Inspection on 05/09/05 for Hillcrest

This inspection was carried out on 5th September 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

Hillcrest 09/01/09

Hillcrest 12/01/07

Hillcrest 23/01/06

Hillcrest 04/11/04

Hillcrest 19/05/04

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

CARE HOMES FOR OLDER PEOPLE HILLCREST Elliott Street Tyldesley Greater Manchester M29 8JE Lead Inspector Julie Conrad Unannounced 5 September 2005 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 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. HILLCREST F06 F56 S5740 Hillcrest V245296 050905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Hillcrest Address Elliott Street Tyldesley Greater Manchester M29 8JE 01942 891949 01942 876393 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Caring Alternatives Limited Ms Margaret Swanson CRH Care Home only 17 Category(ies) of DE Dementia 55 - 65 years (2) registration, with number DE(E) Dementia over 65 years (17) of places MD(E) Mental Disorder over 65 years (2) HILLCREST F06 F56 S5740 Hillcrest V245296 050905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 17 service users to include:up to 17 service users in the category of DE(E) Dementia over 65 years of age up to 2 service users in the category of DE Dementia aged between 55 and 65 years of age up to 2 service users in the category of MD(E) Mental Disorder over 65 years of age 2. One named service user (WF) in the category of MD(E) (Mental Disorder over 65 years of age) may be accommodated within the overall number of registered places. 3. The service should employ a suitably qualified and experienced manager who is registered with the CSCI. 4. The Registered Person must ensure that all staff working in the home have dementia and mental disorder awareness and training, which equips them to meet the assessed needs of the service users accommodated, as defined in the individual plan of care. 5. The service should at all times employ suitably qualified and experienced members of staff, in sufficient numbers, to meet the assessed needs of the service users with dementia and mental disorder. Date of last inspection 4th November 2004 HILLCREST F06 F56 S5740 Hillcrest V245296 050905 Stage 4.doc Version 1.40 Page 5 Brief Description of the Service: Hillcrest is situated on the outskirts of Tyldsley town centre and is close to local ammenities and is on a main bus route. St Georges church is adjacent to the home. Hillcrest is a converted vicarage and provides private accommodation on the ground and first floor. The home has recently had an extension to the property providing two additional bedrooms with ensuite facilities and an additional lounge and a lift has been installed. Three bedrooms are shared rooms, the rest are single bedrooms. All bedrooms have a hand wash basin and three rooms in total have ensuite facilities. Toilets are close to residents bedrooms and the lounge and dining areas. The home has extensive grounds, which the manager is in the process of arranging to have landscaped and made private and secure. The home offers accommodation and care for up to seventeen residents over the age of sixty-five years, who have dementia, including up to two residents under sixty-five but over the age of fifty-five, who have dementia and two designated residents who are over sixty five years of age who have a mental disorder. HILLCREST F06 F56 S5740 Hillcrest V245296 050905 Stage 4.doc Version 1.40 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 5th September 2005 from 9.45am until 1.15pm, by two inspectors. The homeowner who is also the registered manager was present throughout the inspection. A tour of the premises took place and records were checked. The inspectors had conversations with a number of staff and residents and one relative, who all said good things about the home. What the service does well: What has improved since the last inspection? Since the last inspection, the home has had an extension, providing two extra bedrooms with en-suite facilities, a bathroom and an extra lounge, all these rooms are decorated and furnished to a high standard. A new toilet has been added to an upstairs bathroom that is in the process of being redecorated and tiled. HILLCREST F06 F56 S5740 Hillcrest V245296 050905 Stage 4.doc Version 1.40 Page 7 The manager is planning to have the back garden area landscaped and enclosed, so residents will be-able to enjoy walking and sitting in the garden, which will be secure and give residents privacy, the manager said that the work on the garden is to commence in the near future. