Inspection on 22/07/05 for High Hilden

This inspection was carried out on 22nd 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

High Hilden 17/09/08

High Hilden 10/10/06

High Hilden 09/11/05

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE High Hilden Limited High Hilden Close Tonbridge Kent TN10 3DD Lead Inspector Eamonn Kelly Announced 22 July 2005 11:00am 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. High Hilden Limited H56-H06 S64651 High Hilden Ltd V229937 220705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service High Hilden Limited Address High Hilden Close Tonbridge Kent TN10 3DD 01732 353070 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) High Hilden Limited Mrs Carol Tincombe Care Home 40 Category(ies) of Old Age (40) registration, with number of places High Hilden Limited H56-H06 S64651 High Hilden Ltd V229937 220705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: High Hilden has operated as a residential home for 60 years. It is registered with the Charities Commission (Registered No: 208544) and its articles of association states that the home’s land and buildings are vested with the Official Custodian of Charities. A Board of Trustees consisting of a chairman and 7 other members governs the home. The trustees provide their services on a voluntary and unpaid basis. Whilst the home is registered for the care of up to 40 older people, it only offers shared accommodation in specific instances and all current service users are accommodated in single bedrooms. There are 2 shaft lifts. Twenty-four hour care is provided. The 2nd floor of the premises comprises a meeting room, office facilities, an activities room, hairdressing room, staff room, storage facilities, a visitor’s suite and other facilities. Extensive gardens surround the house. The premises are about 1 mile from Tonbridge town centre and the train station. A bus stop is situated at the bottom of High Hilden Close. High Hilden Limited H56-H06 S64651 High Hilden Ltd V229937 220705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit comprised a review of some of the home’s records and policy statements, meeting some service users and members of staff, and visiting parts of the premises. Some visitors were also met: they gave their views of how their relatives were cared for at the home. The report uses information provided in a pre-inspection questionnaire submitted by the manager. In addition, a number of quality assurance questionnaires were returned from service users: these were used in conjunction with the homes own quality assurance surveys. Use was also made of the home’s selfassessment record submitted to the Commission. What the service does well: What has improved since the last inspection? The fire safety risk assessment has been kept up-to-date (with the assistance of a safety consultant). Care plan records seen as part of “case tracking” have been improved with the addition of clear daily records for each service user. Additional management training has been arranged (NVQ Level 4) for supervisory staff. The quality assurance process has been extended. Internal re-decoration and refurbishment has been commenced and is continuing (ground floor bathroom and 2 other bathrooms, additional concrete ramp to garden, repainting and decoration of some corridor areas). High Hilden Limited H56-H06 S64651 High Hilden Ltd V229937 220705 Stage 4.doc Version 1.30 Page 6 Systems and procedures have been re-evaluated (as part of quality assurance measures). 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. High Hilden Limited H56-H06 S64651 High Hilden Ltd V229937 220705 Stage 4.doc Version 1.30 Page 7 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 High Hilden Limited H56-H06 S64651 High Hilden Ltd V229937 220705 Stage 4.doc Version 1.30 Page 8 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) 1, 2, 3 and 6 Prospective service users and their supporters have the benefit of obtaining sufficient information and other support at an early stage. EVIDENCE: Potential service users and their families have access to sufficient written information prior to making a decision on taking up residence. This is supported by other assistance offered by the home [a full assessment is carried out prior to all admissions to determine if suitable levels of care can be provided. Prospective service users are invited to visit, to have one or more meals, to stay overnight and to meet staff and other service users. Visitors have the opportunity to stay overnight in a purpose built suite on the 2nd floor. A copy of a service user’s guide is provided]. A copy of a personal contract is given to all service users whether local authority or privately funded. The service is for longer-term care only. Respite care is provided. High Hilden Limited H56-H06 S64651 High Hilden Ltd V229937 220705 Stage 4.doc Version 1.30 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, 9, 10 Service user’s health and personal needs (which are carefully set out in care plan records) are met by the home. EVIDENCE: High Hilden Limited H56-H06 S64651 High Hilden Ltd V229937 220705 Stage 4.doc Version 1.30 Page 10 District nurses and GP’s have the use of a treatment room on the ground floor for consultation but service users also receive their medical consultations in their bedrooms if they wish. Some service users have incontinence problems, hearing/visual impairments and/or need help with toileting and dressing. None generally need to be helped by more than one member of staff. All need and receive help with washing/bathing. All service users, records indicated, have ready access to a GP, district nurse, optician, dentist and chiropodist. Service user’s key-workers are generally responsible for ensuring the accuracy of information in care plan records. Individual care plan records are begun at pre-admission assessment stage. The daily record information is kept up-todate in an innovative way. MAR (medication administration record) sheets seen were up-to-date. The medication trolley is locked in the treatment room when not in use. Service users who keep their own medication do so within an agreed risk management procedure. Accredited training in administration of medication for members of staff has been provided. There were a number of examples discussed and situations observed which indicated that service users were treated with respect. High Hilden Limited H56-H06 S64651 High Hilden Ltd V229937 220705 Stage 4.doc Version 1.30 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, 14 & 15 Service users benefit from the availability and provision of meals that offer choice and variety and cater for special diets. Service users are able to exercise control over their lives and they have a commendable range of activities and opportunities for physical and mental stimulation. EVIDENCE: A number of visitors were met during the inspection visit: they referred to the range of activities available (including going on individual outings) to their relatives/friends at the home. An activities organiser assists members of staff to identify and provide leisure facilities for service users. An accommodation suite for visitors is available on the second floor. A modern hairdressing salon is also situated there. Visitors are welcome at any reasonable time (including by arrangement for overnight