Inspection on 08/08/07 for The Highgrove

This inspection was carried out on 8th August 2007.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Highgrove 07/10/09

The Highgrove 31/05/06

The Highgrove 12/09/05

The Highgrove 23/05/05

The Highgrove 22/11/04

The Highgrove 01/06/04

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

CARE HOMES FOR OLDER PEOPLE The Highgrove 88/90 St Annes Road Blackpool Lancashire FY4 2AT Lead Inspector Christopher Bond Unannounced Inspection 09:30 8 August 2007 th 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 The Highgrove DS0000009764.V339566.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Highgrove DS0000009764.V339566.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Highgrove Address 88/90 St Annes Road Blackpool Lancashire FY4 2AT 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) 01253 344555 Mr Anand Seedheeyan Mrs Savitree Seedheeyan, Mr Islamuddeen Duymun Ms Nicola Patricia Bryan Care Home 30 Category(ies) of Dementia (25), Mental disorder, excluding registration, with number learning disability or dementia (5) of places The Highgrove DS0000009764.V339566.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service is registered to accommodate a maximum of 30 service users to include up to 25 service users in the category DE (dementia) and up to 5 service users in the category MD (mental disorder). 31st May 2006 Date of last inspection Brief Description of the Service: The Highgrove Care Home is situated on St. Annes Road, Blackpool. It is registered for 30 people, and at the time of the inspection there were 30 people in residence. The Highgrove is registered to care for people who have Dementia and Mental Illness. The home is close to a variety of shops and amenities, and bus services run from close by to Blackpool town centre and other areas of the town. There are some double rooms, but the majority of service users are accommodated in single bedrooms. The home has a private garden to the front of the house; the rear of the house is paved. A lift is available that services both floors. Information relating to the home’s Service User Guide and Statement of Purpose is included in the welcome pack, which would be given to all prospective residents. This information explains the care service that is offered, who the owner and staff are, and what the resident can expect if he or she decides to live at the home. At the time of this visit, (08/08/07) the information given to the Commission showed that the fees for care at the home are from £282.00 per week to 357.00 per week, with added expenses for chiropody and hairdressing. The Highgrove DS0000009764.V339566.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place over a total of four hours. A guided tour of the home was undertaken. Resident records and staff records were also examined. The manager and care staff were spoken to and their responses are to be found in the body of this report. Residents of the home were also spoken to. An ‘Expert by Experience’ joined us to undertake this inspection, as part of an external stakeholder group who have used services in the past. What the service does well: What has improved since the last inspection? There has been a lot of training for the care staff and over 50 of them have now achieved a nationally recognised care qualification (National Vocational Qualification level 2 or 3). The care staff recognised that the training at the home has improved. There is a building next door to the home where training evens take place. Recording every day aspects of care has improved a lot and information is a lot easier to find. Care planning for the residents has improved. The home has a policy regarding smoking. Many people now smoke outside which makes the atmosphere far nicer for those who live at the home. The Highgrove DS0000009764.V339566.R01.S.doc Version 5.2 Page 6 The organisation of the home has improved and there is now a better system adopted by the management team to ensure important tasks are completed on time. 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. The summary of this inspection report can be made available in other formats on request. The Highgrove DS0000009764.V339566.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Highgrove DS0000009764.V339566.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1 and 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents are given good information about this home. They can then make an informed decision as to whether or not the service is right for them. Residents are assessed before they are admitted so that the home can be confident that they can meet people’s needs. EVIDENCE: Most of the people who chose to live at The Highgrove received plenty of information about the home before moving in. A Service User Guide was available to inform prospective residents about the services that were on offer. This information helped the residents and their families to make an informed choice about whether the home was right for them. Most of the residents were able to confirm that they had been given this information. The Highgrove DS0000009764.V339566.R01.S.doc Version 5.2 Page 9 Each of the residents had been assessed before coming to live at the home so that a decision could be made as to whether the staff could care for them properly and address their specific needs. The manager usually visited prospective residents to complete this assessment. There was a copy of this assessment on each of the residents’ personal information files. The Highgrove DS0000009764.V339566.