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Inspection on 16/06/09 for Hillbrow Residential Home

Also see our care home review for Hillbrow Residential Home for more information

This is the latest available inspection report for this service, carried out on 16th June 2009.

CQC found this care home to be providing an Good service.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

People who are considering moving into the home are provided with sufficient information about the service to enable them to decide if the home will be suitable for them. Pre admission assessment policies and procedures ensure that people who move into the home can be confident their needs will be understood and can be met. People who live in the home can be confident their health, personal and social care needs are understood and met in a way that promotes their privacy and dignity and values their individuality. They are protected through the safe handling of medication. Activities at the home satisfy the social, recreational, religious and leisure needs of the people who live there. Arrangements for community contact are good and promote family contact. Policies and procedures are good enabling people to exercise choice over their lives with support as needed.Meals at the home are good and offer variety, choice and healthy eating options. People who live in the home are listened to and encouraged to offer comment or complaint. They are protected from abuse. They benefit from the comfortable, safe and homely environment and the support and understanding of the stable staff team. They are protected by robust recruitment policies and procedures. People benefit from the family atmosphere. Effective quality assurance systems, policies and procedures ensure the home is run in their best interests. People are protected from harm through safe working practices.

What has improved since the last inspection?

The statement of purpose is kept under review to ensure that they accurately reflect the home, staff and the care provided at Hillbrow. The manager ensures that the policies and procedures used within the home are continually reviewed to ensure that they are in line with current good working practices. The manager ensures individual risk assessments are completed for all residents. Medication records have been strengthened to ensure that records and the actual quantities of drugs on site coincide.

What the care home could do better:

It is recommended that care planning and risk assessments should be further developed to adopt a more person centred approach in these areas. All staff should receive training in the specific mental health needs of people who live in the home.

