Inspection on 01/10/07 for Hillscourt

This is the latest available inspection report for this service, carried out on 1st October 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

Hillscourt 30/01/06

Hillscourt 16/05/05

Hillscourt 07/01/05

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Hillscourt The Hillscourt Nursing Home 8-10 Pennsylvania Road Exeter Devon EX4 6BH Lead Inspector Michelle Oliver Unannounced Inspection 1st October 2007 10:00 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 Hillscourt DS0000042993.V343877.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. Hillscourt DS0000042993.V343877.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hillscourt Address The Hillscourt Nursing Home 8-10 Pennsylvania Road Exeter Devon EX4 6BH 01392 431662 01392 433406 gt.care@btconnect.com 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) GT Care Services Ltd. Mrs Jenny Louise Mary Harry Care Home 27 Category(ies) of Old age, not falling within any other category registration, with number (27) of places Hillscourt DS0000042993.V343877.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Notice of Proposal to Grant Registration for staffing/environmental conditions of registration issued 7/6/94 To admit one named person outside the categories of registration as detailed in the notice dated 1st July 2005 The maximum number of persons accommodated at the home, including the named service user, will remain at 27 On the termination of the placement of the named service user, the registered person will notify the Commission in writing and the particulars and conditions of this registration will revert to those held on the 23rd June 2005 19th September 2006 Date of last inspection Brief Description of the Service: Hillscourt is a 27 bedded Home which is registered to provide nursing care for those aged over 65 years. It is an older property situated in Exeter close to amenities. There is a pavement ramp and wheelchair access. At the rear there is a level patio reached by a conservatory. The Home provides nursing care for 27 residents in individual rooms, which are divided between two floors with the upper floor split into two levels. There is a convenience store opposite, which is open 24 hours. There are no car-parking facilities but there is a multi-storey car park only 5 minutes walk from the Home and two hour parking in surrounding roads. The Home does not provide intermediate care. The average cost of care is £ 496-610 per week at the time of inspection. Additional costs, not covered in the fees, include hairdressing and personal items such as toiletries, newspapers and magazines and private chiropody and taxis. Current information about the service, including CSCI reports, which are accessible at the Home, is given to prospective residents/their representatives. The Service Users’ Guide and Statement of Purpose are available in the Home on request and a copy of the Home’s brochure is given to all residents on admission. Hillscourt DS0000042993.V343877.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place as part of the normal programme of inspection. One inspector and a pharmacist carried out the site visit over the course of 10 hours. During this time we looked closely at the care and services offered to three people as a way of judging the standard of care and services generally. Where possible we spoke with these people in depth, looked at their care assessments and care plans closely, and spoke with staff about their knowledge and understanding of the plans. We looked at their bedrooms and we looked at the overall environment from their perspective. We also looked at recruitment records, staff traing record and other records. We spoke with approximately 9 others (of the 27 people living here), with the provider, manager, registered nurse and with carers. We looked around the building at all communal areas and saw many of the bedrooms. We looked at other records including medication, staffing, accident and incident reports, training, fire safety and recruitment and complaints. Prior to the visit to the home we sent surveys to various people asking for feedback and comments. We sent surveys to people who live here to relatives and received , to health and social care professionals who attend people living here and received ; and to staff working here and received . Their feedback and comments are included in the report. Other information given to the commission throughout the year has been taken into account. In addition, and before we visited the home, the manager provided information about the management of the home and their own assessment of what the home does well and what they plan to improve upon. What the service does well: People are provided with comprehensive information about the home before a decision is made for them to live there. People living at the Hillscourt are provided with generally good care in a warm clean and friendly environment. Good quality food is provided and the staff are committed to giving good care. Hillscourt DS0000042993.V343877.R01.S.doc Version 5.2 Page 6 Comments received from people living at the home included,“ Carers and manager very kind and helpful”,“ Manager is very particular, home is always fresh and clean”,“ Everything here is OK”,“ we had to go on a waiting list to get into Hillscourt and it’s the best thing we’ve done” “the staff are excellent, so kind and caring, happy too”, best care