Care Home: Highgate Park (4)

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What the care home does well Staff have good relationships with people who live at Highgate Park, staff showed kindness and respect towards people. One survey said, " All service users are happy and content. Staff are always friendly and welcoming". The information kept about people is good and is the right kind of information needed; this helps staff support service users properly all of the time. Staff think it is important for people to make choices of their own and staff help them with this. This helps people become more independent. Surveys received commented:" The home supports clients to promote independence" " I plan my own timetable with staff support" The training staff do is good, it includes training about people with learning disabilities and how to make sure people who have learning disabilities can have more choice and control in their lives. This means staff know how to support people to be as independent as possible. And are treated kindly and with respect. People have the chance to say what they think about Highgate Park and how it could be better. Surveys are sent to people, these surveys have pictures to make it easier to understand. Meetings are organised where people can get together and talk about what it is like living at Highgate Park and how it could be better. What has improved since the last inspection? People wanted another room so they could entertain guests in private and not all sit in the lounge or kitchen. An extension has been built and this has given people more opportunity to have private time without having to use their bedrooms. People can use the whole of the garden area since new paving has been laid. What the care home could do better: The manager and staff should continue to looks at ways to further enhance the lives of the people who live at the home. CARE HOME ADULTS 18-65 Highgate Park (4) 4 Highgate Park Harrogate North Yorkshire HG1 4PA Lead Inspector Chris Taylor Unannounced Inspection 8th January 2008 09:15a Highgate Park (4) DS0000007895.V352956.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Highgate Park (4) DS0000007895.V352956.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Highgate Park (4) DS0000007895.V352956.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Highgate Park (4) Address 4 Highgate Park Harrogate North Yorkshire HG1 4PA 01423 504506 F/P01423 504506 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) None United Response Susanna Woodcock Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Highgate Park (4) DS0000007895.V352956.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Registered for 4 Service Users with Learning Disabilities who may also have a Physical Disability 16/01/07 Date of last inspection Brief Description of the Service: Highgate Park is registered to provide residential, social and personal care for four younger adults under the age of 65 years who have learning disabilities and physical disabilities. The property is a purpose built bungalow, fully wheelchair accessible, with paved gardens on all sides. The home is situated about 1 mile from Harrogate town centre and offers good access to the towns services and amenities. The home is part of the United Response organisation. The registered manager is Ms S Woodcock. Information provided by the registered manager on 8th January 2008 indicated that the current weekly fees for the home are £1441.04. The inspection report is available on request. Highgate Park (4) DS0000007895.V352956.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. This is what was used to write this report. • • • Information about the agency kept by the Commission for Social Care Inspection. Information asked for from Highgate Park before the inspection, this is called an Annual Quality Assurance Assessment. Information from surveys received. Four surveys were received from service users, two from relatives and friends, three from health care professionals and one from a care manager. An unannounced visit to the home. This lasted four and half hours and included talking to support staff and the manager about their jobs and the training they have completed. A tour of the premises was made. Some of the records, policies and procedures the home has to keep were checked and time was spent talking to people who live at the home and observing how they spent their day. • What the service does well: Staff have good relationships with people who live at Highgate Park, staff showed kindness and respect towards people. One survey said, “ All service users are happy and content. Staff are always friendly and welcoming”. The information kept about people is good and is the right kind of information needed; this helps staff support service users properly all of the time. Staff think it is important for people to make choices of their own and staff help them with this. This helps people become more independent. Surveys received commented:“ The home supports clients to promote independence” “ I plan my own timetable with staff support” The training staff do is good, it includes training about people with learning disabilities and how to make sure people who have learning disabilities can Highgate Park (4) DS0000007895.V352956.R01.S.doc Version 5.2 Page 6 have more choice and control in their lives. This means staff know how to support people to be as independent as possible. And are treated kindly and with respect. People have the chance to say what they think about Highgate Park and how it could be better. Surveys are sent to people, these surveys have pictures to make it easier to understand. Meetings are organised where people can get together and talk about what it is like living at Highgate Park and how it could be better. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Highgate Park (4) DS0000007895.V352956.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Highgate Park (4) DS0000007895.V352956.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2. People who use this service experience good quality outcomes in this area. Peoples’ needs are properly assessed prior to admission this helps make sure that staff know they will be able to met the person’s needs when the person moves in. