Inspection on 22/01/10 for Hillyfield Rest Home

This is the latest available inspection report for this service, carried out on 22nd January 2010.

CQC found this care home to be providing an Excellent 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.

Other inspections for this house

Hillyfield Rest Home 03/10/05

Hillyfield Rest Home 28/04/05

Hillyfield Rest Home 13/12/04

Hillyfield Rest Home 22/06/04

Hillyfield Rest Home 10/02/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

The Briars

Langdale Nursing Home

The Maypole Nursing Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 10/04/2010.

Key inspection report Care homes for older people Name: Address: Hillyfield Rest Home Barnes Lane Milford-on-Sea Lymington Hampshire SO41 0RP     The quality rating for this care home is:   three star excellent 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: Michelle Presdee     Date: 2 2 0 1 2 0 1 0 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 25 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Hillyfield Rest Home Barnes Lane Milford-on-Sea Lymington Hampshire SO41 0RP 01590642121 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: hillyfieldresthome@tesco.net Hillyfield Rest Home Ltd care home 16 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 16 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 : Old age, not fitting within any other category (OP) Date of last inspection Brief description of the care home Hillyfield Rest Home is registered to provide personal support and accommodation for 16 older people. The home has been extended to provide 16 single bedrooms, all en suite. A conservatory has been built to extend the lounge, providing a large, light area. The garden has been renovated. The home is situated in a residential area of Milfordon-Sea and within walking distance of the village shops. 0 Over 65 16 Care Homes for Older People Page 4 of 25 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: three star excellent 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: The unannounced inspection took place on 22nd January 2010 between 10:05AM and 2:45PM. The Commission (we) were assisted by the manager and management team. All staff on duty were part of the inspection. Sixteen people are currently living in the home. The majority of people were involved with the inspection. Surveys prior to the inspection were sent to some people living in the home, health, social care professionals and staff members. At the time of writing this report ten surveys had been received from people living in the home, ten had been completed by relatives, eight had been completed by staff and four social, health care professionals had returned surveys. In parts of the surveys people are asked to tick boxes with judgements ranging form always, usually, sometimes and never. These are referred to in this report. The home has sent us notifications appropriately regarding the welfare of people. Care Homes for Older People Page 5 of 25 Paperwork including assessments, care plans, menus, staffing records and safety checks were seen. A tour of the home including all communal areas, the kitchen and some bedrooms chosen at random was undertaken. All this information has helped form judgements in this report. Care Homes for Older People Page 6 of 25 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 7 of 25 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 8 of 25 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. The assessment process needs to be expanded to record all information to ensure staff can meet peoples needs. People will be given enough information to help them decide if the home is the right one for them. Evidence: In the AQAA we were advised Prospective residents and their relatives are provided with clear information about life at the home and are able to visit before making a decision to take a place here. No one is admitted to the home without an assessment to ensure the home can meet their care needs. The assessment is undertaken at the prospective residents home, or they are able to visit Hillyfield and the assessment is undertaken during the visit. The home offers a one month trial period during which both parties are able to assess the placement. The assessment of one new person who had recently come into the home was viewed. It was noted this detailed some basic information but did not give a clear picture of Care Homes for Older People Page 9 of 25 Evidence: why it had been decided the person had wanted or needed to come to live at the home. The person was spoken to who reported things were going well and felt they had been in the home for a long time. The persons relative was also spoken to who reported they were happy with the way staff were helping their relative settle into the home. This person reported the person had become very confused but felt the person was being very well looked after. In surveys all residents had ticked yes to the question, Did you receive enough information to help you decide if this home was the right place for you, before you moved in? In the AQAA we were advised, The homes statement of purpose and service user guide provide clear information about life at the home. The documents include details of the qualifications and experience of the registered manager and the organisational structure of the home. The documents also clearly state that admission to the home is restricted to those who are able to provide some measure of self-care and a reasonable level of mobility. These documents along with the latest inspection reports from the Commission were available in a folder in the hallway of the home. People spoken to on the day were aware of these documents. The home does not provide intermediate care. Care Homes for Older People Page 10 of 25 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 have all their needs met but care plans need to be developed to demonstrate how these needs are met. Medication procedures are followed and managed in a way which ensures people safety. Evidence: The care plans of several residents were seen who had been in the home for differing lengths of time. All of these residents were also spoken with. It was clear from speaking to people the care plans did not reflect the care which was given. All people spoken to had praise for the staff and felt all their care needs were met. However there was very little detail in the care plans of how the needs of people are met. The manager accepted this and agreed to develop the care plans. It was clear people are involved with their own care plans as they had been signed by the resident. On the day, one resident had their care plan and was showing it to their family. In the AQAA we were advised, residents who are assessed as able to do so, manage their own healthcare and administer their own medication. All residents are protected by staff following the homes clear procedures for the safe handling