Care Home: Highfield House Residential Home

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What the care home does well The good assessment process ensured people who used the service were suitably placed. Plans of care were developed with people who used the service or a family member to ensure their wishes were taken into account. Plans of care were reviewed on a monthly basis with people who used the service to keep their care needs up to date. People had access to health care professionals and specialists to help keep their care needs up to date. Staff were observed treating people privately when delivering personal care. This helps to preserve the dignity of people who use the service. There was a good selection of activities and outings to keep people occupied should they wish to join in. People who used the service said their visitors could come when they wanted to. One visitor said, "there is no trouble with visiting and staff look after my family member very well. It has improved since the new manager took over". Visitors were welcomed to help people who use the service socially interact. People who used the service said food was good. There was a good choice of meals offered at this care home. The nutritional needs of people who used the service were met. There was an accessible complaints procedure for people to voice their concerns. Staff had received safeguarding training. There was a good policy to help minimise the risk to people who used the service from abuse. Two people who used the service said they had nice rooms. Bedrooms visited had been personalised to individual tastes and contained good levels of equipment to help people who used the service be comfortable in their private space. The good facilities, services and staff attitude provided a homely atmosphere for people to live in. Good health and safety systems helped protect the health and welfare of staff and people who used the service. The registered manager said, "I am getting enough support, financial and personal to undertake my work". Both care staff said they had enough training to do the job. Both staff they said they had enough supervision. Staff said, "there is a good staff team we are well supported. The atmosphere is good now". Staff felt supported and were happy working at the home which helped provide a good atmosphere for people who used the service. People who used the service said, "I am very happy here and staff look after me very well", "staff are very nice and although I am feeling poorly they are marvelous and I get the care I need" and "staff look me very well". People who used the service thought staff provided good quality care and met their needs. What has improved since the last inspection? Plans of care had been much improved to help staff meet the needs of people who used the service. Privacy screens had been fitted to bedroom toilets to help protect the dignity of people who used the service. Staff had undertaken a lot of training to be competent to look after people who used the service. There was a suitably experienced and qualified person, who was registered with the Care Quality Commission to manage the home. The registered manager had undertaken quality assurance surveys to gain the views of service users and their families. This means the service can provide a more person friendly approach to care. What the care home could do better: The registered manager should ensure any forms not required or not fully completed be archived or an explanation added as to why they cannot be completed retrospectively. This would explain to professionals the reasons why the forms are understandably blank. The registered manager should devise a form to demonstrate how an equal opportunities interview is conducted and recorded to demonstrate how staff are chosen fairly. The registered manager should produce a summary of the results of quality assurance surveys to demonstrate how the service responds to the views of people who use the service. The registered person should send proof to the Care Quality Commission that the gas equipment has been serviced to prove it is safe to use. Key inspection report Care homes for older people Name: Address: Highfield House Residential Home 67-69 Sudell Road Darwen Lancs BB3 3HW     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Graham Oldham     Date: 1 8 0 5 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 25 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Highfield House Residential Home 67-69 Sudell Road Darwen Lancs BB3 3HW 01254701273 01254701273 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Dhillon Financial UK Limited Name of registered manager (if applicable) Alison Foster Type of registration: Number of places registered: care home 18 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The registered person may provide the following category of service only: Care home on - Code P To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 18. Date of last inspection Brief description of the care home Highfield House is a detached property set in its own grounds. It has a small garden at the front, a car parking area at the side and a small enclosed garden area to the rear. Accommodation is provided in single rooms and five bedrooms have en-suite facilities, W.C. and wash hand basin. There are bedrooms on both the ground and first floors. A passenger lift connects the two floors. There are two bathing and one shower facility. The home is on a bus route into Darwen Town Centre, and is approximately half a mile from the main shopping centre. The statement of purpose and service users guide is Care Homes for Older People Page 4 of 25 Over 65 18 0 1 2 0 2 2 0 1 0 Brief description of the care home available for residents or their families