and support from all staff and management”. In a questionnaire received before this inspection a health care professional, when asked what the home does well, commented, “ Patient care” and another “ I have no concerns about Hillscourt. The staff are excellent”. When asked, in a questionnaire, what they feel the home does well one relative commented, “Looking after elderly people requires special skills, this the care home does well” Another relative commented, in response to whether the home supports individuals to live the way they choose “very flexible and adapt well to suit the needs of the individual”. The home is generally well maintained, furnished with good quality furniture and fittings. The home provides appropriate training for all staff to ensure that people living at the home are cared for by well trained competent staff. The recruitment procedure at the home is robust and protects people living at the home by ensuring that only suitable staff are recruited. Meals provided are of a good standard, nutritional and well presented. People said that they enjoyed the food provided. Comments made by a relative included “ I go in each day and have lunch. I can spend as much time as I like. I feel very welcome”. Complaints are taken seriously at the home and people are listened to. The Registered Provider has worked hard to set up an excellent quality assurance system at the Home, people living at the home are involved in the running of the home. What has improved since the last inspection? Since the last inspection the manager ensures that at least two references are received for staff before they start to work at the home. Ensuring the recruitment procedure is consistent and that all required information is obtained for all employees will protects people, as only those who have undergone this robust procedure will be employed to work at the home. Hillscourt DS0000042993.V343877.R01.S.doc Version 5.2 Page 7 Documentation relating to wound care has improved. Records now clearly show treatment undertaken, progress and any other health professional input. This ensures that staff are informed of the treatment needed to promote good wound care. Staff spoken to were aware of respecting peoples’ privacy and confirmed that they offer people privacy when bathing as they wish if a risk assessment does not indicate otherwise. All bathrooms have call bells that can be operated by people when in the bath. 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. Hillscourt DS0000042993.V343877.R01.S.doc Version 5.2 Page 8 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 Hillscourt DS0000042993.V343877.R01.S.doc Version 5.2 Page 9 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): 1,3 & 6. Quality in this outcome area is good. People have good information about the home that helps them to make a decision about where to live. Systems are in place to ensure peoples’ needs are assessed before they move into the home, promoting the success of their admission. The rights of prospective residents would be more fully protected if they received confirmation that the home can meet the needs identified. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home appreciates the importance of people having sufficient information when Hillscourt DS0000042993.V343877.R01.S.doc Version 5.2 Page 10 choosing a care home. The home’s Statement of Purpose provides people with information about the home including its aims and objectives, philosophy of care, services and facilities and Terms and Conditions of the Home. The home has also developed a website and a brochure, which include photographs, details of what people can expect at the home and gives a clear account of services provided, quality of the accommodation, qualifications and experience of the staff and how to make a complaint. The Statement of Purpose is available to enquirers and people living at the home, a copy is kept on a notice board in the hall, and all enquirers are given a copy of the home’s brochure. This ensures that people are provided with up to date information about the home before they make a choice to live there. Before a person moves into the home an assessments of their individual health, welfare and social care needs are undertaken by either the manager or a suitably experienced registered nurse. This is to ensure that the home can be confident that staff have the skills, ability and qualifications to meet the assessed needs of the prospective resident. People can also be confident that their needs can be met. Before deciding to make Hillscourt their home, people are invited to spend time in the home, have a meal if they wish, meet other residents, staff and to be able to ask any questions they may have. Several completed questionnaires were returned to us before this inspection. People were generally happy with the admission procedure to the home and the information provided. One person commented, “ We heard that this was a good home from someone who had a relative here previously”. The home does not admit people who need intermediate care. Hillscourt DS0000042993.V343877.R01.S.doc Version 5.2 Page 11 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 & 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Health and personal care needs are generally well recorded in individual plans of care. Further improvements would ensure that care is delivered in a person centred way. Medicines are mostly safely managed