Care Home: Highpoint Lodge

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What the care home does well Highpoint Lodge has managed to maintain a stable staff team with the owners working alongside staff. A family atmosphere exists whereby people feel relaxed within a professional setting. Service users indicated that they were happy with the care provided. The registered providers stay abreast of professional developments and adjust policies and procedures accordingly. Staff benefit from in-house training packages. The registered providers continue to be approachable and always listen to concerns or ideas. Service users are involved in the running of this home and in their own care needs. A high level of communication is maintained between the home and service users relatives. What has improved since the last inspection? The home continues to provide a good standard of care and all concerned have to work hard to maintain this position. Staff remain enthusiastic and were observed to be diligently going about their duties. The total number of staff in possession of an NVQ is approximately 80 per cent. New staff are enrolled on these courses. Additional training courses have been arranged over the past 6 months and policies and procedures have been reviewed and updated. On going maintenance and decoration of the home keeps the premises in good order. The overall appearance of the home and the grounds are maintained to high standards. The registered providers make good use of the internet to keep abreast of current developments. What the care home could do better: Based on the areas inspected at this unannounced inspection, it is our opinion that the home is being operated to high standards at this time. Service users told us that there is nothing the home could do better. They stated that they were completely satisfied with all aspects of being at Highpoint Lodge. Key inspection report Care homes for older people Name: Address: Highpoint Lodge 69 Molesworth Street Wadebridge Cornwall PL27 7DS     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home 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 full review a ‘key’ inspection. Lead inspector: Michael Dennis     Date: 0 7 0 4 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought 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 The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial 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. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Highpoint Lodge 69 Molesworth Street Wadebridge Cornwall PL27 7DS 01208814525 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: julielaw_6907@hotmail.co.uk Mrs Julie Law,Mr Alan Wayne Law care home 11 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: Service users to include up to 11 adults of old age (OP). Service users to include up to 3 adults over 65 years of age with a mental illness (MD(E)). Total number of service users not to exceed a maximum of 11. Date of last inspection Brief description of the care home Highpoint Lodge is a registered care home providing accommodation and personal care for up to 11 older persons, 3 of whom may also have a mental disorder. Highpoint Lodge is a large Victorian, detached house situated near the town centre of Wadebridge. It is on the main road leading out of the town towards Padstow. Access to the front of the home is up a graduated slope with a handrail provided to assist service users. Parking and a seating area are provided to the rear of the home and a patio area is accessed from the dining room at the side of the house, via a conservatory. Care Homes for Older People Page 4 of 26 Over 65 3 11 0 0 Brief description of the care home Bedrooms are offered on the ground and first floors with a stair lift provided to assist service users. Communal areas are provided on the ground floor and the Mr and Mrs Law have their private accommodation on the second floor. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced inspection took place on the 7th. April 2010 over a 6 hour period. We met with Mr.and Mrs.Law, the Registered Providers, the staff on duty and with 5 service users.. During the course of the day we observed the service users being attended to by staff in a courteous and professional manner. We spoke with and case tracked 5 service users, one of whom requested to meet with us. We received a number of surveys prior to the inspection plus a comprehensive Annual Quality Assurance Assessment. All were united in saying that they were perfectly content with the services provided and could not think of anywhere else that they would rather be except for back in their own homes. They told us that they were well cared for by both the registered providers and staff alike. Their privacy and dignity was respected at all times. (this was observed to be the case throughout the inspection). They all complimented the food provided. Care Homes for Older People Page 6 of 26 Each service user was asked if they were happy with their lifestyle. A common theme emerged. They told us that visitors were welcomed and that they had frequent contact with friends and relatives, who would often take them out. They stated that the staff also provided opportunities for outings, activities and interests. Based on observation and comments made, service users do not spend large amounts of time sitting in the communal lounge. They prefer the privacy of their own rooms where they entertain visiting guests or friends made within the home itself. Meal times appear to be the main social gathering point. Those spoken with all seemed to have an interest to occupy their time. They were unanimous in stating that they felt safe at this home. All were aware of the complaints procedure should the need arise to use it. They stated that the care they received was of a high standard. They further commented that the registered providers were quick to access other health professionals when the need arose. They told us that call bells were promptly answered both day and night. Service users informed us that their expectations of being in a care home were being fully met. They expressed satisfaction with all aspects of the home. We inspected various records, policies and procedures and found them all to be of a satisfactory standard and in compliance with the regulations. The premises were seen to be clean, tidy and well furbished. Health and safety and food hygiene inspections have recently been conducted resulting in good reports. