Care Home: Highbury House

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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 lives in this house and give lots of opportunities for them to find out about how they should be looked after by reading about it. They 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 if they can`t talk very well the staff are trained to notice if they are upset and to find out why. The residents` bedrooms are on both the ground floor and on the first floor so that people who have trouble getting around do not have to climb stairs. The manager and 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. What has improved since the last inspection? No requirements were made at the last inspection. However, the home has made further improvements to its policies and procedures to give the people living there more protection from abuse and exploitation. What the care home could do better: No requirements or recommendations have been made as a result of this inspection. This is a home that attempts to identify any areas that they need to improve in for themselves. CARE HOME ADULTS 18-65 Highbury House Aston Road Wem Shropshire SY4 5BA Lead Inspector Mike Moloney Key Unannounced Inspection 16th January 2008 10:00 Highbury House DS0000066489.V358297.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 Highbury House DS0000066489.V358297.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. Highbury House DS0000066489.V358297.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Highbury House Address Aston Road Wem Shropshire SY4 5BA 01939 233304 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) Adelphi Care Services Limited Debra Elizabeth Fritzl Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Highbury House DS0000066489.V358297.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home may accommodate 5 Adults with learning disability aged 1865 years. 3rd January 2007 Date of last inspection Brief Description of the Service: Highbury House is situated in a residential area of Wem within walking distance of the centre of the north Shropshire town centre. It is owned by Adelphi Care Services Limited and managed on their behalf by Debra Fritzl. She leads a team that specialise in providing care for people with more challenging conditions and behaviours. This is a home for five people with learning disabilities each of whom has their own room on either the ground or first floor. Further information is available from the home’s service user guide which can be made available in a variety of formats. Currently the home’s fees range from £110,000 per year to £180,000 per year. Highbury House DS0000066489.V358297.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: What has improved since the last inspection? No requirements were made at the last inspection. However, the home has made further improvements to its policies and procedures to give the people living there more protection from abuse and exploitation. Highbury House DS0000066489.V358297.R01.S.doc Version 5.2 Page 6 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. Highbury House DS0000066489.V358297.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 Highbury House DS0000066489.V358297.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): There have been no new service users admitted to this home and therefore it is not possible to assess its admissions procedures. EVIDENCE: Highbury House DS0000066489.V358297.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 of two of the people who live in the home were looked at and these showed that their care plans are reviewed on a regular basis with major reviews taking place twice a year and the senior staff reviewing the care needs at each of their monthly meetings. Direct input into these reviews by the persons concerned would be difficult due to their communication difficulties. However, given that their behaviour and reactions are so closely monitored by the staff team staff would have able to make a good assessment of what they are saying in less formal ways. By talking with the manager and the staff on duty it was seen that they take a person centred approach when dealing with the residents and use the individual’s behaviour as a measure of their approval. Highbury House DS0000066489.V358297.R01.S.doc Version 5.2 Page 10 The manager stated and the files showed that one of the people living in the home has an advocate who has been recruited through a local advocacy group. Highbury House DS0000066489.V358297.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 good. People who live in this home are able to make choices about their life style and are supported to develop their life skills. Social, educational, cultural and recreational activities meet individual’s expectations. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two of the service users records were looked at and these contained weekly timetables of activities for the individuals concerned. These included activities such as attending education groups organised by the provider, horse riding, swimming, visiting pubs and craft sessions. Risk assessments for a number of these activities were seen and these included how any behaviour management procedures should be applied. Records were seen of family and other social contacts. Highbury House DS0000066489.V358297.R01.S.doc Version 5.2 Page 12 Talking with the manager and the staff confirmed that the home has vehicles that are available to get residents to the places that their support plans say they need to be. The records of all of the meals were seen in the kitchen. Talking with the staff confirmed that they know what individuals want by talking to them, observing their reactions to different food at meal times and letting them help with the shopping. The menus appeared varied and nutritious and talking with the staff showed that they were aware of any special dietary needs of the residents. All of the bedrooms were seen to have appropriate locks. Staff were seen to knock before they entered a residents bedroom or any of the bathrooms. Highbury House DS0000066489.V358297.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 good. The health and personal care that people receive is based on their individual needs. 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: Support plans were seen to contain guidance to staff on how personal care and healthcare should be given. Records were seen to be kept that showed that the health of the individual service user was monitored. These included such documents as health action plans, weight charts and behaviour charts. Records seen in both of the files looked at showed the dates, times reasons for and results of healthcare consultations. The administration and storage of medication was looked at with storage consisting of two secure cabinets. 