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. HILLCREST F06 F56 S5740 Hillcrest V245296 050905 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection HILLCREST F06 F56 S5740 Hillcrest V245296 050905 Stage 4.doc Version 1.40 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 standard(s) 1, 3, 5 The home’s statement of purpose and service user guide, entitled ‘your questions answered’, provide prospective residents and their relatives with details of the service and the home, which assists them to make an informed decision about admission to the home. EVIDENCE: The inspector read the home’s statement of purpose, and a service user guide, which is called ‘your questions answered’, which gives prospective residents information on staying at the home on a trial basis, contracts and fees, terms and conditions, staffing, visitors, care needs and services provided, laundry and information on the managers and staff, including qualifications. In addition to this, the manager said that home provides prospective residents with a leaflet, which also gives this information in a user-friendly manner. However, this leaflet was not available on the day of the inspection. Prospective residents and their relatives visit the home to look around and meet the manager and the staff team, this is followed by a trial visit before deciding to stay permanently. HILLCREST F06 F56 S5740 Hillcrest V245296 050905 Stage 4.doc Version 1.40 Page 10 Four residents files were seen, each resident has an assessment of need carried out by a social worker before going into the home. The manager completes a comprehensive care plan, which is reviewed each month. HILLCREST F06 F56 S5740 Hillcrest V245296 050905 Stage 4.doc Version 1.40 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 standard(s) 7, 8, 10 The care planning system and risk assessments in place ensure individual health, personal and social needs are met, to enable residents to live a full a life as possible. EVIDENCE: Three care plans were seen, these contain a client profile, which includes detailed information on each resident’s general health and medical condition, the care plan informs staff how to meet the individual residents health, social and personal needs. The records demonstrate that appropriate health care professionals and consultants are involved in the residents care, to ensure the home is meeting each residents health care needs fully. Residents said that they were well looked after, one resident said, ‘ they have helped me have a bath this morning and have done my hair.’ The resident was very pleased with her hair and pleased that she had been able to have a bath at a time she had chosen to. HILLCREST F06 F56 S5740 Hillcrest V245296 050905 Stage 4.doc Version 1.40 Page 12 The inspector observed two staff assisting a resident with no mobility, transfer from a wheelchair to her chair and later saw a member of staff feeding this resident with mashed food, in a calm, caring manner. Staff were observed as understanding the residents needs and providing the care in a skilled, caring way. The homes care plan objectives records, demonstrate the care plans are reviewed each month. HILLCREST F06 F56 S5740 Hillcrest V245296 050905 Stage 4.doc Version 1.40 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 standard(s) 12, 13, 14, 15 Resident’s interests and links with visitors and the wider community are encouraged, to ensure residents live as normal a life as possible. The meals at the home are good, offering both choice and variety and catering for special dietary needs. EVIDENCE: The inspector spent time talking to a resident who was doing a puzzle, the resident said she could ‘spend all day doing puzzles and word games’. The resident said she went to her daughters for lunch every Sunday, she told the inspector that staff would take residents to the local church if they wanted to go, the church is across the road from the home. The care plan has a section on daily living and social activities, staff ensure that all residents engage in conversation throughout the day. Activities include sing-a-longs, dancing, walks to the local shops, taking residents to see relative, welcoming relatives and visitors to the home. There is music, exercise to music, videos, and hairdressing. Staff were seen to spend time talking to residents on a one to one basis. The activities appear to focus on keeping residents mentally stimulated, mobile and engaged home in everyday matters of homelife. HILLCREST F06 F56 S5740 Hillcrest V245296 050905 Stage 4.doc Version 1.40 Page 14 The inspector observed a lot of interaction between staff and residents and residents were happy to talk to the inspector and were seen moving freely around the home. The inspector chatted to a relative, who visits the home three times a week, the relative praised the staff and care provided and said she was always made welcome and staff always made her a drink of tea. The inspector was told by a resident that she got up around 7.30am, but often stayed up late until 11pm in the sitting area in the dining room, where there is a TV and it is quieter. The home is flexible to the residents needs. Residents said the food served at the home is always good. The inspectors saw staff serving lunch, there was a choice of two hot meals, two meat dishes with mashed potato and carrots and peas, followed by a dessert. The food looked and smelled delicious and residents