Inspection on 06/02/06 for Hillcrest

This inspection was carried out on 6th 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 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

Hillcrest 19/02/07

Hillcrest 06/09/05

Hillcrest 12/01/05

Hillcrest 02/06/04

Hillcrest 29/03/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Hillcrest Hillcrest Harrowden Road Wellingborough Northants NN8 5BD Lead Inspector Mrs Kathy Jones Unannounced Inspection 06 February 2006 04:00 Hillcrest DS0000012813.V264323.R01.S.doc Version 5.0 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 Hillcrest DS0000012813.V264323.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 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. Hillcrest DS0000012813.V264323.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Hillcrest Address Hillcrest Harrowden Road Wellingborough Northants NN8 5BD 01933 272281 01933 272281 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) Tebmar Ltd Mrs Susan Tebbutt Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Hillcrest DS0000012813.V264323.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. All service users accomodated within the home will have a condition that falls within the spectrum of Autism. 6 September 2005 Date of last inspection Brief Description of the Service: Hillcrest provides long term residential care for up to five young adults.This is a specialist service, providing 24hour care for younger people aged 22 to 33 years of age with Autism. The home is a five bedroom (1960’s) detached property situated on the outskirts of Wellingborough town centre, close to a local bus route. There is a separate large activity room for educational sessions and leisure activities and the home also provides a sensory room for relaxation. There is an attractive, well-maintained, garden to the rear of the property, providing a secure outdoor recreation area. Hillcrest DS0000012813.V264323.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over approximately two hours twenty minutes on the late afternoon/early evening of a weekday. The inspection concluded at the time that residents were due to go out as planned for the evening. Prior to the inspection the inspector spent one and a half hours reading the homes service history, previous inspection report, a pre-inspection questionnaire submitted by the registered manager and comment cards from relatives. This information informed the planning of the areas to be inspected. Records for a new resident was reviewed to check how their care needs had been assessed and how their care is planned and supported. The inspector briefly met residents in their rooms introduced by the registered manager, spoke with the registered manager and observed routines, staff practice and interactions between staff and residents throughout the inspection. Due to communication difficulties and the anxiety experienced by people with autism when routines change, or when faced with new people such as an inspector visiting unannounced their views were not asked on this occasion. Observations of general well being and reactions to staff were used as a guide to assess their comfort and safety in the home. Quality assurance processes were discussed with the registered manager. What the service does well: The home specialises in the care of young adults with autism and staff demonstrate a clear understanding of the needs of those people while ensuring they are all assessed and treated as individuals. The home is well organised and managed and the needs of residents are given top priority. For example the introduction of an unexpected visitor into the home was managed in such a way as to minimise any disruption or distress for residents. There are very good relationships between the home and residents relatives who have high praise for the home and staff. For example “we have always been satisfied with the care, it is an excellent establishment run by very caring professionals”. Hillcrest DS0000012813.V264323.R01.S.doc Version 5.0 Page 6 Residents appeared happy and comfortable with staff seeking reassurance where necessary. Four were looking forward to an evening out at the pub while another resident was going to visit a relative. All residents left the home for the evening smartly and age appropriately dressed and well groomed. Care is taken to ensure that the needs of anyone admitted to the home can be met which avoids unnecessary distress. A detailed assessment process for a new resident was seen and records show that residents needs continue to be reviewed once they move into the home. All residents have a plan of care, which is based on their own needs and aims to help them keep existing skills and develop new ones. This is achieved through support and encouragement and lots of praise, examples of which were heard throughout the inspection. What has improved since the last inspection? 