Inspection on 14/02/07 for Hill Brow

This inspection was carried out on 14th February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 10/01/06

Hill Brow 01/09/05

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 Surrey GU10 5DB Lead Inspector Mrs J Hough Unannounced Inspection 14th February 2007 10:25 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Hill Brow DS0000012104.V324563.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Hill Brow DS0000012104.V324563.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hill Brow Address Beacon Hill Road Ewshot Farnham Surrey GU10 5DB 01252851011 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Woodlands and Hill Brow Limited Elizabeth Ann Butt Care Home 32 Category(ies) of Dementia - over 65 years of age (2), Old age, registration, with number not falling within any other category (32) of places Hill Brow DS0000012104.V324563.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th January 2006 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 dementia. 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 relatives 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 DS0000012104.V324563.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The key unannounced inspection was undertaken by June Hough on 14th February 2007 from 10:25am to 4pm. Information and planning for the inspection process was taken from the preinspection questionnaire completed by the registered person, evidence from previous inspections and resident’s surveys. Further evidence for this inspection report was gained during the inspection visit. During the inspection a tour of the premises was made, and residents, staff and visitors were spoken with. Records were examined in relation to resident’s care plans and assessments, staff records, activities, complaints and accidents. The registered manager was not present at the inspection and the proprietor Alison Lee and the deputy manager Helen Osborne provided the information required. Current fees are from £400.00 to £650.00 per week. What the service does well: The home is situated in pleasant surroundings and offers residents a homely, comfortable and safe environment in which to live. The garden is kept neat and tidy and is accessible to residents. The home is furnished and decorated to a high standard and residents can furnish their rooms with small items of furniture and personal possessions of their choice. The home offers a variety of activities that include in house activities and outings are arranged every two weeks. Hill Brow DS0000012104.V324563.R01.S.doc Version 5.2 Page 6 The staff team is competent and experienced to provide the residents with a good standard of care and many members of the staff have worked in the home for several years. Staff individually and collectively showed enthusiasm and dedication to their work. Feedback on resident’s surveys was positive and comments about staff said they were most kind and attentive and nothing was too much trouble. Training for staff takes high priority and the home benefits from having some members of staff qualified as trainers in certain aspects of care, so that much of the training is provided in house. Visiting arrangements for the home are flexible and visitors said that staff always make them welcome. The home is run in the best interests of the residents. Residents are able to express their views in several ways, either at resident’s meetings, on surveys sent out every six months or during daily contact with the manager. What has improved since the last inspection? What they could do better: No requirements have been made. Hill Brow DS0000012104.V324563.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Hill Brow DS0000012104.V324563.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hill Brow DS0000012104.V324563.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All residents have a detailed needs assessment carried out by the registered manager or proprietor prior to moving into the home, to ensure the home is able to meet their individual needs. Assessments are either carried out when the resident visits the home or the registered manager or proprietor will arrange to visit the prospective resident. The home does not provide intermediate care. EVIDENCE: A detailed needs assessment is carried out on all prospective residents to ensure the home is able to meet individual needs. Hill Brow DS0000012104.V324563.R01.S.doc Version 5.2 Page 10 The registered manager or proprietor carry out the assessments and visit the prospective resident when needed. Prospective residents are encouraged to visit the home when it may be agreed to carry out the needs assessment during this visit. The home is in the process of changing and upgrading the documentation used for assessing the needs of residents. Resident’s surveys sent prior to the inspection showed that residents are provided with detailed information about the home so that they are able to make a decision as to whether the home is right for them. Hill Brow DS0000012104.V324563.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s needs are set out in individual care plans that give clear direction to staff on the level of assistance needed. Residents confirmed they received the care and support needed. Medication policies and procedures are in place and staff are trained in the safe administration, disposal and storage of medicines to ensure residents are protected from harm. Resident’s privacy and dignity is highly regarded by staff. EVIDENCE: Hill Brow DS0000012104.V324563.R01.S.doc Version 5.2 Page 12 Resident’s care plans seen were detailed and gave clear direction to staff on the level of assistance needed, and what residents can do for themselves. Care plans are typed and showed evidence that they are reviewed monthly with residents. Care plans examined did not take into account the emotional needs of the residents. This was discussed with the proprietor who explained that the home is developing new formats for assessments and care plans and the emotional needs of residents is included