Care Home: Highbury Rise

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What the care home does well People working in the home said the manager was "really helpful". There are few staff changes and many people living in the home said they found this made them feel more secure. The manager and proprietors carry out their own quality assurance and send out questionnaires to everyone involved with the service and has resident and relative`s meetings which provides opportunities for people to give their opinions of how the service is being run. Records were maintained in good order and information in care plans was readily accessible so that staff can read about any changes to people`s care. The manager works well with colleagues within the organisation and with outside agencies so that information about effective ways of supporting people in the service is up to date and relevant to the service. What has improved since the last inspection? People living in the home were asked about the meals they would like to have and the menu has included these choices. There have been far fewer complaints or concerns raised in the past year and all the feedback is that people in the home and families are happy with the service provided. This shows that there has been a pro-active approach towards resolving issues which have arisen and that measures have been taken to try to avoid such issues arising again.A mini bus has been purchased following a successful bid for a capital grant and this will be used to enable more people to enjoys trips outside the home. The garden has been redesigned with wind chimes and sensory areas, and a green house and garden shed for use by all people living in the home. Activities such as artwork and the use of sensory boards has been introduced to provide more choices of daily activities and interest. What the care home could do better: People living in Highbury Rise are generally well supported. However, consideration should be given to ways in which all people living in the home can have assistance to enjoy meaningful daily occupations which reflect their individual abilities and interests. CARE HOMES FOR OLDER PEOPLE Highbury Rise 6 Highbury Road Hitchin Hertfordshire SG4 9RW Lead Inspector Patricia Rogan Unannounced Inspection 23rd January 2008 14:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Highbury Rise DS0000019424.V359377.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Highbury Rise DS0000019424.V359377.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Highbury Rise Address 6 Highbury Road Hitchin Hertfordshire SG4 9RW 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) 01462 437 495 angela@benslow.co.uk Benslow Management Company Limited Angela Taylor Care Home 23 Category(ies) of Dementia - over 65 years of age (23), Old age, registration, with number not falling within any other category (23) of places Highbury Rise DS0000019424.V359377.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 31st October 2006 Brief Description of the Service: The home accommodates older people, including people with a diagnosis of dementia. It is situated in a residential area of Hitchin, within easy walking distance of local amenities and shops. Accommodation is provided on three floors consisting of single occupancy rooms and one double room. Each floor is served by a passenger lift. The home comprises of a main kitchen, two dining rooms and one large lounge. The smaller dining area is also used as a sitting room by a small number of service users. The laundry is in the basement. There is limited parking to the front of the home and an average sized garden to the rear. Information about the service is contained in the Service User Guide, this and a copy of the most recent CSCI inspection report is available in the home. Care fees are based upon an assessment of care needs and range from £472£636 per week. There is an additional charge for hairdressing, chiropody, clothing, footwear and other items as specified in the individual service contract. Highbury Rise DS0000019424.V359377.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 2 star. This means the people who use this service experience good quality outcomes. This unannounced inspection was carried out during the afternoon and evening. A random selection of people living in the home and visitors and staff were asked for their opinions about this service during one to one discussions and via postal questionnaires. Documentation including training schedules, rotas and care plans were inspected and and discussed with the registered manager. A tour was made of the premises and this included observing how people living in the home spent their time and how staff interacted with the people. An Annual Quality Assurance Assessment (AQAA) was received from the registered manager and this information formed part of the overall inspection. The information provided showed that the manager understood the needs of the people that were being supported by this service. What the service does well: What has improved since the last inspection? People living in the home were asked about the meals they would like to have and the menu has included these choices. There have been far fewer complaints or concerns raised in the past year and all the feedback is that people in the home and families are happy with the service provided. This shows that there has been a pro-active approach towards resolving issues which have arisen and that measures have been taken to try to avoid such issues arising again. Highbury Rise DS0000019424.V359377.R01.S.doc Version 5.2 Page 6 A mini bus has been purchased following a successful bid for a capital grant and this will be used to enable more people to enjoys trips outside the home. The garden has been redesigned with wind chimes and sensory areas, and a green house and garden shed for use by all people living in the home. Activities such as artwork and the use of sensory boards has been introduced to provide more choices of daily activities and interest. 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 Rise DS0000019424.V359377.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Highbury Rise DS0000019424.V359377.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3. (Standard 6 is not applicable to this service.) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service can be assured that the assessment practices in place ensure that their needs are fully understood and the service is able to meet these needs. EVIDENCE: People who are considering moving into this home and their family or representative are given a Service User Guide. This includes information about how the home is run and about qualifications and experience of staff and how to make a complaint. Pre-admission assessments held sufficient individual information about health and social care needs. This information had been gathered from the person who was to move into the home and family members who knew the person well. Professionals that had recently been involved with providing care and support were also consulted. People are invited to visit the home so that a more informed decision can be made about whether the service would suit his or her needs. A quote from a Highbury Rise DS0000019424.V359377.R01.S.doc Version 5.2 Page 9 questionnaire was, The manager did the assessment and we were made very welcome when we came to have a look round. This made me feel they wanted my relative to have a good idea about the home before deciding to accept the placement. Highbury Rise DS0000019424.V359377.