Care Home: Highbury House

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What the care home does well Highbury House provides a friendly, well-maintained clean and homely environment in which people can develop their independence skills and confidence enabling them to make decisions and choices about all aspects of their lives. Highbury House has a staff team that relates well to the people living in the home and is able to demonstrate a good understanding of the needs of individuals and the support required. People living in the home rights are promoted and they are supported to develop their independence and to take part in activities of their choice. The staff interviewed stated that the home has a good supportive staff team. What has improved since the last inspection? The recent improvements to update the home have included the fitting of new carpets in the office and hallway as well a decorating of the entrance hall. Several people who live in the home have had their bedroom redecorated and included new flooring. Other areas of improvement and new equipment included the dining room being redecorated, a new drug cupboard and a large flat screen T.V. for the lounge. What the care home could do better: All people living in the home should have a care plan and risk assessments in place completed by the home. No Requirements have been made in this report. Key inspection report Care homes for adults (18-65 years) Name: Address: Highbury House 207 Outland Road Peverell Plymouth Devon PL2 3PF     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Kim Fowler     Date: 1 0 0 9 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Highbury House 207 Outland Road Peverell Plymouth Devon PL2 3PF 01752753710 01752796299 admin@plymouthhighburytrust.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Plymouth Highbury Trust Name of registered manager (if applicable) Ms Christina Czerwinski Type of registration: Number of places registered: care home 9 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is 9 The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Learning disability (Code LD) Date of last inspection Brief description of the care home Highbury House is a care home providing personal care and accommodation for nine people with learning disabilities. It is owned by the Plymouth Highbury Trust, which is a voluntary sector organisation, which took over the ruuning of the home from Royal Mencap Society in 200. This home is located in the residential area of Peverell, close to shops, pubs, the post office and other amenities. Highbury House is situated on the 1st floor of a building on the site of the Plymouth Mencap Society, where there is also another care home and a day centre owned and managed by the Society. There are Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 9 Brief description of the care home stairs and a shaft lift available. All the homes bedrooms are single and none of them have en suite facilities. There are separate lounge and dining rooms and the home has a call bell system throughout. The home has an attractive patio and garden accessible to everyone living in the home, shared with the other facilities on the site. The current fee start from 308 pounds to 766 pounds but may vary based on individual need. Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The unannounced inspection took place over 1 day and started at 10:00am and finished at 2:30pm on the 10th September 2009. The registered manager Ms Christina Czerwinski was available throughout most of the inspection. We made a tour of the building and spoke to most of the people living at the home. Documentation relating to the care planning process and the management of the home were examined. Any comments received during the inspection are in the relevant section of the report. Care Homes for Adults (18-65 years) Page 6 of 29 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 29 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective new admissions referred to the home can be assured that they will be provided with sufficient information for them to make an informed choice about living at this care home. Evidence: The home has had two new admissions since the last inspection and both files for these admissions were examined. Evidence showed that both files held had preadmission assessment forms completed. Neither was signed by the manager who had visited and completed these forms; however the manager signed and dated both forms immediately. The manager confirmed that the pre-admission process is based on the person centred planning approach to ensure any prospective new admissions are suitable for admission to the home. The admission process also includes taking a full history and assessment of needs. This would ensure that the care needs of any person moving into the home could be Care Homes for Adults (18-65 years) Page 9 of 29 Evidence: met. Pre-admission information would also provide information for individual care plans. This information would be important so prospective admissions are assured that not only can their health care needs but also their physical needs are managed and met by the home. One file recorded details of visits to the home before admission and this included meal visits. And both files also held contracts with Highbury Trust detailing the fees paid and the terms and conditions of occupancy. The homes AQAA states that, When we have vacancies, we offer any prospective resident the opportunity to visit us, they are welcome to come for tea and can come to have some sleep overs for a few times before they become a permanent resident and meet with the other residents on several occasions. Care Homes for Adults (18-65 years) Page 10 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People continue to be encouraged and supported to make daily decisions about their own lives to maintain their independence. Evidence: The files for three people living at the home were examined. Two files examined held individual care plans in place and the details held on these files are needed by staff to met individual needs. These care plans show a breakdown of the services and facilities provided by the home as well as current needs, specialist input and guidelines for staff to manage