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is Excellent This judgement has been made using available evidence including a visit to this service. Information concerning the home is made available. Service users are fully assessed prior to admission to the home. Prospective service users and relatives are afforded the opportunity to visit the home to assess its suitability as to meeting their needs. This home does not provide Intermediate Care Evidence: Up to date Statements of Purpose and Service User Guides were readily available. Service users confirmed a knowledge of these documents. If required all information about the home can be provided in large print documents and by audio tape. Three service user files were inspected and case tracked. All contained information pertaining to pre-admission assessment and copies of contracts etc. Care Homes for Older People Page 10 of 26 Evidence: Policy documents indicate that prospective service users can visit the home before making the decision to move in. Standard 6 is not applicable as the home does not provide intermediate care. The home has operated a dedicated Respite care bed but this facility is currently used as a long term bed. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The health care needs of service users are identified, planned for and met. Service users are treated with dignity and respect. The standard of care planning set is high and is being maintained. Medication administration is followed in accordance to policies and procedures. Evidence: From inspection of documentation it was evident that individual care needs are identified appropriately. From inspection of service users files, and in discussions it is evident that Highpoint Lodge encourages service users and their representatives to express their views in the formation of their care plans. The care plan specifies what actions staff should take to ensure that the care need is approached in a consistent manner. Copies of the care plan pertaining to each individual are held by the person Care Homes for Older People Page 12 of 26 Evidence: concerned in their own room. The care plans have been regularly reviewed at monthly intervals and are supported by running day records, risk assessments, accident reports. Health needs are met by the staff at the home and by external professionals to a high standard. Records of all health professional visits are recorded in detail. Staff were observed to treat service users with respect and it was noted that staff knocked at bathroom and bedroom doors before entering. General practitioners examine and treat all service users in the privacy of their own bedrooms. Medication practices are conducted appropriately. Records are up to date. At present there are no controlled drugs in use at the home. New and appropriate medication storage units have been purchased. Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The routines of daily living and activities made available are flexible and varied. Service users are in control over their lives. Service users receive visitors at any reasonable time throughout the day Service users dietary needs are well catered for with a balanced and varied selection of food and drink available that meets tastes, and choices Evidence: The routines of daily living within the home appear to be flexible to suit individual preferences. The home will offer various activities including trips out. The majority of service users are very private people and in general prefer their own company. They do mix at certain times but in the main organise their own leisure pursuits in company of family and friends. Those spoken with claimed to be quite satisfied with their general routines, which included personal interests and hobbies. A good rapport with staff exists. Care Homes for Older People Page 14 of 26 Evidence: The visitors book indicated that a steady stream of visitors attend the home. This was also evidenced by the number of visitors present on the day of inspection. Service users are able to make informed decisions regarding their lifestyle, supported by staff as required. Service users appear to receive a varied, appealing and nutritious diet suited to individual needs, likes and requirements. The meal looked appetising and service users were seen to be enjoying it in a social manner. Portions were of a good size and suited to the individual. Several service users took lunch in the dining room whilst others preferred to take the meal in their own room. Special diets are catered for and choices are available. Hot and cold drinks are offered and available throughout night and day. We had positive conversations with service users and their comments are detailed in the summary of this report. Care Homes for Older People Page 15 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaints procedure is well publicised and would be used when required. The registered persons ensure that service users are protected from all forms of abuse with staff having knowledge through training of Adult Protection issues which helps to protect service users. Evidence: The home has a complaints policy that