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The people who live at Highgate Park have lived there since the home first opened approximately 10 years ago. United Response has a corporate procedure to follow in the event of a new admission which includes completing a pre admission assessment. This assessment includes information from the person, family and other professionals and is particularly useful for those people who have complex needs and /or difficulties with communication. This document also supports staff in making the admission for the person as smooth and as comfortable as possible. If at this stage the home believes they could offer a service then introductory visits commence and these are taken at a pace set by the person. Compatibility between people is given considerable thought and views of those people already living in the home would be included in this. New placements are under review and further assessments are completed. Highgate Park (4) DS0000007895.V352956.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 and 9 People who use this service experience excellent quality outcomes in this area. Peoples’ needs are assessed and are met promoting independence, choice and respect for individuals. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two people’s case records were looked at. The format for care plans includes different sections for every aspect of the service user’s life. Care plans are written in the first person and each section has an area to complete which identifies what the individual’s needs are and what action is needed to met them. This is documented step by step to make sure the support is provide exactly how the person wants and needs. The care plans looked at were completed fully and included information about religious beliefs and how the individual should be supported in making choices and decisions. Support plans are reviewed regularly and are completed with the person. Also present were risk assessments with the purpose of supporting people to live as Highgate Park (4) DS0000007895.V352956.R01.S.doc Version 5.2 Page 10 independently as possible with safeguards in place These were also reviewed regularly. The way in which support plans are presented is currently being looked at. It is hoped that for one person, able to and interested in technology, will have his support plans recorded on his own laptop. For another onto a commuter communication system. Staff are provided with a good induction and ongoing training which makes sure people are treated with respect, dignity and are supported to make choices in their lives. This was reflected in the observations of staff with people throughout the visit. Surveys commented: “ The service affords proper dignity and respect” “The service support clients to promote independence” Whilst staff were supporting people during the morning it was clear that they understood individuals needs. They supported people sensitively and helped people to make choices. People were assisted to answer the telephone and staff acknowledged that they were supporting people in their own home, by asking people if they could make themselves a coffee. Post was given to a service user to sort and distribute and service users answered the front door and invited visitors in. Highgate Park (4) DS0000007895.V352956.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 15,16 and 17. People who use this service experience excellent quality outcomes in this area. People are supported to make choices about their lifestyle, in developing new skills and to participate in activities. This supports them to lead full and active lives. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each person has a weekly timetable of activities which is put together in consultation with the person. Activities relate directly to what people are interested in and supports people to develop skills. Activities include specialist day centres or college and days at home to participate in personal shopping, laundry and household tasks. Examples of the variety of activities demonstrated staffs enthusiasm to support people in their wishes for instance one person is a volunteer dog walker and another is being helped to find a job. Highgate Park (4) DS0000007895.V352956.R01.S.doc Version 5.2 Page 12 During the visit people were out shopping attending an education centre and shopping to buy materials for the greetings card making company service users have set up to raise funds for additional leisure activities. Additional staffing is provided to ensure people have the opportunity to participate in activities of their choice on a one to one. People’s religious and cultural needs are recorded. Three people living at Highgate Park are supported to attend the church of their choice. Surveys received from service users included:“ I Plan my own timetable with staff support”. “ We all decide whatever we do” “ I go out with my friends at weekends” Daily records provided a good picture of how people spend their day and would provide essential information to track any changes people may experience, with ill health or involvement in social activities. One person said that they discuss menus in house meetings and take it in turns to help with the supermarket shopping. There is a weekly menu but people choose what they want to eat particularly at breakfast and lunch. Staff support these meal choices discreetly to make sure people are choosing a healthy diet. Highgate Park (4) DS0000007895.V352956.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards18, 19 and 20. People who use this service experience excellent quality outcomes in this area. People’s personal and healthcare is provided appropriately and sensitively according to individual needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A whole section on each support plan is related to health care needs. Included was information on health action plans, medical logs, referrals for medical interventions and any further requirements and medication. People can access psychology, physiotherapy, and art therapy, and specialist community nursing from the local learning disability team. Staff said they have a good working relationship with this team and evidence was seen in case records of specialist assessments and guidance for staff. Surveys received from health care professionals include: “ Staff have shown interest in promoting health needs and client well-being” “ The service works well in a multi-disciplinary arena” Highgate Park (4) DS0000007895.V352956.R01.S.doc Version 5.2 Page 14 Medication administration was observed. A monitored dosage system is in use with proper procedures in place for the receipt, storage, administration, recording and return of medicines. Staff receive accredited medication training provided by United Response and are not permitted to administer medication until their competence is assessed. Highgate Park (4) DS0000007895.V352956.