to be informed of the facilities and services the home provides. The fees for Highfield House are £344.50 per week. Extra payment is required for hairdressing, newspapers or periodicals, toiletries and outings. Care Homes for Older People Page 5 of 25 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: This unannounced key inspection, which included a visit to the home, took place on the 18th May 2010. Much of the information gained was obtained from talking to people who used the service and staff members. The views of people who used the service were obtained on a variety of topics. Two people were case tracked. Case tracking gave the inspector an overall view of the specific care for the individual resident by checking the plans of care, other documentation and talking to residents and staff. Two staff members were questioned about the care of the residents case tracked. Some of the views have been reported collectively with specific comments contained within the body of the report. The inspector took detailed notes during the inspection, which have been retained as evidence. Staff were directly and indirectly observed carrying out their tasks and interacting with residents. Paperwork examined included plans of care, assessment Care Homes for Older People Page 6 of 25 documentation, policies and procedures or documents relevant to each standard. A tour of the building was conducted. The service returned a self assessment questionnaire which told us of the current and projected standard for the home. Notifications, which are events the home tell us about were also used to influence the inspection. Care Homes for Older People Page 7 of 25 What the care home does well: The good assessment process ensured people who used the service were suitably placed. Plans of care were developed with people who used the service or a family member to ensure their wishes were taken into account. Plans of care were reviewed on a monthly basis with people who used the service to keep their care needs up to date. People had access to health care professionals and specialists to help keep their care needs up to date. Staff were observed treating people privately when delivering personal care. This helps to preserve the dignity of people who use the service. There was a good selection of activities and outings to keep people occupied should they wish to join in. People who used the service said their visitors could come when they wanted to. One visitor said, there is no trouble with visiting and staff look after my family member very well. It has improved since the new manager took over. Visitors were welcomed to help people who use the service socially interact. People who used the service said food was good. There was a good choice of meals offered at this care home. The nutritional needs of people who used the service were met. There was an accessible complaints procedure for people to voice their concerns. Staff had received safeguarding training. There was a good policy to help minimise the risk to people who used the service from abuse. Two people who used the service said they had nice rooms. Bedrooms visited had been personalised to individual tastes and contained good levels of equipment to help people who used the service be comfortable in their private space. The good facilities, services and staff attitude provided a homely atmosphere for people to live in. Good health and safety systems helped protect the health and welfare of staff and people who used the service. The registered manager said, I am getting enough support, financial and personal to undertake my work. Both care staff said they had enough training to do the job. Both staff they said they had enough supervision. Staff said, there is a good staff team we are well supported. The atmosphere is good now. Staff felt supported and were happy working at the home which helped provide a good atmosphere for people who used the service. Care Homes for Older People Page 8 of 25 People who used the service said, I am very happy here and staff look after me very well, staff are very nice and although I am feeling poorly they are marvelous and I get the care I need and staff look me very well. People who used the service thought staff provided good quality care and met their needs. 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 25 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 25 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. The good assessment process ensured the needs of people who used the service could be met at the care home. Evidence: The care plans of two people who used the service were examined for assessment documentation. A senior member of staff had completed an comprehensive assessment of people who used the service prior to admission. A good background history had been obtained to help develop a plan of care for each person. Information was also supplied from family members and social services to ensure as much information as possible was obtained prior to admission. The full process ensured people placed within this care home were suitably placed. Care Homes for Older People Page 11 of 25 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. Plans of care had been developed and regularly reviewed to fully take account of each persons needs. People who used the service had access to specialists to keep their health care needs up to date. The administration of medication was safe for people who used the service. The good attitude of staff helped maintain the privacy and dignity of people who used the service. Evidence: Two plans of care were examined during the case tracking process. Plans of care had been developed with people who used the service to take account of their wishes. There was very good detail within