Care Home: Highbury New Park Care Home

What the care home does well The home had maintained excellent outcomes for people who use the service. The registered manager and staff have maintained good working relations with the people who use the service and their family members and relevant professionals, who had been useful for appropriate care delivery. It was observed during the interaction with the people who use the service on this inspection that, they were neatly dressed and appeared clean. During the inspection, we spoke with visitors to the home. One visitor has said that `my family and my mother have nothing but praise for the way the home is managed. Our mother, in particular is full of praise for the service`. An other visitor said `I am pleased my mother is here, place is good, neat, clean, staff take care of her well, very happy and her bedroom is good as well`. The premises was clean and tidy throughout without any offensive odors. What has improved since the last inspection? The grant received from the Department of Health has been used to convert a bathroom into an activity room, a small lounge into a reminiscence room, second floor smoking room into a Snoozelen room and third floor smoking room into a quite room. The replacement of corridors carpets with venyl flooring work was in progress, during the inspection. There has been an improvement with regard to the frequency of hair dresser`s visits. Staff have been given training about Deprivation of Liberty in coordination with London Borough of Islington. Nurses are encouraged to develop as Link Nurses within clinical specialists supported by the PCT and community based multi-professional team. What the care home could do better: The registered manager and staff to continue to provide excellent planning and care delivery, in the best interests of the people who receive services. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Highbury New Park Care Home 127 Highbury New Park London N5 2DS     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Pursotamraj Hirekar     Date: 1 9 0 8 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. Copies of the National Minimum Standards – Care Homes for Older People 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Highbury New Park Care Home 127 Highbury New Park London N5 2DS 03332004061 02077049926 manager.highburynewpark@careuk.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Care UK Community Partnerships Ltd Name of registered manager (if applicable) Mrs Siew C Batten Type of registration: Number of places registered: care home 53 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: 1st Floor - Dementia - Over 65 DE(E), Personal Care Only (18- Service Users) 2nd Floor - Dementia - Over 65 DE (E), Nursing Care (17- Service Users) 3rd Floor Dementia - Over 65 DE (E), Nursing Care (18 - Service Users) 1 bed can be used in respect of a named individual aged 63 and over Date of last inspection Brief description of the care home 127 Highbury New Park is a modern purpose-built care home providing care and support for older people with a form of dementia. The home was built and registered in June 2005 and is owned by the company Care UK Community Partnerships Ltd. The service provision is in partnership with Islington Council and Islington Primary Care Trust (PCT). 53 Over 65 0 Care Homes for Older People Page 4 of 26 Brief description of the care home The home is built over four floors. Offices and a day centre are on the ground floor the day centre is not subject to regulation under the Care Standards Act. Accommodation for service users is as follows: 1st Floor for 18 people needing personal care (residential care unit) 2nd Floor for 17 people needing nursing care 3rd Floor for 18 people needing higher nursing care The home is fully wheelchair accessible with 2 lifts to the upper floors and has up to date equipment and facilities and continues to acquire equipment as identified. There are 53 spacious single bedrooms each with en-suite shower, toilet and washbasin. Each floor has a well-appointed dining room and a choice of relaxing sitting areas and quiet room. In addition the home has a fully equipped hairdressing salon, activities centre and garden room. There are landscaped gardens and patio areas. The home deploys a staff team comprising administrative staff, domestic staff, laundry staff, maintenance staff, care staff, nurses, unit managers and a Registered Manager. The home is situated in a residential area in North London, between Arsenal Underground and Highbury & Islington, British Rail and London Underground. A number 393 bus stops outside the home and runs between Highbury and Islington & Stoke Newington. There is limited parking. Care Homes for Older People Page 5 of 26 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: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This is the report of the unannounced inspection carried out on 19/08/09 over 6 hours 40 minutes by PursotamRaj Hirekar. The registered manager coordinated the inspection throughout. The method of inspection included study of sample care plans, risk assessments, staff recruitment records, staff deployment rota, relevant care delivery documents, discussion with registered manager, staff on duty, visitors of people using the service, conversation with people using the service and partial tour of the premises. The feedback from the Pre-inspection survey of people who use the service, the annual quality assurance assessment (AQAA) providers self assessment and in response to the inspection feedback, the documentary evidence received from the registered manager post this inspection is included for analysis and preparation of this report as well. Care Homes for Older People Page 6 of 26 The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. 