in the new documentation. Risk assessments are completed and a senior care assistant responsibility for monitoring residents who have frequent falls. This can involve checking equipment and aids used, looking at the times of day accidents tend to happen and putting the necessary actions in place to reduce risks. Advice is also taken from the physiotherapist who visits the home weekly. Residents choose their own GP and access to health services is provided when needed. Specialist nurses and other health professionals’ visit the home to give advice and support when requested. The medication administration records are clear and well maintained. The senior care staff administer the medicines, and have undergone training in the safe handling, administration and storage of medicines. Medicines are supplied in blister packs, and a list of specimen signatures of staff that administer medicines was available on file. Records maintained on Controlled Drugs were accurate. All medicines for disposal are recorded in a book and signed by the senior care assistant. Medicines taken only as required are recorded on the medicine administration records and on a pain chart that monitor the effects of the medication. Any concerns with regard to medicines are referred immediately to the GP. One resident is able to self-medicate and has a lockable box for storing the medicines. A risk assessment is in place for this and signed by the resident. Staff spoken with understood the importance of maintaining the privacy and dignity of residents and confirmed that personal care is provided in private at all times. Residents spoken with and feedback given on surveys showed that staff are kind and caring and always treat them with respect. Hill Brow DS0000012104.V324563.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A wide range of activities is offered by the home that suits the interests and needs of the residents. Residents choose what they would like to do. Residents are offered a nutritious diet and menus are reviewed monthly to increase variety of food on offer. Resident’s likes and dislikes in food are taken into account when planning menus. Resident’s views on the quality of the food varied. EVIDENCE: The home provides a varied programme of activities for residents that include in house activities run by staff, visiting entertainers and outings. In house activities are arranged daily, and on some days twice a day. Outings are arranged every two weeks when the home hires a mini bus. Residents have a say in what they would like to do and the home arranges activities accordingly. Hill Brow DS0000012104.V324563.R01.S.doc Version 5.2 Page 14 On the day of the inspection an art class took place in the morning and a game of bingo in the afternoon. The home has an open visiting policy and visitors spoken with said they are made welcome anytime, but are asked to avoid mealtimes wherever possible. The menus show a variety of nutritious food is provided. Alternatives are provided on request and menus are developed taking into account resident’s likes and dislikes in food. The home employs a full time cook and the managerial staff do the cooking on Saturdays. Food temperatures are recorded daily and a daily record is kept of the food eaten by residents. The lunch on the day of the inspection was pork chops and applesauce, swede, savoy cabbage and potatoes. Pudding was tinned peaches and cream. Comments about the food were mixed, as some residents liked the food, others said it was okay, one resident thought the food was cooked badly where another felt it was well cooked. Menus are planned for four weeks but are reviewed monthly with residents, to allow for any necessary changes. Special diets are catered for and the home consults with a dietician when needed, who also provides training for staff on nutrition. The dining area is light and airy and is a pleasant environment for residents to eat. Meals are served in the dining area or in resident’s rooms if preferred. Residents are regularly consulted about their views on the home and the services it provides. Residents can express their views at the resident’s meetings, on the surveys sent out every six months and on a daily basis with the registered manager. Hill Brow DS0000012104.V324563.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a complaints procedure in place that is displayed in the home. Residents feel able to speak with the management on any matters of concern. Policies and procedures are in place with regard to abuse to protect residents from harm. Staff understand their individual responsibilities in reporting any untoward incidents. EVIDENCE: The home has a clear complaints procedure that is displayed in the entrance hallway of the home. All complaints are recorded in a book and the home had received one complaint since the last inspection in January 2006 that was satisfactorily resolved. Complaints are recorded giving the nature of the complaint, investigations, actions and outcomes Hill Brow DS0000012104.V324563.R01.S.doc Version 5.2 Page 16 Residents spoken to said they had no reason to complain but would not hesitate to speak with the manager or proprietor should the need arise. Policies and procedures are in place for the Protection of Vulnerable Adults. Staff training records show that staff have updated training in the Protection of Vulnerable Adults. Staff spoken with said they would immediately report any suspicions, allegations or incidents of abuse to management. Hill Brow DS0000012104.V324563.