Care Home: Highfield Nursing Home

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What the care home does well Staff now write good care plans to show how staff should support people`s emotional needs, and how they can best be met. Care plans to show how staff can help inminimising skin damage or falls, and what action they must take if these issues arise, are also well completed. This helps to make sure risks to these people are monitored, and advice sought as soon as it is needed. The majority of people said they `always` or `usually` get the care and support they need, and that staff listen and act on what they say. They all agreed they get the medical care they need. We received comments like `Nurse excellent. Most carers very good - helpful, cheerful etc`. People are offered a number of activities during the weekdays. This includes one to one time with individuals, when staff make a point of checking with the person that they are receiving their care and support in a way which meets with their wishes. People said they like the environment. One said `I`ve got my bedroom - it`s lovely`. Everyone who returned their surveys said there was someone they could speak to if they were not happy. A person living at the home said the manager was good, and that they would go to her with any concerns. Complaints are now well documented, and show what action the home has taken to put things right for anyone who has raised concerns about the home. They show that all complaints, from whatever source, are responded to quickly, so people know the information they have provided has not been forgotten about. The home is also better now at identifying, and reporting issues to the local authority, which they may need to investigate under their safeguarding responsibilities. They also tell us now when they have done this. All staff have received safeguarding training, the content of which which has been checked by the local authority. The manager is going to make sure that staff have contact details so staff can ring the local authority directly, should they ever need to. The home looked clean and tidy, and everyone who returned their surveys said this was always the case. The manager was thinking about how she could make adaptations to assist a person in keeping their independence. This is good practice, because it shows that individual needs are being considered. The home has a proactive manager, who is showing commitment to improve the service people get at Highfields. Some staff are still getting used to the changes there, and we received one comment that the morale was not good because of these changes. However, other comments were very positive and included `The home has improved since we have got a new manager, who follows things through and gives us support. Well done`, `New general manager`s enthusiasm resulting in positive change - improved management systems - increased staff motivation` and `The home is going forward with a new manager, who is implementing new changes for residents and staff and I believe it is all positive. The manager is now offering a variety of training for staff, enabling us to be better equipped. I believe the quality for the carers and care given is high`. What the care home could do better: During the pre admission assessment, staff could think more about people`s needs and requirements, and how they will be met, before deciding that the home has the right resources to meet these needs. This includes the consideration of assessments completed by other professionals already involved in the person`s care. This will help to make sure that the person gets the right care, in the right environment, by sufficient, appropriatelyskilled and trained staff. The daily records completed by staff say more about people`s physical needs, so it is more difficult to identify how people`s emotional needs have been supported and met on a daily basis. Staff could write more to show how this has been achieved. The home could always seek advice where they have to make a decision which affects a person`s liberty, and which may affect the choices of others. This would make sure that such important decisions are not made in isolation, and that every aspect of the individual`s best interests are considered. Although staff store creams prescribed for people in a safer way now, they could make sure they keep the records up to date to show when these were applied. People`s care plans could also be kept up to date to show when one cream has been replaced by another. This would help to avoid confusion for staff when deciding what creams are actually prescribed. People and staff told us that staff availability seems to fluctuate, depending upon the time of day, or whether during the week or at the weekend. When asked what the home could do better, one person said `Quicker response to buzzer at weekends`. Someone else said sometimes the call bell rings for long periods without being answered at weekends. The staffing levels however remain consistent. The manager could look at how the weekend staff operate in her absence, to make sure people are getting consistently good outcomes whether she is present or not. We also told the manager that the top floor lounge could be better supervised. People sitting there were often left unobserved on the day we visited. This makes it difficult for them to attract the attention of staff when they are needed. Although activities during the week are good, people and staff thought more could be offered routinely on a weekend, when there are less social opportunities for them. People could be asked what more they would like to see going on in their home, to make their weekends more interesting. Random inspection report Care homes for older people Name: Address: Highfield Nursing Home Scarthingwell Park Barkston Ash Tadcaster North Yorkshire LS24 9PG one star adequate service The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Anne Prankitt Date: 1 4 