Care Home: High Trees

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What the care home does well The manager and the staff are careful to make sure that they can look after anyone who wants to come and live in the home and give lots of opportunities for them to find out about it by visiting and reading about it. They try hard to find out what people like to do and try to make sure that they can do it and they find out what they like to eat and try to make sure that is what they get. If a resident is ill they make sure that they get treatment. If a resident doesn`t like something they can complain to the manager or any of the other staff. All three areas of the home are clean and well decorated. It is in Bishops Castle and it is very easy to get to local shops from there and there is plenty of transport so that people who live in the home can get to other things like cinemas, bowling and many other places that they would want to go. The staff are cheerful, friendly and helpful and encourage people to enjoy themselves but also try to make sure that they are safe and well looked after. The managers and the owners are also cheerful, friendly and helpful and organise things that help the staff to do their jobs and makes sure that the home is a safe place to be. What has improved since the last inspection? There were no recommendations or requirements made at the last inspection. What the care home could do better: There were no recommendations or requirements made at this inspection. CARE HOME ADULTS 18-65 High Trees Bull Lane Bishops Castle Shropshire SY9 5DA Lead Inspector Mike Moloney Key Unannounced Inspection 15th April 2008 09:00 High Trees DS0000020650.V362462.R01.S.doc Version 5.2 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 High Trees DS0000020650.V362462.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 Adults 18-65. 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. High Trees DS0000020650.V362462.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service High Trees Address Bull Lane Bishops Castle Shropshire SY9 5DA 01588 638580 01588 630233 Bccastlecare@aol.com 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) Mr Robert Gibson Hicks Mrs Margaret Hicks Timothy Duncan Hicks Care Home 18 Category(ies) of Learning disability (18) registration, with number of places High Trees DS0000020650.V362462.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Further input be sought with regard to Learning Disabilities and associated conditions to increase the manager`s (Tim Hicks) knowledge. That the Registered Managers Award and NVQ Level 4 core elements are completed within the first year of registration. 26th July 2006 Date of last inspection Brief Description of the Service: High Trees is a private care home registered with the Commission for Social Care Inspection to provide a full residential service for up to ten adults with a learning disability. An annexe, built in a traditional design and known as High Trees Nova has been added within the grounds to provide an additional eight places. This is a development over two floor levels, designed to provide maximum comfort and convenience for residents. The home is situated close to the entrance to the South Shropshire market town of Bishops Castle. The Home is owned by Mr & Mrs Hicks. Mr Tim Hicks has day to day management responsibility for the home. Service Users and Staff have created a warm homely atmosphere in which residents can relax and be supported following ordinary life principles. Information is available about the home in the form of a service user guide which is available in an easy read version. Fees currently range from £600 to £1800. High Trees DS0000020650.V362462.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 star. This means that the people who use this service experience excellent quality outcomes. A range of evidence was used to make judgements about this service. This includes: information from the provider which included a self assessment document that they are required by law to complete, records kept in the home, medication records, discussions with the staff team, tour of the premises, previous inspection reports and talking with as well as observing the care experienced by people using the service What the service does well: The manager and the staff are careful to make sure that they can look after anyone who wants to come and live in the home and give lots of opportunities for them to find out about it by visiting and reading about it. They try hard to find out what people like to do and try to make sure that they can do it and they find out what they like to eat and try to make sure that is what they get. If a resident is ill they make sure that they get treatment. If a resident doesn’t like something they can complain to the manager or any of the other staff. All three areas of the home are clean and well decorated. It is in Bishops Castle and it is very easy to get to local shops from there and there is plenty of transport so that people who live in the home can get to other things like cinemas, bowling and many other places that they would want to go. The staff are cheerful, friendly and helpful and encourage people to enjoy themselves but also try to make sure that they are safe and well looked after. The managers and the owners are also cheerful, friendly and helpful and organise things that help the staff to do their jobs and makes sure that the home is a safe place to be. High Trees DS0000020650.V362462.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. High Trees DS0000020650.V362462.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection High Trees DS0000020650.V362462.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. People and their representatives have the information needed to choose a home and they are assessed so that the home can determine whether or not they can meet their needs This judgement has been made using available evidence including a visit to this service. EVIDENCE: One person who had come to live at the home since the last inspection was spoken to and his records were looked at. He said that he had been asked what he liked to do and what he would need as support if he were to live at the home. He talked about how he had visited the home before he came to live there and had been given the opportunity to ask questions about things that concerned him. The records also showed that the home had asked healthcare professionals what he would need as support to make sure that they could arrange for it to be provided. A service user guide was seen to be available that was in an easy read format. High Trees DS0000020650.V362462.