Inspection on 05/11/07 for Hill House

This is the latest available inspection report for this service, carried out on 5th November 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Hill House 03/03/06

Hill House 29/07/05

Hill House 25/02/05

Hill House 31/08/04

Similar services:

Ruskin Lodge

Dystlegh Grange

The Good Companions

Springfield Cottage

Cuerden Grange Rest Home

Cornmill Nursing Home

Vitalise Sandpipers Centre

Sue Ryder Care Birchley Hall

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 The Hill Newcastle Road Sandbach Cheshire CW11 1LA Lead Inspector Joan Adam Unannounced Inspection 5 November 2007 10:00 th The Hill DS0000018792.V343615.R01.S.doc Version 5.2 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 The Hill DS0000018792.V343615.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 Adults 18-65. 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. The Hill DS0000018792.V343615.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Hill Address Newcastle Road Sandbach Cheshire CW11 1LA 01270 762341 01270 527414 hill@wwm.leonard-cheshire.org.uk www.leonard-cheshire.org.uk Leonard Cheshire 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) vacant Care Home 33 Category(ies) of Physical disability (33), Physical disability over registration, with number 65 years of age (6) of places The Hill DS0000018792.V343615.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of 33 service users to include:* Up to 33 service users in the category of PD (Physical disability aged 18 to 64) * Within the maximum of 33, up to 19 service users in the category of PD who need nursing care may be accommodated * Within the maximum number of 33, up to 6 service users in the category of PD(E) (Physical disability aged 65 years and above) may be accommodated 31st October 2006 Date of last inspection Brief Description of the Service: The Hill is a care home registered to provide both nursing and personal care for adults who have a physical disability. The home is situated approximately one mile from Sandbach town centre and is set in its own extensive grounds Residents are accommodated on the ground and the first floor. Access to first floor is via passenger lift or staircase. Residents’ accommodation comprises thirty-four single bedrooms, one of which has an en-suite facility. There are two lounges, a dining room and an occupational therapy room. The cost of care at The Hill is based on an individually assessed need approach. The Hill DS0000018792.V343615.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection of The Hill was unannounced. It included a visit to the home by one inspector and was carried out over two days for a total of just over 9 hours. The visit was just one part of the inspection. Before the visit, the manager of the home was asked to complete a Annual Quality Assurance Assessment (AQAA) to provide CSCI with up to date information about the home. CSCI questionnaires were also made available for the people who live at the home, their families, staff working at the home and health and social care professionals, such as nurses and doctors, and their views have been taken into account. Other information received since the last key inspection was also reviewed. During the visit, various records were looked at and a tour of the home was carried out. Observations were made of how staff interacted with and provided care for the people who live at the home. A number of people who live at the home, visiting relatives and care staff were spoken with. They gave their views and these have been included in this report. What the service does well: People who are considering moving to The Hill have an assessment before they move in so they know their needs can be met at the home. Care staff work with each person and their families to develop a plan of care so they receive care in the way they prefer and their needs are met. The principals of privacy and dignity are met at The Hill and people who live in the home spoke highly of the standard of care and services provided. One said, “The home is really good” another said “ things are improving all the time, the new manager is great” People who live at the home say they are free to do as they choose so they can live their life in the way they want to within a risk assessed framework. The Hill DS0000018792.V343615.R01.S.doc Version 5.2 Page 6 The manager and staff understand the importance of helping the people who live at the home to achieve their goals. People are helped to make choices about what they do each day so they are active, stimulated and can learn to develop their personal and life skills as they wish. A new senior nurse has been appointed so that the team leaders and care staff have better support to enable them to care for the residents. Staff are trained, supported and supervised so they have the motivation and skills they need to meet the needs of people who live at the home. Health and safety is promoted and well managed so the people who live at the home and staff are safe. What has improved since the last inspection? The new manager has a clear understanding of the key principles of the organisation and is suitably qualified and experienced so the home is run in the best interests of the people who live there. The care plans in place identify each person’s individual needs and personal preferences so they know they will receive the care they need in the way they prefer. People who live at the home are asked about what they like to do so staff know what activities to offer to keep people stimulated, active and involved. People who live at the home and their relatives say the home has improved since the new manager has been in post and one said” we can trust her, she listens to what we have to say” . The menus, choice and standard of food have improved since the new chef has been in post and he talks to residents each week to discuss the menus. Staff have received relevant training and over 60 have achieved an NVQ at level 2 in care or above so the people who live at the home are in safe hands. All staff receive regular supervision so they are supported in their work and can develop their skills to meet the needs of the people who live at the home. Thorough checks are done on new staff so the people who live in the home are protected and know the staff are suitable to work with them. The Hill DS0000018792.V343615.R01.S.doc Version 5.2 Page 7 A quality assurance system is in place so people who live at the home are consulted on quality issues and their views are taken into consideration. 