the plans of care of each persons needs for staff to deliver effective care. Plans of care had been regularly reviewed to keep staff up to date with the care needs of people who used the service. The new registered manager had worked hard over the last few months to ensure the plans of care meet the standards of the Care Quality Commission (CQC). However, some documentation (such as a property record on admission), which would serve no purpose or be impossible to complete retrospectively should be archived or a statement added explaining the reason for the omission. This would avoid any confusion over the Care Homes for Older People Page 12 of 25 Evidence: omissions and turn what are very good care plans into excellent ones. Each person who used the service had access to professionals such as opticians, podiatrists, dentists, nurses and hospital specialists to ensure their treatments were kept up to date. Nutritional, tissue viability and falls risk assessments had been undertaken on each person to help protect their welfare. There were medication policies and procedures for staff to follow good practice. The Medication Administration Records were examined, contained no errors and had been completed correctly to ensure people who used the service had their medication on time. There was a good system for ordering and then storing medication to ensure sufficient supplies were available. There was a controlled drugs register and a locked device kept within the drugs trolley to keep them safe. All staff who administered medication had been trained and there were medication publications to help supplement staff knowledge. The person responsible for ordering medication said the pharmacist regularly audited the system and were available for advice to help keep practice good. Staff were observed interacting and delivering care with people who used the service. Staff were careful to ensure they gave personal care with privacy and compassion to help people who used the service feel comfortable with the help they needed. Care Homes for Older People Page 13 of 25 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. Suitable activities were provided to help keep people who used the service socially stimulated. Visiting was unrestricted to help people who used the service remain socially active. People who used the service were offered choice in many aspects to help maximise their contentment. Food served at the home met the nutritional needs and tastes of people who used the service. Evidence: There was a list of the weekly activities people could attend and a record retained of those who joined in. Activities included bingo, dominoes, pamper sessions and outside entertainers come into the home. Different denominations of religion attend to meet peoples spiritual needs. The registered manager said they held a lot of themed events such as Halloween or St Georges day parties to help keep people who used the service entertained. One visitor said visiting was open and staff were welcoming. Several people said visitors attended when they wished. Visiting was encouraged to help people who used the service remain in touch with their family and friends. The choices and wishes of people who used the service were excellently recorded in Care Homes for Older People Page 14 of 25 Evidence: plans of care. This was recorded in a very individual way and staff had made a great deal of effort to ensure people who used the service received what they wanted. Choices included dress sense, food, routine, activities and past interests or hobbies. People had the choice of what they wanted to do so they could pass each day as they wished. The food served on the day of the inspection was hot, nutritious and tasty. The cook had consulted people who used the service about the menu and was trying some new choices out. She came out after the meal to see if people liked the meal and this would help her plan future menus. The cook undertook environmental health checks to help protect the welfare of people who used the service. Meals were served in comfort and condiments provided for people to season their food. One person was observed to be fed in a dignified manner. Care Homes for Older People Page 15 of 25 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. There was a good complaints procedure for people to voice any concerns they may have. The robust safeguarding procedures helped keep people safe. Evidence: The registered manager took over at a very difficult time when several complaints had been made against the home. to the CQC and social services. The complaints were dealt with in a satisfactory manner and good outcomes were reached. There have not been any complaints since she took on the managers position. There was a complaints procedure with acceptable timescales and the address of the CQC for people to contact if they wished. There were safeguarding procedures for staff to follow good practice and the Blackburn with Darwen adult abuse procedures to follow a local initiative. One safeguarding issue had been taken just as the new manager started with and was dealt with in line with guidance. There was a copy of the No Secrets document for staff to understand abuse issues and a whistle blowing policy to report abuse should a member of staff spot it. In the plans of care there was a very good action for staff to take for a person who used the service who was difficult. All staff had completed safeguarding training to ensure they were aware of abuse issues. Care Homes for Older People Page 16 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home, furnishings and fittings were domestic in character and provided a homely setting for people who used the service. The accommodation was suitable for people who used the