Inspection on 05/07/06 for Hill View

This inspection was carried out on 5th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Hill View 21/05/09

Hill View 30/05/07

Hill View 18/10/05

Hill View 07/06/05

Hill View 08/11/04

Hill View 17/06/04

Hill View 04/03/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Hill View 46 St Judith`s Lane Sawtry Cambridgeshire PE28 5XE Lead Inspector Nicky Hone Key Unannounced Inspection 5th July 2006 14:00 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 View DS0000015106.V303049.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 View DS0000015106.V303049.R01.S.doc Version 5.2 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 F/P 01487 831709 Oak House Homecare Limited 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.V303049.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th October 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. The weekly fees vary from £351 to £470. A copy of the latest inspection report is kept in the Service Users Guide which is provided to all service users and their representatives. Hill View DS0000015106.V303049.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out by two inspectors who made a tour of the building and spoke to service users, their relatives and staff. Documents were inspected and time was spent with the manager. The inspection lasted for 2.5 hours. This inspection was unannounced and was a key inspection. All of the key standards were assessed. At the time of the inspection there were no service user vacancies. At the time of the inspection the home had submitted an application for more service users with a formal diagnosis of dementia to be admitted. The Commission had agreed that one additional service user could be admitted and the full application is currently being considered. What the service does well: What has improved since the last inspection? What they could do better: Several health and safety issues were identified. Not all of the staff had received training in infection control , the temperature of the hot water used by service users was too high and not all chemicals were stored securely. Staff files were inspected and it was noted that not all of the information required to be received before a person started employment had been received. Hill View DS0000015106.V303049.R01.S.doc Version 5.2 Page 6 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 View DS0000015106.V303049.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 View DS0000015106.V303049.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 Quality in this outcome area is Poor. This judgement has been made using available evidence including a visit to the service. The home’s assessments of new service users are not detailed enough to ensure the home is suitable for the service users. 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 assessments undertaken by the home were very brief and did not contain sufficient information. Several areas of the assessments had not been completed and areas that had been completed did not contain sufficient information. It was also noted that the assessments did not cover all of the areas specified in standard 3 of the national Minimum Standards, Care Homes for Older people. The 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. Hill View DS0000015106.V303049.R01.S.doc Version 5.2 Page 9 Hill View DS0000015106.V303049.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 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 adequate. The judgement has been made using available evidence including a visit to the service. Care plans need to be more comprehensive to ensure that all of the service users needs are identified. EVIDENCE: The manager stated that the current format of the care plans is being reviewed and that at the time of this inspection two of the sixteen care plans had been rewritten using the new format. The care plans of two service users were seen during this inspection. One of these care plans had been written using the new format and was much more comprehensive that the other care plan which used the old format. The revised format provides clear guidance to staff on how to meet the needs of the service user. One of the service users was losing weight but there was not a care plan in place detailing action to be taken to ensure that further weight is not lost. There was evidence that both care plans were being reviewed at least monthly and it was noted that both service users had signed their care plans. One relative spoken to during this inspection stated that she was aware of the care plan and the relative of another service user said that she had not seen a copy of the care plan. Hill View DS0000015106.V303049.R01.S.doc Version 5.2 Page 11 Service users have access to a wide range of health care professionals and GP’s and District Nurses regularly visit the home. A chiropodist visits the home each month and an optician visits twice a year. The home uses a monitored dosage system of drug administration and records confirmed that all staff who administer staff have received appropriate training. One of the service users currently accommodated in the home handles their own medication and an appropriate risk assessment has been undertaken in respect of this. Suitable storage facilities are also in place for this service user to store their medication safely. The records of medication received into the home, administered and disposed of were seen and were satisfactory. The room storing medication and the refrigerator storing medication were inspected and were satisfactory. There was no overstocking of medication and the room was maintained at a satisfactory temperature. Service users stated that they have good relationships with staff, that staff are courteous and polite and that they always call them by their preferred name. Service users confirmed that staff always knock and wait before entering their bedroom. This was witnessed during the inspection. Hill View DS0000015106.V303049.