Inspection on 09/06/08 for Hill Top Care Home

This inspection was carried out on 9th June 2008.

CSCI found this care home to be providing an Adequate service.

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 Top Care Home 27/05/09

Hill Top Care Home 17/12/07

Hill Top Care Home 23/07/07

Hill Top Care Home 12/07/06

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Hill Top Care Home Colliery Road Church Gresley Swadlincote Derbyshire DE11 9LU Lead Inspector Vanessa Davies Unannounced Inspection 9th June 2008 09:30 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.V366088.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.V366088.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.V366088.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 17th December 2007 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 dining room which can be partitioned from the lounge Hill Top Care Home DS0000067538.V366088.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for the service is one star. This means the people who use the service experience adequate quality outcomes. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for people and their views of the service provided. This process considers the home’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provisions that need further development. In order to prepare for this visit we looked at all the information that we received and asked for, since the last key inspection on 17th December 2007. During the site visit case tracking was included as part of the methodology. This involved the sampling of a total of three people representing a cross section of the care needs of individuals within the home. Discussions were held with those people able to do so. Their care planning and associated care records were also examined and their private and communal facilities inspected. Discussions were also held with staff about the arrangements for their care and also for staffs’ recruitment, induction, deployment, training and supervision. Following discussions it was agreed that the people who live in this service would be referred to as ‘residents’ for the purpose of this report. The fees for this service are between £472.87 - £510.87 What the service does well: Each of the files observed have a detailed assessment of need is completed prior to admission to the home and from this care plans are developed 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 trying to ensure that they have everything they need. Complaints are dealt with in a timely fashion and are recorded appropriately. Hill Top Care Home DS0000067538.V366088.R01.S.doc Version 5.2 Page 6 Hilltop is a clean home. There are sufficient staff are on duty at all times, staff clearly have positive relationships with residents. There is a rigorous recruitment procedure in place. What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Hill Top Care Home DS0000067538.V366088.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.V366088.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 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, however failure to review on a regular basis potentially prevents changing needs from being met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three residents files were examined, one of whom had moved to the home recently. All files held a detailed assessment of need. Each file held an up to date nursing assessment. Assessments were reviewed on an annual basis. One of the files included a nutritional risk assessment, an assessment for the use of bed rails, reclining chair and falling from a shower chair, the assessments had been written 2005 and there was no evidence of a review since. The assessments includes hygiene, mobility, there is a detailed documented medical history but a poor social history, with no details about the residents prior to moving into the home. Hill Top Care Home DS0000067538.V366088.R01.S.doc Version 5.2 Page 9 A number of residents were asked about their assessments, however all chose not to comment but did state that they liked the staff. The information provided by the previous manager states that all potential residents are offered the opportunity to visit the home prior to moving in and no specific timescales are set by the home, agreement is reached between the two parties. Hill Top Care Home DS0000067538.V366088.R01.S.doc Version 5.2 Page 10 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): 7,8,9,10 Quality in this outcome area is good. Input from various professionals, appropriate staff training and detailed care plans all help to ensure that the changing needs of the residents are met and continue to be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The health needs of the residents are highlighted in a variety of assessments, providing a great deal of information. 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. Relatives and friends visit without restriction and this was confirmed by a relative during this visit. Staff record accidents accordingly and make a record of an incident. Hill Top Care Home DS0000067538.V366088.R01.S.doc Version 5.2 Page 11 Staffing levels appear to meet the needs of the residents throughout the day Medication is stored appropriately. All medication received and administered at the home is documented accordingly. Medication is administered by staff trained to do so, no issues were evident. 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. A relative spoken with stated that the staff are always polite and welcoming when she visits. Hill Top Care Home DS0000067538.V366088.R01.S.doc Version 5.2 Page 12 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): 12,13,14,15 Quality in this outcome area is adequate. Lack of information relating to the social history of residents potentially prevents staff from meeting the needs of the residents and being aware of their important role within the community prior to moving into the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: It was evident throughout the visit that relatives and friends visit the home on regular occasions, without restriction and stay at the home for as long as they or the resident likes. The Activity Coordinator continues to document all activities in great detail including what residents do, who takes part and what involvement they have. Staff were observed speaking with residents appropriately. When asked staff confirmed that residents are able to go out with their relative but they do not go out with staff. The information held within the files relating to social histories is very poor with little information relating to life prior to moving into the home. Hill Top Care Home DS0000067538.V366088.R01.S.doc Version 5.2 Page 13 A relative spoken with said that the food offered always looked nice and that her mother seemed to enjoy it. A resident spoken with said “the food is always nice” Staffing levels appear to meet the residents needs during the day and staff spoken with stated that they do have sufficient on duty. The information provided by the previous manager states that residents have the opportunity to see a member of the Clergy on a monthly basis and holy communion is provided monthly too. The home offers a choice of menu to all service users. Special dietary needs are catered for and well