Care Home: Highnam Hall Residential Home

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What the care home does well The people I spoke to said they were happy with the care and support they receive. One person said `I feel privileged to be living in such a nice place.` Another said that the staff are `lovely and very hard working`. The pre-admission assessments are thorough and the majority of people commented that they had sufficient information about the home before choosing to live there. One person said `my family sorted this place out for me, they came to look around and the manager came to see me in hospital`. The people who live at the home and their relatives confirmed that they know how to raise a concern or make a complaint, if they needed to. One person said `I would tell the staff or the manager if I have a problem but I`ve never had one`. The staff are aware of their responsibilities if they believe that neglect or poor care practice is taking place and were confidant that if they raised any issues the manager would investigate. There are thorough recruitment and selection procedures in place, to make sure that staff are suitable and safe to work with the people who live at the home. All the staff receive a range of training to equip them with the skills and knowledge they need to do their work properly. People said they enjoyed the food they were given and said that there was a good choice. What has improved since the last inspection? Since the last inspection improvements have been made in many aspects of the service. Staff are now recruited properly and checks are carried out on them before they start work at the home to make sure they are safe to look after vulnerable people. People`s care plans and risk assessments have all been re written and evaluated to make sure people are in receipt of individual planned programs of care. And staff now have clear documentation to work from. Staff have had further training in the administration of medication and the storage for medication has been improved. Work has been carried out on the fire alarm system to improve it and the mechanism that opens the front door in the event of a fire has been repaired. Staff have had further training in the protection of vulnerable people and also in caring for people with a dementia diagnosis. What the care home could do better: The manager and staff team have worked very hard over the past few months to raise the standard of service at the home. They must continue to build upon this and develop further. No requirements have been made from this inspection. CARE HOMES FOR OLDER PEOPLE Highnam Hall Residential Home Park Avenue Hartlepool TS26 0DZ Lead Inspector Bridgit Stockton Key Unannounced Inspection 19th November 2008 09:00 X10015.doc Version 1.40 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 Highnam Hall Residential Home DS0000065270.V373625.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 Older People. 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. Highnam Hall Residential Home DS0000065270.V373625.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Highnam Hall Residential Home Address Park Avenue Hartlepool TS26 0DZ 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) 01429 232068 01429 233715 Mr Matt Matharu Carolyn Janet Noble Care Home 45 Category(ies) of Dementia (5), Dementia - over 65 years of age registration, with number (17), Mental disorder, excluding learning of places disability or dementia (5), Old age, not falling within any other category (45), Physical disability (5) Highnam Hall Residential Home DS0000065270.V373625.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Five persons in the category DE above the age of 55 may be accommodated in accordance with the home`s Statement of Purpose Five persons in the category PD above the age of 55 may be accommodated in accordance with the home`s Statement of Purpose. Five persons in the category MD above the age of 55 may be accommodated in accordance with the homes`s Statement of Purpose 8th May 2008 Date of last inspection Brief Description of the Service: Highnam Hall Residential Care Home is registered to accommodate up to 45 older people, including people with mental health needs. On the day of the inspection there were 29 people living in the home. Highnam Hall is a grade 2 listed building, which retains many of its original features. The home is situated in a quiet road overlooking a popular park and has lawned areas to the side and private car parking to the front. The home is owned by Mr. Matt Matharu, who also runs a number of other care homes in the area. From information provided by the manager of Highnam Hall, fees charged by the home range from £354 to £358 per week. Additional charges include those for hairdressing, chiropody and newspapers. Highnam Hall Residential Home DS0000065270.V373625.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 2 star. This means the people who use this service experience good quality outcomes. The purpose of this inspection was to assess the quality of the care and support received by the people who live at Highnam Hall Care Home. The methods I used to gather information included a visit to the home, conversations with the people who live there, their relatives, healthcare professionals and the staff. I looked in detail at the care and records of four people, examined other records and looked around the home. I spent six hours at the home. The manager also completed some paperwork for us called an annual quality assurance assessment. This provides valuable information to help me form a judgement about the quality of service offered at the home What the service does well: The people I spoke to said they were happy with the care and support they receive. One person said ‘I feel privileged to be living in such a nice place.’ Another said that the staff are ‘lovely and very hard working’. The pre-admission assessments are thorough and the majority of people commented that they had sufficient information about the home before choosing to live there. One person said ‘my family sorted this place out for me, they came to look around and the manager came to see me in hospital’. The people who live at the home and their relatives confirmed that they know how to raise a concern or make a complaint, if they needed to. One person said ‘I would tell the staff or the manager if I have a problem but I’ve never had one’. The staff are aware of their responsibilities if they believe that neglect or poor care practice is taking place and were confidant that if they raised any issues the manager would investigate. There are thorough recruitment and selection procedures in place, to make sure that staff are suitable and safe to work with the people who live at the home. All the staff receive a range of training to equip them with the skills and knowledge they need to do their work properly. People said they enjoyed the food they were given and said that there was a good choice. Highnam Hall Residential Home DS0000065270.V373625.R01.S.doc Version 5.2 Page 6 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. Highnam Hall Residential Home DS0000065270.V373625.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Highnam Hall Residential Home DS0000065270.V373625.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 Quality in this outcome area is good. People’s needs are properly assessed prior to admission to the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans I looked at showed that comprehensive pre-admission assessments had been carried out before offering someone a place. This is to make sure that the home can meet the person’s needs. A senior member of staff (usually the manager) visits the person at home, or in hospital to discuss their care needs. Social Services assessments are also used to determine this as well; these were also available to look at. People are welcome to visit the home before reaching a decision. The home does not provide intermediate care. Highnam Hall Residential Home DS0000065270.V373625.