Care Home: Highfield House

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What the care home does well The assessment system means that residents get the care they need. Residents said that staff were friendly and attentive and welcomed visitors. Medication was up to date to ensure residents health is protected. There have been no complaints to the management or to the Commission since the last key inspection two years ago. Satisfaction surveys that management have supplied were very positive indicating that residents liked living in the home and had their needs met. Residents were satisfied with how their bedrooms were organised. The garden was very well maintained with mature trees and attractive border plants. The Manager has completed risk assessments for safe working practices to keep residents safe. What has improved since the last inspection? The first aid training for the registered provider/manager appears to have been updated in order to provide the most current first aid practice to people living in the home. What the care home could do better: Residents welfare could be more effectively met by ensuring that: All aspects of care e.g. proper toileting programmes, and a full record of daily living wishes etc are detailed in Care Plans to assist staff to meet all residents needs. To provide more activities such as reading out the news, having life history books and memory boxes etc to engage residents in one to one reminiscence with staff and so give them stimulation and interest. An environmental audit is recommended to make facilities better signed for residents with dementia etc. Facilities issues need to be attended to quickly to provide an attractive home for residents by way of having stain free flooring and the elimination of odours. Hot water needs to be properly controlled so as not to pose a risk for residents. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Highfield House 2 Huncote Road Stoney Stanton Leicestershire LE9 4DG     The quality rating for this care home is:   two star good 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: Keith Charlton     Date: 0 6 0 7 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 27 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 27 Information about the care home Name of care home: Address: Highfield House 2 Huncote Road Stoney Stanton Leicestershire LE9 4DG 01455274331 08701325604 clough@btopenworld.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Howard Clough,Mrs Christine Joy Clough care home 3 Number of places (if applicable): Under 65 Over 65 3 old age, not falling within any other category Additional conditions: 0 The maximum number of service users who can be accommodated is 3. The registered persons may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission are within the following category: Old age, not falling within any other category - Code OP. Date of last inspection Brief description of the care home The last key inspection was on 25/7/07. Highfield House is a large detached building situated in the village of Stoney Stanton in South Leicestershire. It provides a service for up to three older people in spacious yet homely surroundings. The home has a comfortable lounge, which leads into the dining area. There is also a large conservatory. The furnishings and decor of the home are in keeping with the period of the building. There is a large well-maintained garden, which also contains an aviary. The home also has ample parking space to the front of the building. The Proprietors of the home have two dogs. All bedrooms are for single Care Homes for Older People Page 4 of 27 Brief description of the care home occupancy and two are located on the first floor, which is accessible via a stair lift. Bedrooms are spacious and well equipped with en-suite facilities (toilet and wash hand basin). The fees are £340 pw. A copy of the last published inspection report is available from reception. Care Homes for Older People Page 5 of 27 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: two star good 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: The quality rating for this service is Two Stars. This means the people who use this service experience good quality outcomes. We as it appears throughout the Inspection Report, refers to The Care Quality Commission. The inspection process consisted of pre-planning the inspection, which included reviewing the Annual Quality Assurance Assessment (AQAA), which is self-assessment tool completed by the Manager of the service, and looking at the last key Inspection Report of 2007. We sent surveys to people who use the service and three surveys were sent back, which the management of the service assisted residents to complete. These Care Homes for Older People Page 6 of 27 were positive regarding the care the service provides. It is recommended that residents are assisted by independent advocates in the future. The unannounced site visit commenced on the 6th July 2009 and was carried out by Keith Charlton. The focus of the inspection is based upon the outcomes for people who use the service. The method of inspection was case tracking. This involved identifying people with varying levels of care needs and looking at how these are being met by the staff at Highfield House. Two residents were selected. Discussions were held with three residents (though this was difficult as two residents had memory difficulties), the Registered Provider and the Registered Manager after the inspection, by phone. 