although some areas have the potential to place people at risk of harm. The privacy and dignity of the people who live here is respected. EVIDENCE: Each person living at the home has an individual plan of care. These are generally good with clear assessments, preferred name details and focus on maintaining independence and personal choices. We looked at three people’s care plans in detail and all showed that appropriate assessments are undertaken in relation to the risk of people developing pressure sores and in relation to how much nutritional support the person might need. These Hillscourt DS0000042993.V343877.R01.S.doc Version 5.2 Page 12 assessments are generally followed up with plans of action and are regularly reviewed. Improvement is needed to ensure that all individual health care needs are met. For example admission details for a person recently admitted were incomplete and no information about their social life had been recorded. This means that there is very little information available to staff to enable them to provide person centred care. A plan of care stated that a person was “ at risk of scalds”, but no information was available as to why or how. This was discussed with the manager who was able to give clear details and of how the risk had been reduced. Plans of care include some detailed information about what care is needed and how this is to be carried out by staff. However, peoples’ individual strengths are not often recorded. This puts people at risk of losing whatever degree of independence they have. Details about some identified issues were brief. For example staff had noted that a person’s appetite had decreased and subsequently they were at risk of having a poor nutritional intake. A doctor was consulted as a result of which a dietary supplement was prescribed. There was no evidence of this supplement being given. A weight chart showed that the person had loss 3 kgs of weight in 16 days. We also noted that this person had a swallowing problem and had been assessed as being at risk of choking. No details had been included in the plan of care and no instructions of how this medical emergency would be dealt with by all staff. This was discussed with the manager who confirmed that the home had the appropriate equipment if required. A person who had been assessed as being unable to use a call bell when in the lounge had been given one. Another person had recorded in the plan of care that they must always be supplied with a nurse call bell had been left without one. All staff need to be aware of individual plans of care to enable them to care for people in a person centred manner. Some plans of care included details such as “ try to orientate”, Give reassurance”, encourage interaction between [the person] and other residents” and “give catheter care” with no details of how these may be carried out. Information of how staff can aim to meet these issues would further promote person centred care. Documentation relating to wound care has improved. Records now clearly show treatment undertaken, progress and any other health professional input. This ensures that staff are informed of the treatment needed to promote good wound care. Reviews had been undertaken monthly. There was some good attention to dignity such as peoples’ likes and dislikes, [but this information wasn’t available for all] people, when they liked to go to bed and choosing clothes. People living at the home said that they always or usually receive the care and support they need and always receive the medical support that they need. Hillscourt DS0000042993.V343877.R01.S.doc Version 5.2 Page 13 People confirmed that they are treated with respect and their privacy is protected. Care staff confirmed this when telling us about the home’s privacy and dignity policy, when seen knocking before entering peoples’ rooms and when seen being discreet in offering to provide personal care or assistance. All personal care was carried out in private and people wear their own clothes, which are very well cared for. Staff spoken to were aware of respecting peoples’ privacy and confirmed that they offer people privacy when bathing as they wish if a risk assessment does not indicate otherwise. All bathrooms have call bells that can be operated by people when in the bath. People in their rooms were comfortable and all but one had their call bells close to hand. All care plans showed regular liaison with appropriate health care professionals. One health care professional commented “when visiting, staff are very courteous, will always knock on peoples’ doors before entering or will ensure any meetings /discussions are conducted in private.” Before this inspection several questionnaires were returned and comments included “ Care and support Marvellous” and “they look after my relative very well”. In reply to what could be improved a person commented, “ Perhaps a more proactive approach to individuals’ needs especially where some level of nursing care is involved. i.e. rather than just maintain some sort of quality of life by providing comfort, care and support, perhaps looking to improve it where possible” We found that medicines were stored securely. We found that some medicines in use it was not possible to determine the date on which they had been opened, meaning that it was not possible to be sure that they were still within the expiry dates as specified by the manufacturers. We also found that one person was being enabled to take medicines out with them on visits although the home were not following their own policy for this and no record was actually being made of the quantities either leaving the home or if any were returned. For those people looking after any part of their own medicines not records were kept of the supply of these medicines and also no risk assessments were present. We found that the home had developed a clear recording method for recording the dose of Warfarin given although it was not always possible to see where the information regarding the dose had come from. Hillscourt DS0000042993.V343877.R01.S.doc Version 5.2 Page 14 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 & 15. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who live here benefit from having easy contact with their friends and family and from a varied and wholesome diet. Although the Home provides activities, which many people can join in, this may not provide adequate stimulation and interest for all people currently living at the Home. EVIDENCE: Staff are currently responsible for organising activities to meet peoples’ social and leisure needs. The provider is currently recruiting an activities person who will be responsible for this. People, who did not choose to spend the majority of time in their room, said they were sometimes bored at the home. Many people said they enjoy sitting outside when the weather allows, some spoke about enjoying watching TV and listening to music. Some said all they do is sit and watch the TV all day. Hillscourt DS0000042993.V343877.R01.S.doc Version 5.2 Page 15 Care plans were not consistent in the amount of information relating to peoples’ individual social histories. This means that not all people are encouraged or supported to take part in meaningful occupation. One person spoke to us about their interests before living at the home. They were “sad” that they were not given opportunities to continue these even in a small way. Comments included in questionnaires included “ Condition makes it difficult [for relative] to move from their room. As a family we have been able to join in any activity or event provided by the management, with my relative as well when they were able”, another, “ only been there for 2 weeks but had a garden fete” and went to a “ meet the new matron evening with food and drink, most enjoyable.” One person said that they“ Don’t take part in them”. Many people praised staff at the home for providing a happy atmosphere where everyone was treated as `equals” with “a lot of laughter and banter”. People are encouraged to visit people living at the home at any time. During this visit many visitors came to the home and were made to feel welcome by the staff. The home does not have an allocated dining room. People may eat either in their rooms, on trays in the lounge or conservatory or at fold out tables put up in the lounge areas at meal times. Lunch served during this inspection was well presented and nutritious. People who needed assistance with eating were seen being assisted by staff sensitively and discreetly. Comments made by residents included “food is very good”. All meals are cooked on the premises and use mainly fresh ingredients. Hot and cold drinks are available throughout the day. A choice of meals is always available at lunch and the evening meal. Since the last inspection people are asked, when making their choice of evening meal, what they would like for breakfast the following day. People are provided with a cooked breakfast at least once a week, which some people said they thoroughly enjoy and look forward to. People say they make choices in their daily lives. These include the times they get up and go to bed, what they wear and where they eat their meals. Hillscourt DS0000042993.V343877.R01.S.doc Version 5.2 Page 16 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 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home and their relatives can be confident that they will be listened to and their concerns acted upon. Residents are protected from the risk of abuse or harm. EVIDENCE: Neither the Commission nor the home has received any complaints about this service, since the last inspection. During discussions, people said that they felt comfortable speaking with staff about any ‘grumbles’ and would report any complaints to the provider or the manager. Staff confirmed that they know the importance of taking people’s views seriously and of listening and responding to any issues raised. Staff said they would report back to the provider or manager any requests, comments or complaints made by people living at the home. The provider said records of any complaints made are kept. A copy of the home’s complaint procedure is made available in the service user guide, one of which is given to each person living at the home and is displayed on a notice board in the home. Hillscourt DS0000042993.V343877.R01.S.doc Version 5.2 Page 17 People spoken to said they feel safe and secure, staff are generally kind very helpful, respectful and that nothing was ever too much trouble for them. Staff are updated yearly in Safeguarding Adults training and were able to discuss their knowledge of different forms of abuse and how to recognise poor practice. The registered provider is trained as a Safeguarding Adults trainer and there are plans for the manager to undertake a Train the Trainer course to enable them to provide in-house training