Inspection on 12/09/05 for Hill House, Combe Raleigh

This inspection was carried out on 12th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 House, Combe Raleigh 18/06/07

Hill House, Combe Raleigh 22/09/04

Hill House, Combe Raleigh 11/05/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Hill House Combe Raleigh Honiton Devon EX14 4UQ Lead Inspector Anita Sutcliffe Unannounced Inspection 12th September 2005 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 House D54 D06 S21951 Hill House V242204 110905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Hill House Address Combe Raleigh Honiton EX14 4UQ 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) 01404 46694 01404 46694 Abbeyfield East Devon Extra Care Society Ltd Mrs Patricia Crisp CRH PC Care Home providing Personal Care 25 Category(ies) of Old age (25). registration, with number Physical disability over 65 years of age (25) of places Hill House D54 D06 S21951 Hill House V242204 110905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 6th May 2005 Brief Description of the Service: Hill House is a care home providing personal care to a maximum of 25 older people who may also have a physical disability. It is a large detached and extended property, standing in its own grounds in the village of Combe Raleigh, near the town of Honiton. Bedroom accommodation is on the ground and first floors. Each is single occupancy with en-suite W.C. and wash hand basin. There is a vertical lift and a stair lift between floors, a large sitting room and a dining room on the ground floor and a library/lounge on the first floor. There is also a dedicated hairdressing room. The home is served by local G.P and community nursing services and there is regular structured support by volunteers. Hill House D54 D06 S21951 Hill House V242204 110905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place on a Monday between 12:45 and 4:30 p.m. Prior to the inspection the home completed a CSCI information questionnaire and comments were received from service users (residents) and family representatives. During the inspection leaflets were left which contained information about the CSCI. Three residents had their care tracked. This involved meeting them, reading their care records and visiting their rooms. Many other residents were spoken with and the majority of the home was visited, including the laundry and kitchen. Staff records were examined, activities were observed and discussions held with staff. At the beginning of the inspection the person-in-charge was a senior carer and for the second part the deputy manager. Both were involved in the inspection. What the service does well: What has improved since the last inspection? What they could do better: Creams and lotions prescribed are the property of that person and must not therefore be used for another person. In this case the cream used was also out of date. To prevent newly opened creams passing their expiry date it is also recommended that the date be written on it once opened. It is the home’s responsibility to ensure that agency staff used have been fully vetted by the agency who employ them. This had lapsed. Training needs are very well met by the home, but it has not yet achieved the 50 care staff trained to NVQ level 2 by 2005. However, it is well on the way to doing so. Hill House D54 D06 S21951 Hill House V242204 110905 Stage 4.doc Version 1.40 Page 6 Residents are protected from abuse, but should staff have the need to disclose concerns outside the organisation they would have to find the whistle blowing policy in the main office. This might discourage them from doing so. It also lacks contact details for the local vulnerable adults team and the CSCI. A recent inspection by the local fire service identified some issues that need to be addressed. 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 House D54 D06 S21951 Hill House V242204 110905 Stage 4.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 House D54 D06 S21951 Hill House V242204 110905 Stage 4.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) These Standards were not inspected on this occasion. EVIDENCE: Hill House D54 D06 S21951 Hill House V242204 110905 Stage 4.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) 9 The home’s previously well managed medicines arrangements need some attention. EVIDENCE: The medication arrangements at the home were inspected at the last inspection visit and were met. However, whilst touring the building it was found that a cream prescribed for one resident was being used for another; it was also out of date. It is also good practice to put the expiry date on an ointment once opened, which had not been done. Hill House D54 D06 S21951 Hill House V242204 110905 Stage 4.doc Version 1.40 Page 10 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 Residents are supported to have fulfilled lives. They benefit from a balanced and nutritious diet. EVIDENCE: Residents described the ways in which they are supported to lead full lives, and confirmed that they make daily lifestyle choices. Staff felt that promoting independence was what they do best. Activities are varied; they include outings in the home’s minibus, a weekly shopping trolley by volunteers, and a video night. There was a visit from the donkey sanctuary during the inspection. The dining room is very attractive; the menu varied; food attractively presented. The majority of residents said that they were very happy with the food provided. Hill House D54 D06 S21951 Hill House V242204 110905 Stage 4.doc Version 1.40 Page 11 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 & 18 Residents benefit from the home’s approach to complaints