Inspection on 01/09/05 for Hill Brow

This inspection was carried out on 1st September 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

Hill Brow 21/01/09

Hill Brow 14/02/07

Hill Brow 10/01/06

Hill Brow 04/02/05

Hill Brow 24/11/04

Hill Brow 03/02/04

Hill Brow 16/09/02

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 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Hill Brow Beacon Hill Road Ewshot Farnham GU10 5DB Lead Inspector Liz Palmer Unnannounced 01.09.05 10:00am 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. Hill Brow H54 S12104 Hill Brow V246773 010905.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Hill Brow Address Beacon Hill Road Ewshot Farnham Surrey GU10 5DB 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) Woodlands and Hill Brow Limited Elizabeth Ann Butt Care Home 32 Category(ies) of Dementia, over 65 - DE(E) - 2 registration, with number Old Age - OP - 32 of places Hill Brow H54 S12104 Hill Brow V246773 010905.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 04.02.05 Brief Description of the Service: Hillbrow provides accommodation for up to 32 people who are within the category of older people, some of whom may have demenetia. The home aims to provide a homely and relaxed environment for service users. The home is owned and operated by Woodlands and Hill Brow Ltd a family business who also have a second home in the area. Staffing is provided twenty-four hours a day. Visitors are welcome and service users families are encouraged to play an active part in their relative’s life where appropriate. The home has wellestablished links with local General Practitioners and nursing services to support and enhance the care provided. The home is situated between the towns of Farnham and Fleet and is set within its own grounds. Accommodation is provided on two floors. Hill Brow H54 S12104 Hill Brow V246773 010905.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over four hours and was assisted by the registered manager and deputy. During the inspection three care staff were interviewed, three residents were met and spoken with, care plans, assessments and other paperwork was inspected and a partial tour of the premises was taken. A preinspection questionnaire was returned by the home and eighteen residents returned comment cards as did six relatives and one district nurse. Comments overall showed satisfaction in the care of the home. Seven residents stated they only liked the food ‘sometimes’ What the service does well: What has improved since the last inspection? New assessment forms have been introduced which will help to ensure that prospective residents needs can be met in the home. Care plans have also improved and are being typed rather than hand written making them tidier and easier to read. A box has been added for residents or their representatives to sign to say they agree with any changes. The manager has recently been on a falls risk management course and has introduced a new risk management plan. This is reducing the amount of falls for some residents. Hill Brow H54 S12104 Hill Brow V246773 010905.doc Version 1.40 Page 6 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. Hill Brow H54 S12104 Hill Brow V246773 010905.doc Version 1.40 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 Hill Brow H54 S12104 Hill Brow V246773 010905.doc Version 1.40 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) 3. Standard 6 does not apply. The new arrangements for assessments enable the home to be clear that prospective residents’ needs can be met in the home. EVIDENCE: Two new residents have moved to the home since the last inspection. Suitable assessments were undertaken to ensure that the home could meet their needs. Assessments are carried out by the proprietor or the registered manager. Both of the new residents were spoken to and said they feel their needs can be met by the home. Hill Brow H54 S12104 Hill Brow V246773 010905.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 The arrangements for care planning, ensures that residents’ needs are met in a consistent way. Arrangements for personal and health care promotes the well being of residents and upholds their dignity. EVIDENCE: Care plans detail each individuals care needs and the things that they can do independently. Any health issues are noted and care plans are reviewed on a monthly basis. The new care plans are now typed rather than written and are being reviewed monthly with the resident or their representative. Care plans also include details of social interests, for example what newspaper someone prefers and what hobbies and activities they enjoy. Each resident is registered with a local General Practitioner (GP) and those asked said they could ask staff if they needed to see a GP and felt confident in the staff to be aware of their health needs. One resident said staff always respond quickly to their requests to see a GP. District nurses and other health professionals support the home to safeguard the mental and physical health Hill Brow H54 S12104 Hill Brow V246773 010905.doc Version 1.40 Page 10 needs of the residents. A comment card returned by one district nurse stated they are satisfied with the overall care in the home and is kept informed of any medical/nursing needs of residents. All residents have call bells and those asked said they are responded to quickly. Suitable risk assessments are in place, for example, for residents who have who are at risk of falling. These residents benefit from the new falls risk management plan which identifies reasons for falls and a plan to reduce them is put into place. This has proven to be successful in reducing the number of falls. Residents spoken to said that staff always treat them with respect and dignity and are always patient. Each individual care plan states the personal care needed. Staff spoken to could say how they maintained privacy and dignity whilst offering personal care. Hill Brow H54 S12104 Hill Brow V246773 010905.