were seen to be enjoying their meal. The inspector chatted with the cook, the menus are set on a four week rotational basis by the manager, the menus offer a cooked breakfast or porridge, toast and preserve. Lunch is the main meal of the day, there is always a choice of two cooked meals served with vegetables and potatoes, whilst the evening meal offers a hot meal or soup or sandwiches. The cook also prepares meals for people with special diets, the cook has written information, which tells her which residents have special diets or need their food pureed. The inspectors saw that staff have this information when serving meals and know exactly what each resident should have or prefers to have on their plate. HILLCREST F06 F56 S5740 Hillcrest V245296 050905 Stage 4.doc Version 1.40 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 standard(s) 16, 18 The home has a policy and procedure on complaints and the protection of vulnerable adults, which ensures residents rights and well-being is protected. EVIDENCE: The home has a complaints procedure and system for recording complaints. The complaints log was examined to find no complaints since the last inspection. The manager said that if a resident had been unhappy with any aspect of life in the home, this would be recorded in the care notes and would include action taken to resolve the issue. Care notes also include details of consultation with relatives about aspects of their relatives care. None of the resident’s spoken to have any concerns or complaints about the home. The home has a policy and procedure on the protection of vulnerable adults. There have been no allegations of abuse at the home. Staff have received training in the protection of vulnerable adults as part of their NVQ training. Residents may leave their money in safe storage, but have access to it at all times, financial records are kept of all transactions. Staff said they were aware of the steps to take if a case of suspected abuse ever arose. HILLCREST F06 F56 S5740 Hillcrest V245296 050905 Stage 4.doc Version 1.40 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 standard(s) 21, 26 The home offers residents a relaxed homely environment in which to live. Redecorating of part of the home would make the home more pleasant for the residents. EVIDENCE: Since the last inspection, the home has had an extension, providing two additional bedrooms with en-suite facilities, a bathroom and lounge. These bedrooms are spacious and nicely decorated in light pastel shades. The lounge is decorated in pale green and cream. There is comfortable furniture, a TV and fresh flowers placed on a small table. The lounge has plenty of natural light and has views to the rear of the home. Throughout the rest of the home many doors are scuffed and need repainting, some carpets need replacing, and in the downstairs hallway the wallpaper is torn and needs redecorating. The main lounge needs wallpaper on one of the walls. HILLCREST F06 F56 S5740 Hillcrest V245296 050905 Stage 4.doc Version 1.40 Page 17 An upstairs bathroom that is being redecorated has had a new toilet installed. The downstairs bathroom is also in the process of being redecorated. The manager is fully aware that parts of the home need to be redecorated and repainted and has a programme of redecoration in place. A resident who shares a room told the inspector, ‘its fine sharing, I hardly know she is there and we have a screen in the room’. Another resident said she ‘liked her room’ and that she likes the new lounge and the choice of sitting areas given. A male resident using the new lounge, told the inspector that he liked the new lounge because, he ‘likes an occasional chat and then enjoys the quieter lounge’. The majority of residents still like to sit in the main lounge, which is full of daily activity. Residents enjoyed chatting to the inspector and said they liked the home, residents were observed chatting to each other in a relaxed, friendly manner. The residents appeared to be accepting of each other and everyone appeared to be settled and content. The manager accompanied the inspectors when viewing a number of bedrooms, which had been personalised by the residents; all the bedrooms appeared clean and tidy. The home throughout was clean, tidy and free from odour. HILLCREST F06 F56 S5740 Hillcrest V245296 050905 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29, 30 There are sufficient numbers of staff on duty, to meet the current needs of the residents. Staff training at the home is good, which ensures residents receive good care. EVIDENCE: On the day of the inspection sufficient numbers of staff were on duty to meet the residents care needs. The staff rotas were seen, these demonstrated that when staff were on leave or sick leave, these shifts were covered. Two members of staff cover a waking night shift. Staff spoken to said the rotas were adequate to meet the residents needs. Staff appear to enjoy working at Hillcrest, one member of staff said, ‘we all get on well and