Care Home: Highfield

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What the care home does well The home prepares care plans, which assists staff in providing consistent and appropriate care. The food is varied, nutritious and well presented. Staff are caring and friendly. The home provides a homely, safe, clean environment. What has improved since the last inspection? Some residents needs have been re-assessed and their care plans have been reviewed. Residents are invited to sign their care plans and risk assessments. Financial records have been made clearer. There is an improved cleaning regime. A staff induction training package has been introduced based on "skills for care". What the care home could do better: All bedrooms should be provided with safe and appropriate locks. Staff should be provided with regular formal supervision. CARE HOMES FOR OLDER PEOPLE Highfield 51 Alpha Road Birchington Kent CT7 9EG Lead Inspector Sue Gaskell Key Unannounced Inspection 10:00 7th December 2007 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 Highfield DS0000023437.V345821.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. Highfield DS0000023437.V345821.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Highfield Address 51 Alpha Road Birchington Kent CT7 9EG 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) 01843 842116 01843 842190 melanie4baker@hotmail.com Mr Egerton Lionel Keith Eckersley Mrs Anne Margaret Eckersley Mrs Melanie Baker Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21) of places Highfield DS0000023437.V345821.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th July 2006 Brief Description of the Service: Highfield Residential Home is a detached three-storey building with service user accommodation situated over three floors and an extension. The home is located within ten minutes walk from local shops and public amenities including public transport, library and church. There is an enclosed rear garden, which is laid to lawn. There is off street parking to the front of the property for approximately six cars. The home provides personal care and support for up to 21 older persons. The home aims to respect service users privacy and dignity. Fees range from £324-£450 depending on choice of room and the nature of the service provided. Highfield DS0000023437.V345821.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 7th December 2007 between 10.00am and 2.00pm. There are currently 20 residents living in the home. I spoke with four residents, and two residents’ relatives. I also spoke with the registered manager, deputy manager, and two care assistants. I toured the building and looked at bedrooms and all communal areas. The inspection process also consisted of information collected before and during the visit to the home, and feedback from care managers. The annual quality assurance assessment required by the CSCI was completed in a satisfactory manner. Other information seen included general assessments, risk assessments and care plans, medication records and the duty rota. There were no outstanding requirements from the previous inspection and no requirements made following this inspection. Some of the judgements would have been rated as excellent rather than good had the home been able to provide evidence of sustainability. What the service does well: The home prepares care plans, which assists staff in providing consistent and appropriate care. The food is varied, nutritious and well presented. Staff are caring and friendly. The home provides a homely, safe, clean environment. Highfield DS0000023437.V345821.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Highfield DS0000023437.V345821.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 Highfield DS0000023437.V345821.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): 1, 3 & 6 People who use the service experience excellent outcomes in this area. The statement of purpose and service user guide says what service will be offered. Prospective residents can be confident that their needs can be met This judgement has been made using available evidence including a visit to this service. Highfield DS0000023437.V345821.R01.S.doc Version 5.2 Page 9 EVIDENCE: The home’s Statement of Purpose and Service User Guide are reviewed and amended regularly and provide residents, prospective residents and their relatives with all necessary information about the home. These documents are available in large print and can be made available in other formats as required. Six care plan files were examined, including two referring to residents who were admitted recently. Several residents confirmed that they had visited the home prior to admission and that the manager and/or deputy manager had also visited them in their own homes or in hospital. All files inspected include comprehensive pre-admission assessments carried out by the home with supporting information from care managers. Highfield DS0000023437.V345821.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 & 10 People who use the service experience good outcomes in this area. Residents’ care plans are reviewed and their health care needs are met. Residents are protected by the home’s policies and procedures for dealing with their medication. Residents are treated with respect. This judgement has been made using available evidence including a visit to this service. Highfield DS0000023437.V345821.R01.S.doc Version 5.2 Page 11 EVIDENCE: All files inspected included reference to all various aspects of daily living including mobility, nutrition, skin condition, and behavioural, needs. The care plans were seen to be reviewed recently and include risk assessments. Residents are encouraged to sign their care plans and risk assessments. Some residents, whose needs might have changed, have been re-assessed since the last inspection and the care plans have been reviewed appropriately. The daily records are clear and both the day and night records contain enough detail to monitor residents’ health and well being. There is evidence in the care plan of the monitoring of residents’ health care needs and general well being, eg residents are weighed regularly and referred for specialist care when necessary.. Residents have access to local health care services. The local District Nurses and GP’s call regularly. Residents are able to choose their own GP and all have access to dentists, opticians and other community