Inspection on 01/12/05 for Highview Residential Home

This inspection was carried out on 1st December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Highview Residential Home 23/03/07

Highview Residential Home 08/08/06

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

CARE HOMES FOR OLDER PEOPLE Highview Residential Home 42 Foxholes Road Southbourne Bournemouth Dorset BH6 3AT Lead Inspector Marjorie Richards Unannounced Inspection 1st December 2005 10:20 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 Highview Residential Home DS0000064372.V269125.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. Highview Residential Home DS0000064372.V269125.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Highview Residential Home Address 42 Foxholes Road Southbourne Bournemouth Dorset BH6 3AT 0208 688 7085 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) Rhodes Care Home Ltd Care Home 10 Category(ies) of Dementia - over 65 years of age (10), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (10) Highview Residential Home DS0000064372.V269125.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. That a suitable manager be registered within six months. Until a manager is registered i.e. for six months, Mr Geoffrey Rhodes may act as Responsible Individual and Manager for both Highview and Nightingales (situated just a short distance away.) That until a suitable manager be appointed, a senior care assistant shall be in place at Highview with NVQ level 3 or equivalent. That the Commission shall be informed when an assessment of the premises and facilities has been carried out by a suitably qualified person and any recommendations made shall be fully implemented within three months. That any outstanding health and safety works, including the guarding of radiators and fitting of a stair rail, be completed within two months. One named person (as known to CSCI) under the age of 65 may be accommodated to receive care. 5. 6. Highview Residential Home DS0000064372.V269125.R01.S.doc Version 5.0 Page 5 Date of last inspection Brief Description of the Service: Highview Residential Home is a care home registered to provide personal care for 10 older people who have dementia or a mental disorder. Two beds are booked by Bournemouth Borough Council social services for the provision of short-term and respite care. The home is situated in a quiet residential road, half a mile from local shops, the cliff top and coastal walks and approximately one mile from the main centre of Southbourne. Southbourne offers a number of amenities, such as post office, shops, a park and bowling greens, places of worship, GP surgeries and a library. There is limited off-road car parking available at the front of the home, with further parking on the road outside. Buses are available nearby, running to and from Southbourne, Bournemouth, Christchurch and beyond. Highview is a large detached house that has been converted for use as a care home. Residents are accommodated in ten single bedrooms on the ground and first floors, with two rooms having ensuite facilities. The home has sufficient communal bathroom/shower/WC provision to meet the needs of residents. The ground floor lounge and separate dining room are situated to the rear of the home, with the lounge having patio doors to the rear garden. There is also a spacious porch area where some residents like to sit and watch the comings and goings. The accommodation is comfortable and “homely.” The area at the front of the home is used mainly to provide car-parking facilities. The small rear garden is laid mainly to lawn, with surrounding shrubs and tree. 24-hour personal care is provided. Laundering of personal clothing etc is carried out on the premises. All meals are prepared and cooked within the home. Although a choice of menu is not offered for the lunchtime meal, a variety of alternatives is available to suit individual taste and preference. An activities programme is being developed to provide stimulation and interest for residents. Rhodes Care Home Ltd own two other care homes in Dorset. Highview Residential Home DS0000064372.V269125.R01.S.doc Version 5.0 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. Highview Residential Home de-registered as a care home on 27 November 2004. The home re-opened under new ownership on 11 July 2005. This unannounced initial inspection took place over 6.5 hours on the 1st December 2005. Mr Geoffrey Rhodes made himself available during the inspection, on behalf of Rhodes Care Home Ltd, and this was appreciated. The main purpose of the inspection was to check that the residents living in the home were safe and properly cared for and to check on progress with the registration of a manager. A tour of the premises took place and a variety of records and related documentation were examined including the care records for four residents. Time was spent observing the interaction between residents and staff, as well as talking with six residents, Mr Rhodes, Mrs Rhodes (Manager), the staff on duty and a visitor to the home, in order to get a real feel of what it is like to live at Highview Residential Home. What the service does well: The Statement of Purpose and Service User Guide contain all