 814525 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) Mr Alan Wayne Law Mrs Julie Law CRH 11 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia - over 65 years of age (3), Old age, of places not falling within any other category (11) Highpoint Lodge D52-D04 S9182 Highpoint Lodge V234134 220805 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Total number of service users not to exceed a maximum of 11. Date of last inspection 15th March 2005 Brief Description of the Service: Highpoint Lodge is a registered care home providing accommodation and personal care for up to 11 older persons, 3 of whom may also have a mental disorder.Highpoint Lodge is a large Victorian, detached house situated near the town centre of Wadebridge. It is on the main road leading out of the town towards Padstow. Access to the front of the home is up a graduated slope with a handrail provided to assist service users. Parking and a seating area are provided to the rear of the home and a patio area is accessed from the dining room at the side of the house, via a conservatory. Bedrooms are offered on the ground and first floors with a stair lift provided to assist service users. Communal areas are provided on the ground floor and the Mr and Mrs Law have their private accommodation on the second floor. Highpoint Lodge D52-D04 S9182 Highpoint Lodge V234134 220805 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 22nd. August 2005 over a three and half hour period. The inspector met with Mr. A. Law, one of the Registered Providers, all of the staff on duty and with 4 service users.. During the course of the day the inspector observed the service users being attended to by staff in a courteous and professional manner. Service users informed the inspector that their expectations of being in a care home were being fully met. Various records, policies and procedures were inspected and found to be satisfactory. The inspector visited all parts of the building and noted a satisfactory standard of hygiene. Service users expressed satisfaction with all aspects of the home What the service does well: What has improved since the last inspection? The home continues to provide a good standard of care and all concerned have to work hard to maintain this position. The inspector spoke with 3 staff during Highpoint Lodge D52-D04 S9182 Highpoint Lodge V234134 220805 Stage 4.doc Version 1.30 Page 6 the course of the inspection and was impressed by their enthusiasm and support of one another. The total number of staff now in possession of an NVQ has reached 75 . On going maintenance and decoration of the home keeps the premises in good order. The overall appearance of the home and the grounds is maintained to high standards. 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. Highpoint Lodge D52-D04 S9182 Highpoint Lodge V234134 220805 Stage 4.doc Version 1.30 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 Highpoint Lodge D52-D04 S9182 Highpoint Lodge V234134 220805 Stage 4.doc Version 1.30 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, 5, and 6. Information concerning the home is made available. Service users are fully assessed prior to admission to the home. Prospective service users and relatives are afforded the opportunity to visit the home to assess it’s suitability as to meeting their needs. This home does not provide Intermediate Care EVIDENCE: Up to date Statements of Purpose and Service User Guides were readily available. Four service user files were inspected and case tracked. All contained information pertaining to pre-admission assessment and copies of contracts etc. Policy documents indicate that prospective service users can visit the home before making the decision to move in. This was confirmed by service users and staff. Standard 6 is not applicable as the home does not provide intermediate care. The home does however have a dedicated Respite care bed. Highpoint Lodge D52-D04 S9182 Highpoint Lodge V234134 220805 Stage 4.doc Version 1.30 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 standard(s) 7, 8, 10, and 11 The health care needs of service users are identified, planned for and met. Service users are treated with dignity and respect. The standard of care planning set is high and is being maintained. Service users and their family are treated with respect at the time of death. EVIDENCE: Highpoint Lodge D52-D04 S9182 Highpoint Lodge V234134 220805 Stage 4.doc Version 1.30 Page 10 From discussion with service users, staff and inspection of documentation it was evident that individual care needs are identified appropriately. From inspection of service users files, and in discussions it is evident that Highpoint Lodge encourages service users and their representatives to express their views in the formation of their care plans. The care plan specifies what actions staff should take to ensure that the care need is approached in a consistent manner. Health needs were not inspected in detail, however service users commented that health needs are met by the staff at the home and by external professionals to a high standard. Records of all health professional visits are recorded in detail. Staff were observed to treat service users with respect and it was noted that staff knocked at bathroom and bedroom doors before entering. General practitioners examine and treat all service users in the privacy of their own bedrooms. The policies and procedures of the home indicate that service users and their families will be treated with care, sensitivity and respect at the time of death. Highpoint Lodge D52-D04 S9182 Highpoint Lodge V234134 220805 Stage 4.doc Version 1.30 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 standard(s) 12, 13, 14 and 15 The routines of daily living and activities made available are flexible and varied. Service users are in control over their lives. Service users receive visitors at any reasonable time throughout the day Service users dietary needs are well catered for with a balanced and varied selection of food and drink available that meets tastes, and choices. EVIDENCE: The routines of daily living within the home appear to be flexible to suit individual preferences. The home will offer various activities including trips out. Service users confirmed the above. Those