services. The home has a key worker system. Each resident has a key worker who monitors that resident’s care and is now also involved with reviewing and updating the care plan. The home’s medication policy is clear and accessible to staff. The deputy manager confirmed that staff do not administer medication unless they have received training, been judged as being competent, and feel confident. There are appropriate records for the receipt, administration and disposal of medication. Medication administration records were in order and important details and administration times are highlighted to make them clearer. Medication is safely and securely stored. A member of staff demonstrated good observational skills and a high degree of competency when she noticed an error regarding medication that was not of the home’s making. Support with personal issues is provided in a sensitive manner that respects residents’ choice and dignity. All staff interviewed spoke of the need to treat residents with respect and to consider dignity when delivering personal care. The four residents and two relatives I spoke to said that the home is a nice place to live in and that the care is good. They said that the staff are very kind and helpful and that nothing is ever too much trouble. Highfield DS0000023437.V345821.R01.S.doc Version 5.2 Page 12 The residents’ Care Managers said that the home provides a relaxed, comfortable, environment for residents and that they are pleased with the service provided. Highfield DS0000023437.V345821.R01.S.doc Version 5.2 Page 13 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, & 15 People who use the service experience good outcomes in this area. Residents’ lifestyle preferences and expectations are generally met. Residents have regular contact with their families and friends. Residents receive a nourishing and balanced diet. This judgement has been made using available evidence including a visit to this service. Highfield DS0000023437.V345821.R01.S.doc Version 5.2 Page 14 EVIDENCE: The care plans contain a list of residents’ needs, likes and dislikes and preferences. There was evidence in the residents’ daily records to show that families, and other visitors are encouraged and welcomed. I also spoke with two visitors who visit on a very regular basis. They both said that they are always made to feel welcome and offered refreshments and meals. The residents I spoke with said that they generally get up and go to bed at the time they choose although this is not always possible if they require assistance. One senior member of staff said that they try to bear in mind which residents like to get up early and which like to stay in bed later when they need to help those residents who require a greater degree of assistance. One resident’ s daughter said that her mother goes to bed when she likes. Breakfast is served between about 7.00am and 8.30am, depending on whether residents wish to take it in their rooms or the dining room. The main meal of the day is generally served at about 12.150pm, with the evening meal at about 4.45pm. The cook said that sandwiches, cakes and biscuits etc are left available for anyone who requires a supper snack and that hot drinks are always available. The food served on the day of the inspection appeared appetising and wholesome and the residents in both parts of the home said that it tasted good. Residents confirmed that there is always an alternative choice for the midday meal and a wider choice for breakfast and the evening meal. The cook said that meals provided are mainly based on residents’ choices, but also take into account the need for a reasonably balanced diet. The store cupboard contained a wide range of food including fresh fruit and vegetables. Nutritional assessments are carried out and residents are weighed monthly. Residents said that they have activities in the home such as weekly exercises and visiting entertainers. The residents said that they also enjoy using the garden in the warmer months. Staff said that they try to encourage residents to join in activities but they have to be flexible if residents’ needs or wishes change. Staff keep a record of the activities offered, The home keeps records of any involvement in residents’ finances, with appropriate receipts and records kept. Highfield DS0000023437.V345821.R01.S.doc Version 5.2 Page 15 Staff said that there are no residents at present with different ethnic or cultural needs but former residents have been assisted in following their religious beliefs. There is a monthly church service within the home and residents are assisted if they wish to attend church elsewhere. The manager said that residents would be supported with personal relationships whatever their gender or choice of lifestyle. Highfield DS0000023437.V345821.R01.S.doc Version 5.2 Page 16 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 & 18 People who use the service experience good outcomes in this area. Residents can be confident that their complaints will be listened to and dealt with appropriately and that they will be protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service user guide includes the home’s complaints procedure. Four residents and two residents’ relatives confirmed that they would feel comfortable in mentioning any complaints to the management or staff and confident that any concerns would be resolved. Highfield DS0000023437.V345821.R01.S.doc Version 5.2 Page 17 Staff are provided with training on safeguarding adults and are issued with a copy of the company’s “whistle blowing” procedures during their induction period. The staff interviewed all showed an awareness of the complaints procedure and safeguarding adults issues. The deputy manager is currently arranging training sessions on the protection of vulnerable adults. The home has a copy of the Kent and Medway safeguarding adults procedures. Highfield DS0000023437.V345821.R01.S.doc Version 5.2 Page 18 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 & 26 People who use the service experience good outcomes in this area. Residents live in a comfortable, safe, clean environment. This judgement has been made using available evidence including a visit to this service. Highfield DS0000023437.V345821.R01.S.doc Version 5.2 Page 19 EVIDENCE: The residents’ accommodation is on two levels and there is a lift and an alarm call system. The home is suitable for people with impaired