Care Home: Highwood

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What the care home does well The home continues to provide a high quality service to residents who have a low dependency, the two current residents have lived there for a number of years and are very happy with their home. The management advised that the aim of the home is to provide a comfortable homely atmosphere for people who need minimum assistance, to encourage them to continue to be independent and make decisions about their lives. The residents said they are well cared for, although they are independent and make decisions about how they spend their time and the level of support that is offered.Meals continue to be well balanced and varied and the residents said the food is very good and they can have what they like. The residents and their families are consulted about all aspects of the service, and appropriate records are kept as part of the quality assurance system. What has improved since the last inspection? There were no requirements made following the last inspection. The home continues to offer a homely and comfortable environment for the residents. What the care home could do better: The home meets the relevant National Minimum Standards and there were no shortfalls identified at this time. The manager advised that she would be seeking further clarification from the Fire Service with regard to keeping residents doors open and the use by a resident of her ensuite for storage. CARE HOMES FOR OLDER PEOPLE Highwood 5 Pashley Road Eastbourne East Sussex BN20 8DU Lead Inspector Kathy Flynn Unannounced Inspection 14.00 25th July 2008 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 Highwood DS0000021360.V367499.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. Highwood DS0000021360.V367499.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Highwood Address 5 Pashley Road Eastbourne East Sussex BN20 8DU 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) 01323 729050 Mr Marcus Samuel Gudgeon Mrs Jennifer Gudgeon Mr Marcus Samuel Gudgeon Mrs Jennifer Gudgeon Care Home 3 Category(ies) of Old age, not falling within any other category registration, with number (3) of places Highwood DS0000021360.V367499.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of service users accommodated must not exceed three (3). Service users must be older people aged sixty-five (65) years and over on admission. 18th September 2006 Date of last inspection Brief Description of the Service: Highwood is a Christian home that is situated in a quiet residential road in Eastbourne. It is the family home of the Manager, her husband and children and is registered to provide care and accommodation for up to three older people. Service users accommodation is on the first floor in spacious single rooms with en-suite bathrooms. There is a reception room on the ground floor, this room comprises the dining room and lounge, overlooking the front garden. Both the front and rear gardens are fully accessible to service users. Visitors are welcomed at all reasonable times. A stair lift allows easy access to the first floor. There is a separate bathroom on this floor with a hoist, should service users prefer to have an assisted bath. Mrs Gudgeon, the Manager provides all the care in the home, and her husband, who holds a catering qualification, provides a variety of home cooked meals. Transport is provided to the local church, shops and the seafront whenever possible A copy of the service users guide, the statement of purpose and a contract is supplied at the time of admission. Most referrals are via word of mouth or personal recommendation. The fees are £365, toiletries (if requested) are included in the fees. Additional charges are made for hairdressing, chiropody, newspapers and dry cleaning. Intermediate care is not provided. The home does not have an email address or website. Highwood DS0000021360.V367499.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 reader should aware that the Care Standards Act 2000 and the Care Homes Regulations 2001 use the term ‘service user’ to describe those living in care home settings. However for the purposes of this report those living at Highwood will be referred to as ‘residents’. The reader should note that due to the size of this home a number of standards relating to staff and staff training are not applicable as the Manager provides all care to residents. This was an unannounced key inspection and took place over 3 hours on the 25th July 2008. There were two residents in residence on the day and both were spoken with and they spoke very positively about the support offered and the management of the home. The Manager and her husband were spoken with, and they explained that the residents are encouraged to make decisions about all aspects of the support provided and be as independent as possible in all aspects of their day to day lives. A range of documentation, including care plans and the daily diary were viewed and the residents invited observation of their rooms and the assisted bath. What the service does well: The home continues to provide a high quality service to residents who have a low dependency, the two current residents have lived there for a number of years and are very happy with their home. The management advised that the aim of the home is to provide a comfortable homely atmosphere for people who need minimum assistance, to encourage them to continue to be independent and make decisions about their lives. The residents said they are well cared for, although they are independent and make decisions about how they spend their time and the level of support that is offered. Highwood DS0000021360.V367499.R01.S.doc Version 5.2 Page 6 Meals continue to be well balanced and varied and the residents said the food is very good and they can have what they like. The residents and their families are consulted about all aspects of the service, and appropriate records are kept as part of the quality assurance system. 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. Highwood DS0000021360.V367499.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 Highwood DS0000021360.V367499.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. Standard 6 in not applicable. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from clear information of their terms and conditions of residence and there is a satisfactory pre-admission process in place. EVIDENCE: The home provides support for two residents at this time and there has been no admission to the home since the last inspection. The manager confirmed that there are no plans to extend the service, although there is a system for assessing prospective residents if needed. Discussions with the residents identified that they were provided with contracts when they first moved in, and they said that the home provides the support that they need and are very happy living there. Highwood DS0000021360.V367499.