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 set out 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 Older People Page 8 of 26 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 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 and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. 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 them 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Pre-admission assessments were completed in sufficient detail to assess the care needs of people considering using the service. Evidence: The Statement of Purpose and Welcome Pack were provided on this inspection, both these documents were comprehensive and included information about the admission procedures, management, staff, various services and facilities, fees and complaints procedure as well. These documents were given to the prospective service users and their family members, to offer an opportunity to know about the home. On this inspection, 9 people who use the services were case tracked, of which 3 people were newly admitted. These 3 people were referred by the Social services. Prior to admission, the registered manager or deputy manager, had carried out the assessment, this admission assessment had been completed in sufficient detail to ensure that an informed decision could be made as to whether the staff team could Care Homes for Older People Page 10 of 26 Evidence: meet the needs of the person. The people living in the home have diverse needs and diagnoses, and staff training information records seen showed that the staff team had the necessary skills and qualifications to meet their needs. This was further confirmed from the discussions with the registered manager and staff. A contract had been prepared for each of the service users. Intermediate care was not provided in the home at the time of this inspection. Care Homes for Older People Page 11 of 26 Health and personal care 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 health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they 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. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care plans and risk assessments had been written in sufficient detail to ensure that the care needs of the people at the home would be met in a consistent and safe way. The staff and the people using the service have a good working relationship. Evidence: Of the 9 people who use the services, their care plans were tracked; all of them had care plans that clearly identified the care need, which included behavior, environmental and physical condition, night care, social skills, general health conditions, personal care, communication, mobility, continence, nutrition and diet, medication, risk assessments, Waterlow, weight and health care professionals appointments. The plans had been written in sufficient detail to ensure that anyone working at the home could provide the necessary care. The care plans have been regularly reviewed and updated to reflect the changing needs of the people who use the service. The care plan documents included a number of assessments and the associated risk assessments as well. It was also noted that, the people were regularly weighed as necessary and BMI recorded, nutritional assessment are carried out and used for diet planning. Care Homes for Older People Page 12 of 26 Evidence: The home was in use of a IT system - Saturn - to record care assessments, plans, reviews, daily notes, professional visits. However, the individual service users hard copy, care folders did not contain all the current documentation, for staff, service user and or their authorized representative of the service user to view. This was brought to the attention of the registered manager during the inspection headline feedback, and in response the registered manager has written to us post this inspection that, each individual service users hard copy care folder have been arranged, to contain all the current care planning and delivery documents, to be referred by the staff, service user and their authorized representatives as well. It was noted that the Administration of Medication Records (MAR) were well kept and clearly provided the necessary audit trail to determine when the medication had been received into the home and when and by whom it had been administered. The MAR sheets for the 9 people using the service, case tracked indicated that there were no gaps and as required medications were used appropriately. We were able to reconcile the medications, including the controlled drugs. None of the people were selfmedicating at the time of the inspection. Storage of medication was noted to be in a locked trolley, that was stored on the respective floors of the home and the controlled drug cupboard was on a wall. The staffs that were giving medication had been trained to do so. Throughout the inspection, we noted that staff treated people living and visiting the home with respect. Personal care was carried out in peoples own bedrooms and all staff knocked before entering a persons private space. All bedrooms have an en-suite facility which assists in promoting, privacy and dignity. It was noted that the people were dressed in their own clothes and that they were treated as individuals. Throughout the inspection staff were seen talking to people and treating them with dignity; this was particularly noticeable at mealtimes, leisure activity and medication times. The people using the service had a good rapport with the staff and the relationship between staff and the people appeared to be that of a large family. All of the 9 people case tracked, their care delivery documents indicated that they had seen various health care professionals such as doctors and community nurses were used appropriately including optician, chiropodist, and a dentist, since the previous inspection. The annual quality assurance assessment (AQAA) received from the registered manager prior to this inspection stated that staff have been given training about Deprivation of Liberty in coordination with London Borough of Islington. Nurses are Care Homes for Older People Page 13 of 26 Evidence: encouraged to develop as Link Nurses within clinical specialists supported by the PCT and community based multi-professional team. Care Homes for Older People Page 14 of 26 Daily life and social activities 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 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. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. 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. The service is committed to and promotes good relationships with people who use this service, and enable them to participate in wide range of activities that enhances their quality of life. The menu was varied with a number of choices including a healthy option. Evidence: All service users have an individual activities plan that suit their preferences , cultural and spiritual beliefs. An Art Therapist visit twice a week, a dance trainer once a week for music and movements. Variety of activities take place on different floors including afternoon activities by care staff to ensure social interaction. Activities also include, birthday celebrations and special occasion celebrations, and planned outings. All the activities undertaken and peoples participation is recorded as well. The people using the services were actively engaged and appeared to have enjoyed the activities throughout. People using the service had the opportunity to meet with their visitors in the lounge or in their own rooms. Visitors reported that they were welcomed into the home, could come and go as they pleased and felt part of the home. During the inspection visitors (families) were spoken to. For example, One person living at the home, her daughter Care Homes for Older People Page 15 of 26 Evidence: said my mother cannot look after herself I am pleased my mother is here, place is good, neat, clean, staff take care of her well, very happy, her bedroom is good. People were able to make choices about, when they got up and what they ate. Observation of the lunchtime meal showed it to be unrushed and enjoyed by the people using the service. Nutritional risk assessments were seen within the peoples care records. The menu plan appeared to provide people with a balance nutritious diet, drinks were served with the meal, and people were encouraged to eat in the dining room and lounge as well. The people expressed satisfaction with the quality, quantity, and presentation. For example one person using the service spoken to, have said that lunch has been always good, staff are polite. The annual quality assurance assessment (AQAA) received from the registered manager prior to this inspection stated that all the activities undertaken and visitors visits are recorded. There has been an improvement with regard to the frequency of hair dressers visits and a reminiscence room made available for people who use the services as a therapy. Also, planned to increase the outings on a monthly basis and weekly visit from a pet e.g. dog. Care Homes for Older People Page 16 of 26 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. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. 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. The service had an open culture, people using the service and staff said that they are happy with the service provided, feel safe and well supported. Evidence: The home had a complaints policy and procedure. It gave simple guidance on how to make a complaint and gave timescales in which the home would respond to a complainant. People using the service spoken to knew how to put across a view or a concern to staff. One person using the service said, I am happy here, staff are good. Another person said I have not experienced any problems or had any concerns about living at the home. Staff demonstrated a good awareness of their role, responsibility, and procedures they are required to follow in relation to any allegation or suspicion of abuse. Staff training records also showed that staff at the home had received training in this area. Staff were confident to whistle-blow on bad practice and confirmed that the manager is available at all times should any concerns arise. The registered manager also through discussion demonstrated a good understanding in this area and was aware of the local guidance in reporting procedures. The home has received 6 complaints since the last inspection and have been resolved as appropriate. The commission has not received any complaint or concern about the home. Care Homes for Older People Page 17 of 26 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, 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. 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. The home was clean, tidy, and free of any offensive odors. The environment is well maintained for the people who use the service to live in. Evidence: The home is a purpose built, with en suite facilities throughout. A tour of the premises was undertaken all the communal areas were found to be clean, tidy, and free of any offensive odors. The people using the service, their rooms that were seen contained personal items, photographs, pictures, and furniture. Grab rails, were also in place to assist with their mobility. The rooms were clean and tidy and no odors were detected. For example, one visitor spoken to on this inspection, have confirmed that the bedroom of her mother is good and well maintained. It was observed during the inspection that corridors carpets are being replaced with venyl flooring. All domestics keep a daily record of the cleaning schedule / tasks undertaken which included bedrooms, communal area, dining room and kitchenette. The annual quality assurance assessment (AQAA) received from the registered manager prior to this inspection stated that the grant received from the Department of Health has been used to convert a bathroom into an activity room, a small lounge into a reminiscence room, second floor smoking room into a Snoozelen room and third floor smoking room into a quite room. Yearly testing of electrical equipment, deep cleaning of kitchen equipment and duct cleaning of the laundry equipment is Care Homes for Older People Page 18 of 26 Evidence: undertaken by an external contractor and certificated. Regular checks of lifts, emergency lighting, legionnaire, fire equipment, carbon monoxide equipment are carried out and certificated for records. Care Homes for Older People Page 19 of 26 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 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 to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. 