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 they receive training in the safe handling of medication. Highbury House DS0000066489.V358297.R01.S.doc Version 5.2 Page 14 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 excellent. Despite their communication difficulties 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 home was seen to have a complaints procedure that was available in an easily read version that contained plain language supported by symbols. The procedure was contained within a document that also explained what the service user could expect from the service with the whole thing being presented in the same accessible format. The manager explained how she had worked in conjunction with a local care providers group and the local authority to explore ways in which the people living at the home could improve their understanding of abuse. She said that the documentary information had been developed as a result of this. She and other staff confirmed that they sat down with individual service users and explained the document in ways that they thought they would understand. No complaints or allegations of abuse had been received since the last inspection. Experiences prior to that inspection showed that the home was aware of and knew how to access the local policies and procedures relating to vulnerable adults. Highbury House DS0000066489.V358297.R01.S.doc Version 5.2 Page 15 The records showed and talking to them confirmed that staff receive training in the protection of vulnerable adults and the local policies and procedures around this. They also confirmed that they receive training in an accepted method of managing aggression and that they were aware of the home’s Whistleblowing policy. Highbury House DS0000066489.V358297.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 is situated on a housing estate in Wem not far from local amenities. Bedrooms are situated on the ground and first floor giving good access for people with mobility issues. The building in clean and brightly decorated and has two lounge areas as well as a dining area which can be made part of the kitchen. There are three distinct areas of the garden to which the people who live in the home have access all of which are secure with access to each being carefully monitored by the staff on duty. Highbury House DS0000066489.V358297.R01.S.doc Version 5.2 Page 17 The home has a well equipped laundry area that can be accessed without going through food preparation or eating areas. Highbury House DS0000066489.V358297.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, 35 and 36 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, in line with their terms and conditions and to support the smooth running of the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Throughout the inspection staff were seen to be interacting with the service users in a sensitive, caring and professional manner. Looking at the rota and talking to the staff established that there were enough staff on duty to meet the needs of the service users. The gender mix of the staff team on duty reflected the mix of the service user group.The files of a number of the newly recruited staff were looked at in the provider’s head office and these were seen to contain evidence of the checks necessary to ensure that people who are employed by the home are fit to work with vulnerable adults. Looking at the staff training records and talking with the staff confirmed that there are training opportunities for all of the staff ranging from the mandatory Highbury House DS0000066489.V358297.R01.S.doc Version 5.2 Page 19 safety training to such things as National Vocational Qualifications in Care of which more than 50 of the staff have at least National Vocational Qualification level 2. Appropriate induction and foundation training is also available to staff who are new to the care industry. Looking at the records and talking with the staff also confirmed that they have regular supervision meetings with their manager and general staff meetings take place every month. Highbury House DS0000066489.V358297.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 excellent. The management and administration of the home is based on openness and respect, has effective quality assurance systems developed by a qualified, competent manager who consistently attempts to develop opportunities for the development of the service users social opportunities and ways of keeping them safe. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager confirmed that she has a number of qualifications that are relevant to working in this home and they include the Registered Managers Award and National Vocational Qualification 4 in care. During the inspection she talked confidently about the aims of the home and the ways in which the service was being developed in line with those, with one example being the development of the easy read service user guide and another being the way behaviour management programmes had been Highbury House DS0000066489.V358297.R01.S.doc Version 5.2 Page 21 developed for each of the people living there. She also talked knowledgeably about anti-discriminatory practice in care and employment issues. Equality and diversity for the service users were seen to be promoted throughout the home within the assessments, care plans and activities. The way that the home approaches the protection of the service users in the that they try to inform service users of their right to be heard, they access the local procedures as well as the way they record any transactions that involve the individual service user’s monies demonstrates that they are being transparent. This is further supported by senior managers of the company who carry out regular monthly visits to the home. During these visits a variety of issues are looked at to ensure that the home is performing at an acceptable level. These visits are formally recorded and copies are sent to the Commission for Social Care Inspection for information. A variety of records that showed that the safety of the environment in which the service users live is monitored were looked at and found to be up to date. These included records of the monitoring of fridge and freezer temperatures, fire equipment test logs, hot water temperatures and the portable appliance test records. The home was also seen to have secure storage for hazardous materials. As mentioned elsewhere in this report the staff team receive appropriate safety training in infection control, the safe handling of medicines, first aid, food hygiene, manual handling and fire prevention. Highbury House DS0000066489.V358297.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 x 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 4 23 4 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 3 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 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 4 x 4 x x 4 x Highbury House DS0000066489.V358297.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 Highbury House DS0000066489.V358297.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 Highbury House DS0000066489.V358297.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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