and are protected from abuse. EVIDENCE: The complaints policy is displayed in the entrance and also found in the service users’ guide, provided on admission. There have been no complaints recorded at the home, and none received at the Commission. Staff are receptive to the changing needs of residents in their daily practice, thus reducing the need for complaints. Residents said they felt safe at the home. Staff showed a good understanding of how to protect the vulnerable adults in their care, and there is regular training on the prevention of abuse. The ‘whistle blowing’ policy does not contain the contact details for either the local vulnerable adults team, or the CSCI. It is kept with other policies in the office. To enable staff to use it with confidence it is best if prominently displayed. Hill House D54 D06 S21951 Hill House V242204 110905 Stage 4.doc Version 1.40 Page 12 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 &26 Residents benefit from a clean, fresh and hygienic home. Fire safety needs to be reviewed. EVIDENCE: The home is spotlessly clean, fresh and pleasant. Hygiene is maintained through staff good practice, and modern laundry equipment. A recent visit by the local fire service identified some areas of concern that need to be addressed. Standard 19 was not fully inspected on this occasion, but was met at the previous inspection. Hill House D54 D06 S21951 Hill House V242204 110905 Stage 4.doc Version 1.40 Page 13 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, 28, 29 & 30 Residents’ needs are met by staff who are properly trained and prepared for their work. Recruitment practice does not fully protect. EVIDENCE: Shortfalls in staffing numbers were met through the use of agency staff during the summer, and the deputy manager felt that this might be the reason for some comment that the home was understaffed. Staff felt that their numbers were sufficient and residents agreed that their needs were always met. Training is given a high priority at the home and many staff are taking their NVQ in care qualification. Staff appeared knowledgeable and well informed. Recruitment is robust and protects residents from people unsuitable to work with vulnerable adults. However, confirmation that staff from agencies are also vetted in this way has not been received. Hill House D54 D06 S21951 Hill House V242204 110905 Stage 4.doc Version 1.40 Page 14 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 & 38 The home is run in the best interest of residents. Health and safety are generally very well managed, but some review is needed. EVIDENCE: The approach to ensuring that a quality service is consistently provided is commendable. All stakeholders in the home are given the opportunity to make their feelings known and influence the way the home is run. This is done through the use of questionnaires, resident, family and staff meetings. The arrangements in place for handling residents’ money were examined and found to be orderly and safe. The home is very well maintained. Staff training ensures that practice is safe. Risks to residents are identified and assessed so that they may be reduced Hill House D54 D06 S21951 Hill House V242204 110905 Stage 4.doc Version 1.40 Page 15 whilst promoting independence. However, a recent fire safety inspection identified some points that need to be addressed within the near future. (See Standard 19). Hill House D54 D06 S21951 Hill House V242204 110905 Stage 4.doc Version 1.40 Page 16 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 x x x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 x x 4 x 3 x x 2 Hill House D54 D06 S21951 Hill House V242204 110905 Stage 4.doc Version 1.40 Page 17 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 OP9 Regulation 13(2) Timescale for action The registered person shall make 12th arrangements for the recording, September handling, safekeeping, safe 2005 administration and disposal of medicines received into the care home. [This refers to creams prescribed for one service user being administered to another]. 20th It must be confirmed that agency staff have been September employed only when the 2005 employer has obtained in respect of that person the information and documents specified in paragraphs 1 - 9 of Schedule 2, and has confirmed to the registered person that he has done so; and the employer is satisfied on reasonable grounds as to the authenticity of the references referred to in Schedule 2. [This refers to the homes responsibility to ensure that agency staff they use are adequately vetted]. Requirement 2. OP29 19 Hill House D54 D06 S21951 Hill House V242204 110905 Stage 4.doc Version 1.40 Page 18 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. 5. 6. Refer to Standard OP9 OP9 OP18 OP18 OP28 OP19 Good Practice Recommendations Ointments and creams should be dated with an expiry date once opened. A system should be in place to ensure that out of date ointments and creams are removed from the home. The whistle blowing policy should contain the contact details for the local vulnerable adults team and the CSCI. The whistle blowing policy should be openly displayed for staff use. A minimum ratio of 50 trained members of care staff (NVQ level 2 or equivalent) should be achieved by 2005. The building should comply with the requirements of the local fire service. Hill House D54 D06 S21951 Hill House V242204 110905 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection Suite 1, Renslade House Bonhay Road Exeter EX4 3AY 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 House D54 D06 S21951 Hill House V242204 110905 Stage 4.doc Version 1.40 Page 20 - 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!