of the information required about Highview and its facilities. Pre-admission assessments are carried out, ensuring that only those whose needs can be met are offered places there. A contract, describing terms and conditions of residency, is issued at the point of admission to the home. Prospective residents and their representatives are invited to visit Highview prior to admission in order to assess the facilities and services on offer. A two-month trial period is available to help with the decision process. A detailed care planning system is in place, which ensures that staff have the information they need to meet the health and personal care needs of residents. Community health professionals provide good support. Staff were observed throughout the inspection to be treating residents with courtesy, kindness and respect. Open visiting arrangements are in place and a visitor commented, I am always well received whenever I arrive. I am always made to feel welcome. Relatives are encouraged to participate in the care process if they wish. Residents commented favourably about the meals provided. I had a very nice dinner. All the dinners are nice. We have lots of food here, I enjoy it all. Highview Residential Home provides a well-maintained, homely and safe environment for residents. There is a dining room and separate lounge, with patio doors offering access to a small, secluded garden at the rear of the Highview Residential Home DS0000064372.V269125.R01.S.doc Version 5.0 Page 7 property. There are sufficient communal bath/shower rooms and WCs to meet the needs of residents. Bedrooms are comfortably furnished and individually personalised to suit the needs of their occupants. The home is clean and there are no unpleasant smells. The home employs sufficient staff to meet the needs of residents and ensure their comfort and safety. Staff are well motivated and enthusiastic in their work. Mr and Mrs Rhodes and their staff have developed good relationships with the residents. This results in a supportive, caring and relaxed environment where residents feel comfortable and secure. What has improved since the last inspection? What they could do better: All residents at Highview are issued with terms and conditions of residence upon admission to the home. It is recommended that the relevant parties sign this document and a copy be retained in each residents records. Mr and Mrs Rhodes carry out pre-admission assessments prior to anyone moving into Highview Residential Home, to ensure the home is able to provide whatever care is needed. At present, following this assessment, prospective residents (or their relatives/representatives) are not assured in writing that the home can meet their needs. Detailed care plans are in place to ensure staff have the information they need to meet health and personal care needs. However, at present there is little recorded about each residents background, social history, previous hobbies and interests etc. Where possible, more information should be recorded, which will help to ensure that the activities on offer at Highview will be person centred, meeting the individual needs, preferences and expectations of residents. The home has an Adult Protection policy in place, which is in line with the Department of Health No Secrets guidance. However, not all staff have yet received Adult Protection training, to ensure a proper response to any suspicion or allegation of abuse. The home has not yet achieved the recommended ratio of 50 NVQ level 2 trained staff, to help ensure residents are in safe hands. Highview Residential Home DS0000064372.V269125.R01.S.doc Version 5.0 Page 8 Employment and recruiting procedures are in place to ensure the protection of residents. However, these procedures have not always been followed and some staff have been employed before the completion of proper checks, leaving residents potentially at risk. The home is working towards equipping staff with the training and skills necessary to meet the needs of residents. It is recommended that a training audit is carried out, to ensure that all staff receive the training they require and this is updated where necessary. The home has not yet implemented and effective quality assurance and quality monitoring system, based on seeking the views of residents, relatives, staff and other visitors to the home. Care staff should receive formal supervision at least six times a year, as a means of ensuring good practice. At present, formal supervision is not taking place on a regular basis. Examination of the fire records shows that the standard of recording could be improved. It was not possible to confirm from records that monthly visual checks of fire fighting equipment, staff fire training and fire drills were taking place at the appropriate intervals. (An Immediate Requirement Notice was issued to ensure that urgent action was taken to rectify this and ensure that all staff know what to do in the event of fire.) 