mobility. All residents are in single room accommodation at present although there is one room registered as a double which could accommodate a married couple. All bedrooms and living areas are furnished and decorated to a reasonable standard, and contained the type of furniture and equipment necessary to provide a homely environment. Beds and bedding are of an acceptable standard. All radiators are fitted with protective covers and windows are fitted with restrictors. Although the care plan of one resident refers to a problem for which the home has sought advice, there was no excessive odour in the rest of the home. All areas were seen to be clean and hygienic and the home has a system for dealing with commodes.. There is a pleasant garden which is for the use of residents. Some of the bedroom doors have a lock that is of a type not recommended, as if residents did use a key to lock themselves in their room, staff might not be able to access the room in the event of an emergency. The manager said that in practice, none of the residents has asked for a key. However the home is commencing a programme of fitting appropriate locks. Staff showed a good awareness of health and safety issues. There is separate laundry room with a commercial washer and a drier. There are disposable hand drying towels and pump soap dispensers in communal WC’s and bath or shower rooms. There are appropriate foot operated bins for particular waste products and personal items were seen to be “double bagged” and disposed of appropriately. Maintenance certificates are current and there are no outstanding health and safety requirements. Highfield DS0000023437.V345821.R01.S.doc Version 5.2 Page 20 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 & 30 People who use the service experience good outcomes in this area. Staffing numbers are adequate to meet the daily needs of the residents. Residents are protected and supported by the home’s recruitment and induction training procedures. Residents benefit from a well trained and supported staff team. This judgement has been made using available evidence including a visit to this service. Highfield DS0000023437.V345821.R01.S.doc Version 5.2 Page 21 EVIDENCE: Staffing generally comprises the registered manager and/or her deputy, and three care staff. There are also adequate kitchen and domestic staff. The residents said that although staff are busy, the staff always have time for them and they never feel neglected. The four staff files that were examined included evidence of sound recruitment practices. The manager said that all staff must be CRB checked and have verbal and written references taken up prior to their employment. All staff showed a good awareness of good practice and of individual residents’ care needs. Staff confirmed that there is a comprehensive induction training for core issues and then further on-going training. The induction training has been improved by being based on the skills for care programme. NVQ training is encouraged and staff have had a variety of training including first aid, food hygiene, fire safety, moving and handling, and medication Although staff said that they are well supported, there is no evidence of regular formal supervision. The manager and deputy manager said that there is frequent informal supervision. Highfield DS0000023437.V345821.R01.S.doc Version 5.2 Page 22 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, 36 & 38 People who use the service experience good outcomes in this area. The current management arrangements ensure that the home is being run in a way which benefits residents and staff. The record keeping, and health and safety systems are sufficient to safeguard residents’ welfare, rights and best interests. This judgement has been made using available evidence including a visit to this service. Highfield DS0000023437.V345821.R01.S.doc Version 5.2 Page 23 EVIDENCE: The registered manager has an NVQ Level 4 qualification in management and care. She showed a clear understanding of the running of the home and the needs of individual residents. There have been improvements in the home since the last inspection, in procedures, the environment and staff training. New baths have been purchased and are due to be installed shortly. Quality assurance is carried out through regularly reviewing policies and procedures, and through obtaining feedback from quality assurance surveys. Residents said that they have regular residents’ meetings. Residents, their relatives and staff said that any feedback from residents and/or their families or advocates is acted upon. One Care Manager, who has recently reviewed clients in the home also confirmed this. The management of the home and completion of records are generally of a good standard. One member of staff said that morale in the home is good and that the manager and deputy manager are supportive. There were no obvious safety hazards around the home and there was evidence to show that health and safety issues are taken seriously eg the home has reviewed infection control procedures, commode washing procedures and fire safety procedures. Accident records are collected and risk assessments for residents and the environment have been carried out. Staff have had fire safety training and their are regular fire drills. There are current certificates to show that regular checks eg gas, electricity, are carried out. Highfield DS0000023437.V345821.R01.S.doc Version 5.2 Page 24 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 4 X 4 X X 4 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 4 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 3 4 X X X X 2 X 4 STAFFING Standard No Score 27 3 28 4 29 4 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 4 2 X 4 Highfield DS0000023437.V345821.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? no 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 2 Refer to Standard OP24 OP36 Good Practice Recommendations The provider must have a plan to place suitable locks on all bedroom doors. They must be of a type which will provide access to staff in the event of an emergency. Staff should receive regular formal supervision. Highfield DS0000023437.V345821.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Highfield DS0000023437.V345821.R01.S.doc Version 5.2 Page 27 - 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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