Inspection on 19/02/06 for Hillcote

This inspection was carried out on 19th February 2006.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hillcote 04/01/08

Hillcote 21/12/06

Hillcote 16/08/05

Hillcote 07/03/05

Hillcote 23/07/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Hillcote 66 Bidston Village Road Birkenhead Wirral CH43 7QT Lead Inspector Andrea Morris Unannounced Inspection 19 and 24 February 2006 13:30p th Hillcote DS0000018897.V284858.R01.S.doc Version 5.1 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 Hillcote DS0000018897.V284858.R01.S.doc Version 5.1 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 Adults 18-65. 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. Hillcote DS0000018897.V284858.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Hillcote Address 66 Bidston Village Road Birkenhead Wirral CH43 7QT 0151 670 0306 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) Alternative Futures Limited Miss Belinda Jayne Price Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Hillcote DS0000018897.V284858.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Only adults with a learning disability may be accommodated. Date of last inspection 16th August 2005 Brief Description of the Service: Hillcote is registered to provide personal care for up to five adults who have learning disabilities. At the time of the inspection, there were four service users accommodated at the home. The home provides each service user with a single bedroom and sufficient communal areas. A new manager has been appointed to the home and an application to register the manager is being processed by the Commission for Social Care Inspection. The home is located in a residential area, close to shops and supermarkets and can be accessed by public transport. The home provides a secure garden that service users are free to access as they wish. The home provides a minibus to give service users the opportunity to go out individually or together. Hillcote DS0000018897.V284858.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out over 5 hours but over 2 separate days. The inspector spoke to the manager and to staff. No client was able to express themselves verbally to the inspector. A tour was made of the home. A selection of documentation was examined; these included staff files, clients care files, health and safety certificates, training records and fire log book. What the service does well: What has improved since the last inspection? What they could do better: All the documentation for staff files needs to be obtained and stored appropriately. The manager must ensure all staff use the correct form of documentation and not to allow care staff to use abbreviations in clients files or any other legal documentation. Hillcote DS0000018897.V284858.R01.S.doc Version 5.1 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. Hillcote DS0000018897.V284858.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hillcote DS0000018897.V284858.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 4, 5 All clients are assessed prior to admission, this assists in ensuring clients needs can be met fully. EVIDENCE: The homes Statement of Purpose contains all the relevant information as requested in the National Minimum Standards. A copy is available upon request. All clients are admitted only after a detailed pre-admission assessment has been completed. The manager carries out an initial assessment, then over a period of time, the potential client is offered the opportunity to visit the home and staff members on several occasions so they can establish that they have made the right choice. All clients who move into the home are issued with a written contract that clearly determines their terms and conditions of residency. There have been no new clients recently admitted to the home. Hillcote DS0000018897.V284858.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9, 10 Care plans are formulated well, this assists in providing the correct care and ensuring clients safety. EVIDENCE: Care files are formulated for each client. These on examination were found to be detailed and contained valuable information on each client. All care files are reviewed on a regular basis. All care files hold a sample of daily living, this information gives details on each client likes and dislikes. The information also details behaviours and what they indicate for staff and how the behaviour is best managed. It was noted that in some recordings within the care plan staff were using abbreviations, this is not good practice and a recommendation for the practice to cease has been made. Clients are encouraged to participate in all activities within the home. Evidence was seen that staff encouraged client participation but within their level of capability. Hillcote DS0000018897.V284858.R01.S.doc Version 5.1 Page 10 Through discussions with staff it was noted that all staff had a good knowledge of each client and how best to care for them. All activities are risk assessed. Risk assessments are reviewed on a regular basis. All care files are kept in a secure cupboard. The home has up to date policies and procedures these are available to all staff and are used as reference material as needed. Confidentiality is discussed initially at induction; staff meetings also address confidentiality as required. Hillcote DS0000018897.V284858.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16, 17 The meals in this home are good offering both choice and variety; special dietary needs are catered for. EVIDENCE: No clients attend work due to client’s individual capabilities. However, there are a variety of activities the clients are able to participate in. These include swimming, cinema and bowling. The clients have recently attended a disco for the first time which was found to be a real success and planned to be repeated again in the future. Any individual activities are recorded in the clients care files. They hold risk assessments as needed. The home operates an open visiting policy, several clients do not have family support and in these cases staff offer the client the support required. The home has access to a minibus, regular outings are provided, these include a drive round the area, and clients’ are able to choose outings as appropriate. Hillcote DS0000018897.V284858.R01.S.doc Version 5.1 Page 12 Mealtimes are flexible and provide a variety of food, formal meals along with finger food options. Staff encourage clients to follow a health lifestyle as much as possible. The menu is on a three-week rota. Variations to the menu are available as needed. Clients are able to participate in meal preparation as their capabilities allow. Any participation from clients is risk assessed to promote safety. Menus were found to be well balanced and nutritious. Hillcote DS0000018897.V284858.