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. Highview Residential Home DS0000064372.V269125.R01.S.doc Version 5.0 Page 9 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 Highview Residential Home DS0000064372.V269125.R01.S.doc Version 5.0 Page 10 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): 1, 2, 3 and 5 Standard 6 is not applicable at Highview Information provided about Highview Residential Home and a thorough admissions procedure allows prospective residents to make informed decisions about admission to the home and ensures that only those whose needs can be met by the home are offered places there. However, the outcome of preadmission assessments is not confirmed in writing, so prospective residents cannot be fully assured that their care needs will be met. Residents are issued with a contract describing Terms and Conditions of occupancy at the point of admission to the home. Prospective residents and their relatives or representatives are invited to visit the home prior to admission to enable them to assess the facilities and services provided. A trial period is also available before making any decision about whether or not to stay. Highview Residential Home DS0000064372.V269125.R01.S.doc Version 5.0 Page 11 EVIDENCE: The Statement of Purpose and Service User Guide have been recently updated and contain all of the information required about the home and its facilities. The Service User Guide gives a good indication of what a resident can expect from the home. All residents at Highview are issued with terms and conditions of residence. It is recommended that the relevant parties sign this document and a copy be retained in each residents records. Individual care records are kept for each resident and four of these were examined. All showed that, prior to moving to the home, care needs had been assessed by Mr and/or Mrs Rhodes. However, the outcomes of such assessments were not confirmed in writing, so these residents were not fully assured prior to admission that their care needs could be met. The information contained in pre-admission assessments and also any assessment supplied by Social Services, is then used to draw up a detailed plan of care. Mrs Rhodes states that she encourages prospective residents and their relatives or representatives to visit the home prior to admission in order to have opportunities to assess the facilities, meet with other residents and staff, and ask any questions. A two-month trial period is available and further information can be found in the Service User Guide and Statement of Terms and Conditions. Staff and a relative confirmed that visits to the home take place prior to admission. Highview Residential Home DS0000064372.V269125.R01.S.doc Version 5.0 Page 12 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): 7, 8 and 10 Highview Residential Home has a detailed care planning system in place, which ensures that staff have the information they need to meet the health and personal care needs of residents. Health needs are well met, with evidence of good support from community health professionals. However, there is currently less information available about social care needs so it is difficult to assess if these are being fully met. Residents are treated with respect and their privacy and dignity is promoted at all times. EVIDENCE: All care plans have been re-written to a new format, commencing on 1st November 2005. All four of the care plans examined were clearly set out and easy to follow, detailing the particular health and personal care needs of each resident, the aims and objectives and the staff assistance necessary to ensure these are met. Daily care notes support and evidence the delivery of care to residents. These are well detailed and give a good picture of the care given to residents, visits by community health professionals and relatives etc. As the current records only started on 1st November, it is not possible to assess if Highview Residential Home DS0000064372.V269125.R01.S.doc Version 5.0 Page 13 regular reviews are taking place on at least a monthly basis. This will be checked at the next inspection. Care plans should be agreed and signed by the resident or their representative wherever possible. At present, there is only limited information recorded about social care needs so it is difficult to assess if these are being met at present. Mrs Rhodes says she is working to obtain further information so this will also be assessed at the next inspection. Records demonstrate, and residents and staff confirm, that residents have access to GPs, District Nurses, Community Psychiatric Nurses, chiropodists, flying dentist, optician, etc and attend hospital appointments as necessary. Residents have recently received influenza vaccinations. Risk assessments are in place and appropriate steps are taken to ensure any risks identified are minimised. All bedrooms at Highview Residential Home are for single occupancy, giving residents opportunities for privacy if they wish. Staff always knock at bedroom doors and toileting activities are carried out discreetly. Staff were observed throughout the inspection to be treating residents with courtesy, patience, kindness and respect. All residents were well presented and one resident commented, They always make me look smart. Highview Residential Home DS0000064372.V269125.R01.S.doc Version 5.0 Page 14 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 and 15 The information recorded about individual residents