Inspection on 06/12/05 for Hillbeck

This inspection was carried out on 6th December 2005.

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

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

Other inspections for this house

Hillbeck 16/04/09

Hillbeck 18/04/08

Hillbeck 17/12/07

Hillbeck 31/01/07

Hillbeck 10/08/05

Hillbeck 23/02/05

Hillbeck 08/06/04

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

CARE HOMES FOR OLDER PEOPLE Hillbeck The Roundwell Bearsted Maidstone Kent ME14 4HN Lead Inspector Debbie Sullivan Announced Inspection 6th December 2005 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 Hillbeck DS0000039699.V260775.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. Hillbeck DS0000039699.V260775.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Hillbeck Address The Roundwell Bearsted Maidstone Kent ME14 4HN 01622 737847 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) Charing Healthcare Mrs Louise Jayne Beaney Care Home 40 Category(ies) of Dementia - over 65 years of age (40) registration, with number of places Hillbeck DS0000039699.V260775.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Two double rooms 14 and 19 currently used as single rooms of 31 March 2002 continue to be so. Bedroom 9a is to be used as a double room for married couples, siblings or friends that it can be evidenced, wish to move into the home together. Care is restricted to one service user under the age of 65 whose date of birth is 15 November 1948. 10th August 2005 Date of last inspection Brief Description of the Service: Hillbeck is a care home for older people with dementia situated on the outskirts of Maidstone in a semi rural area. The town centre is approximately two miles away and there is easy access to the M20.The home is near to local shops, bus rotes and a train station. The home underwent substantial extension and refurbishment during 2004 and 2005 that has enhanced facilities and increased the number of bedrooms. There are now 40 places and a new a sun lounge, kitchen, laundry and sluice room. A safe and secure patio area surrounding the building leads off the lounge. Hillbeck DS0000039699.V260775.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection that took place over five and a half hours. Due to the nature of the service much information and evidence was gained from discussion with the homes’ manager and other members of staff. Time was spent with the manager, speaking with care and ancillary staff, residents and relatives who were visiting. A tour of the premises took place that included the majority of the bedrooms, lunchtime was partially observed and documentation read. It was a busy day at the home, an interview took place for a member of ancillary staff, a resident was to be admitted, the deputy was not on duty and the manager needed to deal with a large number of telephone enquiries in response to an advert in the local press for care staff and spend time with relatives. The manager is to be commended on providing all the information necessary for the inspection and in being available throughout the day for discussion whilst these demands took place. All staff spoken with were helpful in supplying information and making time available to do so. A small number of comment cards were received, comments on the cards and received during the inspection included, From residents, “I am quite satisfied” “ The home treats us very well” “Food good, enough choice” “I’m fairly happy here” “I’m happy because I can walk outside” From relatives, “We are more than satisfied with the care my (relative) receives. The home is always clean and the staff are friendly and very supportive. In our opinion an excellent home” “My (relative) is very happy at Hillbeck, and the staff are very helpful and cheerful” “The manager asked for lots of information before my (relative) moved in.” Hillbeck DS0000039699.V260775.R01.S.doc Version 5.0 Page 6 The condition allowing a resident under 65 to be accommodated will be removed, as it no longer applies. What the service does well: What has improved since the last inspection? What they could do better: Hillbeck DS0000039699.V260775.R01.S.doc Version 5.0 Page 7 Confirmation of the offer of a place at the home by letter to the resident or relative would help to formalise arrangements. When a place in a double room is offered agreement to sharing should be recorded on the care plan. The health and safety within two bedrooms would be enhanced by considering alternative flooring in one room to reduce risk of odour, and by putting up a notice to drivers or a barrier in front of the new bedroom facing onto the car park so that fumes from cars are prevented from entering the room. Training in respect of reaching the target of 50 of care staff NVQ qualified needs to be progressed. 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. Hillbeck DS0000039699.V260775.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 Hillbeck DS0000039699.V260775.