Care Home: Highfield Residential Care Home

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What the care home does well The home has a core of staff who have worked at the home for a number of years and are dedicated to the residents. They work hard and will cover extra shifts to ensure that the residents are cared for by staff who know them. The residents enjoy their meals and although choice is not available at the time of the meal they will have an alternative if they do not like what is on offer. Visitors are made welcome and do visit regularly at any time that suits them. What the care home could do better: The home needs to look at the person centred care approach to supporting people with dementia to ensure the correct care is offered. The skills of the staff need to be improved so they can use their caring and dedicated attitude in a more positive way and meet the individual needs. Staffing levels need to be looked at to ensure busier times of the day meet residents needs appropriately and timely. The environment and facilities available need to be interesting, attractive and stimulating to engage residents more. Training for staff in safeguarding, mental capacity and deprivation of liberty is needed to ensure that staff understand and report on to the correct authorities any concerns. The building maintenance, risk assessments and ongoing recording for health and safety need to be in place and up to date to ensure that the home is suitable and safe. Random inspection report Care homes for older people Name: Address: Highfield Residential Care Home 3 St Marys Road Cromer Norfolk NR27 9DJ two star good service 09/12/2008 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: Ruth Hannent Date: 2 4 0 2 2 0 1 0 Information about the care home Name of care home: Address: Highfield Residential Care Home 3 St Marys Road Cromer Norfolk NR27 9DJ 01263511421 01263879166 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Sterling Care (UK) Ltd Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 20 Number of places (if applicable): Under 65 Over 65 0 20 dementia old age, not falling within any other category Conditions of registration: 20 0 The maximum number of service users who can be accommodated is 20 The registered person may provide the following categories 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 Dementia - Code DE Date of last inspection Brief description of the care home Highfield is situated in a residential area in Cromer and can accommodate 20 older people with dementia in 14 single and three double rooms of which 6 offer en-suite Care Homes for Older People Page 2 of 10 0 9 1 2 2 0 0 8 Brief description of the care home facilities. The home is a converted large family type guest house and has retained many of its original features. There is a discreet and enclosed garden area to the rear of the premises but there is no off street parking available. the fees range from £420-£625 per week, depending on individual assessed needs. Information about the service including inspection reports and quality assurance survey outcomes are available through the management. Care Homes for Older People Page 3 of 10 What we found: This was an unannounced visit completed on the 24th February over a period of three and a half hours. The reason for the visit was due to some concerns raised by an ex member of staff that state breaches of regulations may be taking place within Highfields. We therefore concentrated on the areas of concern during this visit. We spoke to staff, residents and a visitor. We looked at some records and carried out a tour of the building, looking in a number of bedrooms, bathrooms, lounges and dining room. We found a number of concerns around the practices within the home on the care support offered that needs to improve. Residents who are left in chairs with the hoist sling underneath them and with nothing to stimulate them should be discouraged. Comfort and the possibility of pressure area concerns need to be considered. Throughout this visit the one lounge where most of the residents were sitting had nothing to interest them and were like this throughout this visit, except when the lunch arrived at 12 midday. On our arrival one person was still finishing their breakfast and was back eating their main meal an hour and a half later. On discussing this with the Senior this is due the number of residents now requiring two staff for all transfers and making the getting up process a lot longer and some residents are getting up later in the morning. This shows that more staff are required at the busier times of the day to support people appropriately. Through discussions with staff and noted on rotas is the lack of numbers of staff to carry out all the shifts required meaning most of them are covering more shifts so as to not leave the home without cover. On this day 1 senior, 3 carers, 2 kitchen staff and 1 cleaner were in the building to care for the 18 residents. This would be a suitable number if the dependency level of residents was not so high but many of these residents are high dependency and do need more input from staff. Through observation it was apparent that staff have not had the experience or training in person centred care for people with dementia and although it was very obvious that the staff are very caring and dedicated the lack of knowledge was evident. Inappropriate tactility and conversation, staff standing to assist residents with their meal and very limited forms of stimulation through sight, touch, smells or sound were noted during this visit. Staff spoken to do say they are offered training and a new staff member had just received her Skills for Care induction pack and is registered to commence her NVQ 2 in March. What was evident was the lack of training and understanding of the Mental Capacity Act, Deprivation of Liberty and Safeguarding. When discussing safeguarding, the team did not know about the procedures to report any concerns to the safeguarding access team within the Council. They had no phone numbers available and had not had any contact with the safeguarding team. A tour of the building took place with the senior carer who was the responsible person in charge for the day. During this walk about it was noted that the downstairs bathroom had a number of toiletries, bubble bath, shampoo etc sitting on the window sill in easy reach of the residents. There was also a mop bucket soaking the mop in some form of chemical sitting on the bathroom floor unattended. This is a risk and needed removing immediately which the senior was to attend to. Bedrooms seen were in need of some of the furniture Care Homes for Older People Page 4 of 10 replacing that was shabby and stained. One was noted to have picture hooks in the walls but no pictures, again nothing to stimulate or talk about. One bedroom with the curtain hanging down with no stop end to prevent this happening and a fireplace with cardboard blocking it off. Although this is an old building that has been converted to a residential home there needs to be more thought placed on how the rooms can be improved to meet the growing needs of people with dementia. We also looked at records that are held in the office for fire safety. It was noted that the fire alarm, weekly recordings had not been completed since October 2009. The staff informed us that only last week a fire officer had attended the home and checked the fire equipment and alarm. One concern that had been shared with us was the failure of the emergency lighting. This was checked and is functioning correctly as reported by the fire officer. We also checked the water temperature in 4 different areas of the home. They all felt to be running at a suitable temperature except for the staff room wash basin and laundry. Both areas could be accessed by residents and a lock of some form needs to be placed on these doors. There were no records found of water temperature checks throughout the building nor could any records be found of maintenance/health and safety checks such as building risk assessments which should all be available for inspection as part of the Regulation 26 visit. Feedback was given to the Responsible Individual by phone the day after this visit who assured us that all areas of findings would be acted upon. What the care home does well: 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 5 of 10 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 12 16 The home needs to provide stimulation through suitable recreational activities for people with dementia. To ensure residents are offered experiences that will stimulate and create interaction that is suitable for the individual. 01/04/2010 2 19 23 The home must make weekly 01/04/2010 checks of the fire alarms and hold records as evidence To ensure that the alarms are functioning correctly in case of fire. 3 27 18 The home needs to take into 01/04/2010 account the high dependency needs of the residents and employ staff to meet those needs. To ensure that busier times of the day are staffed accordingly. 4 30 18 Staff need to be trained and have the understanding for 01/05/2010 Care Homes for Older People Page 8 of 10 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 the client group they are caring for. Staff need sound knowledge of the requirements of the person centred care of people with dementia. 5 30 18 Staff require knowledge in 01/05/2010 the safeguarding procedures and the understanding of the Mental Capacity Act and Deprivation of Liberty The staff need to be able to act and ensure the health and welfare of residents is upheld. 6 38 13 A record of building risk assessments and building maintenance checks should be in place. To ensure all areas are checked regularly and are free as possible from hazards. 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 01/05/2010 1 19 To ensure the environment is correct for the needs of people with dementia it is recommended that advice be sought from experts in to the most suitable way to adapt an older building to make it dementia friendly. A check of all furniture that is in the building is suggested and damaged and unsuitable furnishings removed. 2 24 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. 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. 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. 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