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 Care Homes for Older People Page 8 of 27 printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 27 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 10 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Highfield House have had their needs properly assessed before moving into the home so that staff can meet their needs. Evidence: A resident said she had been provided with sufficient written information prior to admission to make up her mind about the home. I think my daughter got the information about the home and we thought it sounded very nice, one resident said. We case tracked a person living in the home who had moved into Highfield House in the past. We checked that she had received information to help with the choice of home. We also checked that this person had her needs properly assessed prior to moving in, to ensure that the staff at the home could meet her needs and we found that the assessment system was detailed regarding residents needs. Care Homes for Older People Page 11 of 27 Evidence: Plans showed detail regarding the support required by staff to ensure the physical health of people living at the home,what personal care they needed, and there was some information to inform staff of the residents personal history, though no information of preferred daily living routines of residents to ensure their social and emotional well being is fully supported. Some Plans showed that a referral to a specialist nurse has been done but there was no specific information showing the individual needs as to when people were likely to need to go to assist staff to help before there was an accident. Accident records were checked and medical services were contacted when residents had potentially serious injuries. We checked the medication records, and found that there was good recording of the administration of the medicines in the home, with no gaps. There was good information on medication sheets regarding allergies, so that residents health is protected. There was evidence that only trained staff issued medication. Medicines storage was in a secured cabinet. There was evidence on staff raining recrds that medication training had been carried out. We saw staff being friendly and caring to people throughout the day with residents confirming that staff respected their dignity. Care Homes for Older People Page 12 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People at Highfield House receive good health and social care practice. Evidence: Residents said that staff provided friendly personal care: They are good and treat us as one of the family, said one resident Residents spoken with could not recall having a care plan but said they were not bothered about seeing it. We checked the care plans of two people living at the home who were case tracked. Plans showed detail regarding the support required by staff to ensure the physical health of people living at the home,what personal care they needed, and there was some information to inform staff of the residents personal history, though no information of preferred daily living routines of residents to ensure their social and emotional well being is fully supported. Some Plans showed that a referral to a specialist nurse has been done to work out the individual continence needs of a resident, especially those with dementia, who usually cannot ask staff for assistance when they need to go, so staff can prompt before there is a need to go to Care Homes for Older People Page 13 of 27 Evidence: the toilet, but there was no information showing the individual needs as to when the person needed to go. Accident records were checked and medical services were contacted when residents had potentially serious injuries. We checked the medication records, and found that there was good recording of the administration of the medicines in the home, with no gaps. There was good information on medication sheets regarding allergies, so that residents health is protected. there was evidence that only trained staff issued medication. Medicines storage was in a secured cabinet. There was evidence on staff raining records that medication training had been carried out. We saw staff being friendly and caring to people throughout the day with residents confirming that staff respected their dignity. Care Homes for Older People Page 14 of 27 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. There are are some opportunities for residents at Highfield House to have a relaxed lifestyle. Evidence: Residents said that they were satisfied with the current activities. A resident said There are activities if we want to play games but I am not bothered. We spoke to the Registered Provider and we saw that there is a current list of activities that residents can choose from - board games, cards, word games, painting, trips out, TV, we witnessed age appropriate music being played in a lounge and residents said staff took them out to the garden in good weather though we did not see any activities as residents sat quietly in the lounge. We asked the Registered Provider to look at adding to the homes activities and so providing day to day stimulation, such as reading out stories from the paper to stimulate conversation. Life history books were not evident - this would gain information for staff to do one to one reminiscence with residents - though a resident had photos of her family near her which staff can use for this activity. Memory boxes could also be used to provide stimulation for residents with memory difficulties. Care Homes for Older People Page 15 of 27 Evidence: The relations between staff and residents were observed to be relaxed. Residents said there were no rules though one resident thought there were getting up and going to bed times. This needs to be discussed with residents so that their choice is respected. Residents said visitors are welcomed at Highfield house and can come at any reasonable time and they were always greeted in a friendly way by staff. Residents said they enjoyed the food: The food is good. I enjoy all of it, one resident said. Lunch consisted of Cumberland(mince) pie with roast potatoes and two fresh vegetables followed by jam roly poly with custard. Food records showed a good variety of traditional food served. Care Homes for Older People Page 16 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are listened to and protected from abuse. Evidence: Residents said if they had a complaint they were confident that the Management, would sort it out. A resident said, I have nothing to complain about but I think they would