of medicines and Care Homes for Older People Page 11 of 25 Evidence: the procedures for those who wish to self-administer. When residents are unable to manage their own healthcare, we aim to identify any health problems so that they can be dealt with from an early stage. Residents confirmed they managed their own health needs, which may include asking staff to make appointments for them with the relevant health professionals. We were informed residents where possible will attend all appointments in the community. Details of peoples health visits were recorded in their care plans. All but one survey stated they always get the medical care they needed, the other person had stated usually. The home has a clear medication policy and uses a monitored dosage system. We were advised at the current time no one manages all of their own medication, but would be supported if they wanted and were able to. Staff spoken to confirmed they were all involved with the administration of medication and had received the necessary training. They all confirmed they felt the training was adequate to equip them to follow the homes policy correctly. The medication of two people was checked against the records held for these people. It was found the records matched the medication held. A very clear picuture of how medication is checked when it comes into the home and checked during the day was explained. We were advised no one in the home is on any controlled medication. One resident advised us medication is always dispensed on time. People spoken to confirmed their privacy was respected at all times. Whilst walking around the home it was noted staff always knocked before entering anyones room. People confirmed if a professional visited they would always be taken to their own room. Some people had telephones in their room, whilst others had a mobile phone. Care Homes for Older People Page 12 of 25 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. People are treated as an individual and supported to follow personal interests, and encouraged to keep in touch with family and friends. People have meals they enjoy at a time and place to suit them. Evidence: In the AQAA we were advised, Residents are supported to maintain their independence and exercise choice and control over their lives and participate in activities that meet their needs. Residents interests including religious and cultural needs are documented in their care plans. Regular activities include twice-weekly drives in the minibus, a musician attending weekly and various games and quizzes, so that there is something organised virtually every day for residents who may wish to join in. Many residents enjoy a high level of independence being able to walk to the village and meet with friends. Independent transport is organised for individual residents, for example taxis or cars from Milford Community Care. People spoken to confirmed they decided how they spent their time. On the day some spent time reading newspapers in the lounge and discussing current affairs, others spent time in their own rooms watching television or listening to music. Later in the morning a representative form the church came in and a church service took place for those who wished to attend. Care Homes for Older People Page 13 of 25 Evidence: In the AQAA we were informed the home has strong links with the community including local schools, churches, British Legion, carnival and other village events including the May Fair and the Music Festival. Residents confirmed they have been involved with all of these during the last year. People confirmed they could come and go from the home as they pleased as long as they informed staff. Visitors confirmed they could call at any time and were always made welcome. One visitor on the day called in and took their relative out to lunch. In the AQAA we were informed Three meals, together with snacks and drinks are offered each day. Special diets can be catered for, for example a diabetic diet. Snacks and drinks are available at night and residents are advised that it is in order for them to call staff during the night if they are in need of refreshments. The cook confirmed good quality meals are provided. The cook was aware of peoples preferences and had all this information recorded. The cook confirmed fresh vegetables are served daily and most cakes and puddings are home baked. People spoken to confirmed the meals were very enjoyable and they had plenty of choice. A choice is not available at lunch time but people confirmed the cook knows their likes and dislikes so an alternative is always offered if it is something they do not like. One resident wrote, The food is very good, nicely served from a clean kitchen, with clean and neat staff Care Homes for Older People Page 14 of 25 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 know how to complain and know their concerns will be looked into. The home safeguards people from abuse and neglect. Evidence: In the AQAA we were advised Complaints are recorded and taken seriously. The home has a complaints procedure that indicates who will investigate the complaint and the timescale for the process. Residents would be fully supported by staff in making their complaint. A Copy of the homes complaints procedure was displayed in an information folder in the lobby of the home. It was noticed the address and telephone number of the Commission had not been updated. We were informed this would be changed. Residents spoken to confirmed they would always speak to the manager or a member of staff if they had any concerns. All felt there concern or complaint would be taken seriously and actioned. Visitors spoken to also confirmed if the had any concerns they would speak to the manager or a member of the management team. Staff confirmed the manager always had an open door policy and they knew if they did not want to speak to the manager they could speak to someone in the management team. We were advised the home had received no formal complaints in the last twelve months. comments residents had made had been recorded and it was possible to establish what action had been taken regarding these comments. Care Homes for Older People Page 15 of 25 Evidence: In the AQAA we were informed The homes policies and procedures for the prevention of abuse including whistle blowing are readily available to staff, and staff are trained in the prevention of abuse. Checks are made to ensure that new staff members are suitable to work with the residents. Staff members spoken to confirmed they received adequate training on abuse and adult protection were aware where the homes policies were relating to these issues. Care Homes for Older People Page 16 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean, well maintained and residents have made the home their own. Evidence: In the AQAA we were advised We provide residents with a clean and homely environment that is maintained to a very high