are very happy. During the visit staff were observed to respond quickly to requests for assistance and they also spent time socialising with the residents. Two cooks cover kitchen duty seven days a week. The inspector chatted with the cook on duty, who told the inspector that she had worked as a cook in other homes and that Hillcrest was the best place she has ever worked. The cook said only fresh produce is every used, unlike some other homes who rely on frozen foods. Two staff files were seen, which demonstrated all recruitment checks had been carried out. HILLCREST F06 F56 S5740 Hillcrest V245296 050905 Stage 4.doc Version 1.40 Page 19 A comprehensive staff development programme is in place. All but two staff has attained or is in the process of completing NVQ level 2. A record of all training is kept, ongoing training is available and there is evidence that these opportunities are taken up. Recent training has included medication, health and safety and fire safety. Staff are to attend a moving and handling course in a weeks time. Staff completed dementia care training on 11th May 2005, the manager said further training related to dementia would be provided in the near future. Staff spoken to said that all training was provided to them free of charge. Some staff have not received training in first aid, the manager said all staff will have received this training within the next six months. HILLCREST F06 F56 S5740 Hillcrest V245296 050905 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,35,38 There are a number health and safety requirements, which need to be met to ensure the wellbeing of the residents is safeguarded. EVIDENCE: The manager said that in the past satisfaction questionnaires had been sent to relatives and that she intended to send them out again. The manager said that she makes an effort to meet with relatives on a regular basis. Opinions are sought from residents on a one to one basis rather than a group, as the manager thinks this is more effective in gaining residents opinions. Staff meetings take place regularly and policies and procedures and records are reviewed regularly. The home has a good accounting system in place, the staff on duty are able to determine exactly how much money the home was holding for each resident. HILLCREST F06 F56 S5740 Hillcrest V245296 050905 Stage 4.doc Version 1.40 Page 21 The home looks after small amounts of resident’s personal allowances and detailed records are kept of each transaction. All monies are kept secure. Policies and procedures are in place including health and safety. The staff team have completed health and safety training. Accidents have been recorded appropriately. External contractors carry out regular inspections and maintenance checks of equipment and the building. The gas safety inspection is a month over due, the manager agreed to forward an up to date certificate to CSCI. An outstanding requirement from the last inspection identified that the hot water temperatures to sinks in nine bedrooms exceeds 43 degrees centigrade. The manager said she was planning to address this but indicated no definite timescale, following discussion with the regulation manager, it has been decided that water temperature must be regulated within a three month period. Fire precautions are carried out frequently, however a fire drill is overdue. The manager is competent and is a qualified RGN (Registered General Nurse) and RMN (Registered Mental Nurse) and has a masters degree, (MA Social Gerontology), however, the manager must complete NVQ level 4 and the Registered Managers Award. HILLCREST F06 F56 S5740 Hillcrest V245296 050905 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 2 14 3 15 x COMPLAINTS AND PROTECTION x x 3 x 2 x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x 3 x x 2 HILLCREST F06 F56 S5740 Hillcrest V245296 050905 Stage 4.doc Version 1.40 Page 23 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. 2. 3. Standard 38 30 38 Regulation 23 13 23 Requirement An annual gas inspection is overdue. A number of staff need to receive training in first aid. The hot water temperature in nine bedrooms must be regulated to ensure water temperature does not exceed 43 degrees. A fire drill is overdue Parts of the home need redcorating, repainting and recarpeting. Timescale for action 1/10/05 30/1/06 6/12/05 4. 5. 38 24 23 23 1/10/06 30/1/06 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. Refer to Standard 1 33 Good Practice Recommendations The service user guide should be available at all times. The manager must complete NVQ level 4 and the registered managers award. HILLCREST F06 F56 S5740 Hillcrest V245296 050905 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Turton Suite, Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG 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 HILLCREST F06 F56 S5740 Hillcrest V245296 050905 Stage 4.doc Version 1.40 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. 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