0 5 2 0 1 0 Information about the care home Name of care home: Address: Highfield Nursing Home Scarthingwell Park Barkston Ash Tadcaster North Yorkshire LS24 9PG 01937557724 01937557155 highfield@barchester.com www.barchester.com/oulton Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Holly Rebecca Bainbridge Type of registration: Number of places registered: Conditions of registration: Category(ies) : Barchester Healthcare Homes Ltd care home 55 Number of places (if applicable): Under 65 Over 65 55 0 old age, not falling within any other category physical disability Conditions of registration: 0 55 The maximum number of service users who can be accommodated is: 55 The registered person may provide the following category of service only: Care Home with Nursing, Code N 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 55 Physical Disability, Code PD, maximum number of places 55 Date of last inspection Care Homes for Older People Page 2 of 10 Brief description of the care home Barchester Healthcare Ltd own Highfield Care Home. It provides nursing care for older people and for individuals with physical disabilities. The home is located near the village of Barkston Ash, approximately five miles from Tadcaster, in North Yorkshire. It is a two-storey building, set in its own extensive well-maintained grounds, with a view of a lake and wooded areas for people to enjoy. The bedrooms are on both levels, with a vertical passenger lift to aid access. There are parking facilities next to the house. The manager should be contacted direct for details about current weekly fees, and what people can expect to pay extra for. A copy of the Statement of Purpose, service user guide and the latest key inspection report are available at the home for people to read. Care Homes for Older People Page 3 of 10 What we found: The last key inspection of Highfield Nursing Home took place 25 and 28 August 2009. This is a report of the findings of a random unannounced inspection, which took place on 14 May 2010. For this inspection, we used the following evidence: Information received about the home since the last inspection from other organisations, or any concerns we have been told about, and how they have been addressed. Completed surveys returned by ten people who live at the home, and five staff who work there. The Annual Quality Assurance Assessment (AQAA). This is a self assessment, completed by the manager, which gives us some information about how they think outcomes are being met for the people who live at Highfield Nursing Home. During our visit to the home, we: Looked around some of the environment, including some peoples bedrooms where this was appropriate, and communal areas they share with others, such as the sitting room and bathrooms. Talked to some staff, visitor and the manager. We also spent time watching the general activity, to get a feel about what it is like to live there. We asked some people their views about the home. Checked that the requirements made at the last key inspection had been met. The site visit lasted for six hours. The manager was available throughout, and we gave her feedback about our findings at the end. Overall, the inspection showed that people are generally happy with the way the service is run, and about the care that they receive. The new manager is making positive changes at the home, which should improve outcomes for people living there. She is listening to people and staff when making these changes. This will help to make sure the home is run in peoples best interests. However, there were some matters which could be improved further. For instance, some people thought staff availability could be more consistent, and that more activities could be available at the weekend. We thought some improvements could be made in the way people are assessed before they arrive, so that individual admissions are successful, and in the persons best interests. Some minor changes could also be made to the way some medications are recorded. What the care home does well: Staff now write good care plans to show how staff should support peoples emotional needs, and how they can best be met. Care plans to show how staff can help in Care Homes for Older People Page 4 of 10 minimising skin damage or falls, and what action they must take if these issues arise, are also well completed. This helps to make sure risks to these people are monitored, and advice sought as soon as it is needed. The majority of people said they always or usually get the care and support they need, and that staff listen and act on what they say. They all agreed they get the medical care they need. We received comments like Nurse excellent. Most carers very good - helpful, cheerful etc. People are offered a number of activities during the weekdays. This includes one to one time with individuals, when staff make a point of checking with the person that they are receiving their care and support in a way which meets with their wishes. People said they like the environment. One said Ive got my bedroom - its lovely. Everyone who returned their surveys said there was someone they could speak to if they were not happy. A person living at the home said the manager was good, and that they would go to her with any concerns. Complaints are now well documented, and show what action the home has taken to put things right for anyone who has raised concerns about the home. They show that all complaints, from whatever source, are responded to quickly, so people know the information they have provided has not been forgotten about. The home is also better now at identifying, and reporting issues to the local authority, which they may need to investigate under their safeguarding responsibilities. They also tell us now when they have done this. All staff have received safeguarding training, the content of which which has been checked by the local authority. The manager is going to make sure that staff have contact details so