stays). Service users were making use of extensive indoor and outdoor facilities on the day of the inspection visit. A number of service users gave details of how they spend their time at the home. The information served to positively corroborate the claims in respect to leisure activities and maintenance of lifestyles as made in pre-admission documents. High Hilden Limited H56-H06 S64651 High Hilden Ltd V229937 220705 Stage 4.doc Version 1.30 Page 12 Service users are helped where necessary to obtain an independent advocate to help them handle their legal or financial affairs. Service users may bring personal possessions with them, the extent of which is agreed and recorded prior to admission. A number of service users were met at both dining rooms. They have their meals in comfortable and congenial settings. There was evidence that considerable thought goes into providing good meals with varied menus (ie. by using responses from service users via surveys, taking note and acting upon concerns expressed, ensuring that the standard of food does not fluctuate at weekends). Service users are encouraged generally to have their meals in a dining room which is one way members of staff encourage service users to keep active and meet with others. High Hilden Limited H56-H06 S64651 High Hilden Ltd V229937 220705 Stage 4.doc Version 1.30 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 The home has suitable measures in place to protect service users. Service users benefit by being enabled to express their views. EVIDENCE: The home has a complaints procedure (with a précis prominently displayed and included in pre-admission documents). Members of staff receive training in dealing with Adult Protection situations. All members of staff have been checked under appropriate recruitment procedures now in force nationally (ie. references, application form, CRB/POVA check, probation, induction training, supervision). The home follows the Kent & Medway Policy for Adult Protection. Service users are confident in expressing their views to members of staff, visitors and day centre staff (in person and via the home’s (and CSCI) quality assurance measures). The home has procedures in place for listening to the views of service users and their supporters and for taking expressed views into consideration. High Hilden Limited H56-H06 S64651 High Hilden Ltd V229937 220705 Stage 4.doc Version 1.30 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, 20, 21, 23, 24, 25 & 26 The premises are suitable for the needs of service users who benefit from very good lounge and dining room facilities, bedrooms and extensive external facilities. EVIDENCE: The premises were safe and comfortable. Extensive facilities are available for staff, service users and visitors on the 2nd floor. Service users have access to comfortable indoor and outdoor facilities. There are 5 dayroom areas available to service users and visitors. Five bedrooms have an en-suite facility. There are good bathroom facilities: 12 WC’s, 6 bathrooms and 3 shower units. The home has a commode washing/disinfecting machine and a macerator. There are 3 bath-hoists and 2 portable hoists. All bedrooms and communal areas are equipped with call alarms. The home has 2 shaft lifts to accommodate access to opposite sides of the premises. The laundry room is High Hilden Limited H56-H06 S64651 High Hilden Ltd V229937 220705 Stage 4.doc Version 1.30 Page 15 well equipped. Concrete ramps links the premises with extensive surrounding gardens. All service users have single bedrooms. Provision could be made for a couple requesting to share a bedroom. All bedrooms seen were well furnished with service user’s possessions displayed. Redecorations are carried out constantly and a planned maintenance schedule was seen. The premises are kept clean, hygienic and free from persistent offensive odours. High Hilden Limited H56-H06 S64651 High Hilden Ltd V229937 220705 Stage 4.doc Version 1.30 Page 16 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) x These Standards were not assessed in detail on this occasion. EVIDENCE: High Hilden Limited H56-H06 S64651 High Hilden Ltd V229937 220705 Stage 4.doc Version 1.30 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) 31, 32, 33, 36 and 38. Service users benefit from a well managed home achieved through the personal experience and leadership of the manager and trustees [and good team working by an established core of experienced staff]. Procedures in place for maintaining high standards of health and safety are commendable. EVIDENCE: High Hilden Limited H56-H06 S64651 High Hilden Ltd V229937 220705 Stage 4.doc Version 1.30 Page 18 The manager has completed the Registered Manager’s Award. The organisation chart showed that an assistant manager and 2 senior carers assist in the management and supervision process. Decisions relating to the running of the home are taken at Trustees’ monthly meetings. Trustees also undertake unannounced monthly visits and produce a report following such visits. It was clear that there is an open and positive atmosphere at the home. Discussion with members of staff and service users confirmed there is an atmosphere that enabled service users to feel secure and confident. Meetings with visitors confirmed this opinion. Service user/staff meetings are held: copies of minutes were seen (these are made available to service users and relatives/friends). Copies of comments received from service users and relatives indicated that there is consideration of expressed views by staff in order to improve the standard of service. Independent CSCI “comment” card feedback was also received by the Commission. Examples of specific service user comments were discussed as were how this information is given positive consideration. Procedures are in place to ensure as far as practicable the health, safety and welfare of service users, visitors and members of staff. A health and safety committee meets quarterly to assess the effectiveness of current risk assessment, fire safety measures, training requirements, individual room checks and night-time procedures. The extent of risk assessment carried out relating to premises and procedures and to each individual is comprehensive. Evidence indicating that monthly supervision (with outcomes recorded) is part of the home’s personnel function was seen. The manager made a declaration in the pre-inspection questionnaire in respect of safety certificates and associated records. Those checked on this occasion were up-to-date and satisfactory. High Hilden Limited H56-H06 S64651 High Hilden Ltd V229937 220705 Stage 4.doc Version 1.30 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 3 3 3 x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 3 15 3 COMPLAINTS AND PROTECTION 4 4 3 x 3 3 3 4 STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 3 3 x x 3 x 4 High Hilden Limited H56-H06 S64651 High Hilden Ltd V229937 220705 Stage 4.doc Version 1.30 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 Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations High Hilden Limited H56-H06 S64651 High Hilden Ltd V229937 220705 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection The Oast Hermitage Court Hermitage Lane Maidstone Kent ME16 9NT 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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