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is good. Individuals are involved in decisions about their lives and play an active role in planning the care and support they receive. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The records for two of the service users were looked at and these showed that their support plans had been reviewed on a regular basis. Talking with the individuals concerned confirmed that they had been fully involved in this process. During the inspection staff were seen talking with service users and checking with them what they wanted to do or have. The files were seen to contain lists of their likes and dislikes and the staff confirmed that these had been obtained by talking with the service users or by watching them make choices. High Trees DS0000020650.V362462.R01.S.doc Version 5.2 Page 10 The service user records were also seen to contain a range of risk assessments relevant to the activities identified in their support plans. Risk assessment training for staff was seen to have been included in the range of training that they have to undergo. High Trees DS0000020650.V362462.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, and 17 Quality in this outcome area is excellent. People who use services are encouraged to make choices about their life style and are supported and encouraged to develop their life skills. Social, educational, cultural and recreational activities are arranged to meet individual’s expectations in ways that take into account individual’s strengths and wishes. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three of the service users were spoken to about their lifestyles and the records kept by the home about their activities and interests were looked at. It was clear that they were able to take part in a range of activities of their choice. A wide range of activities had been arranged for the people living in the home. One service user was very enthusiastic about leaving to go and play golf on the morning of the visit. Another said that because of the weather he had chosen to stop activities such as swimming and horse-riding for the time being. The home had also arranged group activities such as music therapy and a number of the service users spoken to during the visit were enthusiastic about this. High Trees DS0000020650.V362462.R01.S.doc Version 5.2 Page 12 Some of the service users also go to day services provided by outside organisations. Some of the older service users talked about how they are offered trips to the cinema, bowling and similar activities. They also said how they liked to spend time sitting as a group, watching television and chatting amongst themselves and with the staff. Given their age and physical problems the less energetic activities were more appropriate for them. Various vehicles were seen to be available to transport service users to and from their activities. Staff were seen knocking before entering rooms and heard asking occupants if they minded if we went into their rooms. They were also seen to be constantly chatting and checking with service users throughout the visit. A number of the service users spoken to about the meals showed a lot of enthusiasm for them. Looking at the menus showed that they were varied and balanced. Where service users had particular requirements these were catered for and some of the service users affected talked about this. High Trees DS0000020650.V362462.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is excellent. The health and personal care that people receive is based on their individual needs, preferences and abilities. The principles of respect, dignity and privacy are put into practice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Looking at the service users’ records showed that health of each of the service users is closely monitored. Examples of the areas included in the monitoring were mental health, behavioural issues, oral hygiene, epilepsy and sleep. A record of each visit to or by a health care professional was seen to be kept. Talking with the managers and the staff confirmed that these appointments had been made as and when necessary. The administration and storage of medication was looked at with storage consisting of secured trolleys. At the time of the inspection no controlled drugs were kept in the home. Appropriate administrative systems were seen to be in place and the records showed that they had been followed. The staff confirmed that only those who had received the appropriate training were allowed to administer the medications. High Trees DS0000020650.V362462.R01.S.doc Version 5.2 Page 14 One of the service users said that he administers his own medication. He said how he had been trained to do so by a nurse and also talked about how the home support him when he does this. He was able to give a detailed explanation of what he had to do and this was confirmed by the written risk assessment seen in his file. Another service user who has been known to the home for some years talked about how he had been able to have quite serious operations on some of his joints over recent years with the staff saying about the high levels of support that had been given by healthcare professionals both as specialists and through the local GP practice. Each service user had a health action plan, weight charts, appointment records and incident records. Where appropriate other records were present such as food intake monitoring records. High Trees DS0000020650.V362462.