social, cultural, religious and recreational needs, is limited, making it difficult to assess if their needs and expectations are fully met. Open visiting arrangements are in place, so residents are able to maintain contact with visitors as they wish. Highview serves a balanced and varied selection of food that meets residents’ tastes and dietary needs within pleasant surroundings. EVIDENCE: Activities available at Highview include board games and puzzles, manicures, a weekly exercise to music session and regular monthly entertainment. An activities organiser comes into the home on two afternoons each week and arranges activities such as cooking and knitting and also working one-to-one with residents. Some reminiscence materials are available and daily newspapers are provided. During the afternoon of the inspection a care assistant was seen providing a manicure for one resident who commented, I feel like royalty having my nails done. Its lovely, very relaxing. At present, care plans contain only limited information about residents background, social history, previous hobbies and interests etc. Mrs Rhodes Highview Residential Home DS0000064372.V269125.R01.S.doc Version 5.0 Page 15 says she is looking to gather further information and is considering the use of life histories, which will help to ensure that the activities on offer at Highview will be person centred, meeting the individual needs, preferences and expectations of residents. Arrangements can be made for clergy to visit individual residents on request. Residents and staff confirm that visiting times at Highview are unrestricted and a visitor commented, I am always well received whenever I arrive. I am always made to feel welcome. Relatives are encouraged to participate in the care process if they so wish. Residents records and the visitors book demonstrate contact with family and friends as well as visits by professionals. One resident is able to go out of the home alone and others with their families/friends or with staff. Mrs Rhodes says she tries to ensure a weekly trip out is arranged to local places of interest for a couple of residents at a time. A telephone is available so that residents can maintain links with family, friends and the community. Lunch on the day of inspection was steak pie, with mashed potatoes, cabbage and sprouts. This was followed by homemade bread and butter pudding. The cook has information available about individual likes/dislikes and alternatives are always provided to suit individual taste and preference. Mealtimes can be flexible to fit in with care needs, appointments etc. The menu shows that residents enjoy a healthy, well-balanced diet. Fresh fruit and vegetables are used wherever possible. Some residents prefer easily managed finger foods, such as sandwiches, crisps, prepared fresh fruit, sausage rolls, fish fingers and chips and staff make sure a selection is offered during the day. Mrs Rhodes says night staff also ensure that snacks and drinks are available whenever needed or requested. One resident confirmed that she had a cup of tea and biscuits when she could not sleep one night. Others commented, I had a very nice dinner. All the dinners are nice. We have lots of food here, I enjoy it all. Highview Residential Home DS0000064372.V269125.R01.S.doc Version 5.0 Page 16 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 and 18 A system is in place for dealing with any complaints. Residents are confident that complaints would be listened to and dealt with appropriately. Not all staff have received training in Adult Protection issues. The policy and procedure alone are not sufficient to ensure residents are fully protected from the possibility of abuse. EVIDENCE: Highview has a complaints policy that is included in the information provided to residents or their representatives and is also displayed in the reception area of the home. No complaints have been received by the home or the Commission since the home re-opened in July 2005. Residents spoken to expressed no concerns. A relative said if he did have concerns, he would speak with the manager and felt confident such concerns would be addressed. The home has an Adult Protection policy, which makes reference to the Department of Health No Secrets guidance and is in line with this guidance, ensuring that any allegations of abuse will be managed effectively. However, not all staff have yet received Adult Protection training, to ensure a proper response to any suspicion or allegation of abuse. Mrs Rhodes is currently planning such training. Highview Residential Home DS0000064372.V269125.R01.S.doc Version 5.0 Page 17 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, 24 and 26 Continuous investment in the upkeep of the home results in a well-maintained, comfortable and safe environment for residents. Residents have access to comfortable communal areas, including a garden. There are sufficient washing facilities and WCs to meet the needs of residents. Bedrooms are comfortably furnished and individually personalised to suit their occupants. The home is clean with no unpleasant odours, making daily life more enjoyable for all in the home. EVIDENCE: Maintenance records show that continual work is carried out