meets all the requirements of Regulation 22. A complaints log is available to ensure that a record of all complaints is recorded and kept. No entries have been made since the last inspection. Details of the complaints policy are available in the statement of purpose and a full copy included within the service users guide The home has a policy in relation to adult protection, which includes information on whistle blowing. This policy references the Department of Health No Secrets guidelines and physical and verbal aggression by service users. Staff are made aware of this policy during induction and at training sessions. Staff have more recently undertaken specific abuse and safeguarding training Care Homes for Older People Page 16 of 26 Evidence: Service users confirmed that they were aware of the complaints policy and how and to whom they would complain if the need arose. The contact details of the Department of Adult Care Support should be added to the complaints procedure. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The location and layout of the home is suitable for its stated purpose and provides a safe and well maintained environment. Suitable equipment is provided to meet service users needs. Bedrooms are well furnished and contain their occupants personal affects. The home was clean, hygienic and free from offensive odours providing an attractive and homely place to live. Evidence: The home is close to public transport, local shops and facilities of Wadebridge. The detached building offers bedroom accommodation on the ground and first floors for service users. The home presents as a safe, well maintained and a homely environment for a maximum of 11 service users. The home is homely and domestic in nature. Bedrooms are suitably furnished and display the personal affects of the occupant. Service users stated they were happy with their living environment. Various aids and equipment is available to aid the care of service users. If a particular item becomes Care Homes for Older People Page 18 of 26 Evidence: necessary it is obtained for use of the individual requiring it. Communal areas are well presented and comfortable. The home was clean, hygienic and free from offensive odours. Disposable gloves and aprons are available as required. Hand washing facilities were satisfactory. The home has an Infection Control policy. Recent Health and safety and food hygiene inspections have occurred. The reports indicate a high level of satisfaction. The gardens and outside seating areas are well kept. Highpoint Lodge presents as a well looked after property. Staff and service users seem to have a vested interest in keeping it that way. Renewal of furniture and fixings takes place when required. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Recruitment policies and procedures are implemented. All staff are supported and Inducted through training opportunities. A positive number of staff are on duty to meet the service users needs Evidence: The home has a duty rota that accurately reflected the number and skill mix of staff on duty during the inspection. There is always a minimum of 2 staff on duty. The registered providers live on the premises so waking night staff are not employed. They are available at all times however and will stay awake if necessary. Evidence that 80 of the staff team have achieved NVQ level 2 or above was presented at the inspection. This represents an improvement from the 55 recorded at the last inspect. New staff are enrolled on NVQ courses. The homes employment policies and procedures are implemented. We inspected staff files and determined that all had completed application forms, references, CRB/POVA clearances, Statements of Terms and Conditions and job descriptions. Staff training, induction and development programmes are ongoing. Current and recent courses include; first aid, basic food Care Homes for Older People Page 20 of 26 Evidence: hygiene, Intermediate food hygiene, health and safety, moving and handling, safeguarding etc. Staff were observed to be quietly and efficiently going about their duties during the course of the inspection. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The management and staff of Highpoint Lodge strive to maintain and improve a good quality of care and lifestyle for the service users and promote their health, safety and welfare. Evidence: Service users live in a home which is run and managed by persons who are fit to be in charge, of good character and able to discharge their responsibilities fully. Mr and Mrs Law are both qualified RMNs and experienced providers who have continued to update their skills and knowledge whilst managing the home. Quality assurance and quality monitoring systems are implemented. The homes policies and procedures are regularly updated as necessary and were seen to be comprehensive. Written records Care Homes for Older People Page 22 of 26 Evidence: are kept of all financial transactions. Service users manage their own finances. The registered providers maintain the health, safety and welfare of service users through implementation of policies and procedures. Records required by legislation are kept. A good rapport exists between management, staff and service users. Supervision of staff is undertaken and appropriately recorded. Care Homes for Older People Page 23 of 26 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, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 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, Care Homes 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 1 16 Add the contact details of the Department of Adult Care and Support to the complaint procedures. Care Homes for Older People Page 25 of 26 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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