Care Home: Highmead

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What the care home does well Staff appear to know the people living in the home well and have identified personality traits and areas of interest that apply to each person as well as being perceptive to how each communicates. Most records were comprehensive and contained meaningful information about life in the home and how the needs of those living there were to be met. The staff are enthusiastic and are justly proud of the work they put into taking each person on an annual holiday, or for special days out. The home has given serious consideration to how to evacuate people with physical disabilities in the event of fire and have made sure that systems are in place to ably manage such an eventuality. What the care home could do better: The home seeks to provide outside activities that provide encompassing experiences. The people living at Highmead would benefit from more such experiences within the home such as multi-sensory equipment, visiting musicians etc. Random inspection report Care homes for adults (18-65 years) Name: Address: Highmead Highfield Road Shanklin Isle Of Wight PO37 6PR two star good service 16/12/2008 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: Wendy Thomas Date: 2 4 0 3 2 0 1 0 Information about the care home Name of care home: Address: Highmead Highfield Road Shanklin Isle Of Wight PO37 6PR 01983866575 01983866575 lin.sims@islecare.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Linda Janet Sims Type of registration: Number of places registered: Conditions of registration: Category(ies) : Islecare Ltd care home 6 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: 6 The maximum number of service users to be accommodated is 6. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home Highmead is a registered residential service providing care and accommodation for up to six younger adults with learning disabilities. The home is owned by Islecare Ltd and has a registered manager, Mrs L Sims. The home occupies the first floor of an older building, which also accommodates The Laurels, another registered care home Care Homes for Adults (18-65 years) Page 2 of 10 1 6 1 2 2 0 0 8 Brief description of the care home managed by Mrs Sims. On the lower ground floor there are a number of offices and training facilities used by Islecare Ltd, and there is also a supported living accommodation within the same building. The manager is supported by experienced deputies in both homes. All bedrooms are spacious, single with a number having ensuite facilities. There is a passenger lift to one residential area, however accessibility to wheelchair dependent service users is restricted due to the poor design of the building, and its situation on the first floor with some areas of the home only accessible via stairs. The home has pleasant gardens around the property that are accessed via the passenger lift to the ground floor and then have level access around the building. Care Homes for Adults (18-65 years) Page 3 of 10 What we found: The last key inspection of this service was on 16th December 2008. The rating following that inspection was two stars, meaning outcomes for people who live at Highmead are good. The report from that inspection is in the public domain and available on our website. The reason for this visit was to monitor the progress of the home and compliance in relation to the requirement made at the last key inspection. This was in relation to ensuring only people for whom the layout of the building was appropriate would be admitted to the home in the future, and reflecting this in the homes statement of purpose. This requirement was found to have been met. We visited Highmead on 24th March 2010 and spent four hours in the home. In this time we met with all the five people who live in the home and observed them and their staff as they went about their usual routines. Paperwork pertinent to the standards being inspected was also examined and discussions had with staff and the manager. When we arrived at the home one person was in the kitchen, one in the lounge and three were in their own rooms. During the course of the morning all gathered in the lounge. The television was on, although no one appeared to be watching it. Due to their cognitive abilities the television wasnt of interest to all of those living there, although staff said that videos, especially those with music were enjoyed by everyone, and the group would sometimes spend evenings together watching a video or DVD. Although the manager explained that in the past they had had visiting entertainers using a multi-sensory approach this was not currently happening. There was no communal multi-sensory equipment other than the television. Similarly drama sessions that had been held in the past jointly with people living in the other residential service housed in the same building were no longer being provided. The manager said that some of the people from Highmead had enjoyed these and found them a positive experience. It was hoped that there would be an opportunity for these to happen again in the future. Musical activities had also been bought into the home, but these too had stopped. The manager was trying to find a replacement, but to get a service at the time of day required was proving difficult. All the people living at Highmead spend some time at a local day service over the course of each week. After lunch on the day of the visit one person was supported to go to the day service. The home provided their transport. The manager explained that sometimes others would also go in the vehicle with them and then go out on an activity, such as the household shopping or on a trip to a place of interest or for a walk. It was reported that everyone living at Highmead enjoyed being out in the fresh air and that activities were often arranged to reflect this. One persons daily recording was looked at in detail. They werent typical in that they had an overnight stay every week with their parents and then went swimming with them before retuning to the home. Over the week examined the activities this person participated in were; spending time with the staff in the kitchen, going out for two drives, watching TV and a DVD and having aromatherapy. In each persons file there were monthly reviews. These detailed activities taken part in and medical issues and Care Homes for Adults (18-65 years) Page 4 of 10 appointments. The activities section was not detailed enough to be useful for measuring peoples level of activities, for example saying that a person had been out in the van ... on several occasions. However the manager explained that she monitored levels of outside activities through the vehicle records where it was logged who went where, when so that individuals could be charged for their use of the vehicle accordingly. She reported that in this way she quickly picked up if anyones level of activity dropped and would investigate the reason for this. She also reported that some staff were very proactive in arranging for people to be out of the home participating in stimulating activities. Another member of staff explained that these were usually done on a group basis because the logistics of supervising and meeting the needs of the people living in the home made oneto-one outings inadvisable. In the AQAA submitted by the manager in December 2009 she says that an aim being worked towards is to involve people in a wider range of activities. During the visit to the home she discussed the need to explore experiential activities as the people living at Highmead are not particularly interested in hands on doing type activities. Reflexology is one such activity that has been introduced. Staff