staff can ring the local authority directly, should they ever need to. The home looked clean and tidy, and everyone who returned their surveys said this was always the case. The manager was thinking about how she could make adaptations to assist a person in keeping their independence. This is good practice, because it shows that individual needs are being considered. The home has a proactive manager, who is showing commitment to improve the service people get at Highfields. Some staff are still getting used to the changes there, and we received one comment that the morale was not good because of these changes. However, other comments were very positive and included The home has improved since we have got a new manager, who follows things through and gives us support. Well done, New general managers enthusiasm resulting in positive change - improved management systems - increased staff motivation and The home is going forward with a new manager, who is implementing new changes for residents and staff and I believe it is all positive. The manager is now offering a variety of training for staff, enabling us to be better equipped. I believe the quality for the carers and care given is high. What they could do better: During the pre admission assessment, staff could think more about peoples needs and requirements, and how they will be met, before deciding that the home has the right resources to meet these needs. This includes the consideration of assessments completed by other professionals already involved in the persons care. This will help to make sure that the person gets the right care, in the right environment, by sufficient, appropriately Care Homes for Older People Page 5 of 10 skilled and trained staff. The daily records completed by staff say more about peoples physical needs, so it is more difficult to identify how peoples emotional needs have been supported and met on a daily basis. Staff could write more to show how this has been achieved. The home could always seek advice where they have to make a decision which affects a persons liberty, and which may affect the choices of others. This would make sure that such important decisions are not made in isolation, and that every aspect of the individuals best interests are considered. Although staff store creams prescribed for people in a safer way now, they could make sure they keep the records up to date to show when these were applied. Peoples care plans could also be kept up to date to show when one cream has been replaced by another. This would help to avoid confusion for staff when deciding what creams are actually prescribed. People and staff told us that staff availability seems to fluctuate, depending upon the time of day, or whether during the week or at the weekend. When asked what the home could do better, one person said Quicker response to buzzer at weekends. Someone else said sometimes the call bell rings for long periods without being answered at weekends. The staffing levels however remain consistent. The manager could look at how the weekend staff operate in her absence, to make sure people are getting consistently good outcomes whether she is present or not. We also told the manager that the top floor lounge could be better supervised. People sitting there were often left unobserved on the day we visited. This makes it difficult for them to attract the attention of staff when they are needed. Although activities during the week are good, people and staff thought more could be offered routinely on a weekend, when there are less social opportunities for them. People could be asked what more they would like to see going on in their home, to make their weekends more interesting. 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 2. Care Homes for Older People Page 6 of 10 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 7 of 10 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, 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 3 18 More consideration must be given to the purpose of the home, and the resources available, when deciding whether the needs of prospective admissions can be met successfully. This is to reduce the risk of failed admissions, and unsatisfactory outcomes for people. 31/05/2010 2 9 13 Records, completed by staff 31/05/2010 when they have administered prescribed creams, must be kept up to date. This is to reduce the risk of error occuring, and so that the doctor has a true record to refer to when reviewing whether they need to make any changes to the persons prescription. 3 14 12 Advice must always be 31/05/2010 sought from the appropriate professionals when decisions about peoples care which affect their liberty are being Page 8 of 10 Care Homes for Older People Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, 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 made. This is so that such decisions are made only following a full and proper assessment to ascertain this action is in the persons best interests. 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 Staff should write more on a daily basis about how peoples emotional needs are being met, so on review, it can be established that this area of their care is being considered on a daily basis, and successfully met. People should be surveyed to find out how they would like their activities programme to be improved on a weekend, so it reflects better the good outcomes they experience during the week. People should be surveyed to establish where changes need to be made in the way staff are deployed on a weekend. This is to assist in providing people with a more consistent service. Steps should be taken so that people who use the top floor lounge have better access to staff, so they can be assisted by them more readily should the need attention from them. 2 12 3 27 Care Homes for Older People Page 9 of 10 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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