CARE HOMES FOR OLDER PEOPLE
Hill View 46 St Judith`s Lane Sawtry Cambridgeshire PE28 5XE Lead Inspector
Don Traylen Unannounced Inspection 18th October 2005 10:30 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 View DS0000015106.V260073.R01.S.doc Version 5.0 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 View DS0000015106.V260073.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Hill View Address 46 St Judith`s Lane Sawtry Cambridgeshire PE28 5XE 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) 01487 831709 01487 834442 Oak House Homecare Limited Julie Elaine Boardman Care Home 16 Category(ies) of Dementia - over 65 years of age (1), Old age, registration, with number not falling within any other category (16) of places Hill View DS0000015106.V260073.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 7th June 2005 Brief Description of the Service: Hill View is registered to provide care to 16 older people including one older person with age-related mental health impairment. The home is set in its own gardens in a quiet location on the outskirts of the village of Sawtry and approximately five minutes walk from the village centre shops and public house. Huntingdon, Cambridge and Peterborough are within a radius of approximately 20 miles. Originally a domestic bungalow, the building has been extended to offer ground floor accommodation in single bedrooms all of which have en-suite facilities. The home is spacious and has a large lounge off the hallway at the front of the home, a dining room with an open plan kitchen, a conservatory and a separate dedicated office used by the manager and for meetings. The home has adequate bathing and washing facilities and is wellmaintained. Hill View has a neat and well kept enclosed and sheltered garden with ponds and flower beds. Hill View DS0000015106.V260073.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was unannounced and was conducted by two inspectors, Don Traylen and Cathryn Bramham, at 10.30 am on 18/10/2005. The registered providers and one of the two deputy managers were present during the inspection. Four service users, two care staff and a visiting District Nurse spoke to the inspectors. The deputy manager was available throughout the inspection. No relatives visited the home during the inspection. The following day the inspector spoke to the Registered Manager. Observations were made of the care given to service users and an inspection of the building and of the grounds was carried out. What the service does well:
It is pertinent to repeat the comments made in the last inspection, “Hill View looks and feels like an ordinary home and has an especially comforting and relaxing environment that service users are content with…. The manager is welcoming and her approach encourages a culture of care based on respect”. An exceptionally dedicated person keeps the home immaculately clean. In addition, this person has a keen understanding and empathy of the needs of service users living at the home. The home is decorated in a neutral, soothing colour scheme to the hallway and the dining and kitchen areas. The home has a managed approach for maintaining the furniture, the fixtures and fittings and the decorative condition. The gardens are well-maintained and are of an enclosed style designed with guide rails along the pathway that is sloped and has ramps for easier access by service users. The ponds are safely fenced and the pathway is kept clear. A plentiful array of roses and other plants ensure the garden is well stocked. The garden provides a small haven of retreat for service users, relatives, or staff. Staff training is organised and well managed by the organisation’s training manager. Care staff have a clear understanding of individual needs and ways of providing personal care and are confident about requesting the professional
Hill View DS0000015106.V260073.R01.S.doc Version 5.0 Page 6 advice and health care from GP and District Nurse when necessary. Service users are thereby assured of attentive and focused care. What has improved since the last inspection? What they could do better:
Both inspectors discussed with the deputy manager and later with the registered manager methods of presenting Assessments and Care Plans as two separate documents. The registered manager is developing the Care Plans and has discussed these with the inspector. The template for the new style Care Plans has been created as a document on computer and is yet to be finalised. The manager stated she would share the development of these documents with the CSCI. The home should consider combining some of the information and detail they keep in separate files. For instance, the assessment information and any arrangements or changes that affect service users state of health and care, such as a referral to hospital for specialist clinic or treatment, should be contained in the Care Plan file so that care planning is a totally informed and continuous project. This aspect of recording Care Plans was discussed with the deputy manager and on the following day, the 19th October, with the registered manager. Please contact the provider for advice of actions taken in response to this
