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Inspection on 12/07/06 for Hill Top Care Home

Also see our care home review for Hill Top Care Home for more information

This inspection was carried out on 12th July 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The manager ensures that a detailed assessment of need is completed prior to admission to the home and from this develops care plans to meet any needs highlighted. Input from other professionals is sought as necessary. Relatives and friends are made to feel welcome and visit the home without restriction. Medication is administered by staff trained to do so and is stored and recorded appropriately. Staff work well with residents offering choice where possible and ensuring that they have everything they need. Complaints are dealt with in a timely fashion and are recorded appropriately. Hilltop is a clean home. The manager ensures that sufficient staff are on duty at all times, staff clearly have positive relationships with residents. There is a rigorous recruitment procedure in place. The home is manager by a suitably qualified nurse who provides support to staff and residents.

What has improved since the last inspection?

All residents have their needs and wishes in the event of terminal illness or death documented on admission to the home.

What the care home could do better:

The manager should ensure that the complainant has the opportunity to sign the complaints form at the end of the complaint to ensure that the response is satisfactory. All staff must have up to date training in Adult Protection. Window restrictors are needed on the windows highlighted at the inspection. Suitable storage space needs to be provided as currently equipment is stored in a variety of communal areas.

CARE HOMES FOR OLDER PEOPLE Hill Top Care Home Colliery Road Church Gresley Swadlincote Derbyshire DE11 9LU Lead Inspector Vanessa Davies Unannounced Inspection 12th July 2006 10:00 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 Top Care Home DS0000067538.V304965.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 Top Care Home DS0000067538.V304965.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hill Top Care Home Address Colliery Road Church Gresley Swadlincote Derbyshire DE11 9LU 01283 550354 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) Mrs Judith Dena Griffin Stewart Westley Barker Audrey Phyllis Ramsell Care Home 23 Category(ies) of Old age, not falling within any other category registration, with number (23), Physical disability over 65 years of age (2) of places Hill Top Care Home DS0000067538.V304965.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 23 places for OP. 3 places for younger people PD aged 50 and over, either sex, included in the above total. 1 day care place. Total Registration not to exceed 23 places. Date of last inspection 13th February 2006 Brief Description of the Service: Hill Top Care Home Limited is a 23 bedded home, providing nursing and personal care to persons aged 65 years and over, including 2 places for people aged 50 years and over with physical disabilities. The home is a purpose built, single storey building, located in Church Gresley, and close to local shops and a bus route. The home has 21 single rooms and 1 shared room. Service users have access to two lounge areas and a separate dining room. Hill Top Care Home DS0000067538.V304965.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Information for this report was gathered from various documentation, speaking with staff, residents and the manager and observing staff working with residents on the day of the visit. What the service does well: What has improved since the last inspection? All residents have their needs and wishes in the event of terminal illness or death documented on admission to the home. Hill Top Care Home DS0000067538.V304965.R01.S.doc Version 5.2 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 Top Care Home DS0000067538.V304965.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Hill Top Care Home DS0000067538.V304965.R01.S.doc Version 5.2 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 the following standard(s): 3,6 Quality in this outcome area is good. Detailed assessments of need ensure that staff are given the information to ensure that the needs of the residents are met. This outcome has been made from evidence gathered before and during the visit to the service EVIDENCE: 3 residents files were examined on the day of the visit. Each file had a completed assessment of need, a nursing assessment tool and a completed continence assessment. From these detailed assessments the manager has implemented care plans to address the needs highlighted. It was evident within all files examined that the family or the residents had input with the preparation of the assessments and the care plans. All care plans were reviewed on a regular basis. The home does not offer intermediate care. Hill Top Care Home DS0000067538.V304965.R01.S.doc Version 5.2 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 the following standard(s): 7,8,9,10 Quality in this outcome area is good. Detailed assessments, input from other relevant professionals and contact with families and friends ensures that the health and social needs of the residents are met. This outcome has been made from evidence gathered before and during the visit to the service EVIDENCE: The health needs of the residents are highlighted in a variety of assessments. There was evidence of input from a range of other professionals; optician, GP, dentist and speech & language therapist. Dietary needs are assessed as are continence needs. It was evident that health needs of the residents are met. The manager tries to arrange activities suitable to meet the complex needs of the residents. Relatives and friends visit without restriction. Medication is stored appropriately. All medication received and administered at the home is documented accordingly. Medication is administered by staff Hill Top Care Home DS0000067538.V304965.R01.S.doc Version 5.2 Page 10 trained to do so. The home has a policy and procedure in place for the safe storage and administration of medication. Staff were observed throughout the visit speaking