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 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. The judgement has been made using available evidence including a visit to the service. Service users experience a lifestyle that matches their expectations. EVIDENCE: Service users have the opportunity to take part in a number of activities either in a group or on an individual basis. At the time of this inspection two service users were playing dominoes. The manager stated that one gentleman enjoys tapestry and others enjoy knitting, word search puzzles, gardening and going to the local shops. Bingo is held in the home each week and entertainers visit the home once a month. A barbecue is due to take place on 22 July and a relative stated that she had been invited to this. A trip to Hunstanton is also being planned within the next month. One relative said that ‘perhaps a little more entertainment would be good’. A hairdresser visits weekly. Relatives spoken to during the inspection confirmed that they are able to visit whenever they wish and that there are no set visiting times. Service users stated that they entertain their visitors in either their bedroom, the communal areas of the home or in the garden during the summer. One service user stated that ‘you can do what you like during the day. You can sit in the home or in the garden. Staff help you if you need it and they are Hill View DS0000015106.V303049.R01.S.doc Version 5.2 Page 13 very nice’. Another service user said that there are no set times for getting up or going to bed. Service users spoken to stated that they were happy with the variety and quality of the food provided. They stated that drinks and snacks are always available. One service user said that if you didn’t like the meal you would be offered something else. A relative stated that her mother requires a special diet and that this is always provided. ‘They always get her what she fancies’. The home employs a cook and there is a 4 weekly rotating menu. Breakfast is served from 7am, lunch at 12.30, tea and 16.30 and supper from 20.00. Fresh fruit is readily available and on the day of the inspection (which was very hot), service users were being given plenty of drinks. Meals are served in either the conservatory or the dining room and adapted cutlery is available for service users who require this. A cooked breakfast is not served in the home. Hill View DS0000015106.V303049.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 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 good. This judgement has been made using available evidence including a visit to the service. The home has thorough systems in place for responding to complaints and allegations of abuse. EVIDENCE: The home has a satisfactory complaints procedure which is on display and is also contained in the service user guide and statement of purpose. Service users spoken to stated that they knew how to complain and would speak to the manager or person in charge at the time if they had any concerns. No complaints have been received since the previous inspection. Complaints received by the home are kept in a file but it is recommended that a complaints log is also maintained. Staff members spoken to stated that they felt confident that they know about abuse and would have no hesitation in reporting any concerns. All staff have received training in the Protection of Vulnerable Adults and the home has satisfactory policies detailing the procedure to be followed when there are allegations of abuse. Hill View DS0000015106.V303049.R01.S.doc Version 5.2 Page 15 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): 19,24,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home is very clean and well maintained so that service users have a comfortable, homely place to live. EVIDENCE: The standard of maintenance and decoration at this home is very good and the cleanliness of the home is excellent. There is an ongoing plan of refurbishment and redecoration and the manager stated that recently the lounge has been redecorated and new garden furniture has been purchased. Four bedrooms were seen and it was evident that service users are encouraged to personalise their rooms, bringing in their own furniture and belongings if they want to. One visitor stated that it would be useful if another chair was in their relatives bedroom as there is only one. This was discussed with the manager during the inspection. It was also noted that one bedroom did not have a mirror. A member of domestic staff works every day and the cleanliness of the home is to be commended. Hill View DS0000015106.V303049.R01.S.doc Version 5.2 Page 16 Hill View DS0000015106.V303049.R01.S.doc Version 5.2 Page 17 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 poor. This judgement has been made using available evidence including a visit to the service. The procedures for employing staff are poor and do not ensure the safety of service users. EVIDENCE: The manager stated that during the day there are a minimum of two care staff on duty and during the night there is one member of staff. Although there was no evidence at the time of the inspection that there were not enough staff on duty, staffing levels must be reviewed to ensure that there are enough staff throughout the 24 hour period. Adequate numbers of catering and domestic staff are employed. Staff have the opportunity to attend a wide range of training courses. Courses