Care Home: Highfield House Residential Home

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What the care home does well Each person who lives at the home has had their needs assessed to make sure the home can give them the care and support they need. All of the people have care plans which give information to staff about how to support them and meet their needs. Care is planned with the people in a way that they prefer and in a sensitive manner. The staff team at the home recognise the differing needs of the people who live there and make sure that they are aware of each person`s preferences. They treat the people as individuals and support them to live the life they choose as much as possible, so they will have new experiences and know that their opinions are valued. People who live at the home experience a variety of activities. This gives them choice, as well as building their self-esteem and confidence. The staff team make sure that the home is clean, warm and adequately furnished so the people who live at the home have a comfortable place to live. Staff support the people to use local services so they are part of the community. The staff make sure the people`s health care needs are met so they remain in good health. All of the people who live at the home have plans of care and risk assessments. This is so staff have the information they need to support each person and keep them safe. The home has procedures for staff for the administration and recording of medication, which is adhered to. This is to make sure the people who live at the home receive their medication when they need it and at the correct times. The home has procedures for dealing with complaints and protecting the people who live there from abuse. This means that the people who live at the home feel safe, know they can talk to the staff and that their views are listened to. What has improved since the last inspection? New Care plan and risk assessments formats have been devised, and these ensure that service users needs are fully met. The new manager ensures that the health, safety and welfare of the service users and staff are promoted and protected. The proprietors have continued to make improvements to the environment, all bathrooms and toilets have been refurbished to a high standard, all en suite facilities have also been refurbished, and a large conservatory has been built. What the care home could do better: No requirements or recommendations were identified. Key inspection report Care homes for older people Name: Address: Highfield House Residential Home 17, Sycamore Terrace Haswell Co. Durham DH6 2AG     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: Jim Lamb     Date: 0 1 0 6 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 27 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 27 Information about the care home Name of care home: Address: Highfield House Residential Home 17, Sycamore Terrace Haswell Co. Durham DH6 2AG 01915261450 01915261450 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Marion Burns,Susan Burns Name of registered manager (if applicable) Mrs Sylvia Ann McLeod Type of registration: Number of places registered: care home 25 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 25 The registered person 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 to the home are within the following categories: Old age, not falling within any other category - code OP, maximum number of places 25 Dementia Code DE(E), over 65 years of age, maximum number of places 25 Date of last inspection Brief description of the care home Highfield House is a care home that provides personal care and accommodation for up to 25 people. The home is registered to provide care for older people and older people with dementia. This home does not provide nursing care. The home has been operating for about 20 years. The current owners have almost fully refurbished it. Care Homes for Older People Page 4 of 27 Over 65 25 25 0 0 Brief description of the care home Highfield House is in a pleasant rural location on the outskirts of Haswell village. The home is close to the local communitys resources, including a shop, pubs, club, post office, and health centre. The ground floor accommodation has a large lounge and separate dining room, with good access to a conservatory, patio and lawned gardens. The majority of bedrooms, toilets and bathrooms are also located on the ground floor. The first floor has a small number of bedrooms and an additional bathroom, with both lift and stair access. Bedrooms are single occupancy, ten have en-suite facilities. The weekly fees at the time of inspection were £404.00 to £ 425.00 depending on care needs. 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: We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The quality rating for this service is 2 stars. This means that the people who use the service experience good quality outcomes. How the inspection was carried out. Before the visit we looked at information we have received since the last visit, how the service dealt with any complaints and concerns since the last visit, any changes to how the home is run, the providers view of how well they care for people, and the views of Care Homes for Older People Page 6 of 27 people who use the service and their relatives, staff and other professionals. During the visit we talked with people who use the service, relatives, staff, the manager, one of the proprietors and visitors, looked at information about the people who use the service and how well their needs are met, looked at other records which must be kept, checked that staff had the knowledge, skills and training to meet the needs of the people they care for, looked around the building/parts of the building to make sure it was clean, safe and comfortable, and checked what improvements had been made since the last visit. We told the manager/provider what we found. Care Homes for Older People Page 7 of 27 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 Care Homes for Older People Page 8 of 27 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 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. Prospective service users are provided with enough information about the service to enable them to make an informed choice about whether this is where they want to live. Evidence: The homes Statement of Purpose and Service User Guide have been updated. These guides contained all of the information that is required to enable people to make an informed choice about where to live. Evidence was seen in service users files