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 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care plans provide information regarding the assessed needs of the residents, and the residents are protected by satisfactory systems for the recording, storage and administration of medication. EVIDENCE: The residents care plans were viewed, and although brief they were found to include an assessment of their current needs, as well as their personal preferences, and choices concerning any assistance they may require. The home is managed on the basis that the residents live independent lives with services provided as a safety net when required. Their needs are monitored, with any details of appointments with their GP, or allied health professionals, including chiropodists, recorded in a daily dairy. Highwood DS0000021360.V367499.R01.S.doc Version 5.2 Page 10 Both residents said they were very happy in the home, they feel they are treated like one of the family and can ask the manager/owners to help them with anything. One resident self medicates and a satisfactory risk assessment is in place to ensure she maintains this independence without being compromising her safety. The manager confirmed that she has attended appropriate training and has developed systems to record administered medication should this situation change. Highwood DS0000021360.V367499.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 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home offers residents opportunities to experience a lifestyle that matches their expectations in terms of leisure activities and meals. EVIDENCE: Residents are encouraged and enabled to exercise choice over all aspects of their daily lives. They decide how they spend their time and ask for support from the owners when they need it. The managers’ husband provides transport to shops and the local church as required, or for outings when the weather permits. Residents spoke positively about the meals provided. The managers husband has a catering qualification and is able to meet their nutritional needs, and the residents said he consults them about what they would prefer to eat. Highwood DS0000021360.V367499.R01.S.doc Version 5.2 Page 12 Visitors are welcome at all reasonable times and residents confirmed that their friends and families visited frequently and were always made welcome. Highwood DS0000021360.V367499.R01.S.doc Version 5.2 Page 13 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 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints procedure, residents feel that their views are listened to and acted upon and they are further protected by satisfactory adult protection systems. EVIDENCE: The home has clear complaints policies and procedures although there have been no complaints since the last inspection, to the home or the CSCI. The residents said they have nothing to complain about, and if they have any concerns they discuss them with the manager at the time so they are resolved straight away. The home uses the updated East Sussex, Brighton and Hove multi-agency guidelines as the basis for its policies and procedures for adult protection, and the manager is aware of her responsibilities in this matter. Highwood DS0000021360.V367499.R01.S.doc Version 5.2 Page 14 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 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Highwood offers residents a comfortable and homely place to live, with appropriate cleaning and washing facilities. EVIDENCE: The home is clearly a family home and the residents are able to feel part of the family. Their rooms are on the first floor and they are able to access the ground floor using the stair lift, which enables them to use the dining room. Residents have personalised their rooms with ornaments and photographs and small pieces of furniture. They said that is like their own home and they are very comfortable. Highwood DS0000021360.V367499.R01.S.doc Version 5.2 Page 15 The laundry facilities are satisfactory and washing machines are able to wash clothes at temperatures that control the risk of infection. Both the Manager and her husband are aware of infection control procedures. Highwood DS0000021360.V367499.R01.S.doc Version 5.2 Page 16 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 and 29. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The support provided by the manager and her husband is sufficient to meet the residents assessed needs. EVIDENCE: Staffing has remained the same since the last inspection in that the Manager provides any care that residents need, however, this mainly comprises supervision while bathing and occasional additional care if residents are feeling unwell. Her husband provides all meals and transport to the shops and healthcare appointments for residents. When the family takes holidays the residents spend the time in alternative care homes of their choosing or with members of their families. Highwood DS0000021360.V367499.R01.S.doc Version 5.2 Page 17 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 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a well managed, well maintained home that is run in their best interests and all aspects of their health and welfare is promoted and protected. EVIDENCE: The Manager has been managing the home for over twelve years, and confirmed that she is up to date with relevant training. Residents said that they are consulted on all aspects of how the home is run and how support is delivered. The manager records discussions with the Highwood DS0000021360.V367499.R01.S.doc Version 5.2 Page 18 residents to demonstrate they are consulted and as part of the quality monitoring process. The home does not handle the financial affairs of residents. Residents are responsible for their own finances if appropriate, or relatives and solicitors would do so. The manager confirmed that the electrical systems and electrical appliances are serviced annually, as are call bell systems. Risk assessments have been undertaken in respect of the environment and fire safety, following advice from the fire officer. Further advice is to be sought regarding keeping residents doors open and the use of the bath for storage, to ensure that safe systems are in place. Highwood DS0000021360.V367499.R01.S.doc Version 5.2 Page 19 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 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Highwood DS0000021360.V367499.R01.S.doc Version 5.2 Page 20 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 Highwood DS0000021360.V367499.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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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