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. The Hill DS0000018792.V343615.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Hill DS0000018792.V343615.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. New people who are interested in moving to The Hill have their needs assessed so they know their needs can be met there. EVIDENCE: The files of two people who have recently moved in to the home were looked at. The residents had been visited by a senior staff member before admission to the home so that they know their needs could be met. They all contained appropriate assessments, including a social worker’s assessment where appropriate, and care plans. The Hill DS0000018792.V343615.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individual plans of care ensure that residents’ health and personal care needs are met and medicines are well managed at the home to make sure that the people who live there receive the correct prescribed medication at the right time. EVIDENCE: All of the people who live at the home have a care plan. These are developed with each individual and confirm how his or her health and personal care needs are to be met. Care plans looked at had been signed by the residents and reviews of the care had been held. The care files for five residents were looked at and these contained adequate detail to enable care staff to know how to care for the residents. Risk assessments are in place, which enable the residents to choose how they spend their day and to live their lives as they wish. The Hill DS0000018792.V343615.R01.S.doc Version 5.2 Page 11 Staff at the home maintain good links with community health services. A record is kept of visits to residents made by doctors, nurses and other health care professionals. The optician, dentist and chiropodist visit the home or residents can make their own arrangements. These visits are recorded in the care plans. When people need help with decision-making, support is obtained from their independent advocates, relatives or health and social care professional to help them make an informed decision in their best interests. The Hill DS0000018792.V343615.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care and support is provided so the lifestyle in the home reflects the choices, expectations and personal preferences of people who live there. EVIDENCE: The manager and staff understand the importance of helping the people who live in the home to achieve their goals. Some residents are attending college courses and some are completing courses on line. They are encouraged to follow their interests and to take part in community life accessing places such as the local disability group, cinemas, pub lunches, market visits, bird of prey centre and local theatres. Residents spoke about trips to the theatre to see comedians such as Jim Davidson and a future trip to see Jethro. The Hill DS0000018792.V343615.R01.S.doc Version 5.2 Page 13 New computers are to be purchased in the near future with web cams to enable service users to interact with friends and relatives more easily. People who live at the home will be assessed to enable equipment to be purchased to assist them in using the computers. The home has employed a volunteer’s co-ordinator to improve the numbers and types of volunteers at the home so that the residents can go out more often with a staff member supported by the volunteers. The gardens have been replanted with help from the volunteers. An enabler has been appointed which has focused the residents to form an action group. One action taken by the group has been that letters have been written to the local MP to address the need for better transport provision. New staff have been employed in the kitchen and people who live at The Hill praised the standard of catering. Menus have been improved and more choice can be given to the residents. The home has an experienced cook who provides nutritious food, including specialist diets. He speaks with the resident’s daily to talk about meals and the standard of meal produced has weekly meetings with them to discuss the food choices for the week. “ We have more choice now in what we have to eat” “ The food has improved greatly” The Hill DS0000018792.V343615.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. his judgement has been made using available evidence including a visit to this service. The residents’ health, personal and social care needs are met by the staff team who enable them to maintain their privacy and dignity. EVIDENCE: Residents spoken with said that the new manager at the home had improved the communication with residents, relatives and staff. Meetings are held on a regular basis and minutes are taken which are available for everybody. Residents felt supported by staff and said” the staff are helpful and assist me as I need it.” “ The staff are very good” “ the staff work hard and support me well” “ staff seem to be happier which makes for a better atmosphere” The home has a policy about administration of medicines. Residents are helped to look after their own medicines if a risk assessment shows it’s safe for them to do this. At present the qualified nurses administer medications to all residents, however the team leaders are to receive training and support to enable them to give medication to residents who do not receive nursing care. The Hill DS0000018792.V343615.R01.S.doc Version 5.2 Page 15 The medicines records were checked at the visit and were being maintained appropriately. Medication storage was looked at and cupboards were clean, tidy and well organised. Throughout the visit, staff were seen to knock on bedroom doors before going in and treating the residents with respect. One resident commented, “Staff are very helpful and have a friendly attitude.” The Hill DS0000018792.V343615.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is an effective complaints procedure so people can raise their concerns and be listened to. The home uses the local authority’s procedures to make sure that people who live in the home are safeguarded from possible abuse or harm. EVIDENCE: The complaints procedure for the home sets out how to make a complaint and how it will be dealt with. The procedure is available in the home and people spoken with said they knew how to make a complaint. Residents have been given the Leonard Cheshire leaflet “ have your say” which sets out how to make a complaint. Access to Leonard Cheshire service users support team helps the people who live at the home to raise their concerns. There have been nine complaints since the last inspection and these have been recorded and the action taken documented. Residents said that they were happy with the way concerns and comments were taken seriously and acted upon by the new manager. The local authority’s adult protection procedures are used at the home. These give clear guidance on what to do if there is a suspicion or evidence of abuse or neglect. They also include arrangements for whistle blowing. All staff working at the home have received training on the procedures for safeguarding adults so they know when incidents must be referred to the local authority and can ensure that vulnerable people are safeguarded from abuse. The Hill DS0000018792.V343615.