to keep the home and garden in good condition. Care staff and the part-time maintenance person were able to confirm that prompt attention is always paid to any defects. The fire records show appropriate checks being carried out on the fire warning system and emergency lighting. Highview Residential Home DS0000064372.V269125.R01.S.doc Version 5.0 Page 18 Both the lounge and dining room are homely and comfortable rooms. Additional communal space is available in the entrance porch, where some residents like to sit and watch the comings and goings. There is also a small, garden to the rear of the property, which can be accessed through patio doors from the lounge. This garden is laid mainly to grass, enclosed with mature trees and shrubs. Plans are in hand to create a paved patio area. There are sufficient communal bath/shower rooms and WCs to meet the needs of residents. The first floor bathroom has a portable lifting seat to offer assistance where necessary in accessing the bath. The ground floor has a walk-in shower room, which is easily accessible to residents. Suitable locks, which can be opened from the outside by staff in case of emergency, are fitted to all bathroom and WC doors. Two bedrooms have ensuite WCs. A tour of the building confirms that residents’ bedrooms are comfortably furnished and personalised to varying degrees. Residents commented, “I like my room.” “I love my room, I am very cosy here. I like it here, I am nice and warm. The laundry facilities are sited outside of the main building and include a commercial washing machine and tumble dryer. The walls of the laundry are currently being painted to ensure they are readily cleanable. Disposable gloves and aprons are available for staff and new staff uniforms have been ordered. An infection control policy is in place. The home is clean and there are no unpleasant smells, making life within the home more pleasurable. Suitable procedures are in place for the disposal of clinical waste. Highview Residential Home DS0000064372.V269125.R01.S.doc Version 5.0 Page 19 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 and 30 The home employs sufficient staff to meet the needs of residents and to ensure their safety and comfort. The home is working towards the recommended ratio of 50 NVQ level 2 trained staff, to help ensure residents are in safe hands. Employment and recruiting procedures are in place, but some work is still needed to ensure the protection of residents. The home is working towards equipping staff with the training and skills necessary to meet the assessed needs of residents. EVIDENCE: Staffing rosters are in place, showing which members of staff are on duty and when. Care staff are responsible for carrying out all personal care tasks for residents, as well as domestic duties such as cleaning and laundry. On the day 8 a.m. -- 8 8 p.m. -- 2 9 a.m. -- 1 8 p.m. -- 8 of inspection, p.m. 2 p.m. 1 p.m. 1 a.m. 1 staffing was as follows: Care Assistants Care Assistant Cook wakeful Care Assistant and 1 sleeping in, on call. Highview Residential Home DS0000064372.V269125.R01.S.doc Version 5.0 Page 20 From 8 p.m. until 8 a.m., one night Care Assistant is on wakeful duty and one works evenings and then sleeps on the premises and is on call if needed. A total of six care staff are currently employed and the home is actively recruiting further staff. At present, one member of night staff is supplied by an Agency. The Agency supplies the same person each time, to ensure continuity of care. Two part-time members of staff are also employed, one to carry out maintenance tasks and one to assist with administration. Residents spoke positively about staff. One said, I like the people here, they look after me. A visitor said, The staff are very good and very caring. Standard 28 recommends that a minimum ratio of 50 per cent trained members of care staff at NVQ level 2, or equivalent, is achieved by 2005, to help ensure that residents are in safe hands. Mr Rhodes is working towards achieving this standard. One member of staff has NVQ level 3 and two staff are commencing NVQ level 2 training in January 2006. Mr Rhodes is employing one member of staff from abroad whom he believes has the equivalent of NVQ level 3 training, but this has yet to be evidenced. The home has a thorough recruitment procedure in place, based on equal opportunities and ensuring the protection of residents. The three files examined for staff employed when the home opened showed that the necessary documentation was in place. However, examination of Criminal Record Bureau (CRB) disclosures demonstrated that these had been received after the employee had commenced working in the home. There were no records of any POVAfirst (Protection Of Vulnerable Adults) checks being made prior to employment commencing. In addition, one file had no references in place. Where reference forms had been completed on the two other files, these had not been dated and there was no indication as to who had written the references and in what capacity. Where staff are coming from abroad, those files of viewed did demonstrate that appropriate information had been gathered about the right to work in the UK and any possible restrictions on that work. Mrs Rhodes