Inspection on 02/02/09 for Highstone Mews Care Home

This inspection was carried out on 2nd February 2009.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Highstone Mews Care Home 22/02/07

Highstone Mews Care Home 29/11/05

Highstone Mews Care Home 15/06/05

Highstone Mews Care Home 05/01/05

Highstone Mews Care Home 06/07/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 27/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Highstone Mews Care Home Highstone Road Worsbrough Common Barnsley South Yorkshire S70 4DX     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Mike ONeil     Date: 0 2 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Highstone Mews Care Home Highstone Road Worsbrough Common Barnsley South Yorkshire S70 4DX 01226733966 01226779427 highstone.mews@fshc.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Debra Ann Owen Type of registration: Number of places registered: Tamaris Healthcare (England) Ltd care home 60 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: 30 beds in one unit are registered for N, Nursing Care or PC, Personal Care in the category DE/E, Dementia for people aged 65 or over OR MD/E, Mental Disorder for people aged 65 or over. For the DE/E, MD/E unit, minimum staffing levels and the manager supernumerary hours must be maintained as agreed with the previous registration authorities, see attached, Appendix 1. For the OP unit, staffing levels must be maintained as follows: one member of staff must be on duty when 1 to 10 service users live at the home; two staff for 11 to 20 service users; and three staff for 21 service users and above. Of the 30 beds above two can instead be used for the category DE or MD for people aged 55 or over and 28 for people aged 60 and over. Care Homes for Older People Page 4 of 26 0 0 0 Over 65 30 30 30 The remaining 30 beds in a separate unit are registered for PC, Personal Care in the category OP, Older People. Two of these beds can be used instead as PD, Physical Disability for people aged 55 or over. Date of last inspection Brief description of the care home Highstone Mews is a registered care home for 60 older people. The home is divided into two units, which comprise of a 30-bed unit providing residential care and a 30-bed unit providing dementia/mental disorder nursing care. The home was purpose built. Both units share the same facilities for kitchen, laundry and administrative support. The home is situated in the residential area of Worsbrough Common on the outskirts of Barnsley, close to the M1 motorway and local bus routes and shops. All 60 places are accommodated in single en-suite rooms. Resident?s rooms are located on the ground and first floors and the home is equipped with handrails, other adaptations and a lift to assist people in moving around the home. Similarly, aids for residents are provided in bathrooms and toilets. The home had a range of communal areas. An enclosed garden and car park are provided. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This is what was used to write this report. Information about the home kept by the Commission for Social Care Inspection. Information returned to us by 3 relatives of people who live at Highstone Mews and 1 staff member. An unannounced visit to the home. This was carried out by Michael ONeil, regulation inspector on 2nd February 2009 and included talking to 6 staff and Matt Sharpe, home manager about their work and the training they have completed. And checking some of the records, policies and procedures the home has to keep. Matt has been manager at Highstone Mews for 4 weeks and he is not registered with the CSCI as manager but is aware that he needs to undertake the process to register promptly. Four Seasons Health Care Limited also need to inform the CSCI of the changes in the management arrangements at the home. Some time was spent observing staff supporting people and talking with 8 Care Homes for Older People Page 6 of 26 people, a visiting health professional and 4 visiting relatives. We wish to thank the people living in the home, staff, and relatives for their time, friendliness and cooperation throughout the inspection process. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get Care Homes for Older People Page 8 of 26 printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were individually assessed prior to admission to ensure their needs could and would be met. Evidence: Three care plans checked showed that people within the service had been assessed before moving into the home. Risk assessments and a plan of care reflected any specialist interventions. The assessment forms checked were detailed and fully completed. The manager and staff liaised with professionals, the person and their families to find out about peoples needs. The manager or senior member of nursing/care staff visited people and undertook assessments, prior to admission. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health is monitored and arrangements for dealing with health issues were met with support from health professionals. People were treated with respect and said they were very happy with the care they received. Medication policies and procedures were well managed ensuring the safe administration of medication. Evidence: Three peoples care plans were checked. The peoples care plans contained details about the persons biography, personality and their preferences and choices. Overall we felt the standard of the plans were good and they did focus on the individual person (person centred). The plans were being regularly reviewed and the changes in peoples health were being observed and recorded. There was evidence recorded to show that people and/or their relatives were involved in drawing up and reviewing the care plans. Care Homes for Older People Page 12 of 26 Evidence: Risk assessments were included within the documentation and included moving and handling, skin integrity, and other risk factors. The care plans identified that a