standard. All of our residents are accommodated in single rooms with en-suite bathrooms. The rooms are spacious and well decorated. Residents are able to bring as much of their own furniture as they wish and they bring many personal items into the home, including pictures and ornaments. They can have a key to their room if they wish. On the visit a tour of the home was undertaken including all communal areas and some bedrooms where residents were in were viewed. All areas were very clean with no unpleasant odours detected. People spoken to were very pleased with the cleanliness of the home, reporting It is always spotless. Another resident stated, My room is kept clean and laundry is done well daily. The home has a separate dining area where tables are set each day. Residents spoke of their enjoyment of lunch time and clearly it was a very social time. The kitchen and laundry were clean and all in good order. Staff told us they receive training in infection control and disposable gloves and aprons were seen around the Care Homes for Older People Page 17 of 25 Evidence: home. The health and safety notice was displayed and had been filled in appropriately. The home has safe gardens which are well maintained. There are various areas where residents can sit outside including a summerhouse. One resident spoke of their enjoyment of being able to sit in the summer house, especially in the summer months. Grab rails have been fitted where necessary. The home has a call bell system with an accessible alarm facility in every room. Each room is double-glazed and centrally heated with controls in each residents room. The home has a motorised or mechanical bath lift. Care Homes for Older People Page 18 of 25 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 have their needs met by well trained staff members who have undertaken a rigorous recruitment process to ensure people are kept safe. Evidence: In the AQAA we were advised Residents needs are met by the sufficient number of staff employed and residents are supported and protected by our robust recruitment procedures and good staff training. On the day it was clear there was adequate staff on duty to meet peoples needs. People spoken to confirmed there was always enough staff on duty in the home to meet their needs. Residents knew staff individually and it was clear staff knew residents as individuals from the banter and conversations with them. This was confirmed by statements in surveys from residents who wrote, I am always kindly treated, staff are helpful. Relatives also wrote, All the staff very caring and friendly, Staff are happy. In the AQAA we were informed, All care staff members are qualified to at least NVQ (National Vocational Qualification) Level 2 level or are being trained to achieve this. We were advised the home does not use agency staff. In the AQAA we were informed Application forms are completed containing all the Care Homes for Older People Page 19 of 25 Evidence: required information; two written references are obtained and proof of identity is checked. CRB (criminal reference bureau checks) and POVA (protection of vulnerable adults) checks are carried out and staff are not employed until the necessary checks have been completed. The staffing records of two members of staff were viewed. It was found all the necessary checks, references, application forms, evidence of personal identification had been sought before they started work in the home. Staff spoken to stated they were a very supportive group. All staff could remember the necessary checks being carried out on them before they started work. In the AQAA we were informed Staff are required to attend regular training sessions and obtain qualifications. Staff spoken to on the day felt they received good quality training at regular intervals. All felt they received the training they needed to enable them to carry out their roles efficiently. Training certificates were seen, which supported staff have regular training. It was evident a range of training methods were used including attending college, recognised trainers coming into the home and some in house training took place. Care Homes for Older People Page 20 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have confidence in the care home because it is well managed. The environment is safe for people and appropriate health and safety practices are carried out ensuring safety for people. Evidence: In the AQAA we were advised, The home is run well in the best interests of the residents whose safety is protected by the safe working practices we operate. The registered manager has completed the NVQ Level 4 qualification in management and care. She is well supported by our management team. The management structure is clear and countable. Residents, staff and visitors spoken to all had praise for the management team. It was clear they were approachable and always available. One staff member wrote, Managers always have time to listen to staff and residents equally. It was clear the home is run in the best interests of the people who live there. The home has a friendly open atmosphere. All surveys received from residents, Care Homes for Older People Page 21 of 25 Evidence: professionals and relatives praised the home and the management of the home. Relatives confirmed they were always kept in touch with developments regarding their relative and the home. We were advised the home has regular staff and service user meetings which are minuted. It was noted during the day changes had been made in the home as a result of suggestions from residents the time people got up in the morning. It was noted surveys asking for views on the home had been sent out to a range of professionals and visitors to seek their views on the home. We were advised this information is collated to look for any common themes which may need improving. We were advised the home does not become involved with any of the finances of the residents. Residents can have lockable containers in their room if they wish to lock away money or other valuables. Staff spoken to stated they received regular supervision and felt much supported by the management team. Records demonstrated staff received an annual appraisal and regular supervision. All records were signed and dated by both parties. The AQAA advised us the home has clear policies on health and safety. Regular checks are made on the equipment in the home and professionals service these. Staff reported they all have the equipment and training they need and there is always a supply of appropriate gloves and aprons. Care Homes for Older People Page 22 of 25 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 23 of 25 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 Care Homes for Older People Page 24 of 25 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 25 of 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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