Key inspection report Care homes for older people Name: Address: Hillbrow Residential Home Hillbrow 18 Mill Road Epsom Surrey KT17 4AR     The quality rating for this care home is:   two star good 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: Ruth Burnham     Date: 1 6 0 6 2 0 0 9 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 24 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) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Hillbrow Residential Home Hillbrow 18 Mill Road Epsom Surrey KT17 4AR 01372720633 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: v_sumessur@hotmail.com Mrs Soomit Sumessur,Mr Vinod Sumessur care home 12 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 12 The registered person may provide the following category of service only: Care home only (PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: Dementia (DE) Mental disorder, excluding learning disability or dementia (MD) Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home The home is located near to Epsom Town Centre. The home is currently registered for twelve older people and cares for 7 residents. The Care Homes for Older People Page 4 of 24 12 12 0 Over 65 0 0 12 Brief description of the care home accommodation at the home has four single and four double bedrooms. Two male residents share a room at present and there is ample space throughout the premises. The home is located near to Epsom Town Centre. Weekly fees range from 385 to 550 pounds. Care Homes for Older People Page 5 of 24 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: two star good 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 was an unannounced site visit as part of the key inspection process by the Care Quality Commission. The visit included a full tour of the premises, observation of practice, informal talks with people who live in the home and interview with the owner/manager. We asked the service to complete the Annual Quality Assurance Audit before the visit. This contained all the information we asked for. The inspection process included a review of documents, policies, procedures and any other relevant records. The visit commenced at 8:30 am and finished at 12:00 noon. Care Homes for Older People Page 6 of 24 People who use this service experience GOOD quality outcomes. Care Homes for Older People Page 7 of 24 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 24 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 24 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who are considering moving into the home are provided with sufficient information about the service to enable them to decide if the home will be suitable for them. Pre admission assessment policies and procedures ensure that people who move into the home can be confident their needs will be understood and can be met. Evidence: People who are considering moving into the home are provided with sufficient information about the service to enable them to decide if the home will be suitable for them. This information is provided in the statement of purpose and service user guide. These documents are reviewed regularly to ensure they accurately reflect staffing levels and any new qualifications undertaken by the staff. People who move into the home can be confident their needs will be understood and Care Homes for Older People Page 10 of 24 Evidence: can be met. Clear and concise assessments are in place for all residents in the home, including the social and healthcare needs of the individual. Information contained within the assessment identifies the cultural and diverse needs of potential residents. The home does not offer any form of intermediate care. Care Homes for Older People Page 11 of 24 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home can be confident their health, personal and social care needs are understood and met in a way that promotes their privacy and dignity and values their individuality. They are protected through the safe handling of medication. Evidence: People who live in the home can be confident their health, personal and social care needs are understood and met in a way that promotes their privacy and dignity. Although care plans would be improved by a more person centred approach, outcomes for people who live in the home are good and observation of interaction and practice show that staff and management know each person well and value and promote their individuality when caring for them. Care plans are developed according to the individuals assessed needs using all available information. They include information about health, personal and social needs. The care plans are reviewed and updated monthly or more frequently if changes occur. Wherever possible the manager ensures that the care plans are signed by the residents and or their representatives. Care Homes for Older People Page 12 of 24 Evidence: People who live in the home are protected from harm through good risk management systems. A basic risk assessment is undertaken and recorded by the manager on each person. Those seen covered a variety of day to day activities. Some discussion took place about how to develope these documents further to ensure there is clear, person centred guidance for staff on how to minimise risk in line with peoples individual needs and lifestyle choices. The health of people who live in the home is promoted and safeguarded. Health assessments are carried out by qualified staff who are experienced in assessing the needs of people who live in this home. Records show people are supported to access a variety of professional healthcare services according to their individual needs, these include dentists, community nurses and opticians. People who live in the home are protected through the safe handling of medication. There is a policy and procedure in place for the administration, storage and recording of medication. Records seen were in good order. The culture of the home promotes person centred care and focuses on peoples abilities rather than their loss of abilities. Staff and management treat people with respect. Interactions observed during our visit were warm and friendly. Staff gain permission before entering peoples rooms. Care Homes for Older People Page 13 of 24 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Activities at the home satisfy the social, recreational, religious and leisure needs of the people who live there. Arrangements for community contact are good and promote family contact. Policies and procedures enable people to exercise choice over their lives with support as needed. Meals at the home are good and offer variety, choice and healthy eating options. Evidence: People who live in the home are supported to access a range of recreational and social activities, which meet their needs and preferences. During our visit one person went out for a walk and people took part in an exercise class. The social needs, hobbies and interests of individuals are recorded in their care plan. Care plans show peoples expectations and preferences are discussed and developed to ensure that the home can meet these. People can be confident their rights are promoted. These are detailed within individual care plans. Staff recognise the diversity of the individuals within the group and ensure Care Homes for Older People Page 14 of 24 Evidence: they are supported in every aspect of their daily lives. All staff employed at the home have undertaken equality and diversity training to ensure peoples rights are respected and their diverse needs can be identified and the home can establish appropriate ways to support people to maintain their diversity. The home has arrangements for meeting peoples religious needs. A local minister visits to offer Holy Communion if they wish, or just a friendly face to chat to. People are supported to maintain contact with family and friends. Menu plans show that people are offered variety, choice and healthy eating options. The home uses a flip chart menu, which shows the daily menu and the alternatives if people do not like the main choice. menus are discussed in residents meetings. Care Homes for Older People Page 15 of 24 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. People who live in the home are listened to and encouraged to offer comment or complaint. They are protected from abuse. Evidence: People who live in the home are listened to and encouraged to offer comment or complaint. There is a complaints procedure in place, which complies with the National Minimum Standards. There have been no complaints about the service since the last inspection. People who live in the home are protected from abuse. There are no current safeguarding adults investigations within this home. All staff receive protection of vulnerable adult training. Care Homes for Older People Page 16 of 24 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. People who live in the home benefit from the comfortable, safe and homely environment. Evidence: People who live in the home benefit from the comfortable and homely environment. The home is relatively spacious, well maintained and safe. All areas of the home are decorated and furnished to a reasonable standard. People are encouraged to choose the colour and layout of their bedrooms. All areas in the home are accessible by a chair lift. The kitchen is well equipped, clean and tidy. People enjoy the friendliness of the home, there is a family atmosphere and it meets its stated purpose. Communal areas are comfortable and homely. The outside area at the rear of the property is pleasant and well maintained. The premises were generally clean and free from unpleasant odours. Care Homes for Older People Page 17 of 24 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. People who live in the home benefit from the support and understanding of the stable staff team. They are protected by robust recruitment policies and procedures. Evidence: People who live in the home benefit from the support and understanding of the stable staff team. There are currently only five people living in the home and staffing levels are adequate to provide appropriate care and support. Robust recruitment policies and procedures protect people from harm. There have been no new staff recruited since the last inspection when it was noted that staff recruitment files contained completed application forms, written references, statement of terms and conditions, training records, CRB (Criminal Record Bureau) checks and a recent photograph of the employee. All staff have copies of the GSCC (General Social Care Council) code of practice to safeguard the welfare of service users. Staff recruitment files are securely stored to promote confidentiality. People who live in the home are supported by staff who understand their needs and have been trained to maintain their health and safety. Some discussion took place about how staff are trained in the specific needs of people who live in the home including training in supporting people with mental health difficulties. The manager is a Registered Mental Nurse and confirmed that in house training includes some Care Homes for Older People Page 18 of 24 Evidence: awareness of these issues. it was agreed that further training would be provided. Staff receive training in Dementia Awareness, Nutrition and Health, first aid, protection of adults, health and safety awareness and safe administration of medication. There is commitment to supporting staff to obtain National Vocational Qualifications. Care Homes for Older People Page 19 of 24 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from the family atmosphere. Effective quality assurance systems, policies and procedures ensure the home is run in their best interests. People are protected from harm through safe working practices. Evidence: People who live in the home benefit from the family atmosphere. The home is managed in the best interests of the people who live there by the manager who is a Registered Mental Nurse and the deputy manager who has completed NVQ level 4 in care and the Registered Managers Award. The manager and the deputy manager are also the owners of the home. The management structure maintains clear lines of communication and accountability. There are effective quality assurance systems in the home with the views of people who live there being taken into account when decisions are made. The manager completed the Annual Quality Assurance Audit for the Commission as part of this inspection. This contained all the information we asked for and shows how quality is Care Homes for Older People Page 20 of 24 Evidence: monitored and what they intend to do to make further improvements in the service. People who live in the home are protected form harm and their health and safety is promoted through safe working practices. The home has a policy on health and safety and staff have training in health and safety, fire safety, food hygiene, infection control and other relevant and appropriate training. The home has a policy on COSHH (Control of Substances Hazardous to Health) with products stored in a locked cupboard to promote safety. There are systems and procedures in place for routine service and maintenance of installations and equipment. Care Homes for Older People Page 21 of 24 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 22 of 24 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 2 7 9 Care planning should be further developed to include a more person centred approach to record keeping. Risk assessment documentation should be further developed to provide clearer guidance to staff on how to minimise risk according to peoples individual abilities and lifestyle choices. All staff should receive training in the specific mental health needs of people who live in the home. 3 30 Care Homes for Older People Page 23 of 24 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 24 of 24 - 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!