range of health professionals visited the home to assist in maintaining peoples health care needs. People said they had regular contact with their GP and other health professionals such as district nurses and opticians. People looked clean, well dressed and had received a good level of personal care. People said The staff are really nice I like it here Its a lovely home. Relatives said The care is excellent I have no worries when I leave, I know mum will be well looked after Im kept informed about what is going on and whenever I visit the staff are always helpful. Health professionals said that they felt the care delivered at Highstone Mews was good and that staff communicated well with them. Medication was securely stored. Medication records were up to date with no gaps. The Controlled Drugs Register was checked and this had been completed correctly with two signatures and a diminishing total. Staff said they had received medication training and records were seen of this training having taken place, however, some of this training was 3 years ago. Staff said that the manager had regularly observed them undertaking medication administration rounds as part of their training programme. We would recommend that all staff undertake more theoretical medication training on a more frequent basis. Staff were aware of the need to treat people with dignity and respect. During our visit we saw good interactions between people and staff. Staff took time to explain what task or support they were about to offer people. We saw staff being very warm to all people who use the service. Staff frequently held Care Homes for Older People Page 13 of 26 Evidence: or touched people when communicating with them. Care Homes for Older People Page 14 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People had a choice of lifestyle within the home and were able to maintain contact with family and friends ensuring that they continued to be involved in community life. People were able to make choices about daily living and be involved in some social activities. Meals served at the home were of a good quality and offered choice to ensure people receive a balanced diet. Evidence: People said they were able to get up and go to bed when they chose and generally how they spent their day and evenings. They said they often went out with their families. Relatives said they were able to visit at any time and were made to feel very welcome. We saw that everyone coming to the home was offered hospitality and staff took time to make sure friends and family were made to feel comfortable whilst visiting. A friendly, lively and welcoming feel was evident in Highstone Mews. People and relatives said that the home was a happy place this was evident on the day of our Care Homes for Older People Page 15 of 26 Evidence: visit. Some people said they enjoyed the activities available at the home, whilst other people said that they chose not to join in with the activities arranged. Activities were advertised around the home. The programme was comprehensive and included events within the home and some in the local community. Activities that people had participated in were recorded in their care plans. We spoke with the one of the two activities coordinators employed at Highstone Mews. The coordinator showed great enthusiasm about her role and was keen to include as many people as possible in different types of activities. There was not enough information displayed in the home that may help people with orientation. There were clocks around the home that showed the correct time, however, pin boards on two corridors contained little or no information. Displaying information such as the date, the menu for the day, the weather and a news item, may help the people further with orientation to time and place. The mealtime experience for people in the home was generally positive. The tables, particularly on Kingstone units, were set nicely with cloths, condiments and matching crockery. The dining rooms on Dillington unit looked more sparse and aesthetically not as pleasing. Staff on both units were supporting people with their meal in a polite and discreet way. People said they were always offered a choice and asked what they wanted for their breakfast, lunch and teatime meals. People said that the quality and choice of food served was generally very good. People said they were offered drinks on a regular basis throughout the day. Care Homes for Older People Page 16 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints procedures were in place and people and their relatives felt confident that any concerns they voiced would be listened to. Staff had an understanding of the procedures to be followed should they suspect any abuse at the home, so helping to ensure that people were protected from abuse. Evidence: People and their representatives had been provided with a copy of the homes complaints procedure, which was also on display in the entrance hall. This contained details of who to speak to at the home and who to contact outside of the home to make a complaint should they wish to do so. People said that they felt very comfortable in going to the manager knowing that any concerns they may have would be addressed without delay. Regarding safeguarding adults, the safeguarding policies and procedures were available to the staff. Staff said they had undertaken Safeguarding Adults training, and the manager was able to evidence this by producing the training records. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was clean, pleasant and hygienic although some areas of the home are in need of redecorating and refurbishing. Evidence: The home was clean and tidy and no unpleasant odours were noticeable. People, and relatives said the home was always kept very clean. Kingstone Unit lounge and dining areas were domestically furnished to a good standard. Since our last visit new furniture has been purchased for this unit and the communal areas have been redecorated and new carpets have been fitted. People said they were very comfortable at the home. Their bedrooms contained a variety of their own furniture and touches such as ornaments and pictures. This gave their rooms a homely feel. Some areas of the home, Dillington unit, are in need of refurbishment and redecoration. In particular the paintwork in some communal areas and bedrooms is damaged and needs redecoration. The furniture in the lounges is worn and was marked and needs replacing. As mentioned earlier the dining rooms feel stark and not a very pleasant place for people to eat their meals. The shower room in the unit is also in need of refurbishment. The room is very stark and clinical and there is no privacy curtain around the shower just a waist high opaque glass screen. Care Homes for Older People Page 18 of 26 Evidence: Window restrictors were fitted to all first floor windows checked. The hot water temperature in one bathroom checked measured a safe temperature below 45 degrees centigrade. This will assist in maintaining resident safety. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff were employed in sufficient numbers and recruitment procedures promoted the protection of people. People receive care from a well-trained staff team. Evidence: People spoke highly of the staff team and said staff always listened and acted on what they said. People said that staff were always available when needed. Staff and the manager confirmed that staffing levels were adequate. Three staff files were checked at this visit. The files contained a range of information including two references and a declaration of health and identification. The staff had undertaken a criminal record bureau check (CRB), at the enhanced level. This confirmed thorough recruitment practices were in place, which was sufficient to safeguard people. Staff said that they really enjoyed working at the home and got a lot of job satisfaction. We found that the staff were very enthusiastic and keen to improve the service further. Staff were able to talk about the various training courses that they had Care Homes for Older People Page 20 of 26 Evidence: attended. Development and training records were checked these records showed when staff had completed mandatory training and refresher training. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The procedures and ethos of the home ensure that the home is run in the best interests of people who use the service. In the main the homes policies and procedures promoted the health, safety and welfare of residents and staff. Evidence: Matt Sharpe has been manager at Highstone Mews for 4 weeks and he is not registered with the CSCI as manager but is aware that he needs to undertake the process to register promptly. Four Seasons Health Care Limited also need to inform the CSCI of the changes in the management arrangements at the home. Matt has many years experience within the nursing and caring profession and has completed the Registered Managers Award. Staff, people and relatives said they were still getting to know Matt as the new manager but said that so far they had found him very approachable and helpful. Care Homes for Older People Page 22 of 26 Evidence: The home had a good quality assurance system. There was evidence of internal auditing of the homes environment, services and records. Staff meetings were held and minutes of these meetings were seen. The responsible individual visited the home on a regular basis, a report was written following the visits. People who use the service and their families met regularly with the management of the home. The results of questionnaires returned from people and relatives had been collated to determine satisfaction ratings. This information was displayed on a notice board in the home. These quality assurance systems will help to ensure that the service is operating in the best interest of the people who live there. The home handles money on behalf of some people. Account sheets were kept, receipts were seen for all transactions and a second individual witnessed all transactions. However, peoples financial interests were not fully safeguarded because peoples personal money accounts had not received any interest payments despite some people having larger sums of money held in a Highstone Mews bank account. Some peoples confidentiality was not protected by some of the staffs actions. Staff had left some peoples care plans in a lounge where other people and visitors were sitting. These files were left on a table over the lunchtime period where they could have been accessed by an unauthorised person. The fire risk assessment had been reviewed in November 2008. It was recorded that issues requiring action had been addressed. Staff said they had received recent fire safety and other health and safety training .A sample of records showed that staff were receiving this statutory training. At the time of the visit fire exits were clear and hazardous products were safely stored in the home. This will promote the safety and welfare of the people. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 37 17 Peoples records must be securely stored. To protect peoples rights. 01/05/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 3 9 12 19 Staff should receive practical and theoretical medication training at frequent intervals. Arrangements should be improved so that people can be orientated to date, time and place. A programme of renewal of the fabric and decoration should be produced, and work started to implement the plan. The Dillington unit shower room should be redecorated and refurbished and touches added to make it more domestic in style and so less clinical. Peoples financial interests should be safeguarded by interest being paid on any savings held on their behalf. 4 21 5 35 Care Homes for Older People Page 25 of 26 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - 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!