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 The range of activities offered by the home promotes residents’ mental and physical well being. Arrangements for visitors ensures relatives and friends are free to visit the home. Improvements to the meal planning would enable residents to have more food of their choice cooked in a way they prefer. EVIDENCE: Regular activities offered by the home include, armchair exercises, bingo, an art class, scrabble, skittles, nail care and a visiting hairdresser. Residents spoken to said they had enough to do on a daily basis and also enjoy the trips out for a pub lunch and things like the recent garden party. Comments cards reflected satisfaction with the activities offered. Some residents like to go for walks or just and sit in the garden. Holy communion can be taken in the home and taxis are provided for those wishing to attend a church or other religious service of their choice. Four residents attend a local seniors club each week others get taxis to the local shops and two have their own car and arrange their own leisure pursuits. The menus show a variety of healthy food is provided. Alternatives are provided on request and a record is kept of who had what. Hill Brow H54 S12104 Hill Brow V246773 010905.doc Version 1.40 Page 12 Some comments from residents spoken too and from comment cards suggest that they are sometimes unhappy with the food in the home. The manager stated that residents are encouraged to voice their opinions about the food and any requests or complaints are acted upon. An alternative choice of main meal can be arranged on request but is not shown on the menu. There is a likes and dislikes board in the kitchen and staff know who likes what. Offering an alternative on the menu has been tried in the past and has not worked. Some of the comments made were about how the food is cooked and a recommendation to address this has been made. Hill Brow H54 S12104 Hill Brow V246773 010905.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 The arrangements for complaints allows residents to make their views known and have then responded to. Policies and procedures are in place in the home to protect residents from abuse. EVIDENCE: There is a complaints procedure available to residents and their families/representatives. Residents spoken to said they would discuss any concerns or complaints with the staff or the provider, Mrs Lee. One resident said any small issues had been dealt with by the home and she felt confident in staff to sort out complaints or concerns. The home has various literature on adult protection including the Hampshire County Council policy. An abuse awareness training day was recently held and all staff attended. Arrangements are looking after residents monies are in place. Residents can ask for their money whenever they want and the amount s signed out by the staff member and the resident. Hill Brow H54 S12104 Hill Brow V246773 010905.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 The home provides a comfortable and pleasant environment for residents. The cleaning routine for the home ensures residents enjoy a bright, clean, and hygienic environment at all times EVIDENCE: The home employs a handy man and residents commented that they can ask for pictures to be put up and minor repairs to be done and these requests are responded to promptly. Bedrooms are cleaned daily with a more thorough clean done once a week. There is a cleaning checklist to ensure this takes place. Residents spoken to said they were happy with the cleaning arrangements. All staff re trained in food hygiene, health and safety and infection control. Relevant policies are also in place. Hill Brow H54 S12104 Hill Brow V246773 010905.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 Staff are employed in sufficient numbers to meet the needs of residents. Appropriate training is provided to ensure staff are qualified in understanding and meeting the needs of residents. EVIDENCE: The home employs a total of twenty staff. Rotas show that generally, during the week six staff work the morning shift, three work the afternoon and two wok at night. At weekends four work the morning shift. Four of the staff are National Vocational Qualification (NVQ) assessors, two staff are currently doing NVQ 2 and three are doing NVQ 3. The home has a comprehensive training programme which includes, for example, medication, falls risk management, dementia, fire safety and first aid. Staff spoken to said they thought the training was good and appreciated the support they got during their NVQs. Staff were also able to demonstrate their competency and confidence to carry out their roles. Hill Brow H54 S12104 Hill Brow V246773 010905.doc Version 1.40 Page 16 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 and 38 The home aims to seek the views of residents and makes decisions based on the information received. All safety checks are completed on a regular basis to promote the safety of residents and staff. EVIDENCE: Residents meetings are held every six months and a survey is also carried out six monthly, in between the residents’ meetings. Views of residents are therefore sought on a three monthly basis. The proprietor, Mrs Lee also visits every two weeks to do a quality audit on the cleanliness of the home. She also carries out monthly regulation 26 visits. All residents’ comment cards reflected that residents do not wish to be any more involved in the running of the home. Hill Brow H54 S12104 Hill Brow V246773 010905.doc Version 1.40 Page 17 Regular testing of fire equipment is carried out. Staff receive fire training every three months and night staff receive one to one training from the deputy. Staff receive manual handling, infection control and first aid training. Aprons and gloves are worn and relevant safety notices are posted around the home. Hill Brow H54 S12104 Hill Brow V246773 010905.doc Version 1.40 Page 18 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 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 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 3 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 3 x x x x 3 Hill Brow H54 S12104 Hill Brow V246773 010905.doc Version 1.40 Page 19 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 15 Good Practice Recommendations Negative comments about the food should be addressed. Hill Brow H54 S12104 Hill Brow V246773 010905.doc Version 1.40 Page 20 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. Extracts may not be used or reproduced without the express permission of CSCI Hill Brow H54 S12104 Hill Brow V246773 010905.doc Version 1.40 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!