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 and 5 Prospective residents and their relatives are able to access information about the home and to visit before making a decision about moving in. Needs are assessed prior to admission to ensure that they can be met by the home. EVIDENCE: The homes’ statement of purpose and service users’ guide give comprehensive information on the service, a copy of the service users’ guide was clearly on display in the reception area. Prospective residents and their relatives are able to visit the home and spend time there before making a decision, relatives of a recently admitted resident said that they had visited other homes and decided upon Hillbeck as they liked the layout of the building, it had plenty of light, could meet needs and was near for visiting. Choice of bedroom had been offered and their relatives’ needs had been assessed prior to admission. It is recommended that when a place is offered this be put in writing. A resident said that they had visited the home before deciding to move in and made a decision straight away. The homes’ manager or deouty manager undertake pre admission assessments which are then placed on the care plan. Hillbeck DS0000039699.V260775.R01.S.doc Version 5.0 Page 10 Each resident has a contract regarding the terms and conditions of the home, located securely in the main office. The home does not offer intermediate care. Hillbeck DS0000039699.V260775.R01.S.doc Version 5.0 Page 11 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 and 11. Care plans include comprehensive information and are kept up to date. Procedures for administering medication are adhered to and residents are treated with respect and dignity by staff. EVIDENCE: The home uses Charing Healthcares’ organisational care plan, which may be reviewed next year to customise it for use in homes for people with dementia. A sample of care plans was read, including those of residents recently admitted. Care plans included a new admission documentation checklist, information on contacts and other professionals involved, risk and dependency assessments, daily report sheets that included information of activities undertaken and if relatives have been keen to complete it and a history of the resident with information on previous work and interests. Monthly reviews of needs take place; each resident has a key worker responsible for reviews. Specialist health professionals are involved when necessary, the manager spoke of relatively recent involvement from a CPN and consultant regarding a resident presenting behavioural difficulties, treatment and review of medication had alleviated these problems enabling the resident to remain at the home. Hillbeck DS0000039699.V260775.R01.S.doc Version 5.0 Page 12 A district nurse visited during the inspection and a medical professional returned a comment card saying that they had a good relationship with the home, and that staff were very open to suggestions, incorporating changes into care plans. Medication is stored appropriately; MAR sheets read had been correctly filled in and included a photograph of the resident. Two members of care staff administered the lunchtime medication round and all staff doing so have received medication training. Throughout the day all staff were observed to be assisting and aiding residents in a respectful and dignified manner, and to be attending to personal care needs discreetly. Care plans include a section for wishes in the event of death to be recorded. Hillbeck DS0000039699.V260775.R01.S.doc Version 5.0 Page 13 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 and 15. Residents are able to exercise choice and control over their daily lives and contact with friends and relatives is promoted. Meals are well cooked and varied with plenty of choice. EVIDENCE: The interests of residents are recorded on their care plans; a list of food preferred or disliked is completed on admission. The home employs an activities coordinator for three days a week; the coordinator was not in on the day of the inspection although had discussed the activities programme at the last inspection. Group and individual activities take place and care staff have time to talk with residents and help them with interests, such as knitting, in the afternoons. Contact with friends and family is promoted, visitors including one residents’ hairdresser arrived and another resident had gone out with a family member. Birthdays are celebrated with a homemade cake and preparations were underway for Christmas, including a pantomime to be put on at the home by professional entertainers followed by a party. During the day residents were seen to be able to access all parts of the home safe for them to use as they wished, and to remain in their rooms if preferred. Choice of time to get up and eat breakfast is encouraged as far as possible Hillbeck DS0000039699.V260775.R01.S.doc Version 5.0 Page 14 with later risers still at the breakfast table at 10 am, this being their choice. At lunchtime residents who were sleepy or not ready for lunch were left until for a while and if necessary gently reminded the meal was ready. Time was spent with the cook who was aware of individual preferences, choice is offered for each meal and options chosen recorded. Pureed diets were