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using this service can be certain that their care needs will be met in accordance with their wishes and that they will be protected by the services policy and procedures around medication administration. EVIDENCE: The care plans are reviewed regularly and show that delivery of personal care is based upon individual needs and that peoples wishes are taken into account. One person said, What I like is that the ladies (care workers) know I like to wake early and they bring me a cuppa and leave me till Im ready for the day. If there is a change to a persons care needs before the next review is due, the care plan is amended so that care staff are aware and will provide support in the most appropriate way. Risk assessments, health care needs and access to Highbury Rise DS0000019424.V359377.R01.S.doc Version 5.2 Page 11 other health and social care professionals were recorded so that people could receive individualised support. Care staff spoke to the people living in the home in a polite, friendly manner and they were discrete when talking about private matters. The home has an efficient medication policy supported by procedures and practice guidance, which staff understand and follow. Medication administration is only carried out by staff that have had training to do so. The manager audits the practice to ensure that records are fully completed, contain required entries and are signed by appropriate staff. Highbury Rise DS0000019424.V359377.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in Highbury Rise have opportunities to participate in activities that are appropriate to their needs. People can be assured that they will be offered a varied diet that meets their needs. EVIDENCE: People using the service are given the opportunity to take part in a variety of activities both within the home and in the community. Where possible, people are given assistance to visit local community-based events and to go to the local town centre. The manager has purchased a new wheelchair accessible mini bus with a charitable grant and has asked people using this service what places they would like to visit. Representatives of different faiths visit the home regularly so that people living in this home can attend services and speak with the representative of their choosing about their spiritual needs. In the past year, the manager has been introducing more activities such as different forms of artwork and gardening. The garden has been made more Highbury Rise DS0000019424.V359377.R01.S.doc Version 5.2 Page 13 accessible with sensory garden ornaments and a potting shed and greenhouse for use by people living in the home. The manager has been exploring ways in which people with dementia can have more opportunity to take part in activities. A small sensory board with different textures has been fixed on the corridor wall and helpful picture signs are on walls and doors. Some people who are less mobile and who may not be able to express their wishes did not appear to be benefiting from some of the activities and this could result in those people feeling isolated or bored. A reevaluation of what additional individual occupation could be provided, should ensure that people can have meaningful interest in their daily lives. The menu is seasonal and recently people have been asked what additions or changes they would loike to see on the menu and all of these wishes have been included in the revised menu. One person said, I liked the food before and theres always plenty of it, but its nice that we can have a say in what we get. Highbury Rise DS0000019424.V359377.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using this service can be confident that they will be kept safe by the services procedures around safe working practices. EVIDENCE: The service has a complaints procedure that is clearly written and easy to understand. It is available on request in a number of formats including other languages and large print. The additional support of an advocate is available to help people living in the home to complain or make suggestions for improvement. The complaints procedure is supplied to everyone living at the home and is displayed in a number of areas within the service. Residents and others involved with the home said they understand how to make a complaint and are clear about what will happen if a complaint is made. The home record of complaints was inspected and this included details of the investigation and any actions taken. There have been no serious complaints in the past year, which shows that the manager has looked at what was causing complaints and has tried to address them. Highbury Rise DS0000019424.V359377.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in Highbury Rise benefit from a comfortable, clean environment that is well maintained. EVIDENCE: A tour of the premises confirmed that the home was clean and there were no areas, which were in need of repair. Some lounge chairs had been replaced and people said they were comfortable. Bedrooms were personalised offering a homely, lived in feel. People spoken to said that they were happy with their bedrooms and other facilities. One respondent said, This is a very homely place. Picture signs were on doors and communal areas, which made it easier for people with dementia to be more independent. Records showed that staff have been provided with training in hygiene and infection control. One member of staff is delegated as the ‘link person’ for infection control in the care home. Highbury Rise DS0000019424.V359377.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in Highbury Rise are supported and protected by competent staff who are trained to provide a good standard of care and support. EVIDENCE: The recruitment procedure includes a robust vetting procedure to ensure that people who are appointed are suitable to care for people. There are clear contingency plans for cover for vacancies and sickness and because there is a low staff turnover, there is little use of any agency or temporary staff. One person said, It makes me feel more secure not having to keep getting used to new carers. The rota shows that there are adequate numbers of staff on duty during the day and night so that people living in the home are given assistance when it is needed. People said of the staff, They are nice. and I feel like they are my pals. Almost all members of staff are studying for, or have gained, their National Vocational Qualification at level two or above. Additional training including dementia care training is ongoing. Feedback in a questionnaire from a professional who is involved with the service, was that, Highbury has a dedicated and caring staff team. Highbury Rise DS0000019424.V359377.R01.S.doc Version 5.2 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service can be confident that the manager has skills and experience, and is competent to run the home so meeting its stated aims and objectives. EVIDENCE: The experienced manager has gained her Registered Manager Award and ensures that staff understand their role and responsibilities towards the health and welfare of people in the home. People living in the home are protected by the policies and procedures in the home and these are reviewed regularly in line with current legislation. Highbury Rise DS0000019424.V359377.R01.S.doc Version 5.2 Page 18 Staff confirmed that the registered manager operated an open door policy, describing her approach towards staff as, Strict but fair. The Annual Quality Assurance Assessment contains clear, relevant information supported by a wide range of evidence and this demonstrates the managers intention ensure that the people living in this home will have a good experience. Highbury Rise DS0000019424.V359377.R01.S.doc Version 5.2 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x 3 x x x n/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Highbury Rise DS0000019424.V359377.R01.S.doc Version 5.2 Page 20 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. 1 Refer to Standard OP12 Good Practice Recommendations A wider variety of activities which are suitable for different needs and abilities would ensure that all people living in this home would be given the opportunity to enjoy more meaningful occupation each day. Highbury Rise DS0000019424.V359377.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Inspection Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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 Rise DS0000019424.V359377.R01.S.doc Version 5.2 Page 22 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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