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents health and social care needs are met and well planned. Residents are supported and protected in their daily lives. The people in this home were looked after well and treated with dignity and respect. EVIDENCE: Everyone who lived at this home had a plan of care that documented all of their daily needs and how the staff would address these needs. There was lots of information written down. We looked at five of the care plans and there was enough information in each of these plans to show that the care needs of the residents were being dealt with properly and appropriately. One of the residents was case tracked and it was found that he was receiving appropriate care and support regarding his health needs. There were visits by mental health professionals to supplement the care given by the home. The gentleman felt that his needs were being met and that he was happy living at the home. The Highgrove DS0000009764.V339566.R01.S.doc Version 5.2 Page 11 Appropriate measures were in place to prevent the development of pressure sores. The manager was fully aware of the necessary action to take should anybody develop these. There was special equipment available to prevent pressure sore development and to aid healing. There were no residents with pressure sores at the time of the inspection. The district nurse visited the service on a regular basis to help care for some of the residents with medical needs. There were notes within the care plans to ensure that the care staff were aware of her actions. There were also good notes regarding the visits to doctors and other care professionals. Only senior care staff were responsible for assisting the residents with their prescribed medication. There had been recent training in the correct handling of medication. This is important because it meant that staff had the necessary skills to ensure that medication was handled properly. The medication record sheets of each resident were looked at and they were completed appropriately. Everyone had a photograph attached to his or her records to help identification. Systems were in place that ensured that all medication was handled correctly and professionally ensuring the safety of service users. The manager and assistant manager had worked hard to ensure that all of the requirements from the last inspection had been completed and that the medication procedures for the home were being adhered to properly. The care staff were seen to speak to the residents respectfully and properly. One of the residents said that she was always spoken to nicely and looked after properly by the staff at the home. The Highgrove DS0000009764.V339566.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Visitors to the home are welcomed and encouraged in order to maintain valued relationships. The activities programme is varied and helps to keep the residents attentive and active. Mealtimes are planned and unhurried and residents’ preferences are respected. EVIDENCE: An ‘Expert by Experience’ joined us to undertake this inspection, as part of an external stakeholder group who have used services in the past. He found that the atmosphere at the home was relaxed and friendly and that the staff were on hand for people without being overbearing. He also commented that those who were able to could come and go as they pleased. Risk assessments were completed for those who were able to exercise their autonomy and go out into the community to use the facilities and resources that were available there. The expert also commented on the strong spirit of community at the home. One resident said that he liked the home because they ‘had a good laugh’ there, and people were seen to get on well together. The Highgrove DS0000009764.V339566.R01.S.doc Version 5.2 Page 13 He commented that mealtimes were relaxed, with people choosing to eat at different times. All of the residents that were spoken to said that they thought the food was generally very good and that they mostly looked forward to meal times. We sampled the lunchtime meal. This was nicely cooked and appetising. One resident commented, “The food is usually lovely, there’s always a choice.” There was a public phone in the main lounge. This was not in a very private place and other residents could overhear conversations. This was commented on by the expert. There was a trip out to the zoo for some of the residents during the inspection and there were a number of other activities planned for the forthcoming month. There were regular parties planned to celebrate important events and entertainers were booked on a regular basis. Some of the residents enjoyed playing cards and dominoes. There was a reminiscence pack for those with cognitive disorders. There were no visitors to the home at the time of the inspection. Several residents confirmed that their visitors were always welcomed, offered refreshments and asked whether or not they would prefer privacy. It is important that visitors are encouraged and valued relationships are maintained and nurtured. A visitor’s room was planned for the future where people would enjoy more privacy. The Highgrove DS0000009764.V339566.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are safeguarded through good training, policies and procedures. Complaints are treated seriously to ensure that the residents’ rights are protected. EVIDENCE: There were policy documents for the staff to read about how to ensure that people were safeguarded from harm. All of the staff that were spoken to said that they had a good awareness of this important issue and knew what to do if they were not happy about something they had seen. The manager was aware of her responsibilities and knew whom to contact should abuse be suspected. Recent training had taken place regarding safeguarding adults for all of the staff. It is important that all of the care staff that work at the home have access to this information as it helps to ensure that people are safeguarded from harm. All of the staff that were spoken to said that they knew what to do if someone was unhappy about the service. The complaints procedure was displayed in the home and was part of the Service User Guide. The manager was aware of her role regarding the complaints procedure and how complaints can be used as a quality tool to ensure that the home is run in the best interests of the residents. Four of the residents who were spoken to said that they were aware The Highgrove DS0000009764.V339566.R01.S.doc Version 5.2 Page 15 of the procedure to follow if they were unhappy about anything at the home. All felt confident that their concerns would be dealt with appropriately. The Highgrove DS0000009764.V339566.