documented, this was evident on the day of the visit. Residents are now offered a hot alternative to a sandwich in the evening. Residents needing support eating are given the support always ensuring that dignity is preserved. Staff complete nutritional assessments and regularly review them. Staffing levels are increased at mealtimes to ensure that the dignity of residents is respected and that changing needs are met. It was a very sunny day on the day of the visit and a number of residents were out on the patio in the sun, all were wearing appropriate protection and one stated that he enjoyed to be out in the sun and staff ensure that he is protected with sunscreen and a hat. Two of the residents who were tracked had moved bedrooms, however there was no evidence within the files to so freedom of choice or whether the move was discussed with them. The home does not currently have a manager and the provider was ill on the day of inspection, therefore this was not discussed with them. There was documentation within the files indicating that the residents were happy in their new rooms. Hill Top Care Home DS0000067538.V366088.R01.S.doc Version 5.2 Page 14 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): 16,18 Quality in this outcome area is good. Detailed recruitment and complaints procedures and up to date staff training all help to ensure that residents feel safe, are listened to and cared for by qualified staff, therefore ensuring their safety. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A complaints procedure was available to all residents and this was included in the service user guide. The residents spoken with felt able to speak to the staff and manager if they were not happy about anything to do with their care as did the relative spoken with. The main response given was “I’d tell the manager” One survey received stated that the resident had no need to make a complaint since moving to the home. The home has a rigorous recruitment procedure in place, which is followed by the providers. The home is currently without a manager therefore staff records were not examined on this occasion, however the provider stated following the visit that all relevant and necessary records for staff are in place. There was a safeguarding adults policy in place. All staff have completed Safeguarding adults training. Staff spoken with had a basic understanding of the action to be taken if an allegation was made and the different types of abuse. Hill Top Care Home DS0000067538.V366088.R01.S.doc Version 5.2 Page 15 Hill Top Care Home DS0000067538.V366088.R01.S.doc Version 5.2 Page 16 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): 19,26 Quality in this outcome area is adequate. A clean and tidy home helps residents to feel safe within the environment, however using bathrooms and toilets for storage potentially causes a hazard and therefore puts residents at risk. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is adequate private parking, a patio with planted beds and seating outside with access via patio doors. There is a large lounge/diner with ample seating for all residents, a large TV and stereo unit. The carpet outside the lounge in the hall is very stained and needs to be cleaned or replaced. There is a second smaller lounge with a TV and aquarium. There are a number of bathrooms and toilets, however all were being used to store things from easy chairs to boxes. A member of staff did state that the Hill Top Care Home DS0000067538.V366088.R01.S.doc Version 5.2 Page 17 boxes had been delivered that morning and would be moved to appropriate areas later in the day. Bedrooms seen were personalised, clean and tidy. Hill Top Care Home DS0000067538.V366088.R01.S.doc Version 5.2 Page 18 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): 27,28,29,30 Quality in this outcome area is good. Appropriately trained staff in sufficient numbers helps to ensure that residents needs are met and that they are safe and feel safe, promoting a positive environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The duty rota evidenced that there are 4 staff on duty in the morning and 3 staff in the afternoon with 1 qualified nurse on duty throughout the day. During the night there is one care worker and 1 qualified nurse. Although there is currently no manager at the home, staff stated that they are receiving supervision approximately once every 8 weeks. Staff have training booked for Safeguarding Adults in July, Manual Handling in June, all First Aid courses were up to date. Staff have completed training in Dementia. As stated previously there is a rigorous recruitment procedure in place and the provider confirmed that all staff have an application form, 2 written references and a Criminal Records Bureau check. Hill Top Care Home DS0000067538.V366088.R01.S.doc Version 5.2 Page 19 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): 31,33,38 Quality in this outcome area is adequate. Appropriate audits, suitable staff training all help to ensure the home runs well and meets the changing needs of the residents, however the lack of a Registered Manager on site limits support for staff and potentially puts residents are risk. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is currently no manager at the home as she was dismissed for gross misconduct. The provider has developed a quality audit and forwarded it to relatives and other professionals for feedback, however as she was ill on the day of the visit this was not seen. Care plans and risk assessments are reviewed on a regular basis. The provider has evidenced that she is able to act on any issues, which Hill Top Care Home DS0000067538.V366088.R01.S.doc Version 5.2 Page 20 may affect the safety of the residents. The provider is currently advertising for a new manager. Staff appear to be working well and feel supported, although there is currently no manager. All staff training is up to date and further courses booked. A quality monitoring person has been appointed to monitor staff training and the service provided. The landlords gas certificate is dated 30/04/08, hoists were serviced 18/04/08. The home has a fire drill every quarter and the fire alarms are tested every week. Hill Top Care Home DS0000067538.V366088.R01.S.doc Version 5.2 Page 21 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 2 13 2 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X X X X 2 Hill Top Care Home DS0000067538.V366088.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? N/A 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 OP12 Regulation 16.2 (m) Requirement Suitable arrangements must be made to enable residents to be involved within the local community in order to promote their wellbeing. Bathrooms and toilets must not be used as storage areas as this puts residents at risk. Timescale for action 31/10/08 2. OP19 OP38 13.4 (a)(c) 31/07/08 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 OP13 Good Practice Recommendations Residents should be given the choice of changing rooms and evidence provided within the file. Hill Top Care Home DS0000067538.V366088.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Top Care Home DS0000067538.V366088.R01.S.doc Version 5.2 Page 24 - 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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