Inspection on 08/07/05 for East Hill House Residential Care Home

This inspection was carried out on 8th July 2005.

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

East Hill House Residential Care... 23/08/06

East Hill House Residential Care... 13/12/05

East Hill House Residential Care... 31/01/05

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE East Hill House Residential Care Home East Hill Drive Hillbrow Road, Liss Hampshire GU33 7RR Lead Inspector Nick Morrison Unnannounced 08.07.05 10:00 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 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. East Hill House Residential Care Home H54 S61353 East Hill House V235026 080705.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service East Hill House Residential Care Home Address East Hill Drive Hillbrow Road Liss Hampshire GU33 7RR 01206 828290 01206 828291 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) East Hill (Liss) Limited Care Home 24 Category(ies) of Old Age - OP - 24 registration, with number of places East Hill House Residential Care Home H54 S61353 East Hill House V235026 080705.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 31.01.05 Brief Description of the Service: East Hill House is a large old house just on the outskirts of the village of Liss. It has been modernised to meet the requirements of the National Minimum Standards but still retains much of the old character and charm of the original house. The house is owned by Caring Homes Limited who have recently acquired it. The previous Registered Manager has now left and the company is in the process of employing a new Manager. In the menatime, the day-to-day management of the home is undertaken by the Deputy Manager with support from the Regional Manager. The home is set in three acres of landscaped gardens on a site that also includes seven cottages and a number of apartments that also house older people (referred to as The Cottages). These dwellings do not form part of the the homes registration and are not registered in their own right either. It has been common practice for staff from the home to support the people living in The Cottages with some tasks including taking them meals and assisting them at night if required. This has detracted from the support availble to people living in the main house. The Regional Manager assured the Inspector that Caring Homes had identified this anomaly and were re-organising the management of the site so that satffing in the main house would be from The Cottages. East Hill House Residential Care Home H54 S61353 East Hill House V235026 080705.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection lasted for five hours during which time the Inspector toured the premises, spoke with service users, staff, the Deputy Manager and the Regional Manager. All records referred to in the report were seen on the day of inspection. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. East Hill House Residential Care Home H54 S61353 East Hill House V235026 080705.doc Version 1.40 Page 6 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 Standards Statutory Requirements Identified During the Inspection East Hill House Residential Care Home H54 S61353 East Hill House V235026 080705.doc Version 1.40 Page 7 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 Standard 6 was not applicable to this service. Service users had their needs assessed prior to moving into the home but the quality of this could be improved with further staff training. EVIDENCE: The home has a very comprehensive initial assessment process that identifies the full range of needs for prospective service users. They include questions about service users’ hobbies and whether or not here are things they used to do that they would like to try again or things they have never tried that they would like to try. This is supplemented by a biography of the person so that staff understand their history. The assessments were complet6ed prior to admission and included a clear statement on whether or not the service would be able to meet the service user’s needs. The home has a keyworking system and encouraged Care Assistants to complete the initial assessments. While there were advantages to this system the Inspector was of the view that the Manager ought to make the decision about whether or not the service could meet the person’s needs as s/he would be responsible for the decision. Also, as different Care Assistants completed the assessments, the quality of the East Hill House Residential Care Home H54 S61353 East Hill House V235026 080705.doc Version 1.40 Page 8 assessments varied. The Regional Manager acknowledged that this was a training and development issue and she would be planning to address it. East Hill House Residential Care Home H54 S61353 East Hill House V235026 080705.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 and 10 Care Plans and practices within the home ensured that services users’ needs were met. The respect service users experience could be improved with further staff training. EVIDENCE: Individual plans were in place for all service users and set out clear methods for meeting the needs identified in the initial assessment. Staff spoken with were aware of the plans and good records were kept about the support given to service users. The healthcare needs of service users were monitored regularly and they were supported to access healthcare services as appropriate. Records were kept of each appointment and the care plans were updated in relation to these where necessary. Service users spoken with during the inspection felt that they were in control of their own health matters but had support from staff where necessary. The Inspector observed staff supporting service users on the day of inspection and was impressed with the way they interacted. They were able to demonstrate positive respect towards people living in the home. Service users spoken with felt they were treated with respect most of the time, but that this varied depending on which staff were on duty. One service user said most staff East Hill House Residential Care Home H54 S61353 East Hill House V235026 080705.doc Version 1.40 Page 10 were quite nice but others were a bit brusque. The Regional Manager was aware that the quality expected by the company was not always achieved by all the staff and was planning to address this through training. East Hill House Residential Care Home H54 S61353 East Hill House V235026 080705.doc Version 1.40 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 and 15 Service users benefit from being supported in maintaining contact with their families and friends and in receiving a varied and nutritious diet. EVIDENCE: Service users’ interests and hobbies were assessed on admission. The current range of activities in the home appeared limited and service users spoken with confirmed this. There was an Arts and Crafts session on Tuesday afternoons and various social activities were encouraged in the evenings. The home has recently appointed an Activities Coordinator who, at the time of inspection, was yet to start work. The Regional Manager felt confident that when the Coordinator starts the range of activities would improve and reflect the interests of service users. The home has positive policies in place with regard to visitors and to personal relationships of service users. Activity