catered for. Food is freshly cooked and plenty of snacks are available in between meals to keep up nutritional intake. The meal was well presented; residents needing help with their food were discreetly assisted. The meal was unhurried and the dining room a pleasant environment, although a cleaner was hoovering and using spray polish on furniture near residents whilst they were eating which was not appropriate. Hillbeck DS0000039699.V260775.R01.S.doc Version 5.0 Page 15 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,and 18. Residents and their relatives can feel confident that any concerns or complaints will be listened to and acted upon. Residents are protected from abuse by the homes’ policies and procedures. EVIDENCE: The home has a complaints procedure that is displayed next to the managers’ office along with forms to be completed in the event of a complaint. There had been no complaints since the last or previous inspection, a folder is held in the office to contain any complaints, it is a recommendation that recording is made in a hardback book. There had been no adult protection alerts since the last inspection. Staff spoken with asked about how to deal with a complaint said that they would feel happy referring matters to the manager or deputy. Relatives visiting a newly admitted resident were observed to ask the manager about their relatives’ missing glasses and some other concerns as soon as they arrived, they to received a helpful response and the managers’ full attention, which was clearly appreciated. Staff receive adult protection training and updates from accredited trainers within the organisation. CRB and POVA checks are undertaken on all new employees. The home has an organisational adult protection procedure. Hillbeck DS0000039699.V260775.R01.S.doc Version 5.0 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 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 and 26. Residents live in a safe, comfortable, clean and well-maintained environment. Individual bedrooms meet personal needs and equipment is available to maintain independence. Alternative flooring in one bedroom would help to prevent the presence of an odour. EVIDENCE: The home was safe, well decorated and maintained; it employs a handyman to undertake minor work and repairs. Some tiles were missing around a washbasin in an upstairs bathroom; the manager took action during the inspection to request they be replaced. Extensive refurbishment has improved the space and facilities available to residents. The addition of a conservatory provides a pleasant room for residents to access or to see relatives away from the main lounge. Hillbeck DS0000039699.V260775.R01.S.doc Version 5.0 Page 17 Residents have access to safe and secure outdoor space in terms of a patio than runs around part of the building, and that has gates at each end to prevent access to areas outside the property. One resident spoke of enjoying being able to be outside, in good weather residents can use seating and tables provided on the patio. A number of bedrooms were seen, all had personal items that residents had brought with them, and were attractively decorated. Double rooms had screens to allow for privacy and separate storage space. One double room is specifically for the use of married couples or those who may wish to move to the home together. In the case of other double rooms agreement to sharing will need to be recorded on the care plan. One bedroom had an unpleasant odour due to the nature of the needs of the resident, the cleaner was in the room at the time and evidence was seen of measures being taken on a daily basis to minimise the odour. The possibility of flooring alternative to carpeting will be considered. Grab rails are fitted throughout areas accessed by residents and equipment for personal or communal use was in evidence. Hillbeck DS0000039699.V260775.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 A competent and committed staff group supports residents; further training will increase skills in general and knowledge regarding specific topics. Residents are protected by the homes’ recruitment policies and procedures. EVIDENCE: The manager, deputy manager, senior carers, carers and ancillary staff make up the staffing compliment and the organisations’ area manager supports the manager. Some care staff that had been recruited from abroad had gained a nursing qualification in their own country and were contracted to work at the home for at least six months before commencing adaptation training. Three carers were leaving in January 2006 to commence adaptation training and recruitment was underway to replace them, consequently it was likely the home would be overstaffed for a while, this was preferable to understaffing should recruitment have been delayed. Staff on duty at the time of the inspection comprise of a mix of well-established carers at the home and those from abroad. All staff observed were competent in their roles, attentive and cheerful towards residents, comments from staff included “I love working here, really enjoy it”,” The residents are wonderful, it is a really nice place” and “It’s really nice working here”. All staff are CRB checked, in the case of those recruited from abroad the area manager interviews them in their country of origin, police checks are then done both there and in the UK. A number of staffing files were read and evidenced that CRB and POVA checks take place, and that references are taken Hillbeck DS0000039699.V260775.R01.S.doc Version 5.0 Page 19 up and followed up verbally. Other documentation on the files included work permits where applicable, as well as training records and references. Staff receive induction training and training on core topics such as adult protection, moving and handling and fire safety from the organisations’ trainers. The manager acknowledged that more training needs to be provided in coming months and had already approached an outside provider for some sessions. Service specific training such as that on dementia is provided in house. The home had not reached the target of 50 NVQ trained care staff but had a commitment to increasing the number on the courses, at the time of the inspection four senior carers had completed NVQ 2 and started NVQ 3, and other carers had commenced or were due to start NVQ 2.The cook and kitchen assistant were on NVQ 1 training. Hillbeck DS0000039699.V260775.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,36,37 and 38. The home is well managed in the best interests of residents and staff. Residents can be confident that their welfare is protected by the policies and procedures in use at the home. EVIDENCE: Throughout the inspection it was clear that the management style is open and inclusive and that residents and staff benefit from a friendly and supportive atmosphere. Staff were complimentary regarding the management of the home stating that “ we have a very good manager”, “the manager organises training really well” and “ the home runs really smoothly”. The manager is nearing completion of NVQ 4 and will be commencing the BSc in dementia studies next year. Staff receive regular supervision and staff meetings are held. Ongoing investment in the home is made and staff spoken said that where refurbishment or equipment is needed funding is provided promptly. Hillbeck DS0000039699.V260775.R01.S.doc Version 5.0 Page 21 An annual questionnaire regarding the service is circulated annually, one had recently been sent out, records are kept safely and securely in the managers’ office. A valid insurance certificate is clearly displayed and safe working practices could be seen throughout the home including the correct recording of kitchen fridge and freezer temperatures, kitchen cleaning schedules and fire procedure records. Hillbeck DS0000039699.V260775.R01.S.doc Version 5.0 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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 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 3 3 3 3 3 3 2 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 4 3 3 X 3 3 3 Hillbeck DS0000039699.V260775.R01.S.doc Version 5.0 Page 23 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP26 Regulation 16(1)(k) Requirement “ The registered person shall keep the care home free from offensive odours” In that the provision of alternative flooring be looked into for the bedroom with an offensive odour in consultation with relatives. “ The registered person shall ensure that at all times suitably qualified, competent and experienced persons are working at the care home.” In that progress must be made on enrolling care staff on NVQ raining to each the required target of 50 NVQ trained care staff. “ “ A person shall not manage a care home unless he has the qualifications, skills and experience necessary”. In that the manager of the home needs to complete the NVQ in Hillbeck DS0000039699.V260775.R01.S.doc Version 5.0 Page 24 Timescale for action 06/02/06 2 OP28 18(1)(a) 06/02/06 3 OP31 9 06/02/06 management and care. This remains a requirement from the last inspection and it is recognised that progress has been made with the course that should be completed early in 2006. 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 OP3 Good Practice Recommendations It is recommended that a letter be sent to prospective residents and their relatives to confirm that a place can be offered at the home. It is recommended that agreement to sharing double rooms is recorded in the care plan. It is recommended that if cleaning in the lounge/dining room area has to take place at lunchtime it be unobtrusive and polish and Hoovers not be used. It is recommended that complaints be recorded in a hardback book. It is recommended that tiles missing in the upstairs bathroom be replaced as soon as possible. It is strongly recommended that signs and a barrier be put in place on and in front of the wall outside the bedroom facing onto the car park to prevent cars emitting fumes into the room. 2 3 OP7 OP15 4 5 6 OP16 OP21 OP38 Hillbeck DS0000039699.V260775.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Hillbeck DS0000039699.V260775.R01.S.doc Version 5.0 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. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!