Care Home: Highstone Mews Care Home

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What the care home does well During this visit we mainly looked at care plan documentation, staff training records and adult safeguarding records. We did find however that the new manager had already started to identify inadequacies in care planning ,risk assessments and staff training and was able to produce some evidence of planned improvements she planned to make. What the care home could do better: People`s care plans and risk assessments must be clear to read and reflect any changing mental or physical health needs of the person. Records and systems must be put in place to minimise the risk to the person and other people at Highstone Mews so that people are protected from abuse. Staff must be given the training they need to enable them to work safely, protect people and meet the needs of people living in the home. Random inspection report Care homes for older people Name: Address: Highstone Mews Care Home Highstone Road Worsbrough Common Barnsley South Yorkshire S70 4DX two star good service 02/02/2009 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: Mike ONeil Date: 2 1 0 6 2 0 1 0 Information about the care home Name of care home: Address: Highstone Mews Care Home Highstone Road Worsbrough Common Barnsley South Yorkshire S70 4DX 01226733966 01226779427 highstone.mews@fshc.co.uk www.fshc.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Tamaris Healthcare (England) Ltd Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 60 Number of places (if applicable): Under 65 Over 65 30 30 30 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Conditions of registration: 0 0 0 30 beds in one unit are registered for N, Nursing Care or PC, Personal Care in the category DE/E, Dementia for people aged 65 or over OR MD/E, Mental Disorder for people aged 65 or over. For the DE/E, MD/E unit, minimum staffing levels and the manager supernumerary hours must be maintained as agreed with the previous registration authorities, see attached, Appendix 1. For the OP unit, staffing levels must be maintained as follows: one member of staff Care Homes for Older People Page 2 of 9 must be on duty when 1 to 10 service users live at the home; two staff for 11 to 20 service users; and three staff for 21 service users and above. Of the 30 beds above two can instead be used for the category DE or MD for people aged 55 or over and 28 for people aged 60 and over. The remaining 30 beds in a separate unit are registered for PC, Personal Care in the category OP, Older People. Two of these beds can be used instead as PD, Physical Disability for people aged 55 or over. Date of last inspection Brief description of the care home Highstone Mews is a registered care home for 60 older people. The home is divided into two units, which comprise of a 30-bed unit providing residential care and a 30-bed unit providing dementia/mental disorder nursing care. The home was purpose built. Both units share the same facilities for kitchen, laundry and administrative support. The home is situated in the residential area of Worsbrough Common on the outskirts of Barnsley, close to the M1 motorway and local bus routes and shops. All 60 places are accommodated in single en-suite rooms. Residents rooms are located on the ground and first floors and the home is equipped with handrails, other adaptations and a lift to assist people in moving around the home. Similarly, aids for residents are provided in bathrooms and toilets. The home had a range of communal areas. An enclosed garden and car park are provided. 0 2 0 2 2 0 0 9 Care Homes for Older People Page 3 of 9 What we found: On 21st June 2010 we visited Highstone Mews and carried out a random Inspection. The main reason the inspection was carried out was in response to concerns we had received about recent adult safeguarding issues that had occurred in the home. Our visit to Highstone Mews was carried out over a period of four hours between 14:3018:40 hours. We talked to 4 staff about their work and the training they have completed specifically relating to adult safeguarding, protecting vulnerable adults, dementia care and caring for people who may exhibit aggressive behaviour. We checked parts of peoples care plans including health care professional visits, risk assessments and the care plans relating specifically to peoples behaviour and the management of their mental health. We also looked at safeguarding referrals that had been made to the local safeguarding team and checked staff training records. We checked one previous requirement issued in February 2009 relating to the safe storage of peoples records.This had been met. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. A newly appointed manager was in charge of the home at the time of our visit. She has been managing Highstone Mews for less than 2 weeks but has many years experience in managing care homes, and particularly caring for people with dementia and mental health conditions. We checked 12 peoples care plans alongside the 9 referrals that had been made to the local safeguarding team. Overall the care plans and safeguarding records were inadequate for the following reasons. Peoples care plans did not contain sufficient detail as to measures or interventions staff needed to take to either protect the vulnerable person or how to minimise the risk of the physical abuse reoccurring. Only one person whose file we checked had a risk assessment formulated in relation to their aggressive behaviour and the risk this posed to other people or staff. There was no clear audit trail of the actions staff had taken in relation to referring cases of alleged abuse to the local safeguarding team or the responses the team had made to the home. Information was found of discussions with social workers. However these discussions were recorded on the daily record notes of people that were several months old and therefore filed at the back of the persons notes. Following discussions with health or social care professionals discussions care plans had not always been updated or risk assessments formulated. Care Homes for Older People Page 4 of 9 This poor documentation and omissions in safeguarding protocols means that vulnerable people are not fully protected at Highstone Mews. We therefore wrote a letter to the provider on 22 June 2010 instructing the provider to send us details or recent safeguarding incidents with the people involved, the type of abuse and whether this was taken as an alert by the local safeguarding team. We also wanted to know what systems have been put in place to minimise the risk to people at Highstone Mews and let us know the measures they intend to take to protect people from abuse. We asked that the provider respond to us within 48 hours. Staff said that the amount of training available has increased over the past few months. They said training has been provided on safe working practices for example fire safety and moving and handling.They said they had also received safeguarding of vulnerable adults (SOVA) training. However one member of staff said they had not received (SOVA) training in the 4 months since they started working at Highstone Mews. Some staff said they had received SOVA training although we were concerned about their perceptions and responses relating to abuse and what they deemed was acceptable or the normal behaviour by some people who lived at the home. Some staff clearly need more in depth SOVA training to help ensure people are protected. Some staff said they had not received dementia care training or training on how to support a person or people around the person who is exhibiting aggressive behaviour. Some staff need training in these areas so they can meet peoples needs in a safe way. 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 Older People Page 5 of 9 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 6 of 9 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 1 18 13 Records must be provided and updated of all safeguarding alerts since November 2009. These details and records must include the people involved, the type of abuse and whether this was taken as an alert by the local safeguarding team. Details must be provided of what systems have been put in place to minimise the risk to the person and other people at Highstone Mews. You must also let us know the measures taken to protect people from abuse. To protect people. 24/06/2010 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 Peoples care plans and risk assessments must be clear to read and reflect any changing mental or physical health needs of the person. To ensure peoples mental and physical health care needs are met. 01/08/2010 2 18 13 All staff must be given 01/08/2010 Page 7 of 9 Care Homes for Older People 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 sufficient updated and detailed training in the safeguarding of adults. To protect people 3 30 18 Staff must be given the training they need to enable them to work safely, protect people and meet the needs of people living in the home.This training must include dementia care and supporting people exhibiting aggressive or challenging behaviour. To protect and meet the needs of people. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 01/08/2010 Care Homes for Older People Page 8 of 9 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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