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home provides a comfortable and pleasant environment for residents. Residents can furnish their rooms with personal possessions of their choice. Residents live in a bright, clean and hygienic environment at all times. EVIDENCE: The home was fresh and clean throughout and furnishings and décor were good. Residents said the bedrooms were cleaned daily and had no concerns about the cleanliness of the home. The home has a homely and relaxed atmosphere. The home is situated in pleasant surroundings with a large garden that is accessible to residents. Residents are able to furnish their rooms with small item of furniture and personal possessions of their choice. Hill Brow DS0000012104.V324563.R01.S.doc Version 5.2 Page 18 Three spare rooms are in the process of being decorated and new carpets fitted. The home has ample communal space for residents with two lounges, dining area and a conservatory. The office has been refurbished with new furniture, carpets and blinds. The inspector was informed that there are future plans to upgrade the bath in the assisted bathroom. The home has an on going maintenance plan in place and areas of the home are decorated when needed. Following discussions with residents it was agreed to purchase a tropical fish tank to go in the lounge. Residents spoken with said they got a lot of pleasure from watching the fish. The laundry offers suitable washing facilities for the number of residents living in the home. Staff are trained in health and safety and infection control. Hill Brow DS0000012104.V324563.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Staff are employed in sufficient numbers to meet the needs of residents. Many of the care staff have worked in the home for several years. The home provides a comprehensive induction training programme for staff that ensures staff are competent and experienced to provide the residents with a good standard of care. The recruitment procedures and practices in the home ensure residents are protected from harm. EVIDENCE: The home employs a total of fifteen care staff with three ancillary staff. The home has a stable team of staff as many have worked in the home for several years. Hill Brow DS0000012104.V324563.R01.S.doc Version 5.2 Page 20 Staff rotas show that there is a minimum of four care staff working in the mornings, three in the afternoon and two at night. However, there are several days when this number is increased. The home has no staff vacancies at present and so the use of agency staff is not necessary. Residents felt the staffing numbers were good and said staff are always around when you want them. Eight care staff have achieved the National Vocational Qualifications and four care staff are trained as assessors. Two staff files were examined to check recruitment procedures. Both files contained the necessary documentation and proof that the relevant checks are carried on staff prior to working in the home. The home has a comprehensive induction-training programme that includes the Skills for Care workbooks for staff to complete. New staff work under supervision that is structured to suit individual needs. Hill Brow DS0000012104.V324563.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home seeks the views of residents and makes decisions based on the feedback received. The home is managed and well run by an experienced and qualified manager. All safety checks are carried out within the home on a regular basis and equipment and systems are well maintained. The home has a comprehensive training programme for staff to ensure staff are competent and experienced for their work. EVIDENCE: Hill Brow DS0000012104.V324563.R01.S.doc Version 5.2 Page 22 The current registered manager has been in post since 2003. She has achieved the National Vocational Qualification (NVQ) at level 4 in management. Both residents and staff said she ran the home well and was very approachable and felt they were included in any decision making within the home. The home is keen to gain the views of service users and relatives on the service it provides. Residents have daily contact with the registered manager and the proprietor of the home works closely with staff and has regular contact with residents. Surveys are sent to residents, relatives and other health professionals every six months and feedback received is acted upon as necessary. The results of surveys are published and placed in the Service User Guide for reference. Resident’s meetings are also held every six months. Procedures for safeguarding resident’s financial interests are in place. The home only handles small amounts of spending money for residents and all transactions are recorded and signed by two persons. The home has a comprehensive training programme and senior members of staff and the proprietor are qualified to provide aspects of the training for staff. Training records show that food hygiene, first aid, infection control, health and safety, fire, medication, manual handling and dementia training has been provided in the last twelve months. Future training planned is stroke awareness, continence, diabetes and insulin, nutrition, medication and care of the dying. Staff training needs are monitored and discussed through formal staff supervision and annual appraisals. The pre-inspection questionnaire shows that all equipment and systems within the home are serviced and well maintained. Risks assessments are in place for a safe working environment. The home employs a maintenance person who carries out in house checks that are carried out at weekly and monthly intervals. Maintenance work is on going in the home. Accidents, injuries and incidents are recorded and reported to the appropriate authorities. The accident book was examined and there have been two accidents since the last inspection in January 2006 that resulted in any injury that resulted in the resident going to hospital. Hill Brow DS0000012104.V324563.R01.S.doc Version 5.2 Page 23 Hill Brow DS0000012104.V324563.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 3 STAFFING Standard No Score 27 4 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 4 X 3 3 X 3 Hill Brow DS0000012104.V324563.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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 OP15 Good Practice Recommendations Negative comments about the food should be addressed. Hill Brow DS0000012104.V324563.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Hill Brow DS0000012104.V324563.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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