Inspection on 10/01/08 for Hill Top Lodge

This inspection was carried out on 10th January 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 Lodge 07/01/09

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Hill Top Lodge 93 Hill Top West Bromwich West Midlands B70 0PX Lead Inspector Mandy Beck Key Unannounced Inspection 10th January 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 Lodge DS0000070287.V357398.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 Lodge DS0000070287.V357398.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hill Top Lodge Address 93 Hill Top West Bromwich West Midlands B70 0PX 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) 0121 556 3322 www.pressbeau.co.uk Pressbeau Ltd Phaik Lim Care Home 84 Category(ies) of Dementia - over 65 years of age (54), Old age, registration, with number not falling within any other category (30) of places Hill Top Lodge DS0000070287.V357398.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: either, whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP, maximum number of places 30. Dementia over 65 years of age - Code DE(E), maximum number of places 54. The maximum number of service users who can be accommodated is 84. 12th November 2007 2. Date of last inspection Brief Description of the Service: Hill Top Lodge is registered to provide personal care for older people and older people who have dementia. It does not provide any nursing care at this time. The home has three floors and each one has their own living and dining area. There are bathrooms and toilets on each floor. People who live at this home do not have to share bedrooms. Each room is furnished appropriately and with prior agreement from the manager people are encouraged to bring their own possessions with them when they move in. Each bedroom has a partial en suite facility, a toilet and hand basin. This home operates a non-smoking policy. It is situated close to the town of West Bromwich and is accessible via public transport. The fees for this home are included in the Statement of Purpose and the Service User Guide and range from £390 and £600 per week for residency. People are advised that they may have to pay en extra “top up” charge. Other fees not included are extras such as newspapers and magazines, hairdressing service and non NHS chiropody. People are also expected to provide their own toiletries. Hill Top Lodge DS0000070287.V357398.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit to the service. It was undertaken by two inspectors from the Commission for Social Care Inspection (CSCI) and lasted for two days. We have used a variety of methods and evidence to help us make the judgements in this report. The manager has provided us with the home Annual Quality Assurance Assessment (AQAA). We have used the information in the AQAA to help us plan this inspection. We looked at people’s care plans as part of our case tracking process. This process allows us to look in depth at the care and treatment of certain of people who live at the home and make judgements about whether their needs are being met. We spent time on this inspection talking to the people who live there, the staff on duty and the manager. We also had the opportunity to speak to the owner. Staff files were examined to make sure the home is recruiting new workers safely and protecting the people who live there. We would like to thank all of the people who live at Hill Top Lodge and the staff for their hospitality throughout this inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. What the service does well: This home provides a homely place for people to live. Staff are enthusiastic and show a caring attitude and approach towards the people who live there and their families. Service users told us “The care and support seems very satisfactory”. Each person has access to their own doctor when they need it. They are also seen by other specialist community services such as Mental Health Nurses and District Nurses. “When my mother has needed a doctor or needed to go into hospital they have arranged it and kept us well informed”. The home has improved the activity provision and this means that people are more involved and stimulated throughout each day. “The staff arrange activites and entertainment to try to keep their minds and bodies more active”. Hill Top Lodge DS0000070287.V357398.R01.S.doc Version 5.2 Page 6 There is a pro-active approach to complaints and the manager will listen to and act upon people’s views and concerns. 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 Lodge DS0000070287.V357398.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 Lodge DS0000070287.V357398.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): 1,2,3,4,5,6 Quality in this outcome area is adequate. People who may live in this home will have the information they need to make an informed choice about living there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who may wish to live at Hill Top Lodge are given a copy of the home’s Statement of Purpose and Service User Guide. These documents outline the home’s aims and objectives and a guide to what type of service people can expect once they have moved in. We saw that both documents needed to be updated to reflect recent changes. This was discussed with the new owner and the manager during the inspection who confirmed that the Statement of purpose and Service User Guide are currently in the process of being updated. Each person moving into the home will be given a contract/terms and conditions of residency. these documents will outline the responsibilities of both the provider and service users during the time they reside at Hill Top Hill Top Lodge DS0000070287.V357398.R01.S.doc Version 5.2 Page 9 Lodge. It will also indicate some but not all of the extra charges service users may be expected to pay for. Service users are expected to pay for their own toiletries but this is not clear in the contracts of the people we saw. This was bought