support all the people living at Highmead on an annual holiday. Photographic records had been kept of these showing a busy schedule with lots of visits to places of interest. There was similar evidence of days out and birthday celebrations etc. These activities are important in the life of the home with staff talking with those living there enthusiastically about these events, reminiscing on ones past such as Walk the Wight and pop concerts, and looking forward to those being planned such as a coming holiday to Centre Parks for two people and individual holidays or specific days out for others. It was clear from spending time in the home that some staff know the people there very well and can explain their needs, their responses to certain situations, their likes and dislikes and what their behaviour is communicating, as well as being aware of their personality traits. The wellbeing of those living at Highmead is their prime concern. This was demonstrated by voicing worries about what the future may hold, with a move to new accommodation expected within the next eighteen months and the possibility of care being given by a different provider. Because of the high level of support needed, their cognitive abilities and communication needs, it is vital that staff who know the people well are involved in their care. Although staff put their concern for the wellbeing of the people living at Highmead foremost, there were occasions when they talked over people and did not involve them in the conversation. There were also occasions when they discussed issues particular to one individual in the presence of other people. This was not the case all the time and instances of good practice demonstrating the involvement of the people living in the home and valuing their privacy were also observed. Peoples care needs are very well documented along with their detailed personal histories and likes and dislikes. Two peoples files were looked at, one in close detail. They were found to be very comprehensive and written in a very valuing way from the persons perspective. Support plans, records and risk assessments were all in place covering all areas of need. The daily records were conscientiously kept and gave a real picture of what life is like for the people living at Highmead. This is especially important as the people themselves are unable to communicate this to others. Each person has a communication passport which explains their communication needs and how they Care Homes for Adults (18-65 years) Page 5 of 10 communicate. This is important in helping people to understand them. Where restraint is necessary it is carried out with all due regard to the persons wellbeing. Consultation has been thorough and checks are in place to make sure that it is used only when necessary. Staff reported that over the time the person has been living in the home the use of restraint has become necessary much less frequently. Staff have established what causes the person distress and endeavour to mitigate against this. They also aim to provide a stimulating and interesting environment for the person. They recognise that this person enjoys being part of what is going on and likes to spend time in busy areas of the home with staff, as well as periods in their own room. Individuals rooms have been personalised to reflect their personalities and interests. Despite peoples lack of verbal communication, the staff were able to explain their likes and preferences. One person who enjoyed the stimulation of flashing lights had a string of lights around their room. Another who liked bright colours and cartoon characters had their room decorated accordingly. It was explained that for one person their preferences were not so clear so the room had been decorated in a colour that staff felt reflected the persons personality. It was clear from the furnishing and personal items in the rooms that consideration had been given to making the rooms individual and suited to the person living there. The home is located on the first floor of a large building which also houses another residential care service and Islecares offices. Part of the home is on another level up several steps. All the people living in the home have severe learning disabilities. Some of them use wheelchairs, two are wheelchair dependent and their rooms have appropriate hoists and tracking to enable their physical needs to be met. Due to their cognitive disabilities none of the people leave the building without staff support. Although all of the people living there enjoy being outside, the nature of the building and garden mean that they can not go outside independently. The desirability of ground floor, level accommodation where the ambulant members of the household could independently go outside to a secure enclosed garden was discussed. However, given that for the time being the group are housed at Highmead, the home has been made as accessible as possible and effort has been put into making the environment as pleasant as possible. The kitchen and dining area is bright and airy with suitable furniture and food preparation areas. The manager was pleased to announce that despite the limited future the home has (the lease runs out in eighteen months and it is thought people will move to supported living) there were plans to redecorate the lounge and provide new seating. Care is being taken to ensure that it is suitable for the needs of the people who live at Highmead and will be comfortable for the way they use it. In response to the requirement from the last inspection that only people whose needs the home can fully meet are admitted in the future, the manager was clear that she would only consider admitting someone who was ambulant or who used a wheelchair and was dependent on others to propel this, as the building has severe limitations and health and safety risks for someone in a wheelchair who can move around independently. Although the homes statement of purpose has been changed slightly, the main way in which this is put into effect is in the pre-admission procedure for someone considering moving to the home which would highlight if this was likely to be a problem. The previous key inspection raised concerns about the procedure for the evacuation in the event of fire. This has always been taken seriously by the home. They were already Care Homes for Adults (18-65 years) Page 6 of 10 engaged in consultation with the fire authority at the time of the last inspection. Since then they have consulted with the fire officer who is satisfied with the homes strategies for dealing with a fire. They have purchased fire pods so that physically disabled people can be transported down stairs effectively. Staff have been trained in the use of these. Staff confirmed that they have had fire training and have practiced evacuating the building. Fire fighting and detection equipment is regularly serviced and the home has a risk assessment relating to fire in accordance with the Regulatory Reform (Fire safety) Order 2005. 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 following this report, you can contact them using the details set out on page 2. Care Homes for Adults (18-65 years) Page 7 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 Adults (18-65 years) Page 8 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 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 Adults (18-65 years) 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 Adults (18-65 years) 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial 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 Adults (18-65 years) Page 10 of 10 - 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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