that service users or their representatives had signed a contract. The contracts were detailed and included a breakdown of the fees and who was responsible for paying them. The manager confirmed that visits to prospective service users takes place before their admission to the home, to carry out an assessment of needs. Four care plans examined contained notes from assessments made on these visits. Also, each service users care plans contained assessments from the placing authority that were responsible for commissioning the service users care at the home. Care Homes for Older People Page 11 of 27 Evidence: The home does not provide intermediate care 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. The care planning system is clear enough to ensure that staff have the information they need to meet the assessed needs of the service users. Evidence: There are a range of assessments in the service users care plans. There is also a comprehensive risk assessment of service users. There are advocacy arrangements, as well as family input to represent service users. Care plans are drawn up with service users and their relatives. Plans are amended and reviewed on a regular basis. The plans are person centred and based on activities of daily living. The care plan format clearly describes each persons holistic care needs, and how these will be met by staff. There are systems in place that will ensure that the placement and the service users plans are reviewed annually. These involve the care managers and the service users representatives. The service users confirmed that their privacy and dignity are Care Homes for Older People Page 13 of 27 Evidence: respected at all times. Service users care records showed that they have access to external health care services. G.Ps visit when necessary. Service users are referred for specialist health care if appropriate. All service users receive regular health care checks. The medication systems were examined for ordering, receiving, administering and disposal. The medication systems are managed well. All staff have had accredited medication training. Appropriate systems and procedures are in place for the management of controlled drugs. Staff who have completed relevant training administer medication. A sample of medication records was examined. These include photographs for identification purposes. Clear directions were recorded and each dose of medication was signed for, or a code entered to verify the reason not given. Privacy and dignity issues are built into the homes policies and procedures and staff training. All personal care and medical examination/treatment is carried out in private. Service users said that they are able to make decisions for themselves, and that they are happy with all aspects of the care that they receive. One person said, The support is fantastic, the staff are superb, and the food is great. They have all looked after me so well since i moved in. A relative said,There is no need to inspect this home because it is a fantastic place, the staff are the best. 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. The service users are offered a good quality lifestyle, which includes varied social contact and activities. Evidence: Service users confirmed they could exercise choice in their daily lives, such as what clothes they wore and how they spent their time, including when they got up and went to bed. They said there were different events and activities that they could take part in if they wished, including social evenings, bingo, board games, crafts, visiting entertainer, seasonal events, quizzes, raffles, chair exercises, videos and DVDs, reminiscence and outings. There is also a visiting hairdresser. There are some very good links with the local community and service users have access to the local facilities. Staff are in the process of organising a summer garden party, and they said that they always receive good support from the local community. Typical comments from service users included: I am very happy here and wouldnt change a thing. The staff are very good to me and the food is also very good. Service users and relatives are invited to regular meetings, at which matters of interest and suggestions are discussed. The minutes of these meeting are displayed in Care Homes for Older People Page 15 of 27 Evidence: the home. Service users confirmed that they could pursue individual interests such as reading, listening to music, reading daily newspapers and watching television. Service users and relatives said that visitors were always made welcome and there were no set visiting times. Some service users went out with relatives or friends for part of the day. All the those spoken to said the catering was very good. They felt there was a good choice and the Cook understood their preferences. Nutritional screening takes place routinely and the home provides a wide range of meals based on healthy eating and appetizing menus for older people. Service users mainly dined together in the various dining areas. They could, however, eat their meals elsewhere (such as their bedrooms) and at different times if required. Decor and furnishing in dining areas are attractive, creating a relaxed and welcoming environment. Tables were supplied with napkins, plus floral arrangement and menu. Records are kept of meals served. A good choice of menu is provided, with ample portions and the quality of meals was observed to be very good. 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. The complaints management is effective, and this results in the service users being protected from harm and abuse. Evidence: Information about complaints is displayed on notice boards around the home and in the homes Statement of Purpose and Service Users Guide. The people spoken to by the inspector confirmed they were aware of how to raise any concerns or complaints. Although nobody spoken to had any cause for complaint, all expressed confidence that any complaints they might have would be taken seriously. Service users and families views are obtained through regular contact and an open door policy. Service users / Family Meetings are held, which provide an additional forum to discuss any concerns or potential difficulties. Staff meetings are also held. One person spoken to said, I have never had to make a complaint, but if there is a problem I speak to the staff or the manager. Another person said, The staff always listen to what i have to say. The organisations policy and procedure documents relating to adult protection provide information and guidance to staff. A copy of Durham & Darlington Adult Protection Committees Inter-Agency Adult Protection Policy & Procedures on abuse and the Care Homes for Older People Page 17 of 27 Evidence: protection of vulnerable adults is available in the home. The home also has a copy of the Department of Healths NO SECRETS. Additional staff training about abuse and the protection of vulnerable adults has taken place for all staff staff during the last 12 months. This is good practice. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a comfortable and safe environment for those living there. Evidence: The home was clean, well decorated and very well maintained. The grounds were highly attractive, tidy, safe, and accessible. The home has an appropriate amount of sitting, recreational and dining space. There are enough rooms for a variety of activities to take place. During the last twelve months, there has been some significant improvements made to the environment, several bedrooms have new furniture and most have recently been decorated, all en suite facilities have been refurbished, and all bathrooms and toilets have also been refurbished and a new conservatory has been erected. More improvements are planned for this year. Service users can see visitors in private in their own rooms. Furnishings and fittings were domestic in design and in good condition. All doors have privacy locks. Service users bedrooms have opening windows and restrictors are in place. The rooms Care Homes for Older People Page 19 of 27 Evidence: were centrally heated and the heating level could be controlled within each bedroom. Radiators and pipes were guarded. There are several attractive garden areas that have been landscaped, and service users have easy access to these areas. There are plans to create a new patio area. There was emergency lighting throughout the home. The kitchen was spotlessly clean and very well organised. Water is stored at over 60 C. Valves at water outlets ensure water is provided close to 43 C to prevent scalding. The home was clean and free from offensive odours. The laundry facilities are very well organised. The washing machines have the specified programme to meet disinfection standards. 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. There is a good match of well-qualified staff, who are appropriately recruited and supervised. Evidence: The home currently has 15 service users. There are enough staff employed to meet the service users needs. In addition to the manager and one of the proprietors, there is 1 senior and 1 care staff on duty each morning Monday to friday. During the evenings and at weekends there are 3 staff on duty. There are 2 night staff on duty each night. The personnel records of four staff were examined. All three examined had completed application forms, the dates of employment were clear, making it easy to follow a clear employment audit trail. The manager also completes an audit check list and this ensures that all the necessary checks have been completed prior to commencing employment. All had the required two work references, (crb) criminal record bureau check, documentary evidence of identity, induction and training and development information. Care Homes for Older People Page 21 of 27 Evidence: The manager confirmed that, if there are any concerns about the content of a CRB disclosure, these are discussed with the proprietors. All staff have an annual training matrix drawn up, this covers all mandatory training needs, and other core training needs, such as control of infection and Adult Protection. Individual staff members have his or her individual training needs analysis on their personal file. These have recently been revised to cover developmental as well as mandatory and core training. All staff have completed NVQ level 2/3/ training, one care staff has completed level 4. The manager said that, mental capacity and deprivation of liberty training had taken place during the next 12 months. 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. The manager is providing good leadership throughout the home, with staff demonstrating an awareness of their roles and responsibilities. Evidence: The registered manager has the required qualifications and experience to run the home. There is a range of quality systems in the home. There is an annual survey of the views of the service users and their families. The findings are collated and an action plan drawn up to address any areas of concern. There are also regular meetings held with both the service user groups and with the staff group. These are minuted and action points listed. Service users and staff expressed satisfaction with the way the home was run and the good standards that were evident in many instances. For example, all service users and relatives Care Homes for Older People Page 23 of 27 Evidence: commented that the home was always fresh and clean. Service users and staff said they enjoyed living and working at the home and believed the home was safe and run in the best interests of the service users. Both individual and central supervision records were studied. These records show an appropriate bi-monthly pattern of supervision, with an annual work performance appraisal. All staff receive annual health and safety training. This is good practice. Checks of the fire log book showed that all the required checks and tests of equipment and systems take place at the proper intervals, as does fire safety training. The homes accident book is kept up to date and information is fully recorded. Each accident is reviewed after 24 hours to check the outcomes of the accident and any treatment given. There is a monthly audit of accidents, and a detailed audit of all falls. The majority of service users had requested that the home take on day-to-day responsibility for overseeing their money. Staff signatures had been obtained for all money spent on behalf of service users and receipts had been obtained and attached to their financial balance sheets. Financial records showed evidence of regular audits. The home does not acting as an appointee for any of the service users. Servicing and maintenance records are comprehensive and well maintained. 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 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 Care Homes for Older People Page 26 of 27 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. © 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. Care Homes for Older People Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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