individuals. Each individual plan provides staff with the information on how to care for each person and ensure continuity in care and have been completed to enable staff to carry out their duties. All plans ensure that all aspects of health, personal and social needs will be met. However the 3rd file examined for the last new admission to the home 5 weeks ago Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: does not have a risk assessment or a completed care plan. There are risk assessments and a care plan from this persons previous placement. Other files were supported by the placing authority care plan and a list of review dates and meetings of regular review meeting and who was in attendance at these meetings. This ensures that people living in the home were involved in regular reviews. The home has also started to develop PCPs (Person Centred Plans) for each person within the home and several examined showed the work in progress. Observed throughout the day were people discussing with staff about everyday issues. This included one person discussing with staff about some clothes they needed to sort out and replace and some one arranging to go to the local churches coffee morning independently. One person confirmed they had been out shopping and chosen a new item of furniture for their bedroom. The manager confirmed that individuals are provided with options about were to go on holiday or day trips and then the options available are discussed and destination chosen. The homes AQAA states, We have up dated the format that the care plans are in so they are more user friendly and they are activity involved in implementing their care plan saying what they want. All resident plans have been updated. Most people require staff support to manage their money and this includes people having bank cards and savings accounts. The statements for some people were seen and confirmed benefits were paid into individual bank accounts. The money held for 2 people was checked and found to be correct with a clear audit trail of income, expenditure with receipts kept. Two files held risk assessments to cover all aspects of risk. These risk assessments included independent living skills and manual handling risk assessments with assistances on using the hoist if required. This information is important to minimize risk. The manager confirmed that one person is currently having support from outside professionals and guidelines have been provided to assist the staff with this person. One person living in the home said, I went out to a coffee morning and go to the Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: shops on my own. Care Homes for Adults (18-65 years) Page 13 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Highbury House continues to promote and provide support for people to access the local community and leisure activities while promoting independence. Evidence: The home is planning to change to Supported Living. Currently people are having assessments on their Independent Living Skills with other professionals involved. Two people have recently left the home to live independently and the home is to be commended in the support that was provided to assist these people moving to independent living. Most of the people living in the home were available throughout the day of the inspection. Some were able to confirm that they go out to different places and includes local shops and day services. Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: Observation during the inspection were people discussing with staff the plans for the day and included going to the shops and what they wished to purchase with their money. The files recorded, and staff and individuals spoken with, were able to confirm that everyone attends a variety of day time activities. This included one person attending a day service provided by the placing authority, one person doing voluntary work in Charitys shops and another person having a job in a day centre. One person said, I have an enabler to take me out. The home arranges different activities and this included visits to the pubs, restaurants and the local swimming pool. One person confirmed they had been to the local church during the inspection as they were holding a coffee morning. One person was away in Germany on the week of the inspection with a member of staff. Another person confirmed they had been on day trips and someone else saying, I went to Torquay and stayed in a hotel. The homes AQAA records under their plans for the next 12 months,To continue to provide our residents with valued activities and with opportunities to increase their social circle of friendship. To become active citizens within their hometown. Throughout the inspection people living at the home were observed coming and going either out in the community, including local shops, or going to there designated day service. Observation throughout the day were people living in the home participating in daily routines including preparing the tables for meals and assisting with preparing the evening meal. One person said, I am helping with the carrots. Information held on files is used to promote the respect, privacy and dignity of each person living in the home and the home and the grounds are assessable for all. One family member was contacting the home during the inspection and was heard to arrange a visit to the home. This included this family member staying for a meal with their relative. The manager confirmed that other people see family members regularly and information is recorded into individuals files on the family and friends involvement for each person. Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: One person was able to confirm that the staff knock on their bedroom door and they have their bath in private. All care plans seen showed they are based on the promotion of independent living skills and this included all people living at the home having keys to individual bedrooms. All the people spoken with about the food and who were able made positive comments and one person said that they go to the local shops to help with the shopping. One person said, The food is nice and another stated, I like the food. One person was observed preparing the evening meal of chicken and pasta and corn beef hash as a second choice and fresh vegetables. One person stated they had, Cheese on toast for lunch and everyone is encouraged to make their own lunch. Everyone has access to the kitchen at all times and several people were observed making hot drinks throughout the day. The manager confirmed that the menu is drawn up daily and is dependent on the meat order that arrives and people sit down and chose a menu each day. Healthy eating is encouraged and the home provides fresh vegetable and fruit to assist with this. Care Homes for Adults (18-65 years) Page 16 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff were observed promoting individuals independence and providing good personal support promoting privacy and dignity at all times. Access to health care is maintained to promote the wellbeing of all who live in the home. Evidence: The files examined showed that all personal support is recorded into individual care plans and these are easily accessible for staff and all rooms are single. People who require a moving and handling plan have this information recorded into their files and this information is drawn up to assist staff on how best to provide personal support to individuals. This ensures consistency in the care provided. These care plans are based on assessed needs and evidence was recorded that these are regularly reviewed and then signed. Guidance on personal care is clearly recorded into individual files and this ensures that staff are aware of peoples needs and will promote consistency in care. The homes AQAA states, We have involved the residents in their care plans, they have expressed Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: their wishes in their care plans about how they want to be cared for and how they like things done. Each person has a Health Action Plan held on their file. The information held on these plans includes medical visits and any actions or follow ups required and yearly check ups people have with their own GP. One person was able to confirm that the staff supports them with their personal needs and in a way with is suitable to them. One person confirmed that their bedroom door was shut. The homes Health Action Plans provided evidence that specialist support is provided and included attendance of Occupation Therapist services. Other files contained letters for hospital out patient appointments and confirming future dates arranged. This ensures that each person living at the home health needs are met and that specialist input is sort. The home uses the Blister pack system to dispense medication and the pharmacist had completed an inspection of the homes system last year. The recording sheet staff are to sign when medication is dispensed was checked and found to have gaps in the recordings. The manager stated that if people did not receive their medication this would have been picked up with the blister packs not having been dispensed. The manager confirmed that all staff receives medication training and staff files showed certificates held with some staff spoken with confirming they had attended medication training course. Care Homes for Adults (18-65 years) Page 18 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in this home can be confident that any complaints or concerns raised will be listened to, acted upon and well managed by the home, which protects the welfare of all. Evidence: The homes complaint procedure is held in each person bedroom as well as the homes notice board. The complaints procedure is in sign format to assist people living in the home. The homes complaints procedure is clearly displayed on the homes notice board and is also available in the homes Statement of Purpose and Service Users Guide. This information included how to contact the CQC and the process of how a complaint is dealt with including timescales. The Commission had received no complaints. The home has received two complaints since the last inspection. The complaints held were in the designated complaints folder and showed the complaint, action taken and the outcome for each. Both complaints were dealt with within the home and no safeguarding issues were raised. All staff have received safeguarding training and one staff spoken with was able to confirm the process if a concern is raised. The staffs training files held certificates from the local authority on Safeguarding training completed by the staff team. Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: The homes AQAA states, Our residents are comfortable and confident and openly express their feelings on any issues they may have, knowing they will be listened to and their concerns acted upon. Some of the people spoken with and were able to confirm they knew who to talk to if they had any concerns and that the staff and management were approachable if needed. Care Homes for Adults (18-65 years) Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in Highbury House enjoy a comfortable environment and are involved in all decisions relating to the decoration of the home. Everyone is encouraged and supported to personalise their bedrooms. Evidence: A full tour of Highbury House shows it is suitable for its stated purpose and the home remains to be well kept, safe and accessible for all the people currently living at the home. Plymouth Highbury Trust employs their own maintenance person who carries out regular everyday repairs. A tour of the home showed it to be a warm, bright and a well decorated home. Individual bedrooms showed that peoples rooms contained personal items including furniture, ornaments and pictures that reflect their personality and interests. And the premises were clean hygienic and free from offensive odours and the laundry facilities were separate and a sluice was available. All bedroom doors have locks fitted; however some people choose not to hold keys. Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: Risk assessments are held on individual files reflecting these choices. The recent improvements to update the home have included, the fitting of new carpet in the office and hallway as well as the main entrance area being repainted. Some individual bedrooms have been redecorated and have new flooring. One person confirmed that they have chosen the new paint for their bedroom which is due to be painted next week. This person said, I chose blue paint. The AQAA records under there plans for the next 12 months, To continue with the ongoing process of re-decoration and refurbishment where deemed necessary. Many staff had completed Infection control training and on the day of the inspection 2 other staff were undertaking an Infection Control course and the manager confirmed that the home has linked up with the local Infection Control working group. The staff spoken with were able to confirm that the home provided disposable aprons and gloves for their protection. Care Homes for Adults (18-65 years) Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Highbury House staff team are well trained, well supported and safely recruited, which assures the people living in the home that their needs will be met in safe and informed manner. Evidence: The staff were observed throughout the inspection responding sensitively and respectfully to each person living in the home and thus were able to use their knowledge of individuals to encourage choice and independence were possible. All staff were observed to be friendly, good-natured, courteous and respectful at all times. They interacted well with the people living in the home and some of the activities being planned and undertaken were observed showing that the staff and the people living in the home having fun in a relaxed friendly atmosphere. The staff spoken with were able to confirm that there were sufficient staff on duty to meet the current needs of people living in the home. On the day of the inspection there was the manager and two support staff. The home also provides sleep in staff and an on-call system for the management. Observation showed that the staff members on duty were aware of individuals needs Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: and how best to support them. Several people spoken with were able to agree that the staff team were very good and it was evident that there was a good rapport between everyone living and working in the home. Examination of staff files showed that all staff had the required pre-employment checks, including CRB (Criminal Record Bureau Disclosure) in place ensuring as far as possible unsuitable staff are not employed. The homes AQAA returned to the Commission states. All new staff completes the Learning Disability Qualification Award, which meets the Skills for Care Induction Standards. Discussions with manager and the staff showed that all staff participate in and update training course when needed. The training recorded in individuals files show that induction, adult protection, first aid, health and safety, fire safety, medication, food hygiene, National Vocational Qualifications (NVQs) and courses related specifically to working with people with learning disabilities is regularly undertaken. These include course on epilepsy, dementia and total communication skills. The home currently has four of the eleven staff employed holding an NVQ qualification The homes AQAA records what they plan to do in the next 12 months and it states, For staff to gain relevant qualifications and for the manager to keep up with relevant information. The staff on duty spoken with during this inspection confirmed regular training was offered. These staff also felt that they were able to express their view at staff meetings held in the home. Regular consultation with staff ensures staff can contribute to the running of the home and are aware of the homes aims and objectives, philosophies of care and promotes consistency and improvement. One staff member said of the staff team, I really enjoy it here. When asked several people living in the home agreed that the staff helped and supported them. The staff confirmed, with records held on individual files, that supervision and appraisals are regularly undertaken and staff confirmed they are well supported. Care Homes for Adults (18-65 years) Page 24 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in Highbury House benefit from a well run home, in which their safety and welfare is protected. A range of auditing systems are in place which help monitor and improve the quality of the service and help to protect peoples health and safety. Evidence: The home has a new manager since the last inspection. Ms. Christina Czerwinski is registered with the Commission and has worked in the care profession for a number of years. Ms. Czerwinski holds a degree in Health and Social Care Management and has also completed many courses including courses on Dementia, 1st Aid and Dignity and Respect. The staff and people living at the home who were spoken with were able to confirm that the manager is approachable and is highly thought of by all spoken with. Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: The home has produced a quality assurance survey and the completed surveys were examined. These forms were all positive and included comments from relatives that included, Staff always keep me informed of any problems and another saying about the staff, Very friendly, helpful and approachable. A excellent dedicated staff. The homes AQAA states, To continue to implement the new health and safety management systems and improve the training for staff in this area. Sampling of servicing records indicated that equipment is serviced regularly and maintained in good working order, including the fire alarm system. Certificates were available on all Health and Safety equipment i.e. hoist ensuring all have been checked. Gas and electrical appliances were being routinely serviced and checked. Electrical systems were being serviced during the inspection by a outside contractor. The fire protection system was well maintained. Maintenance checks are being carried out. Staff are receiving appropriate fire protection training to ensure they have the skills to deal with emergencies. Good health and safety practices reduce any unreasonable risk, affecting people living at the home, to an acceptable level. Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 6 All people living in the home should have a care plan and risk assessments in place completed by the home. Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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