to the manager’s attention and recommended that contracts be specific about fees so that service users can be very clear about what they are expected to pay for. We looked in depth at the care files of some of the people living in the home. We saw that each person has an assessment of their needs but that it did not always provide a true reflection of people’s needs. The manager told us that the introduction of new care planning system had been a major piece of work and the decision had been made to copy existing information straight into the new paperwork. Now that this has been completed they hope to build upon the information and make the assessments more robust and reflective of peoples individual needs. Staff who work at this home have received specialist training in dementia care and person centred care. It was pleasing to see that all the staff we spoke to said that the training was enjoyable and they felt they has learned a lot. We also noticed that some staff may not have grasped the information as they should have and showed a poor understanding of person centred care that the manager will need to address if the service is to go forward and continue improving. People who answered our questionnaires were very positive about the home. they told us “We were given information about the home and she spent a few weeks of respite there before we decided on making the move permanent”. The manager also confirmed that people are encouraged to spend time at the home before making a decision about moving in. Once the decision has been made the manager will write to service users and confirm that the home is able to meet their needs. This home does not provide intermediate care service at this time. Hill Top Lodge DS0000070287.V357398.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 adequate. People who live at this home do have their needs met and they can feel confident that they will have access to medical services when they require it. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All of the people whose care we case tracked had a plan of care that included information about their health, personal and social care needs. There was evidence that care plans included service users choices such as time of getting up and going to bed and which gender of care staff they preferred to care for them. It was pleasing to see how care plans have improved. Staff are now completing them although care plans were generally sparse would benefit from more information in order to provide a more person centred approach to care planning and care delivery. Each person is assessed for their risk of developing pressure sores, of falling, moving and handling, and malnutrition. Once a risk has been identified the home will then draw up a plan of care to reduce the risk to service users. In Hill Top Lodge DS0000070287.V357398.R01.S.doc Version 5.2 Page 11 addition to this the home is supported by the district nursing service that will visit service users at the home and provide them with specialist equipment for pressure area relief for example. All service users have access to and are seen regularly by a range of health professionals opticians, chiropodists, dentists and when they are ill staff ensure that their Doctor is called to arrange for a visit. Relatives also confirmed that this is case by telling us “When my mother has needed a doctor or needed to go into hospital they have arranged it and kept us well informed”. They also said “Staff are always available and checking on them regularly” and “the care and support seems very satisfactory”. Medication practices were generally found to be good. Staff record the receipt of medicines and are now requesting prescriptions and seeing the prescription before it goes to the chemist which was not the situation previously. It was recommended that two members of staff sign to confirm the accuracy of hand written MAR charts. This will reduce the risk of errors being made. The manager also needs to make sure that staff record the temperature of the room where medication is stored. This will provide records that show medication is being stored at recommended temperatures and service users are not being placed at risk as a result. Observations made during the inspection were that staff generally treated residents with respect and there was much laughing and joking. At times some staff were a bit loud making both the inspector and the service users jump on occasions. Another staff member was seen to give out two mugs of tea at a time without asking whether people wanted milk and sugar or even if they wanted a cup of tea or coffee. Staff did explain that they knew the service users preferences and therefore did not always need to ask. It would be nice to see them ask as this would promote conversation and inclusion for service users. One service user was walking around and her trousers were falling down showing her underwear it was pleasing to see that staff took immediate action to prevent her from further embarrassment. We saw another service user walking around in a t-shirt, staff approached him and asked if he was warm enough and helped him to go and get his cardigan. Hill Top Lodge DS0000070287.V357398.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. People who live in this home do enjoy some activities. They will be encouraged to maintain contact with their family and friends. Meals are satisfactory but could be improved upon. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home employs one person to coordinate activities for service users. The person in this role is having a positive effect on service users and one relative commented “ xxxxx has excelled in exploring new avenues of getting residents involved in not only interacting with each other but also developing their own capabilities and skills”, “when the new people came they said yes get some entertainment which we had not before”. At times, activities can be limited this can be attributed to the fact that only one person is covering the whole home and resources can be a little stretched. We saw that staff are also involved and they enjoyed the time spent with service users. “its so nice to be able to sit and draw and talk to the residents”. One person said “I love doing this and the music can you hear, its George Formby”. Hill Top Lodge DS0000070287.V357398.R01.S.doc Version 5.2 Page 13 The activity coordinator is also planning to undertake further training in specialist activity for people with dementia and taking her minibus test. Both of these will benefit service users as the will become more involved and stimulated in their environment. “the owner came to one of the Christmas parties we did a raffle and with the profits will buy a karaoke machine the owners said that they would match what ever we raise.” Relatives and friends are encouraged to visit as often as service users would like them to. They can spend time with service users in the privacy of their own rooms, the communal areas and in the grounds outside should they wish to do so. Meal times have improved since the home participated in the thematic inspection September. We made recommendations about meal times and it was pleasing to see that the staff have made efforts to do this. For example we saw that everyone was asked if they wanted to sit at the table for their meal. The tables were laid and people had access to condiments and sauces as they wanted. There is still room for improvement, we saw that staff helping to feed some service users but left this task half way through to assist others. This is not ideal as some people were waiting for over ten minutes to finish their meal. Others would have benefited from aides such as plate guards and sticky mats to stop their plates from moving around the table as they tried to eat. Service users were offered two choices of meal but one option ran out halfway through service. This obviously reduced the choice for some people. None of the service users were asked if they wanted to have gravy on their meal, everybody had it. This was the same for the fresh fruit and cream. One person said “I don’t like fruit salad”, she was offered a banana instead but she declined this. Eventually staff went to the kitchen to fetch an ice cream. The dishes for the cold desert were kept inside the hot trolley. This means that people were eating a cold desert from a warm bowl. We also noticed that one trolley was so hot at the top it had burnt the peas but the lower half of the trolley was barely warm. This meant that the fish and chips stored there was barely warm. This was bought to the manager’s attention during the inspection, she will address this problem promptly. Hill Top Lodge DS0000070287.V357398.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): 16,17,18 Quality in this outcome area is good. People living in this home can feel confident their views will be listened to and acted upon. They can feel assured that they will be protected from harm or abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Pressbeau has a detailed complaints policy and procedure that is available to all service users and their families. The manager responds positively to any concerns, complaints raised. Since Pressbeau took over ownership of Hill Top Lodge in August there have been four complaints. The manager keeps good records of complaint investigations and outcomes. We are now being informed of potential cases of abuse and the home works well with other agencies to ensure that service users are being protected. There have been three Adult protection strategy meetings for three different service users all of which have been successfully resolved and meant that people are not being placed at harm. Staff told us that they have received training in Adult protection and were aware of the homes “whistleblowing” policy that would allow them to report their concerns in a confidential way. The home is working hard to make sure that service users get the help and support they are entitled to. For instance we noticed that one service user had not received any of their personal allowance for over 12 months. This is clearly unacceptable and when we discussed this with the staff they were able Hill Top Lodge DS0000070287.V357398.R01.S.doc Version 5.2 Page 15 to tell us that they had already reported this to the persons social worker and were awaiting a decision about Appointeeship for this particular service user. Some of the staff have received some training about the Mental Capacity Act 2005 and their role in supporting people to make decisions. Others said that they were still waiting for training. Staff were unsure about the Act or of the requirements made upon them by it. More importantly staff did not know how to determine or make judgments about a persons capacity to give consent or make decisions about their care. It is recommended that the manager arranges more training for staff to ensure that they are aware of their role and responsibilities when supporting people who may lack capacity. Hill Top Lodge DS0000070287.V357398.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): 19,20,21,22,23,24,25,26 Quality in this outcome area is adequate. People who use this service can expect to find the home is generally clean and tidy, although improvements could be made. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We looked around the majority of the home during this inspection. At present there is building work being undertaken to join the two homes together. It is hoped that the walk way will be completed in the very near future. The owner told us “we want to get away from the “them and us” feeling that sometimes happened, joining the building together will bring the home together”. In order to make things better for the people who live there the home has a programme of routine maintenance and also a programme for the replacement and refurbishment of the home. Recent purchases have included new profiling Hill Top Lodge DS0000070287.V357398.R01.S.doc Version 5.2 Page 17 beds for service users added comfort and the provision of new lifting hoists and slings, again to make moving service users a more comfortable experience. There are also plans to construct a sensory garden for service users enjoyment. It is hoped this work will begin shortly and be completed by March. This will provide some much needed outdoor stimulation for the people who live in this home. Generally the home is well kept. We saw that improvements could be made to the cleanliness of the home. The manager told us that they have increased the number of domestic hours they have and things are getting better. Relatives said “The home seems to be kept very clean and they are trying to stop the building smelling of old people I am pleased to say”, “the home is clean and fresh”. We saw some of the bedrooms that people occupy, they are brightly decorated and have sufficient furniture for people to use. People are encouraged to bring in their possessions to make their rooms more personalised to them and to maintain some familiarity with their surroundings. The bedrooms at Hill Top Lodge do not offer a full en suite facility but they are equipped with a toilet and hand-washing basin. There are no shared rooms in this home. Infection control procedures could be improved to help prevent the spread of infection in the home. For instance we saw that service users soiled clothing was placed on the floor in one sluice and not in the laundry skip as expected. There are hand-washing signs throughout the home and there is some liquid soap available for people to use but there were not always paper towels available to dry your hands once you had washed them. It is positive that staff are now beginning to have training in infection control. This should make them more aware of good practice in reducing the risk of cross infection to service users. We also noted that there are no waste bins with lids in the toilets and bathrooms. This means that soiled continence products are being put into open topped bins and leaving an unpleasant odour in some cases and possibly adding to the risks of cross infection. Additionally there is no sluice in the older part of the home and staff are having to empty commode pots into toilets and wash them in the bath. It is recommended that the manager reviews this practice. Hill Top Lodge DS0000070287.V357398.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 adequate. People living in this home are supported by staff that have been trained to meet their needs. There is generally enough staff on duty to meet people’s needs. The home has good systems in place to make sure staff are recruited safely reducing the risks to the people who live there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We saw adequate levels of staff on duty during the inspection. The people who live there said “they are very good, they do help me a lot”. We asked one person if they had to wait very long to carers to come to them. They said “sometimes but it is a busy home you expect it.” Relatives told us “Staff are always available and checking on them regularly”. The manager told us that staffing levels are kept under review and will change along with the needs of the people who live there. For example if residents become more challenging to look after the home will assess the situation and provide more staff to help look after them. The home is supports its staff to completed National Vocational Qualifications (NVQ’s). Some of the staff have completed their level 2 and 3 and have progressed to the level 4. At present the home has 36 of its 50 care staff with an NVQ and a further 12 working toward completing one. This means that Hill Top Lodge DS0000070287.V357398.R01.S.doc Version 5.2 Page 19 staff will have the knowledge and skills they will needs to look after the people living in the home once they have completed it. Staff told us “we are supported by the manager, if we need help or don’t understand she tells us”. We looked at the staff files for new workers. We found that apart from some minor improvements such as photographs of staff and making sure that a full employment history is obtained for each new worker, files were up to date and contained relevant information. We noted that one workers file contained an old Criminal Records Bureau (CRB) disclosure from their previous employment at the home. This must be addressed and new CRB obtained. The manager was informed of this during the inspection and is taking action to rectify this. All of the staff we spoke to and who answered our questionnaires said that they had been supported through a period of induction when they started employment at the home. “I did an induction it was good but I learnt a lot when I began working with the residents”. We spoke to staff who raised issues about language barriers and limited communication between residents and staff. This problem had been identified and is being addressed by the manager. She has arranged for some of the staff to begin English lessons in order to improve their spoken English and communication skills. Some staff said “some of the staff just seem to lack the confidence to use English, but in this job and helping people with dementia you really need good communication skills”. Hill Top Lodge DS0000070287.V357398.R01.S.doc Version 5.2 Page 20 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): 31,33,35,38 Quality in this outcome area is adequate. The manager is working hard to improve the service people who live in this home receive. The home if managed well and people’s health and safety is protected by safe working practices. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The new manager of Hill Top Lodge is Phaik Lim. She is an experienced manager who both recognises and makes changes to the care practices in the home. This benefits the people who live there because staff are being appropriately trained, supported and encouraged to work to the best of their abilities. Phaik is aware of the shortfalls in service provision and is working hard to address this. She has said that she wants to the home to go forward and improve the care it gives to its residents. Hill Top Lodge DS0000070287.V357398.R01.S.doc Version 5.2 Page 21 We spoke to staff during the inspection that told us, “the manager is very good, she is here on the floor if we need her, and she helps us its so much better”. “I know that if I have a problem I feel confident to go to her and she will me sort it out”. Another person told us “there is a major transformation compared to the way residents were motivated and encouraged prior to the residential home falling under new management”. “The new owners seem to be trying really hard to make things better, this is good to see”. Pressbeau is the company that own Hill Top Lodge, they have good systems in place to make sure they are maintaining the quality of the service they provide. The manager completes monthly checks (audits) of health and safety, the environment and the food for example. She does this so that any shortfalls can be easily identified and addressed. In addition to the managers checks the company also completes a monthly, unannounced visit (Regulation 26). During these visits the person completing this will tour the premises, talk to staff and the people who live there to make sure that things are satisfactory for them. The manager also told us that they are in the process of sending out customer satisfaction surveys to the people who live at the home and their representatives. This will give them the opportunity to express their views about the home and the service it provides. People who live at this home can choose to keep their money and valuables safe in their own rooms or they can ask the home to keep their money safe for them. There good systems in place for the safekeeping of money and the person in charge obtains receipts and signatures for all transactions. We “spot checked” five people’s monies and found them to be an accurate record. Health and safety issues are being managed in a satisfactory way. We looked at some of the records the home keeps such as hot water temperatures, fire drills and fire alarm testing. We saw that they were in order and up to date. We did recommend to the manager that all night staff be included in a fire drill to make sure that all staff are aware of actions to take in the event of fire. We have also noticed an improvement in the way the home reports incidents to the CSCI. We are now receiving more Regulation 37 notifications that keep us informed of incidents, accidents and other events in the home. Staff told us that they are having lots of training. They said “I think I am trained out I have done so much since they (Pressbeau) came to take over”. “the last one I did was moving and handling, we watched a DVD then the manager showed us how to use the hoists and slings safely so we don’t hurt the residents”. They also said “we have more equipment now, new hoists and slings things are better which can only be better for the residents can’t it?”. We also saw during the inspection staff giving encouragement and support to people whilst they tried to manoeuvre them or transfer from wheelchair to chair. This was very positive and the moving and handlings practices we saw should be commended. Hill Top Lodge DS0000070287.V357398.R01.S.doc Version 5.2 Page 22 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 2 2 2 2 2 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 2 18 3 2 2 3 3 3 3 3 2 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 3 X 3 X 3 X X 2 Hill Top Lodge DS0000070287.V357398.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No new service 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 OP1 Good Practice Recommendations The statement of purpose and service user guide should be reviewed so that they are consistent in the fees the home is charging to avoid confusion. It should also make reference to the home being a non smoking environment. Assessments should be completed in a more person centred way that shows individual needs and how those needs are to be met. A more person centred approach to care planning and delivery is needed When staff hand write service users Medication Administration Records two members of staff to sign the sheet to reduce the risk of error. Service users eye drops should have a date of opening written on them this will make it easier to identify out of date medication People may benefit from memory aids in the home to enable them to get around more independently and not DS0000070287.V357398.R01.S.doc Version 5.2 Page 24 2 3 4 5 6 OP3 OP7 OP9 OP9 OP19 Hill Top Lodge 7 OP17 8 OP26 9 10 OP29 OP38 11 OP38 have to rely and staff to take them. Greater numbers of staff should receive training in Mental Capacity Act 2005 and have a better understanding of their role in supporting people who may not have the capacity to make their own decisions. Service users would benefit from review of the current system for emptying and cleaning commode pots on the older part of the building in order to reduce the potential risks of cross infection. Staff files should be audited to make sure that they contain all the required information, such as photographs The manager should review the home’s clinical waste agreement to ensure that they are not in breach of their contract when district nurses place clinical waste into black bags. Greater numbers of staff should have a fire drill so that service users can feel assured they will be in safe hands in the event of a fire Hill Top Lodge DS0000070287.V357398.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection 1st Floor Chapter House South Abbey Lawn Abbey Foregate Shrewsbury SY2 5DE 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 Lodge DS0000070287.V357398.R01.S.doc Version 5.2 Page 26 - 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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