undertaken by staff in the last six months include Moving and Handling, First Aid, Protection of Vulnerable Adults(POVA), Dementia, Induction, and the administration of medicines. Three members of staff hold the NVQ qualification at Level 2 and another 3 members of staff are working towards gaining this qualification. Two staff files were inspected. Neither of these contained all of the required information. One member of staffs written references had been received after they had commenced employment at the home and another file only contained one written reference. The application forms had not been fully completed and neither application form required the applicant to detail their full employment history. The manager stated that the new application forms have been Hill View DS0000015106.V303049.R01.S.doc Version 5.2 Page 18 implemented and that these now require a full employment history and for any gaps to be explained. Hill View DS0000015106.V303049.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36,38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. The health and safety issues identified during this inspection must be addressed to ensure that service users are not put at risk. EVIDENCE: The manager has been employed by the organisation since June 2005 and has worked at the home as the manager since February 2006. She has attended a number of courses relevant to her role and enrolled on the Registered Managers course in June 2006. She hopes to have obtained the award by Christmas. The manager stated that she is in the process of completing her application to be registered as the manager of the home. During discussion with the manager it was evident that she was aware of her responsibilities as required by the Care Standards Act 2000. Hill View DS0000015106.V303049.R01.S.doc Version 5.2 Page 20 Service users views about the home are sought informally on a daily basis and the home also operates a quality assurance system. Questionnaires have recently been sent to relatives or representatives and service users questionnaires are due to be distributed later in the week. The home will hold money on behalf of service users. The money held on behalf of two services users was checked and this balanced with the records of money held. Supervision records were seen and it was noted that staff were receiving supervision every two months. The manager supervises the assistant manager and between them they supervise the staff team. Staff meetings are held monthly and minutes of these meetings are maintained. The provider is required to visit the home at least once a month and write a report. The reports were available in the home and these are now more detailed than they were previously. Training records were seen. Staff have received all of the mandatory training apart from Infection Control. All staff who handle food have received training in basic food hygiene and there is always a member of staff on duty who has received training in first aid. The Environmental Health Officer visited the home on 4 July 2006 and left a satisfactory report. The Fire Safety Officer visited the home on 1 March 2006 and also left a satisfactory report. Records of fire drills, fire training and the testing of the fire alarms and emergency lighting system were inspected and were satisfactory. The hot water temperatures are recorded monthly. It was noted that on occasions the temperature had been recorded as 51C. This is too high as the maximum temperature should be 43C. The accident book was inspected and was satisfactory. Risk assessments were also inspected and were satisfactory. During the tour of the home it was noted that not all cleaning fluids were stored securely. Hill View DS0000015106.V303049.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 1 X x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 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 3 17 X 18 3 3 X X X X 3 X 4 STAFFING Standard No Score 27 2 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 3 X 1 Hill View DS0000015106.V303049.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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 Standard OP3 Regulation 14(1) 15 18(1)(a) Requirement A full assessment must be undertaken before a service user is admitted to the home. The care plans must detail how to meet all of the service users needs. Staffing levels must be reviewed to ensure that there are suitably qualified, competent and experienced persons working at the home in sufficient numbers as are appropriate for the health and welfare of the service users. All information required about staff must be obtained before they commence employment at the home. Arrangements must be made for all staff to receive training in infection control. All chemicals must be stored securely. Water temperatures in areas that service users have access to must not exceed 43C. Timescale for action 31/08/06 31/08/06 31/08/06 OP7 OP27 4 OP29 19 05/07/06 5 6 7 OP38 OP38 OP38 13(3) 13(4)(a) 13(4)(a) 31/08/06 05/07/06 31/07/06 Hill View DS0000015106.V303049.R01.S.doc Version 5.2 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. Refer to Standard OP7 OP15 OP18 OP24 Good Practice Recommendations All care plans should use the new format. Service users should be given the option of a cooked breakfast. A complaints log should be maintained. Additional seating should be provided in bedrooms for service users’ visitors. Hill View DS0000015106.V303049.R01.S.doc Version 5.2 Page 24 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 © 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 View DS0000015106.V303049.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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