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. The service has a good recruitment procedure, staff are appointed and start working with appropriate references or other important documentation being received to protect people using the service. The staff had the necessary training and experience to meet the assessed needs of the service users. Evidence: The staffs are deployed to satisfactory levels and the staff rota reflected this. The interaction of staff with the service users was good, showed there was a good rapport both verbal and non-verbal communication used and a good understanding. On this inspection 10 staff members records were seen and found that, the homes recruitment procedure was robust. 1 staff member that was working at the home, her records did not evidence, that she was eligible to work in the country. However, the registered manager contacted the staff member and evidence was produced post this inspection that the staff member was eligible to work in U.K. A couple of staff members were employed on a student visa, the home need to be vigilant with regard to their eligible hours of working, whilst studying, and the number of eligible working hours, should be reflected in their employment contract, as appropriate. These findings were brought to the attention of the registered manager during the inspection headline feedback. The registered manager stated that all staff members working with student visa, their employment contracts shall be verified in relation to their eligible Care Homes for Older People Page 20 of 26 Evidence: hours of working and employment contracts shall be amended as appropriate. The annual quality assurance assessment (AQAA) received from the registered manager prior to this inspection stated that of the total 34 care staff members, 21 staff members have attained National Vocational Qualification (NVQ) level 2 or above. Staff training records showed that staffs have attended a variety of courses and workshops, in addition to mandatory training staff had received training in dementia awareness, infection control, end of life care communication skills and diabetes, which reflected the needs of the service users at the home. Staff spoken with described other training that they had undertaken including the National Vocational Qualification in Care. Staff confirmed that the manager supported, and indeed encouraged them, to attend training courses. Care Homes for Older People Page 21 of 26 Management and administration 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 led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate 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. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. 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. The registered manager and staff have good working relationship with the people who use this service and key stakeholders that promote the quality of life of people using this service. Evidence: It was apparent that the staff team worked well together and respected the registered manager. Staff supervision was regular and showed how information is shared with staff, concerns raised by staff are addressed in the best possible way, which benefits the people who use this service. Staff said that in addition to supervision sessions they could speak to the registered manager at any time. The home had an internal quality assurance system and procedure, to ensure that the quality of care provision and delivery is of always-high standard and the people who use this service; their quality of life goals are addressed. The service had also sought the views of people who use this service and their relatives, and other key stakeholders as well. The results are analyzed, on how the service, then use these Care Homes for Older People Page 22 of 26 Evidence: views to influence and further improve the care provision and delivery. The moving and handling techniques observed during the inspection were good, with appropriate use of slings, and the use of footrests on wheelchairs to avoid injury to staff and people who use the service. The annual quality assurance assessment (AQAA) received from the registered manager prior to this inspection stated that there is a programme of servicing and testing of equipment, maintenance, and fire detection and emergency equipment. Risk assessments are in place for the home, people who use the service, and staff. Staff and their training records confirmed that they had been trained in a variety of Health and Safety areas including moving and handling and food hygiene. The people, who use the service spoken to, reported that they found the staffs and the manager to be a very good listener and all felt that they were very easy to talk to and that they trusted them. Staff said that they found the manager to be very committed to the care of the people using the service and is approachable. One persons family member said my family and my mother have nothing but praise for the way the home is running. Our mother in particular is always full of praise for the service. Care Homes for Older People Page 23 of 26 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 Older People Page 24 of 26 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 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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