Care Home: Highfield Hall Care Centre

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What the care home does well The expert by experience wrote in her report, `I found the staff to be very attentive with the residents. They seemed to have a good manner and had a joke with residents, which was nice to see. They appeared to listen to residents requests and got down to their level to listen and speak.` Nine of the residents who completed the surveys indicated they always or usually received the care and support they needed. One resident wrote, `The carers are friendly.` Another resident put, `I`m very happy at Highfield.` During the inspection one resident said, "The staff are very good, we have a laugh." A visitor who attended the cheese and wine evening said, "Nothing`s too much trouble, it`s home from home. We`re listened to and if we raise concerns they do address them." All the residents who completed the survey indicated there were always or usually activities they could take part in. One resident commented, `I join in with all the activities and enjoy the outings as well.` A full time activities organiser had developed a varied programme of activities to suit the needs and abilities of residents on all units of the home. The daily routine was flexible to meet the needs and preferences of the residents. All the residents asked said they could choose when to get up and go to bed.Visitors were welcomed into the home at anytime and offered refreshments. All the residents asked said the meals were good. What has improved since the last inspection? Members of staff received training, which was updated regularly, in fire safety. Care workers were observed using correct moving and handling techniques during the inspection. Although the home is well maintained recent improvements include new carpets to several corridors and communal areas, new chairs for the residential unit lounge, new sinks and a nail bar for the hairdressing salon and new furniture for most bedrooms. What the care home could do better: It is important to ensure care plans identify all the care needs of each resident and clearly explain how these needs are to be met. A falls risk assessment must be carried out for each resident on admission to the home. Urgent action must be taken to ensure recruitment procedures are thorough. Two written references and a POVA/CRB check must be obtained before any new employee start working at the home. CARE HOMES FOR OLDER PEOPLE Highfield Hall Care Centre Grane Road Haslingden Rossendale BB4 5ES Lead Inspector Mrs Susan Hargreaves Unannounced Inspection 28th November 2007 10:00 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 Hall Care Centre DS0000022505.V352020.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 Hall Care Centre DS0000022505.V352020.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Highfield Hall Care Centre Address Grane Road Haslingden Rossendale BB4 5ES 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) 01706 222326 01706 219455 Highfields.Hall@ashbourne-homes.co.uk Ashbourne Homes Limited Mrs Carole Ann Ashburne Care Home 75 Category(ies) of Dementia - over 65 years of age (21), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (2), Old age, not falling within any other category (52) Highfield Hall Care Centre DS0000022505.V352020.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. 7. 8. The total number of service users within these categories not to exceed 75 (seventy five) Staffing for service users requiring nursing care will be in accordance with the Notice issued on 15 January 2002 Within the overall total of 75 a maximum of 25 service users requiring nursing care who fall into the category of OP. Within the overall total of 75 a maximum of 33 service users requiring personal care who fall in the category of OP. Within the overall total of 75 a maximum of 21 service users requiring personal care who fall into the category of DE(E). Within the overall total of 75, 2 named service users requiring personal care who fall into the category of MD(E). When any of the named service users are no longer resident in the home, the registration must be changed to reflect this. The registered provider must, at all times, employ a suitably qualified and experienced person who is registered with the Commission for Social Care Inspection as manager of Highfield Hall Care Centre. 6th February 2007 Date of last inspection Brief Description of the Service: Highfield Hall Care Centre is a two-storey purpose built care home in it’s own grounds. The home offers 24-hour care for up to 75 older people who require either nursing or personal care. There is also a separate dementia unit. Accommodation is provided in single en-suite rooms. Communal lounges and dining rooms are located on both floors. A passenger lift facilitates access to all areas of the home. There is an enclosed garden, which is easily accessible to residents. There is ample parking for staff and visitors. Highfield Hall is situated in the small town of Haslingden close to local amenities and public transport. The current fees charged at Highfield Hall are £324.50 to £640 per week. Additional charges are payable for hairdressing, papers, magazines and massages. A statement of purpose and service user guide was available to prospective residents and their relatives on request. Highfield Hall Care Centre DS0000022505.V352020.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A key unannounced inspection, which included a visit to the home, was conducted at Highfield Hall on the 28th November 2007. No additional visits have been made since the last inspection. An expert by experience assisted with this inspection and her comments are included in this report. Ten completed surveys were received from residents, five from the relatives of residents, seven from members of staff and two from GP’s. At the time of this inspection 71 residents were living at the home. A tour of the premises took place and staff files and care records were inspected. Members of staff on duty, residents and visitors were spoken to. Discussions also took place with the manager regarding issues raised during the inspection. What the service does well: The expert by experience wrote in her report, ‘I found the staff to be very attentive with the residents. They seemed to have a good manner and had a joke with residents, which was nice to see. They appeared to listen to residents requests and got down to their level to listen and speak.’ Nine of the residents who completed the surveys indicated they always or usually received the care and support they needed. One resident wrote, ‘The carers are friendly.’ Another resident put, ‘I’m very happy at Highfield.’ During the inspection one resident said, “The staff are very good, we have a laugh.” A visitor who attended the cheese and wine evening said, “Nothing’s too much trouble, it’s home from home. We’re listened to and if we raise concerns they do address them.” All the residents who completed the survey indicated there were always or usually activities they could take part in. One resident commented, ‘I join in with all the activities and enjoy the outings as well.’ A full time activities organiser had developed a varied programme of activities to suit the needs and abilities of residents on all units of the home. The daily routine was flexible to meet the needs and preferences of the residents. All the residents asked said they could choose when to get up and go to bed. Highfield Hall Care Centre DS0000022505.V352020.R01.S.doc Version 5.2 Page 6 Visitors were welcomed into the home at anytime and offered refreshments. All the residents asked said the meals were good. 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 Hall Care Centre DS0000022505.V352020.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 Hall Care Centre DS0000022505.V352020.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A thorough admissions procedure ensured sufficient information was obtained in order to identify the needs of each resident. EVIDENCE: A senior member of staff visited and assessed prospective residents in hospital or their own home before admission. The care records of a recently admitted resident included a pre-admission assessment. This assessment provided important information for the care plan. Prospective residents or their relatives also received confirmation in writing that their needs could be met at the home. Standard 6 is not applicable to this service. Highfield Hall Care Centre DS0000022505.V352020.R01.S.doc Version 5.2 Page 9 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. Residents individual care needs were identified and their privacy and dignity promoted. Medication was managed safely. EVIDENCE: The individual care plans of six residents were inspected. Five of these plans identified and addressed the care needs of each resident. However, the care plan for a resident on the dementia unit did not provide any information or guidance for staff to follow about how to meet this resident’s mental health needs. Although appropriate risk assessments were seen in five of these care plans a falls risk assessment had not been carried out for a resident admitted for respite care to the dementia unit. A written report about the care given to individual residents was completed during each shift. Highfield Hall Care Centre DS0000022505.V352020.R01.S.doc Version 5.2 Page 10 Care plans were reviewed monthly and up dated when the needs of the resident changed. Residents and their relatives were invited to attend a review meeting every few months. Residents were registered with a GP and had access to other healthcare professionals. Medication was stored correctly on each unit of the home and administered by registered nurses or suitably trained care workers. Records for the management of medication were in place. Controlled drugs were stored securely and a stock check was satisfactory. The unit manager was advised to make sure the controlled drugs book was filled in correctly with name of the drug written on top of the page and the actual dose given instead of ‘1 tablet’. Personal care was carried out in the privacy of the resident’s own room or the bathroom. Members of staff were observed attending to residents in a polite and friendly manner. One resident said, “ The staff are very good.” One resident commented on the survey, ‘I find all the staff excellent’. Highfield Hall Care Centre DS0000022505.V352020.R01.S.doc Version 5.2 Page 11 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 excellent. This judgement has been made using available evidence including a visit to this service. Resident’s decisions were respected and they were supported to have an active and fulfilling lifestyle. Menus offered variety and choice. EVIDENCE: An activities co-ordinator was responsible for organising a range of leisure activities and social events for the residents. The expert by experience spoke at length with the co-ordinator and reported as follows: The activities co-ordinator is keen to involve as many as possible in the activities programme. Those not well enough do get one to one support. There is a visiting dog, Banner each Wednesday, which the residents love. She provides residents with dog biscuits to give to him. Today the residents have had a Church service in the morning and after lunch a Card making class when residents will make individual cards for Christmas for family members. Outside entertainers regularly visited the home and a visiting theatre group had been booked to perform ‘Cinderella’ before Christmas. Highfield Hall Care Centre DS0000022505.V352020.R01.S.doc Version 5.2 Page 12 A sensory room on the dementia unit had reclining chairs, coloured lights, mobiles, a lava lamp and reclining chairs had been created. Members of staff or visitors could take residents to this room to relax and listen to soothing music. Visitors were welcomed into the home at anytime. Local clergy regularly visited the home. Residents were encouraged to make decisions about their lifestyle and daily routine. One resident said she could get up and go to bed when wanted. Residents were encouraged to personalise their rooms with photographs, ornaments etc. The meal served at lunchtime on the day of the inspection was wholesome and appetising. All the residents and visitors asked said the meals were good. The expert by experience reported; ‘I stayed for lunch sitting at a table with three other people. There was a choice of beef with vegetables and Yorkshire pudding or fish bake followed by ice cream or bread and butter pudding and custard. The main course was served on a hot plate and the food was hot. There was water on the tables and tea was served in small teapots. The room was bright and clean and people were chatting over lunch.’ Highfield Hall Care Centre DS0000022505.V352020.R01.S.doc Version 5.2 Page 13 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. Complaints were taken seriously and investigated. Staff had a good understanding of protection issues. EVIDENCE: A comprehensive complaints procedure was in place. The manager had investigated six complaints since the last inspection. Detailed records of the complaints, investigation and any action taken were seen. Policies and procedures relating to the safeguarding of vulnerable adults were in place. This issue was discussed with four members of staff. They were aware of the procedure and said they would report any concerns immediately. Highfield Hall Care Centre DS0000022505.V352020.R01.S.doc Version 5.2 Page 14 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 excellent. This judgement has been made using available evidence including a visit to this service. The premises were well maintained and provided a very comfortable and ‘homely’ environment for the residents. EVIDENCE: At the time of the inspection the home was clean, tidy, free from offensive odour and well maintained. Recent improvements to the premises include new carpets to several corridors and communal areas, new chairs for the residential unit lounge, new sinks and a nail bar for the hairdressing salon and new furniture for most bedrooms. The manager explained that nine profiling beds had been obtained increasing the total number available to sixteen. The grounds and gardens were well kept and a secure garden area was accessible from the dementia unit. Laundry facilities were appropriate for the size of the home. An infection control policy was in place. Highfield Hall Care Centre DS0000022505.V352020.R01.S.doc Version 5.2 Page 15 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 adequate. This judgement has been made using available evidence including a visit to this service. Members of staff were encouraged to acquire the skills and knowledge necessary in order to meet the needs of the residents. Recruitment procedures did not fully protect residents. EVIDENCE: Examination of the duty rota confirmed that staffing levels were appropriate to meet the assessed needs of the residents. It was evident from discussion with members of staff and the manager that training was encouraged. This included induction training for new employees, moving and handling, basic food hygiene, health and safety, fire awareness, abuse awareness and minimising the potential for abuse, whistle blowing, handling difficult behaviour, infection control and dementia awareness. Seventeen care workers had an NVQ qualification at level 2 or above in care. In addition to this a further twelve were working towards NVQ level 2. All members of staff had individual training records. The files of three members of staff appointed since the last inspection were examined. Two of these files indicated that all the required pre-employment checks to ensure protection of the residents had been completed prior to Highfield Hall Care Centre DS0000022505.V352020.R01.S.doc Version 5.2 Page 16 appointment. However, a POVA/CRB had not been obtained for the other employee and she had been allowed to start working at the home before the second written reference was received. Highfield Hall Care Centre DS0000022505.V352020.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. The home has a competent manager. The views of residents and their relatives are considered when decisions about the care and facilities provided at the home are made. EVIDENCE: The registered manager is an experienced nurse and has an NVQ level 4 in management. She keeps up to date with current practice by attending relevant study days, reading care journals and using the internet. The home has achieved the nationally accredited RDB star rating quality assurance award. They have been awarded five stars, the highest rating, for the standard of care and environment, three crowns for facilities and access for people who use wheelchair. Highfield Hall Care Centre DS0000022505.V352020.R01.S.doc Version 5.2 Page 18 The annual survey of residents and their relatives was carried out in September 2007. Meetings for residents and their relatives were held regularly. A meeting and cheese and wine evening was held on the day of this inspection. Staff meetings were also held regularly. An annual development plan, which closely followed the National Minimum Standards and focused on outcomes for residents, was in place. Records of transactions involving resident’s money were seen to up to date and accurate. Policies and procedures for safe working practices were in place. Fire alarms and emergency lighting were tested weekly. A fire risk assessment was in place. This was reviewed annually. Fire drills took place monthly and a staff attendance record was kept. Records of the routine servicing of equipment were seen. These included up to date gas safety and electrical installation certificates. Records maintained in the kitchen included fridge, freezer and food temperatures. Safety notices were displayed in the home. Highfield Hall Care Centre DS0000022505.V352020.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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Highfield Hall Care Centre DS0000022505.V352020.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. 1 OP7 Standard Regulation 15(1) Requirement To ensure the care needs of all residents are met. If a resident has mental health problems a care plan explaining how this need is to met must be in pace. A falls risk assessment must be carried out for all residents. In order to safeguard residents from abuse two written references and a POVA/CRB check must be obtained before new employees start working at the home. Timescale for action 11/01/08 2 OP29 19(1)(b) Schedule 2 30/11/07 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 OP9 Refer to Standard Good Practice Recommendations The name of the drug should be clearly written at the top of each page in the controlled drug’s book. The actual dose given instead of ‘1 tablet’ should be recorded. Highfield Hall Care Centre DS0000022505.V352020.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ 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 Hall Care Centre DS0000022505.V352020.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. 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