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 People who use the service experience good quality outcomes in this area. Good systems are in place to ensure that health care needs of the people are met. People can be confident that their privacy and dignity is protected and that they are treated with respect. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Extensive work has been carried out on care planning. The manager and staff have worked very hard in completing the new format of care plans on all of the people who use the service. The plans have improved and now give staff clear detailed instructions on how to care for people properly and safely. Risk assessments have been incorporated into the plan of care; these were comprehensive and gave staff instruction on how to manage the identified risk. There was evidence of involvement of specialist healthcare people such as the community psychiatric nurse, the dietician and continence nurse. Highnam Hall Residential Home DS0000065270.V373625.R01.S.doc Version 5.2 Page 10 Storage of medication has now been improved. Control drugs are now stored correctly and stock balances of medication are now recorded on the medication administration records. This makes auditing of peoples medication easier and any mistakes can be quickly identified and rectified. The fridge that it used to store some medication is not suitable as it did not lock. The manager said that she would make sure that a new fridge was ordered that conformed to the correct storage of medication. Staff were seen to be treating people with respect and dignity and this was also reflected within the care plans. One person said that ‘the girls are so kind and caring to us all’ Another said ‘they help me with a bath and getting dressed. They do the things I cannot manage myself anymore. I don’t know where I would be without them.’ Highnam Hall Residential Home DS0000065270.V373625.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. The recreational and social needs of people are well catered for which enables them to make daily choices and promotes independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During my visit the atmosphere in the home was friendly and welcoming, with visitors coming and going throughout the day. Some people were enjoying chatting with each other; some were listing to music or else reading. An activities program was on display. The program was varied and included church services, bingo and sing-a-longs. Some people were playing dominos and cards in the lounge area. Everyone said the food was good, and a choice of meals was offered. One person said ‘we get lovely food here, good home cooked meals.’ People told me that the general routine of the home was flexible and that they could get up and go to bed when they wanted to, one person was having a late breakfast following a ‘lie in’. Highnam Hall Residential Home DS0000065270.V373625.R01.S.doc Version 5.2 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. People can be confidant that their concerns and complaints are dealt with appropriately and that safeguards are in place to protect them from abuse This judgement has been made using available evidence including a visit to this service. EVIDENCE: There are adequate written policies and procedures in place to deal with complaints and the care staff spoken to confirm they were aware of these. Staff knowledge of these help ensure that they were able to address any issues or anxieties of the residents, relatives and visitors to the home. People who live at the home told me they would speak to the manager or any of the staff if they had any concerns or complaints. Staff told me that training has taken place in the protection of vulnerable adults in abuse. I looked at four personnel files and found that staff recruitment procedures were adequate and staff were employed and deployed following appropriate checks. The manager and staff team were clear and confident in the protection of vulnerable adult procedures. Highnam Hall Residential Home DS0000065270.V373625.R01.S.doc Version 5.2 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. People live in a safe, comfortable, well maintained and homely environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All the bedrooms that I saw reflect the person’s individual preferences and taste. There is a programme of re-decoration for the bedrooms, as well as for the rest of the home. Several bedrooms and some communal areas have recently been re-decorated and look fresh and attractive. The home is fresh, clean, comfortable and well looked after. Everyone who commented agreed that the home is always well kept. The mechanism that opens the locked front door in the event of the fire alarm being activated has been repaired. And all fire extinguishers are now securely fixed to the wall. Highnam Hall Residential Home DS0000065270.V373625.R01.S.doc Version 5.2 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. People can be confident that staff are trained and on duty in sufficient numbers to meet their assessed needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The rotas and staff numbers suggest that there are enough staff on duty at all times to meet the needs of the people who live at the home. I looked at a selection of staff files. They all included completed application forms and two written references. The files showed that satisfactory Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) register checks have been obtained. I was assured that no new member of staff starts work until a POVA register check had been completed. Then, if the CRB check had not been received, they would work only under the supervision of an experienced staff member. The manager makes sure that staff have the necessary training to help them do their work as well as possible. There is a wide range of courses available and the records confirmed that the staff are allowed the time to attend. Highnam Hall Residential Home DS0000065270.V373625.R01.S.doc Version 5.2 Page 15 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good The home is safe and well managed and people who live and work at the home can contribute to the decision-making processes. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager has the qualifications and the skills to manage the home effectively. The operational manager visits the home and carries out audits, to make sure the home is operating to company policy. I looked at the records held at the home regarding people’s personal allowance. All transactions are recorded correctly and receipts are kept. One person’s money was counted and matched the total on the record. Highnam Hall Residential Home DS0000065270.V373625.R01.S.doc Version 5.2 Page 16 Policies and procedures are kept up to date; to make sure they provide relevant information to guide staff on how to act in every situation. All the regular health and safety checks for the home are carried out in a timely manner. Staff have basic health and safety training. All these measures make sure that the health, safety and welfare of the people who live at the home is promoted and safeguarded. Highnam Hall Residential Home DS0000065270.V373625.R01.S.doc Version 5.2 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X 3 X X 3 Highnam Hall Residential Home DS0000065270.V373625.R01.S.doc Version 5.2 Page 18 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. 1. Refer to Standard OP27 Good Practice Recommendations Overall staffing levels should be kept under review as occupancy levels rise. Highnam Hall has a number of floor levels and extension wings. When the home is full, and dependency levels are high, additional staff will be required. The fridge that stores some medication needs to be locked. 2 OP9 Highnam Hall Residential Home DS0000065270.V373625.R01.S.doc Version 5.2 Page 19 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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. Extracts may not be used or reproduced without the express permission of CSCI Highnam Hall Residential Home DS0000065270.V373625.R01.S.doc Version 5.2 Page 20 - 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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