said she was aware of the serious shortcomings in recent recruitment practice and had taken steps to address these issues. The reference request form has been re-written to include date and information about the person completing the reference. Evidence was seen for a recently recruited member of staff who was awaiting receipt of the CRB disclosure, before commencing work in the home. Mrs Rhodes said she would now ensure the correct policy and procedure was followed. A staff training and development programme is in progress, which will ensure that all staff receive appropriate training so they can fulfil the aims of the home and meet the needs of residents. Individual training and development files are being implemented for all staff. These will provide evidence that staff receive a minimum of three paid days training per year. Copies of all training Highview Residential Home DS0000064372.V269125.R01.S.doc Version 5.0 Page 21 certificates are being retained. Some training certificates on file were obtained prior to employment at Highview. Mr Rhodes has copies of the recently introduced Skills for Care Common Induction Standards and will be incorporating these into induction training at Highview Residential Home. All staff have undertaken external training in moving and handling and fire safety, and all but one have undertaken training in health and safety matters. Three staff have undertaken basic food hygiene training and Mrs Rhodes says she is intending such training for all care staff and infection control, first aid and Adult Protection training is also being planned. Staff also need to receive training appropriate to the work they are to perform, for example dealing with dementia, mental disorders and challenging behaviour. Four staff have now received dementia awareness training and Mrs Rhodes says further training is being arranged. It is recommended that an audit of training be carried out, to ensure that all staff receive the training they need for the work they have to do and this is updated wherever necessary. Where training needs are identified, this should be programmed in as soon as possible. Discussions with staff show that they are well motivated and enthusiastic in their work. They are keen to learn and value the training that is being offered. I am looking forward to doing the NVQ training. I have learned a great deal since coming here. I have learned many things since I started to work in this place. I enjoy my job and the training makes it more interesting. Highview Residential Home DS0000064372.V269125.R01.S.doc Version 5.0 Page 22 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, 36 and 38 The registered person is qualified and experienced in care. The management arrangements of the home support good care practice for residents. The home has not yet commenced reviews of its performance but is planning to seek the views of residents, staff, relatives and other visitors to the home, to ensure Highview is run in the best interests of residents. Residents are assured of sound management of their financial interests. Staff are being supervised informally, but there is no evidence of formal staff supervision taking place to ensure good practice. The home works to ensure the health, safety and welfare of residents. However failure to evidence that staff fire training, fire drills and all fire fighting equipment checks by taking place at the appropriate intervals, has the potential to place residents at risk in the event of fire. EVIDENCE: Highview Residential Home DS0000064372.V269125.R01.S.doc Version 5.0 Page 23 One of the conditions of registration for Highview Residential Home is that a manager is registered with the Commission for Social Care Inspection within six months of registration. Until this can be achieved, Mr Rhodes, on behalf of Rhodes Care Home Ltd remains the Responsible Individual and also manager for the home. Mrs Rhodes has been appointed to the post of manager at Highview. She is currently in the process of submitting her application for registration as manager with the Commission. She has experience in caring for older persons and is currently undertaking the National Vocational Qualification (NVQ) level 4 in care and management. Mr and Mrs Rhodes and their staff have developed good relationships with the residents. This results in a supportive, caring and relaxed environment where residents feel comfortable and secure. The home has an open, relaxed atmosphere, which is beneficial to residents, staff and visitors. Discussions with staff show that they are clear about their roles and responsibilities within the home and feel they are an important part of the team. They speak positively about Mr and Mrs Rhodes and their management of Highview. The home has not yet implemented an effective quality assurance and quality monitoring system, based on seeking the views of residents, relatives, staff and other visitors to the home. Mrs Rhodes said it is intended to seek feedback from residents and relatives very shortly with other visitors and staff to follow. Questionnaires are currently being prepared for distribution early in the New Year. In order to protect residents the home prefers, wherever possible, to have no