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19, 20, 21, 23, 24, 25 and 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The house had a ‘homely’ feel but this was compromised by shared bedrooms and poor quality furnishings. EVIDENCE: There had been some furniture purchased for the home recently. This brightened some of the rooms up a little but there were still rooms that had poor quality furniture, beds and vanity units. The communal areas were pleasant and the residents that were spoken to said that they liked the way that the home looked and felt comfortable there. Some of the bedrooms were bright and well decorated but there were rooms that were in need of refurbishment. Most of the bedrooms were double rooms. The residents that were asked said that they didn’t mind sharing. The Highgrove DS0000009764.V339566.R01.S.doc Version 5.2 Page 17 The home was safe, well maintained, warm and parts of it had a ‘homely’ feel. There were quite a few people who smoked and there was an area reserved for smokers at the back of the home. There was a paved garden area to the front of the home with a high hedge to help keep this area private. The Highgrove DS0000009764.V339566.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff were caring and competent in their roles. Well -qualified care staff helped to ensure that a quality service was given. EVIDENCE: There were enough care staff on duty during the inspection to ensure that the assessed needs of the residents were adequately dealt with. The staff rotas showed that staffing was good and that there were plenty of staff on each shift to ensure that people were being properly looked after. All of the questionnaires received said that there was always or usually staff available when they were needed. Most of the care staff had achieved a nationally recognised qualification in care (National Vocational Qualification level 2 or 3). There was a good induction process to help ensure that new care staff were competent before commencing their role. Staff records showed that new carers had been properly checked before starting their jobs, including obtaining Criminal Records Bureau checks. This helped to make sure that the residents were safer by ensuring that suitable The Highgrove DS0000009764.V339566.R01.S.doc Version 5.2 Page 19 staff are employed. There was evidence within the care staff files to show that the correct information had been gathered prior to employment. The Highgrove DS0000009764.V339566.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 32, 33, 35, and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed in a competent and a professional manner. Good safety procedures and a well-trained staff team protect the residents. The home is being run in the residents’ best interests. EVIDENCE: Good records were being kept of safety checks within the home. These showed that professionals were checking the lift, electric and gas equipment and the fire alarm system regularly. This helped to ensure that the residents lived in a safe home. Trained maintenance people were also checking the lifting equipment in the home on a regular basis. The Highgrove DS0000009764.V339566.R01.S.doc Version 5.2 Page 21 Staff were being instructed in safety aspects within the service. They were being shown how to move those residents, who had difficulty in supporting their own weight, safely and respectfully. Other safety training included fire safety awareness, and food hygiene. All of the care staff that were spoken to were able to confirm that they had received safety training. There is still a need for the manager to complete a recognised qualification in management (National Vocational Qualification level 4 in management and care). This is important because such training helps to give the manager more skills regarding managing the home properly and professionally. One resident chose to smoke in his bedroom. This was a shared room and there were safety issues to address regarding other residents in the home. He had been advised no to do this to respect the health and welfare of other residents. The manager had completed a full risk assessment regarding this practice and the advice of the fire service had been sought to improve procedures should there be a fire. The owners of this service were in daily contact with the home and visited the home frequently. They were always on hand to offer advice and support for the manager of the home, which was important for the smooth running of the home. The Highgrove DS0000009764.V339566.R01.S.doc Version 5.2 Page 22 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 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 X X X 2 2 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X X 3 The Highgrove DS0000009764.V339566.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes 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 OP24 Regulation 16(2c) 23(1a) Requirement Furniture in service users bedrooms must be of good quality and suitable for its intended use. The registered manager must complete National Vocational Qualification level 4 in Management and Care. Timescale for action 31/10/07 2. OP31 9 (2) (b) 31/12/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Highgrove DS0000009764.V339566.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 The Highgrove DS0000009764.V339566.R01.S.doc Version 5.2 Page 25 - 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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