spoken with claimed to be quite satisfied with their general routines which included personal interests and hobbies. They stated that a good rapport with staff existed. The visitors book indicated that a steady stream of visitors attend the home. Service users confirmed that they were free to receive visitors at any time. Service users told the inspector that they were well able to make informed decisions regarding their lifestyle, supported by staff as required. Service users appear to receive a varied, appealing and nutritious diet suited to individual needs, likes and requirements. The meal looked appetising and service users stated that it was hot at the point of delivery. Portions were of a good size and suited to the individual. Highpoint Lodge D52-D04 S9182 Highpoint Lodge V234134 220805 Stage 4.doc Version 1.30 Page 12 Lunchtime appeared a sociable occasion with staff offering discreet help as and when required. Many of the service users took lunch in the dining area; others preferred to remain in their bedrooms. Comments from the service users regarding meals were very favourable. Special diets are catered for and choices are available.. Hot and cold drinks are offered and available throughout the day. Highpoint Lodge D52-D04 S9182 Highpoint Lodge V234134 220805 Stage 4.doc Version 1.30 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 standard(s) 16 and 18 The complaints procedure is well publicised and would be used when required. The registered persons ensure that service users are protected from all forms of abuse with staff having knowledge through training of Adult Protection issues which helps to protect service users EVIDENCE: The home has a complaints policy that meets all the requirements of Regulation 22. A complaints log is available to ensure that a record of all complaints is recorded and kept. Details of the complaints policy are available in the statement of purpose and a full copy included within the service users guide The home has a policy in relation to adult protection, which includes information on whistle blowing. This policy references the Department of Health No Secrets guidelines and physical / verbal aggression by service users. Staff are made aware of this policy during induction and at training sessions. Service users informed the inspector that they were fully aware of the homes complaints procedure and stated that they were quite prepared to use it. Highpoint Lodge D52-D04 S9182 Highpoint Lodge V234134 220805 Stage 4.doc Version 1.30 Page 14 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) 19 and 26 The location and layout of the home is suitable for it’s stated purpose and provides a safe and well maintained environment. The home was clean, hygienic and free from offensive odours providing an attractive and homely place to live. EVIDENCE: The home is close to public transport, local shops and facilities of Wadebridge. The detached building offers bedroom accommodation on the ground and first floors for service users. The home presents as a safe, well maintained and a homely environment for a maximum of 11 service users. The home is homely and domestic in nature. The home was clean, hygienic and free from offensive odours. Disposable gloves and aprons are available as required. Hand washing facilities were satisfactory. The home has an Infection Control policy. Highpoint Lodge presents as a well looked after property. Staff and service users seem to have a vested interest in keeping it that way. Bedrooms were seen to be individualistic in appearance, the occupants stating their satisfaction. Highpoint Lodge D52-D04 S9182 Highpoint Lodge V234134 220805 Stage 4.doc Version 1.30 Page 15 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, 29 and 30 Recruitment policies and procedures are implemented. All staff are supported and Inducted through training opportunities. A positive number of staff are on duty to meet the service user’s needs EVIDENCE: The home has a duty rota that accurately reflected the number and skill mix of staff on duty during the inspection. There is always a minimum of 2 staff on duty. The registered providers live on the premises so waking night staff are not employed. They are available at all times however and will stay awake if necessary. Evidence that at least 75 of the staff team have now achieved NVQ level 2 was presented at the inspection.. The home’s employment policies and procedures are implemented. Staff training, induction and development programmes are Highpoint Lodge D52-D04 S9182 Highpoint Lodge V234134 220805 Stage 4.doc Version 1.30 Page 16 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) 31, 36 and 37 The management and staff of Highpoint Lodge strive to maintain and improve a good quality of care and lifestyle for the service users and promote their health, safety and welfare. EVIDENCE: Service users live in a home which is run and managed by persons who are fit to be in charge, of good character and able to discharge their responsibilities fully. Mr and Mrs Law are both qualified RMN’s and experienced providers who have continued to update their skills and knowledge whilst managing the home. Staff informed the inspector that they received regular supervision. The homes’ policy and procedure documentation was inspected and found to contain all relevant information. Records, as required by law, are well maintained. Highpoint Lodge D52-D04 S9182 Highpoint Lodge V234134 220805 Stage 4.doc Version 1.30 Page 17 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 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 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 x x x x 3 3 x Highpoint Lodge D52-D04 S9182 Highpoint Lodge V234134 220805 Stage 4.doc Version 1.30 Page 18 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 none 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 none Good Practice Recommendations Highpoint Lodge D52-D04 S9182 Highpoint Lodge V234134 220805 Stage 4.doc Version 1.30 Page 19 Commission for Social Care Inspection John Keay House Tregonissey Road St Austell PL25 4AD 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 Highpoint Lodge D52-D04 S9182 Highpoint Lodge V234134 220805 Stage 4.doc Version 1.30 Page 20 - 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!