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. People who use the service are able to express their concerns and have access to a robust, effective complaints procedure, are protected from abuse and have their rights protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The managers present said that the home has received no allegations of abuse or complaints. The home had a copy of the local policies and procedures for the protection of vulnerable adults as well as a copy of their own complaints procedure both being part of the systems that ensures that the service users are listened to and protected from abuse, neglect and self-harm. Although the disabilities of some of the service users means that they are unlikely to be able to access these formal policies, observation of the staff interacting with them and communicating between themselves indicated that they, the staff, would be aware of any dissatisfaction expressed by a service user and it was seen that a whistle blowing policy is available to be used. However, a number of the service users spoken to talked about how they had approached the managers and the staff with issues and these had been either resolved or explained to their satisfaction. The managers also explained that some of the service users monies are managed by the home. Full records were seen to be kept outlining any transactions and those records are monitored by the home’s managers. High Trees DS0000020650.V362462.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. The physical design and layout of the home enables people who use the service to live in a safe, well-maintained and comfortable environment, which encourages independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home consists of two buildings and these are divided up into three separate living areas. Each area is accessed separately and is available only to those service users who have bedrooms there. Each has its own kitchen, laundry and bathing facilities that are available in a similar manner. Those facilities were seen to be appropriately equipped. One building is the older High Trees building and has one group of service users and the other building is the Nova building that has two flats each being home to four people. One of those groups have lived together in other premises for a number of years. Both houses are on two floors with a shaft lift being available in the Nova building for those with mobility needs. High Trees DS0000020650.V362462.R01.S.doc Version 5.2 Page 17 Each area has its own secure and private garden area. There is a large car parking area between the two buildings. The home is situated on the edge of the town of Bishops Castle in south Shropshire. High Trees DS0000020650.V362462.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome area is good. Staff in the home are trained, skilled and in sufficient numbers to support the people who use the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Talking with the service users, the staff, the managers as well as looking at the staffing rotas for all three areas established that there were enough staff available to meet the needs of the people living in the home. The home’s staffing is divided into three separate teams with each one catering specifically for each of the three residential areas. Staff also confirmed that they have professional supervision at least six times a year which confirmed what the home’s manager wrote in the self assessment provided to the Commission for Social Care Inspection. Records were looked at that showed that training was available to the staff and these were confirmed by a number of the people who were spoken to during the visit. The training ranged from induction and foundation training to the mandatory safety training in such things as food hygiene to specialist training in such things as epilepsy to National Vocational Qualification training. High Trees DS0000020650.V362462.R01.S.doc Version 5.2 Page 19 The home has an established National Vocational Qualification training programme with most of the staff being qualified to levels 2, 3 and 4 in care. Staff recruitment records for all of the homes in the group were kept centrally in one office in a standardised format. The records of one of the other homes had been looked at the previous week and as they were seen to be kept appropriately none were looked at during this inspection. Throughout the inspection staff were observed to be treating the service users with respect, dignity and friendliness. All of the service users spoken to during the visit were very positive about them. High Trees DS0000020650.V362462.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. The management and administration of the home is based on openness and respect, has effective quality assurance systems developed by a qualified, competent manager. This judgement has been made using available evidence including a visit to this service. EVIDENCE: In the home’s formal self assessment the manager confirmed that he has completed the Registered Managers Award as well as National Vocational Qualification 4 in care, both of which are the qualifications that are considered appropriate for someone who is managing a service such as this. As the manager is also one of the proprietors his regular presence enables him, as a proprietor, to monitor the performance of the home on a day to day basis. Each of the residential areas was seen to hold monthly residents meetings that also provided feedback on how the residents saw the service that they were receiving. High Trees DS0000020650.V362462.R01.S.doc Version 5.2 Page 21 A number of other records were looked such as those about hot water temperatures, fridge freezer temperatures, fire alarm systems and portable electrical appliances which showed that the safety of the people living in the home is monitored. Various risk assessments were seen to be carried out showing that the safety of the residents was considered when they are carrying out activities and when such things as cleaning materials are being used and stored within the home. High Trees DS0000020650.V362462.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 Adults 18-65 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 x 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 4 13 3 14 x 15 4 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 4 x 3 x 3 x x 3 x High Trees DS0000020650.V362462.R01.S.doc Version 5.2 Page 23 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations High Trees DS0000020650.V362462.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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 High Trees DS0000020650.V362462.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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