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The general maintenance of the home needs to be maintained so that the home provides a clean and comfortable environment for the people to live in. EVIDENCE: Some areas of the home are looking tired however some maintenance work has been carried out to enable the home to meet the needs of residents living there. Some bedrooms have been redecorated and new flooring installed. The people who live at the home said they were happy with the way their room had been redecorated. The dining room has been repainted to improve the general appearance. New furniture has been purchased including fifteen profiling beds and appropriate pressure relieving mattress to enable the home to care for the diverse needs of the residents living there and to replace the old hospital beds. The Hill DS0000018792.V343615.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are trained and there are enough of them on duty at any time to make sure that the needs of the people living in the home are met. EVIDENCE: Observation and staff rotas show that the service has enough staff available to help the people who live at the home with care and activities. A new senior nurse has been appointed to enable the better organisation and support of team leaders and care staff. Domestic staff including cooks and cleaning staff are employed in sufficient numbers so the catering needs of all the people who live at the home are met and the home is kept clean, hygienic and free from unpleasant odours. Four staff files were seen and showed that the recruitment procedures used at the home are thorough so the people who live in the home are protected from possible harm. The Hill DS0000018792.V343615.R01.S.doc Version 5.2 Page 19 There is a full training programme for staff at the home. In the last twelve months, training available has included: infection control; control of hazardous substances; fire safety training; moving and handling refresher training; continence and catheter care. Fourteen of the nineteen care staff members have an NVQ in care at level 2 and three staff members have attained an NVQ level 3 so the people who live at the home are in safe hands. Arrangements have been made to make sure that staff receive the training they need so they have the skills to do their jobs effectively and ensure the well being of all people who live at The Hill. The Hill DS0000018792.V343615.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The health, safety and welfare of the service users are protected. The views of service users are obtained and used to influence the running of the home. Staff are fully supervised EVIDENCE: The new manager leads a strong and established staff team. She is a qualified nurse with extensive experience in the care of older people. She is shortly to commence an NVQ in management and care at level 4 so as to improve her knowledge and skills of meeting the diverse needs of the people who live at the Hill. She has applied to be registered with CSCI. The Hill DS0000018792.V343615.R01.S.doc Version 5.2 Page 21 She has a clear understanding of the key principles of the organisation and is suitably qualified and experienced so the home is run in the best interests of the people who live there. Staff and residents said “the new manager listens to what we have to say” “ we can trust the manager to act when we make comments and raise concerns” Staff spoken with and questionnaires that were completed said that the “ atmosphere at the home is much better” “ the manager and senior staff talk to us and our opinion is listened to” “ we can speak out at meetings “ Senior staff spoke of improvements in management style with staff learning more, receiving more feedback and feeling better supported. A new senior nurse has been appointed to enable more support and organisation of the team leaders and care staff. Care staff said they are happy with the management of the home and describe the manager as an open, approachable and supportive leader. An effective quality assurance processes are in place so the people who live at the home and their advocates and representatives will be involved in its continuous improvement. Staffing rotas showed that the home is staffed by adequate numbers to meet the needs of the residents living there and the domestic staff including cooks and cleaning staff are employed in sufficient numbers so the catering needs of all the people who live at the home are met and the home is kept clean and hygienic, free from unpleasant odours. Staff files were seen and showed that the recruitment procedures used at the home are thorough so the people who live in the home are protected from possible harm. There is a full training programme for staff at the home. Staff records confirm that all staff have regular formal supervision meetings so the people who live at the home benefit from a well informed and appropriately supported staff team. Arrangements are in place to ensure the health and safety of all employees and people who live in or visit the home. The manager ensures that risk assessments are carried out for all safe working practices. Information provided indicates that fire precautions are in place and routine maintenance checks of gas and electrical systems, electrical appliances, lift, stair lift, mobile hoist, fire alarms, extinguishers and emergency lighting systems are undertaken and are up to date. The Hill DS0000018792.V343615.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 x The Hill DS0000018792.V343615.R01.S.doc Version 5.2 Page 23 NO Are there any outstanding requirements from the last inspection? 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 The Hill DS0000018792.V343615.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 The Hill DS0000018792.V343615.R01.S.doc Version 5.2 Page 25 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!