service. Evidence: A tour of the premises was conducted on the day of the inspection. The home was warm clean and did not contain any offensive odours. Communal areas contained sufficient good quality furniture to provide comfortable seating and dining for people who used the service. There was an accessible outside area with seating for people to use in good weather. There was a lift and other aids for the disabled such as hand rails. This meant people who used the service were able to access all areas of the home when they wished. The opening of windows was restricted. Radiators were covered and the temperature of hot water outlets were regulated to be safe for people who used the service. Bedrooms visited contained sufficient furniture and had been personalised to each persons tastes to encourage each person to feel more at home in a residential setting. Care Homes for Older People Page 17 of 25 Evidence: There was a good system in place to repair any defects and keep the home in good order for people who used the service. Bedroom doors were lockable to ensure people could have privacy if they wished. The laundry was well equipped to keep people who used the services clothes clean. Care Homes for Older People Page 18 of 25 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. There were sufficient numbers of well trained staff on duty to meet the needs of people who used the service. The good recruitment procedures helped protect people who used the service from possible abuse. Evidence: On the day of the inspection the registered manager was supported by three care staff and two ancillary staff. The off duty rota showed this to be the norm. 100 of staff had completed NVQ2 or better in care studies. Staff said they had undertaken a lot of training in the past few months including dementia care, first aid, food hygiene, moving and handling, infection control and health and safety. Staff were well trained and had the knowledge to care for the people who lived at the home. Two staff files were examined during the inspection. Staff files contained evidence a good recruitment procedure was conducted for new staff and included a criminal records check, proof of identity, two written references, an application form and other documentation for the manager to employ staff safely. There was no written record of how an interview for employment had gone or the reasons a person had been chosen. It was recommended a form be developed to demonstrate an equal opportunities interview had been conducted to demonstrate how staff were chosen fairly. Care Homes for Older People Page 19 of 25 Evidence: Both staff files examined showed new staff had undergone the common induction standards to help them gain confidence to look after people who used the service. Care Homes for Older People Page 20 of 25 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. Quality assurance systems took into account the views of people who used the service to help demonstrate a responsive management style. The good handling of the pocket monies of people who used the service helped protect them from financial abuse. Good health and safety systems helped protect the health and welfare of staff and people who used the service. Evidence: The manager holds the relevant qualifications and had successfully registered with the CQC to meet current requirements. The registered manager held regular recorded meetings with staff and people who used the service to take account of their views. The registered manager had conducted quality assurance questionnaires for people resident at the home and their families. Once a summary has been completed this standard will be met. The registered manager said the home was not responsible financially for any person Care Homes for Older People Page 21 of 25 Evidence: accommodated at the home. There was a safe system for handling small amounts of pocket money which always involved two members of staff checking records and obtaining receipts. There were health and safety policies and procedures for staff to follow good practice. Electrical equipment such as fire alarms and supply had been serviced and certificates of compliance obtained to help keep people safe. The registered manager was aware of health and safety legislation to advise staff. When going through the equipment servicing folder it was discovered the gas equipment servicing was out of date. The registered manager phoned the company they used and was told they would attend to service the equipment the same day. The registered manager said she would send a copy of the certification when it had been completed to show compliance with this standard. Care Homes for Older People Page 22 of 25 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 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 7 The registered manager should ensure any forms not required or not fully completed be archived or an explanation added as to why they cannot be completed retrospectively. This would explain to professionals the reasons why the forms are understandably blank. The registered manager should devise a form to demonstate how an equal opportunities interview is conducted and recorded to demonstrate how staff are chosen fairly. The registered manager should produce a summary of the results of quality assurance surveys to demonstrate how the service responds to the views of people who use the service. The registered person should send proof to the Care Quality Commission that the gas equipment has been serviced. 2 29 3 33 4 38 Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 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) Care Quality Commission (CQC). 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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