involvement in personal finances. Therefore, all residents who are unable or do not wish to handle their own affairs, have a relative or other representative to deal with their finances etc. The home does look after the Personal Allowance for one resident and this was checked during the inspection. An account is kept showing all transactions. Receipts are retained, as necessary. All monies and related records are held securely. Care staff should receive formal supervision at least six times a year, as a means of ensuring good practice, emphasising the philosophy of care within the home and looking at individual career development needs etc. A start has been made. However, records show that supervision is not taking place on a regular basis and a few staff have not yet received any formal supervision. From touring the premises, looking at records and discussions with staff and residents, it is evident that measures are in place to promote the health and safety of residents, e.g. all substances that could be potentially hazardous to health are handled and stored safely and restrictors are fitted to windows. All radiators are guarded, to minimise the risks to residents from hot surfaces. Highview Residential Home DS0000064372.V269125.R01.S.doc Version 5.0 Page 24 Examination of the fire records shows that recording could be improved. Regular maintenance of the fire warning system, emergency lighting and fire fighting equipment is taking place. Routine checks of emergency lighting and the fire warning system are carried out at appropriate intervals and staff confirm this. However, monthly checks of fire fighting equipment are not being recorded. Staff also say that fire training and fire drills are taking place but it is not possible to evidence from records that these are held at the required intervals and that all staff, including new/Agency staff have received appropriate training. An Immediate Requirement Notice was issued requiring urgent steps to be taken to ensure compliance. (Notification has subsequently been received by the Commission that satisfactory action has been taken to meet this requirement.) Highview Residential Home DS0000064372.V269125.R01.S.doc Version 5.0 Page 25 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 3 2 2 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 3 3 X X 3 X 3 STAFFING Standard No Score 27 3 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 2 X 3 2 X 2 Highview Residential Home DS0000064372.V269125.R01.S.doc Version 5.0 Page 26 Are there any outstanding requirements from the last inspection? N/A 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 OP3 Regulation 14(1) Requirement The registered person must confirm in writing to the resident that, having regard to the assessment, the care home is suitable for meeting his/her needs in respect of health and welfare. All aspects of each resident s health, personal and social care needs must be recorded and regularly reviewed. Care plans are to be agreed and signed by the resident or their representative wherever possible. The registered person must ensure that staff receive suitable training to ensure residents are fully protected from the possibility of abuse. The registered person must operate a thorough recruitment procedure to ensure the protection of residents. All staff must be properly checked before being employed. It is a condition of registration that a manager be registered in respect of Highview. DS0000064372.V269125.R01.S.doc Timescale for action 28/02/06 2 OP7 14 and 15 28/02/06 3 OP18 13(6) 28/02/06 4 OP29 19(1) Schedule 2 28/02/06 5 OP31 8(1) 31/01/06 Highview Residential Home Version 5.0 Page 27 6 OP33 24 7 8 OP36 OP38 18(2) 23(4) 9 OP38 23(4) The registered person must introduce effective quality assurance and quality monitoring systems. These should be in place to measure success in meeting the aims, objectives and Statement of Purpose of the home. The registered person must ensure that staff are appropriately supervised. Staff fire training and fire drills must take place at the appropriate intervals and be recorded in detail. Monthly visual checks of fire fighting equipment must be carried out and recorded. 28/02/06 28/02/06 01/01/06 01/01/06 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 OP2 OP12 Good Practice Recommendations It is recommended that the terms and conditions of residence document (contract) is signed by the relevant parties and a copy retained in each residents records. It is recommended that much more be recorded about each residents background, social history, hobbies and interests etc, so that activities in the home can be tailored to meet individual needs. It is recommended that a minimum ratio of 50 per cent trained members of care staff at NVQ level 2, or equivalent be achieved. It is recommended that an audit of staff training be carried out, to ensure all staff are receiving the training they need. 3 4 OP28 OP30 Highview Residential Home DS0000064372.V269125.R01.S.doc Version 5.0 Page 28 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 Highview Residential Home DS0000064372.V269125.R01.S.doc Version 5.0 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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