records and the Visitors’ Book showed that many service users have very regular contact with their families and friends. Service users spoken with confirmed that visitors were able to come to home at any time and that they often went out with their families. Service users spoken with had varying opinions on the food in the home according to their personal tastes. The menu showed a varied and nutritious diet and food was served in comfortable surroundings in the two dining rooms. On the day of inspection the Inspector observed a member of staff going around to all service users, wherever they were, and sitting down spending East Hill House Residential Care Home H54 S61353 East Hill House V235026 080705.doc Version 1.40 Page 12 time explaining what was on the menu and recording what preferences the service users had. East Hill House Residential Care Home H54 S61353 East Hill House V235026 080705.doc Version 1.40 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 Service users are confident their complaints will be listened to and are protected by the procedures and practices within the home. EVIDENCE: The home has a Complaints Procedure in place that is available to all service users in the Service User Guide and is also posted around the building. Service users spoken with were aware of the procedure for complaining and felt confident that they would receive a response. All complaints were recorded, even where someone had had the wrong filling in her sandwich, and were responded to according to the procedure. Comment cards from the Commission for Social Care Inspection were available on the table in the entrance hall for all service users and visitors to use as and when necessary. The home has adequate procedures in place for responding to instances of suspected abuse and staff spoken with were aware of these. Staff training in protecting vulnerable adults is ongoing. All service users spoken with said they felt safe within the home. East Hill House Residential Care Home H54 S61353 East Hill House V235026 080705.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 26 Service users benefit from living in a safe, clean and comfortable home. EVIDENCE: The home is very comfortable, safe and well maintained. The furnishings in the home are of very good quality and contributed to the feeling of comfort in the home. The home employs two maintenance people who attend to maintenance issues promptly. The grounds are spacious and the gardens kept very tidy. The home has won prizes for the gardens. The home has comprehensive, detailed and practical procedures in place for infection control and all areas of the home appeared very clean and tidy on the day of inspection. East Hill House Residential Care Home H54 S61353 East Hill House V235026 080705.doc Version 1.40 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 30 Service users would benefit from adequate staffing at night time and from ongoing staff training to improve the quality of the service. EVIDENCE: Some service users and their families had expressed concerns to the Inspector about the staffing arrangements in the home at night. Their concern was that there were not enough staff available and that, when ringing the bell, they had to wait a long time for assistance. One service user on one occasion had actually telephoned her daughter to come and assist her rather than have to wait for attention from staff. The home employs two members of staff at night. The problem is that those staff have been supporting people who live in the other parts of the complex (The Cottages) during the night and so have not always been immediately available to people living in the main house. This leaves the people in the main house vulnerable if they require assistance. The Inspector discussed this with the Regional Manager who assured him that, as part of the reorganisation, separate staffing arrangements would be made for The Cottages. When this is in place the Manager of the home will need to monitor whether or not two night staff is adequate for the people who live there. The staff induction programme was comprehensive and included all the information and guidance new members of staff needed. There are some staff training issues referred to elsewhere in this report, but the organisation has good training facilities and can meet the needs of staff. Systems were in place to identify training needs and the new company is aware of the need to ensure East Hill House Residential Care Home H54 S61353 East Hill House V235026 080705.doc Version 1.40 Page 16 that all staff are trained adequately in order to deliver the quality of service the company wants. East Hill House Residential Care Home H54 S61353 East Hill House V235026 080705.doc Version 1.40 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 35 and 38 Service users benefit from living in a safe environment where policies and practices protect their interests. Service users will benefit from having their views sought when the quality assurance process is fully implemented. EVIDENCE: The new owners of the home are keen to ensure that the home is run in the best interests of service users and is introducing systems to support this. They have a questionnaire for service users and also one for staff. They hope to use the information gained from these to identify areas for improvements and implement a plan to achieve those improvements. The home had adequate procedures in place to protect the financial interests of service users and most service users had families to support them with their finances. All service users spoken with were happy about their financial arrangements and did not feel at all at risk. East Hill House Residential Care Home H54 S61353 East Hill House V235026 080705.doc Version 1.40 Page 18 All accidents and incidents in the home were recorded, monitored and the information analysed. Good, clear risk assessments were in place regarding general risks, fire and risks from potentially harmful substances. Safety procedures were posted throughout the building. Staff had received training in health and safety issues and all equipment was well maintained. East Hill House Residential Care Home H54 S61353 East Hill House V235026 080705.doc Version 1.40 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 2 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 2 x 3 x x 3 East Hill House Residential Care Home H54 S61353 East Hill House V235026 080705.doc Version 1.40 Page 20 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 27 Regulation 18 Requirement Staffing arrangements for the main house must be kept from staffing support for The Cottages Timescale for action 20/9/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. Refer to Standard 3 10 27 33 Good Practice Recommendations Staff completing initial assessments should receive appropriate training Some staff should further training in demonstrating respect towards service users at all times Staffing arrangements at night should be monitored to ensure there are adequate numbers of staff for the needs of service users The companys Quality Assurance system should be fully implemented. East Hill House Residential Care Home H54 S61353 East Hill House V235026 080705.doc Version 1.40 Page 21 Commission for Social Care Inspection 4th Floor, Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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