for all staff in Safeguarding adults. Comments included in returned questionnaires included “they do the best they can for my relative. If I feel something is not right I only have to mention it to the staff and things are put straight right away” and another,“ never had to raise a concern”. Hillscourt DS0000042993.V343877.R01.S.doc Version 5.2 Page 18 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 & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live here can be assured of a homely, clean and safe environment. EVIDENCE: Hillscourt is well maintained and provides comfortable accommodation including a lounge and conservatory. Peoples’ rooms were homely and most had been personalised with their own belongings and some small items of furniture; all were well decorated and fresh. The home is very well furnished and maintained to a high standard. A maintenance manager and a maintenence assistant are emplyed at the home to ensures necessary repairs are carried out. Hillscourt DS0000042993.V343877.R01.S.doc Version 5.2 Page 19 The inspector had a full tour of the building unaccompanied and all the areas were extremely clean and fresh. Hand washing facilities are provided in all rooms and bathrooms to ensure good hygiene practice at the home. The provider said that rooms are redecorated when they become vacant and a routine of general maintance and carpet cleaning is in operation. At the time of this inspection carpets were being cleaned in a persons room. Two domestics are emplyed at the home during the week and one during the weekend. Monday to Friday and one at weekends The home employs a laundry assistant 7 days a week. The laundry facilities were clean and well organised. Handwashing facilities, antibacterial gel dispensers, aprons and gloves are provided in the washroom. All laundry is managed at the home following robust procedures to prevent cross infection. Everybody was well dressed at the time of this visit and several said that their clothes are well looked after. Hillscourt DS0000042993.V343877.R01.S.doc Version 5.2 Page 20 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, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at this home benefit from good recruitment practices and a staff group who are generally well trained. EVIDENCE: The home has attained an Investor in People award and the provider and manager are committed to providing training at the home Outside agencies provide many different courses such as, first aid, falls awareness and prevention, diabetes awareness and medication management. Staff are able to request training at any time. The home has training bulletins made available to them by training providers and should a specific course be requested in a performance review then it will be sourced as recently in the case of the first aid. This means that staff are supported and encouraged to achieve qualifications, and for knowledge to be shared, to enable them to meet peoples’ needs Hillscourt DS0000042993.V343877.R01.S.doc Version 5.2 Page 21 Some staff spoke of their experience in caring for people who live with dementia, but some had not received recent training or updates. Staff said that training in this subject would be important to enable them to understand people who may have difficulty in communicating or making their choices and wishes known. Staff are also encouraged and supported to undertake a nationally recognised qualification [NVQ]. Currently 60 of staff have attained an NVQ at level 2 or above and 3 carers are currently undertaking training. Training Certificates are displayed and staff said that they feel valued. The home employs a chef and kitchen domestic as well as a laundry person 7 days a week and 2 maintenance personnel. There is a RGN on duty 24 hours a day and between 8 am and 5 pm there are 2. All new staff undergo a period of induction training when they are employed at the home, which includes principles of care, safe working practice, abuse and whistleblowing policy. We spoke to two care staff who described their period of induction training, which includes completing a set of questions to establish what they have learned. This is then gone through with the manager who can clarify any issues that the carer may have. This ensures that people living at the home are well cared for by trained competent staff. People living at the home said that their needs were met generally in a timely manner but some said that they might have to wait a little longer at busy time such as “at bedtime”. On relative commented “More staff and perhaps more outings for people who can be taken” when asked for any suggestions as to how the home could improve. Another relative commented, “ The staff are well trained but minor problems arise when there are language difficulties and certain phrases and words are not understood, but these are usually sorted out by consulting manager or staff”. People spoken to praised staff saying that they were ‘wonderful’ and ‘very kind, do everything for me’. The home operates a generally good recruitment procedure that clearly highlights the processes to be followed. Three randomly selected staff recruitment files were Hillscourt DS0000042993.V343877.R01.S.doc Version 5.2 Page 22 checked. These contained all the checks recommended to ensure that suitable staff are recruited. These include written references, a police check and proof of identity. Ensuring the recruitment procedure is consistent