Hill View DS0000015106.V260073.R01.S.doc Version 5.0 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Hill View DS0000015106.V260073.R01.S.doc Version 5.0 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hill View DS0000015106.V260073.R01.S.doc Version 5.0 Page 9 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5, Service users are only admitted to the home through an planned process of assessing prospective service users’ needs. EVIDENCE: Two service users’ files were read and contained assessments made by the home prior to admission plus a health care assessment conducted by a nurse. The deputy manager stated the home would not admit any service user unless they were satisfied the home were able to meet their needs. Service users are given the opportunity to visit the home at any time before planning to move to the home and a trial period of 6 weeks is given to all new service users. Service users are issued with contracts either by the local authority or by the home, if privately funding. Hill View DS0000015106.V260073.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10, EVIDENCE: Two Care Plans were read and contained adequate information about needs. Separate files were read that both included arrangements and details about providing care and it is recommended these two files should be combined wherever possible so that a single document of planned care can be maintained. Separate sheets for daily records of service users’ circumstances and welfare are maintained and these form the diary of care for each service user. The inspector spoke to the deputy manager and the registered manager about the ways to include staff in the recording of person-centred information in Care Plans. A visiting District Nurse confirmed that The GP and District Nurses are regularly consulted by the home regarding service users health and that a good relationship has developed between the home and the GPs’ group practice. Hill View DS0000015106.V260073.R01.S.doc Version 5.0 Page 11 Four service users spoken to stated they were well cared for and were treated with respect and kindness by the care staff. Medication records were accurate and clearly recorded. Medication that was waiting to be returned to the pharmacist had been recorded. Detailed policies an procedures in respect of the receipt, administration and disposal of medication were seen. It was noted that refrigerated medication was not stored securely but when this was discussed with the deputy manager during the inspection she immediately dealt with it. Hill View DS0000015106.V260073.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15, Service users experience a lifestyle that matches their expectations. EVIDENCE: Four service users who were spoken to stated they were happy with their style of living and some had visits from their families. A wholesome and appealing meal of quiche and fresh vegetables was observed being eaten by service users at lunchtime. Service users confirmed they always had sufficient food to eat. Hill View DS0000015106.V260073.R01.S.doc Version 5.0 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): 18, Service users are protected from abuse by the policies and checks carried out by the home. EVIDENCE: Staff have been trained in protecting vulnerable adults from abuse and the home has adopted Cambridgeshire County Councils policy to protect vulnerable adults. All staff have received satisfactory Criminal Record Bureau checks. Hill View DS0000015106.V260073.R01.S.doc Version 5.0 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): 19,20,21,22,23,24,25,26, Service users benefit from a comfortable and safe environment with suitable facilities and equipment for service users. EVIDENCE: The comments made in the same section of the previous report should be read in conjunction with comments in this section. Further improvements have been made to the internal environment of the home. The doors and architrave and handrails in the corridor have been painted in a pleasing neutral colour to match the paintwork in the dining area closest to the kitchen. During the inspection the bathroom was in the process of being totally refurbished. There is a plan to improve the environment with a priority schedule agreed by the manager and the registered provider. The deputy manager explained there are plans to redecorate the main lounge that is already very comfortable, clean and inviting. Overall, the home offers suitable facilities for elderly persons and has a homely environment that is comfortable and well maintained.
Hill View DS0000015106.V260073.R01.S.doc Version 5.0 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): Service users are protected by sufficient trained staff who are competent and attentive. EVIDENCE: There were two care staff and the deputy manager working at the time of inspection. Staff receive training opportunities appropriate to the needs of service users. All staff have received training in dementia related care. All staff have received training in protecting vulnerable adults. Additional care staff can be sought from the wider organisations bank of care staff if and when required. In addition to usually having two care staff and a deputy manager or manager on duty, the home employs a cleaner, a handyman/ gardener and an administration assistant and the support from the organisation’s training manager. Hill View DS0000015106.V260073.R01.S.doc Version 5.0 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): 31,32,36,37, Service users benefit from living in a well managed home. EVIDENCE: The registered manager is competent and suitably qualified to manage Hill View. Care staff confirmed the manager conducts regular and helpful supervision every two months. Care Plans, Medication Administration Sheets, service users’ assessments and the complaints procedure were read and all were satisfactory. Hill View DS0000015106.V260073.R01.S.doc Version 5.0 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 3 3 3 3 3 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 X 17 X 18 3 3 3 3 3 3 3 3 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 3 3 X X X 3 3 X Hill View DS0000015106.V260073.R01.S.doc Version 5.0 Page 18 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. 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 OP7 Good Practice Recommendations The new Care Plans intended to be implemented by the manager should include all aspects of care rather than be kept in two separate files. Hill View DS0000015106.V260073.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office CPC1 Capital Park Fulbourn Cambridge CB1 5XE National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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