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 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, 19, 20, 21 The medication is well managed and promotes safe practice. EVIDENCE: All clients have their own room. Risk assessments are documented in relation to clients care. Care plans are amended as needed and all care plans are reviewed on a regular basis. Medication for clients is held in the client’s own room in lockable cupboards. Medication documentation is recorded accurately and stock is well managed. Staff during the induction period receive training in medication administration, the manager is currently doing further drug administration via distant learning programme. There is a possibility of all staff being able to study the distant learning programme in the near future. All staff receive training in First Aid, this is re-newed every 3 years. Any client admitted to the home with specific medical need i.e. Epilepsy staff receive training in the condition prior to the client being admitted to the home. The home has an adequate policy in relating to care of the dying client. Hillcote DS0000018897.V284858.R01.S.doc Version 5.1 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Protection, this assists to protect clients from harm. Staff receive training in Adult EVIDENCE: All staff receive adult protection training during the induction period. Most staff have received further training in adult protection issues this helps to safeguard clients from harm. The home has a copy of the Wirral No Secrets Policy on Adult Protection. All staff are made aware of where it is kept and on how to use it. The home has an adequate complaints procedure. There is a copy available upon request from the office. The home documents all complaints received and the action taken. The Commission for Social Care Inspection has not received any complaints since the last inspection. Hillcote DS0000018897.V284858.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 28, 30 The home has had some re-decoration this ensures the environment for the clients remains pleasant and homely. EVIDENCE: Each client has their own room, which is personalised with their own effects. Each room also has some specialist sensory equipment installed to promote a calm and relaxing environment. Clients are able to move about the home freely. Areas considered to pose a potential danger are supervised on the client entering. Clients are able to go to their room freely during the day. The bathrooms are all decorated to a good standard. Clients are able to have baths/showers on a daily basis if they choose. All clients were noted to be treated with respect. No staff member enters any room without knocking on the door first. The lounge and the Dining room have both been recently decorated. New furniture is due into the home in the next few weeks. There has been re-decoration to two of the bedrooms also since the last inspection. On the day of the inspection the home was found to be clean and free of any unpleasant odours. Hillcote DS0000018897.V284858.R01.S.doc Version 5.1 Page 16 Hillcote DS0000018897.V284858.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 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, 35, 36 The manager provides strong leadership; this assists with promoting safe practices of care. EVIDENCE: The staff rota was examined and found to be recorded accurately. No agency staff are used, as the home is fully staff. The majority of care staff hold an NVQ2 or above in care. Some new staff are currently on the NVQ programme and are due to complete later in the year. The home manager is not yet registered with the Commission for Social Care Inspection; an application has been put forward and awaiting processing. The staff that spoke with the inspector stated they found the manager helpful, supportive and an active team player. They stated they had confidence in her ability to lead the team. A selection of care files were examined and it was noted that photographic evidence was missing from some of the files. A requirement has been made to ensure all staff files contain all the information as required in the National Minimum Standards. Staff receive regular training in all mandatory subjects, these include First Aid, Fire, Moving and Handling, Challenging Behaviour and medication. Other training is sort as needed. All staff receive supervision on a 4-6 weekly basis. The manager maintains records of all supervision. Hillcote DS0000018897.V284858.R01.S.doc Version 5.1 Page 18 Hillcote DS0000018897.V284858.R01.S.doc Version 5.1 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 40, 41, 42, 43 The home has clear policies and procedures relating to all practices; this assists in promoting safe practices in care. EVIDENCE: The home along with the Company regularly review the policies and procedures relating to care. This ensures all care practices are kept up to date and relevant to the client group. Copies of all policies and procedures are available for staff to access if required. The certificates relating to Health and Safety were examined and found to be in date and relevant. Fire safety records are also recorded accurately and staff receive regular fire training and drills to promote safety in the home. There is a clear management structure within the Company and in the home. This is detailed in the Statement of Purpose. The home operates a clear structure of responsibility, all staff are aware of their roles and responsibilities within the home. The Company also operates an on call system for out of Hillcote DS0000018897.V284858.R01.S.doc Version 5.1 Page 20 hours, staff in all homes are able to access a senior member of staff for advise or support if required. Hillcote DS0000018897.V284858.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 N/a 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 N/a 28 3 29 N/a 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 N/a N/a N/a 3 3 3 3 Hillcote DS0000018897.V284858.R01.S.doc Version 5.1 Page 22 Yes 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. 1 Standard YA34 Regulation Requirement Timescale for action 31/03/06 19(1)(b)(i) The registered person shall not employ a person to work in the care home unless he/she has obtained in respect for that person the information and documents specified in paragraphs 1-7 in schedule 2 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 Refer to Standard YA7 YA23 Good Practice Recommendations It is strongly recommended that all documentation be recorded in full. No abbreviations should be used as this can cause confusion to their meaning. It is strongly recommended that all staff receive annual adult protection training to promote safe practices within the home. Hillcote DS0000018897.V284858.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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 Hillcote DS0000018897.V284858.R01.S.doc Version 5.1 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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