and that all required information is obtained for all employees will protects people, as only those who have undergone this robust procedure will be employed to work at the home. Hillscourt DS0000042993.V343877.R01.S.doc Version 5.2 Page 23 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 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People benefit from living in a well managed home that is working hard towards trying to make sure the home is run in their best interests. EVIDENCE: The home has recently employed a manager who will be making an application to the Commission to be registered. She has been involved in elder care since 1984 and has been registered as the manager of a nursing home before taking up this post. There is a clear management structure including the manager, senior nurse, team leader, personnel development manager and maintenance manager. Staff said that Hillscourt DS0000042993.V343877.R01.S.doc Version 5.2 Page 24 there was good communication and there was obviously a good rapport between staff and the management team. Mandatory training was up to date as were fire checks. All windows were fitted with restrictors for safety and radiators were covered. Baths have thermostatic controls to avoid scalding. Prior to this inspection a pre inspection questionnaire was completed by the provider giving information about the management of the home and how the home has carried out improvements based on the feedback from the last inspection. The manager and staff have worked hard to meet the requirements made at the last inspection. Records are securely stored and would be made available to people living at the home, or their representative, with their consent. Records are kept in lockable filing cabinets, and those seen were up to date. Peoples’ feedback about such things as the quality of their life at the home, staffing, meals, cleanliness and activities is sought on a daily basis. The home has an annual Quality Assurance Programme. A questionnaire is sent to all people living at the home and also to a cross section of outside health care professionals who visit the home. Questions focus on peoples’ individual experience and expectations of; standard of care, quality and quantity of food,quality of laundry service,cleanliness and up-keep of the home and staff/management/owners conduct. People living at the home are given the choice of handling their own money if they wish to. If they choose to have the home handle their money records of all transactions are kept. All money for clients is kept in individual pouches and safely stored in the company safe. Records and receipts are kept for all transactions. Two key staff hold Manual Handling Assessor certificates and they regularly update all staff and induct new staff when employed at the home. Information received before this inspection states that fire procedures in place at the home. The fire safety is the responsibility of the home’s Maintenance Manager, who undertakes regular fire checks with staff, and outside engineers who check alarms and appliances. Records 60 of staff attended a first aid course held at the home during 2006. First aid boxes are provided and an accident book is kept in the Nursing office to keep a record of all accidents that happen in the home. Records confirm that fire alarms and emergency lighting tests have been carried out regularly. Information received before this inspection indicated that all equipment is well maintained regularly. Hillscourt DS0000042993.V343877.R01.S.doc Version 5.2 Page 25 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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 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 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X 3 3 Hillscourt DS0000042993.V343877.R01.S.doc Version 5.2 Page 26 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. 1. Standard OP9 Regulation 13(2) Requirement To ensure that medicine is only used within the expiry dates set by the manufacturers the date of opening of products with a revised expiry date after opening must be recorded. For those people looking after any of their own medicines, a risk assessment must be in place and a record of supply of the medicine made. Timescale for action 31/12/07 2. OP9 13(2), 17(1) 31/12/07 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 OP7 Good Practice Recommendations 1. Care plans should clearly show the actions needed to meet all peoples’ needs. Information should be available for staff to ensure that all these needs are met. Hillscourt DS0000042993.V343877.R01.S.doc Version 5.2 Page 27 2. OP9 3. 4. OP12 OP30 To ensure that medicines are stored within the correct temperature range it is recommended that the temperature of the medicine storage room is regularly monitored and any appropriate action be taken. All people living at the home should have the opportunity to exercise their choice in relation to leisure and social activities. All staff should be able to meet the needs of all people living at the home. This relates to staff understanding the choices and wishes of people who have dementia. . Hillscourt DS0000042993.V343877.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Devon Area Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Hillscourt DS0000042993.V343877.R01.S.doc Version 5.2 Page 29 - 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. 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