look into anything if I told them. We saw that there had been no complaints received since the last inspection. The Complaints procedure was detailed though did not give people the choice to go to the home or to the Lead Agency, the Social Services Department - it only gave the choice to go to the home first. The Manager said this would be ammended. Records showed staff had received training about safeguarding adults from abuse, and there was relevant information in the office to refer to if this became necessary. We looked at the staff recruitment records to see whether all the proper checks had been made on staff and we asked that the Registered Provider send us the legal check for one staff member, though there as evidence that she had a proper CRB from another job she had. Care Homes for Older People Page 17 of 27 Care Homes for Older People Page 18 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Highfield House live in a homely environment, which needs to be maintained at all times. Evidence: All residents spoken to said they liked their bedrooms: I have all my things the way I want them to be, one resident said. We saw people at Highfield house living in a homely environment. The furnishings in communal areas of adequate quality, and people said that they were encouraged to bring their personal possessions into their bedrooms. However some bedroom carpets were stained, particularly for one bedroom. The Registered Provider agreed with this assessment. There were also low level odours to bedrooms. The Manager is recommended to review signs around the home to improve the environment to further help residents with dementia, e.g. colour coding toilet doors, pictures of residents favourite scenes on bedroom doors etc to make facilities clearer, and orientate residents to go to their own bedrooms etc. Residents said they loved the large gardens that were well maintained. Care Homes for Older People Page 19 of 27 Care Homes for Older People Page 20 of 27 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. Residents needs are met by a competent staff group. Evidence: There were no comments from residents there were not enough staff to meet their needs, though two out of the three residents had memory difficulties: I never have had a problem with staff coming to see me when I need them, one resident said. We saw the rota. Staffing is the Registered Providers and their daughter with usually two staff on duty throughout the day/evening for the three residents that live in the home. We found that staff have been on a number of training events to help update their practice on areas such as Medication, First Aid, COSHH, Health and Safety,Moving and Handling, Fire Safety, Infection Control, Deprivation of Liberty etc though some issues regarding residents health conditions were missing from the Training records we saw e.g. Dementia, Sight and Hearing Impairment, etc. Staff records did not show that all checks had been carried out to protect residents the Registered Provider said she would forward a check that we asked for. Care Homes for Older People Page 21 of 27 Care Homes for Older People Page 22 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are management systems in place to protect the health and safety of residents. Evidence: Howard Clough is the Registered Manager of the home, and has completed training in management skills. Residents were positive about the management of the home.We get everything we need here, one resident said. We saw evidence that there is no current need to make Deprivation of liberty referrals (this is if for any reason residents are deprived of their liberty in their best interests to ensure this has official approval). Satisfaction questionnaires were sent around the home last year, and the results were seen to be very positive. Written records regarding finances for residents are properly in place, with a running Care Homes for Older People Page 23 of 27 Evidence: total to prove the balance. There was no evidence of residents and relatives meetings discussing relevant issues activities, food etc, to show residents involvement in the running of the home - the Registered Provider said there were only three residents, two with memory problems, so one to one talking with them was seen as the best method to get their views rather than having a meeting. There are proper Health and Safety systems in place in the home. We saw risk assessments for safe working practices and COSHH assessments to keep residents and staff safe. We did not see fire records as the Manager was not working though he later sent these to us and they showed proper testing of systems were in place. The fire risk assessment was ifound to be in place - this is to minimize fire risks to residents. We tested the hot water and found it did not meet the National Standard to fully protect residents from scalding. The Registered Provider said it was tested before residents were lowered into the bath but would be lowered to fully eliminate this risk. Care Homes for Older People Page 24 of 27 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 25 of 27 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 1 38 13 Water temperatures must be 07/07/2009 kept at a safe temperature. To protect residents from the risk of scalding injury. 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 1 38 13 Water temperatures must be 07/07/2009 kept at a safe temperature. To protect residents from the risk of scalding injury. 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 1 7 Care plans should include the daily living wishes of residents and their individual continence needs if this is identified as an issue for them. It is recommended that activities are extended to provide more stimulation to residents. Bedroom carpets need to be stain free. Odours need to be eliminated. 2 3 4 12 19 26 Care Homes for Older People Page 26 of 27 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. 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. 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