appropriately with residents and relatives, knocking on bedroom and bathroom doors before entering and offering choice. The residents spoken with confirmed that the staff treated them appropriately. Hill Top Care Home DS0000067538.V304965.R01.S.doc Version 5.2 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 the following standard(s): 12,13,14,15 Quality in this outcome area is good. Regular contact with families and friends and positive approaches from staff ensure that the home meets the expectations of the residents and their families. This outcome has been made from evidence gathered before and during the visit to the service. EVIDENCE: As stated previously the manager ensures that detailed assessments of need are completed, these include detailed information of life prior to moving into the care home. Residents spoken with felt that they had enough to do during the day. It was evident throughout the visit that relatives and friends visit the home on regular occasions, without restriction. Staff were observed speaking with residents throughout the visit, offering choice. One resident had recently moved into the home and was clearly confused, the staff were very supportive and spend a great deal of time ensuring she understood where she was and who they were. Hill Top Care Home DS0000067538.V304965.R01.S.doc Version 5.2 Page 12 The home offers a choice of menu to all service users. Special dietary needs are catered for and well documented. The manager and staff complete nutritional assessments and regularly review them. Hill Top Care Home DS0000067538.V304965.R01.S.doc Version 5.2 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 the following standard(s): 16,18 Quality in this outcome area is adequate. Timely responses to complaints ensures that residents and families feel listened to. Lack of adult protection training at present for staff could potentially put residents at risk. This outcome has been made from evidence gathered before and during the visit to the service. EVIDENCE: The home has a detailed complaints procedure and the manager documents all complaints and responses, although there is no signature from the complainant to indicate a satisfactory response. Complaints are dealt with in a timely fashion. Although staff spoken with were aware of what to do in the event of a report of a possible adult protection incident, there are a number of staff at the home who need to receive training in Adult Protection, the manager stated that since the change of ownership this was now being arranged. Hill Top Care Home DS0000067538.V304965.R01.S.doc Version 5.2 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 the following standard(s): 19,26 Quality in this outcome area is adequate. The home is clean, however the lack of storage space and the need for window restrictors on some first floor windows, potentially puts residents at risk. This outcome has been made from evidence gathered before and during the visit to the service. EVIDENCE: The environment is clean and pleasant, however the manager needs to arrange for suitable storage areas for wheelchairs and other equipment. A number of rooms are currently used to store equipment. Window restrictors are needed on the windows highlighted on the day of the visit. Hill Top Care Home DS0000067538.V304965.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. Staff in sufficient numbers with appropriate training ensures that residents are safe, however a large number of staff without up to date Adult Protection training potentially puts residents at risk. This outcome has been made from evidence gathered before and during the visit to the service. EVIDENCE: There were sufficient staff on duty during the visit and the duty rotas evidenced that there are sufficient staff on duty at all times. The manager stated that a range of training is offered to the care staff and since the new provider had been in place other training was being arranged. As stated previously Adult Protection training for many staff is out of date, the manager did state that his was being arranged. The home has a rigorous recruitment procedure to ensure that all staff have 2 written references, job history and a Criminal Records Bureau check in place prior to starting at the home. Hill Top Care Home DS0000067538.V304965.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 38 Quality in this outcome area is good. A suitably qualified nurse manager with support from providers ensures that the residents are offered a high quality service. This outcome has been made from evidence gathered before and during the visit to the service. EVIDENCE: The manager is a competent, well qualified nurse who has managed the home for a long time. She stated that the new providers had implemented positive changes and felt more supported, particularly as there were 2 other sister homes. Fire alarm checks, drills and training were all up to date. Hill Top Care Home DS0000067538.V304965.R01.S.doc Version 5.2 Page 17 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 X 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X X X 3 Hill Top Care Home DS0000067538.V304965.R01.S.doc Version 5.2 Page 18 Are there any outstanding requirements from the last inspection? YES 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 2 3 4 Standard OP18 OP19 OP19 OP33 Regulation 18.1 c i 13.4 a 23.2l 13.4 c 24 Requirement Staff must receive the training needed to undertake their duties. All areas of the home must be free from hazards. Unnecessary risks to residents health and safety must be eliminated as far as possible. A written quality assurance system must be developed, in accordance with the regulation. (outstanding since October 2004) Timescale for action 31/08/06 31/10/06 18/07/06 31/10/06 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 OP16 Good Practice Recommendations The manager should ensure that all complainants are given the opportunity to sign the end of the complaint. Hill Top Care Home DS0000067538.V304965.R01.S.doc Version 5.2 Page 19 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Top Care Home DS0000067538.V304965.R01.S.doc Version 5.2 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. 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