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23. People who use this service experience good quality outcomes in this area. People can be confident that concerns are listened to and appropriate action is taken. There are sufficient effective systems in place to safeguard people from harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People are provided with a complaints procedure which is produced in an easy to read format. Advocates are available to provide an independent voice for people. No formal complaints have been made directly to the home. One anonymous complaint has been made to the Commission for Social Care inspection. The issues raised were addressed during the visit. Evidence was found that the manager had dealt with these concerns appropriately. There is a comprehensive policy and procedure with regard to safe guarding adults and the procedure to take if there is a suspicion of abuse. Staff receive training in adult protection and safeguarding issues during induction and foundation training and as part of NVQ level 2 and 3. The procedures are also revised every three months at staff meetings. Highgate Park (4) DS0000007895.V352956.R01.S.doc Version 5.2 Page 16 Some people take care of their own personal allowance and others need staff to do this on their behalf. Money is locked away and there is a recording sheet to record when money is spent and this is receipted. These records are audited and are checked as part of shift change routine. Highgate Park (4) DS0000007895.V352956.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 and 30. People who use this service experience good outcomes in this area. People live in a clean, comfortable and safe home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is purpose built bungalow and provides spacious accommodation for service users. The home is clean and comfortable. It is decorated and furnished to a very good standard and each bedroom was individually decorated. An extension has recently been built providing an additional communal lounge for people to meet with friends and visitors in private. There are two bathrooms with assisted baths and ceiling tracking to make bathing safer and more comfortable for people. The garden area is now fully paved making it fully accessible to people. Highgate Park (4) DS0000007895.V352956.R01.S.doc Version 5.2 Page 18 A range of checks is completed on a regular basis to make sure that the house is safe and secure. Highgate Park (4) DS0000007895.V352956.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards32, 34 and 35. People who use this service experience excellent quality outcomes in this area. People receive support from staff that are properly recruited and vetted. And who are appropriately trained and supervised. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff recruitment procedures make sure that staff are vetted and checked to a very safe standard. Prospective staff complete an application form and attend two formal interviews. One interview is conducted by people who live at Highgate Park and they are assisted with a pictorial prompt sheet to score the interviewee’s answers. Written references and POVA (Protection of Vulnerable adults) first checks are made and staff are not permitted to work in the home until they have a CRB (Criminal Records Bureau) check. Staff training records examined showed a comprehensive training programme. All staff complete a home specific induction programme followed by Common Induction Standards accredited induction. There is an expectation that staff Highgate Park (4) DS0000007895.V352956.R01.S.doc Version 5.2 Page 20 complete National Vocation Qualifications in Care (NVQ) level 2 or 3. There is only one member of staff without this qualification. A range of other training including health and safety training is provided. This provides staff with the knowledge and skills to perform their duties in a competent manner. Staff spoken to thought that the training provided is good and that the staff team was very supportive. There are usually two or three members of staff on duty with additionally funded hours for specific people to attend specific activities. There are two members of staff on duty at night one awake and one asleep. There is also an on call system for emergencies. The manager carries out individual staff supervision every four to six weeks, each session has an agenda and is recorded and signed by both parties. An annual appraisal is also completed with feedback forms completed by people who live at the home. Staff meetings are held regularly. Highgate Park (4) DS0000007895.V352956.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39, 41 and 42. People who use this service experience excellent quality outcomes in this area. The home is managed in such a way that promotes the best interests of people. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has extensive experience in the field of learning disabilities, she places the service users’ needs as her first priority and she demonstrates enthusiasm and imagination in ensuring the best for people. She is well organised and delegates responsibilities appropriately to all staff team members. Comments from surveys include: Highgate Park (4) DS0000007895.V352956.R01.S.doc Version 5.2 Page 22 “ I think the home is running very well at the moment”. “ There is sometimes a lack of communication, I am not always aware of staff changes” “ I am always in informed of any changes which affect my friend” There is a formal quality assurance system called Annual Service Planning. This process includes collating surveys form service users, their families and friends and other professionals and staff. A development plan is formulated from the outcome of surveys and is monitored to ensure achievement. Surveys are provided in pictorial format for those who need it. Additionally, monthly audits are completed by a manager from another service, this includes talking to people about their experiences of living in the home. Records were seen which confirmed that equipment is maintained and serviced appropriately. Fire detection and fire fighting equipment is tested and maintained regularly. Staff receive training with regard to all health and safety matters and there is an effective system to ensure updates are completed. Highgate Park (4) DS0000007895.V352956.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 4 33 x 34 4 35 4 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 x 4 x LIFESTYLES Standard No Score 11 x 12 4 13 4 14 X 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 4 x 4 x 4 x 4 4 x Highgate Park (4) DS0000007895.V352956.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Highgate Park (4) DS0000007895.V352956.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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