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 DS0000012813.V264323.R01.S.doc Version 5.0 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 Hillcrest DS0000012813.V264323.R01.S.doc Version 5.0 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): 2, 4 The admission process provides assurances that the needs of Residents entering the home can be met. EVIDENCE: A new resident had been admitted to the home three weeks prior to this inspection. There was evidence of a detailed assessment process to ensure that the resident’s needs could be met within the home. Discussion with the registered manager confirmed that care had been taken to consider the needs of existing residents before making a decision about the admission of a new resident. The prospective resident had visited the home prior to admission and consultation had taken place with relatives, health professionals, and the placing authority. Due to the nature of autism admission to the home occurred quite quickly after the resident had visited the home to try and avoid distress. Records, observations and discussion with the registered manager indicated that the resident was settling into the home and a structured routine based on his needs had been developed. Hillcrest DS0000012813.V264323.R01.S.doc Version 5.0 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, 9 Residents receive a good standard of care and support which meets their individual needs. EVIDENCE: Records for planning the care of a new resident were reviewed. Brief guidelines to assist staff in working effectively with the resident had been put in place prior to a more detailed care plan being developed. The guidelines provide staff with clear information about the resident’s needs and expectations in order that they are able to work in a consistent manner. The guidelines were based on information gathered through the assessment process. The registered manager advised that the full care plan is being developed based on staff observations and the residents choices. The home uses the TEACCH, method, which provides a structured approach to the residents day through verbal or picture prompts. Individual picture boards are in place for each resident and are used on a daily basis to assist with understanding the routine of the day, which reduces anxiety. The picture boards are also used to assist residents with making choices. Hillcrest DS0000012813.V264323.R01.S.doc Version 5.0 Page 10 Risk factors are identified as part of the assessment process and strategies put in place for minimising risks. Staff demonstrated a good understanding of the needs, of individual residents, and were observed to be providing residents with an appropriate level of support. Hillcrest DS0000012813.V264323.R01.S.doc Version 5.0 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, 14, 15 Resident’s individual support and personal development needs are identified and opportunities and strategies put in place to maximise their potential. EVIDENCE: Discussion and a sample check of residents records confirms that the manager and staff are committed to providing opportunities and supporting residents to increase their potential at a pace and in a manner which is appropriate to their needs. Individual plans take account of resident’s social, emotional, communication and independent living skills. On the evening of the inspection four residents were going out to the pub, which is part of a regular activity programme. Another resident was going to visit a parent for the evening. A relative describes the range of activities as “great” in a comment card forwarded to CSCI. Family contact is clearly encouraged and residents are supported in maintaining regular contact with their family. Comments from relatives confirm that they are welcomed into the home, can visit in private and are kept informed of important matters affecting their relative. This was supported by a Hillcrest DS0000012813.V264323.R01.S.doc Version 5.0 Page 12 sample check of records, which showed regular communication with residents families. Hillcrest DS0000012813.V264323.R01.S.doc Version 5.0 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, 21 Residents receive an appropriate level of support are treated with sensitivity and according to their individual needs. EVIDENCE: The assessment and care planning processes take account of individual preferences and needs in relation to personal care. Residents are encouraged to be as independent as possible and picture cards are used in en-suite bathrooms where necessary to remind residents of their personal care routines. The home had the experience of a resident dying in the home last year, this would appear to have been handled with great sensitivity. Through discussions with the registered manager it was evident that staff and relatives have been supportive of each other and the residents through the grieving process. Staff have monitored carefully the effects on residents without assumptions being made about their ability to be affected due to their autism. Discussion with the registered manager identified that staff and resident feelings were considered when deciding on the appropriate time to admit a new resident. Hillcrest DS0000012813.V264323.R01.S.doc Version 5.0 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): This section of the standards was not reviewed during this inspection. This section of the standards was not reviewed during this inspection. EVIDENCE: This section of the standards was not reviewed during this inspection. No concerns were identified at the previous inspection or during this inspection. Positive comments have been received from relatives about the care provided. Hillcrest DS0000012813.V264323.R01.S.doc Version 5.0 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, 26, 28, 30 The home was clean, comfortable and in good decorative order providing a pleasant environment for Residents. EVIDENCE: The home is indistinguishable from other large family houses in the area, it is set back slightly from the main road with car parking at the front of the house. There is a large garden to the side and rear of the house, which is well tended. A limited tour of the premises was carried out during the inspection; all areas were very clean and tidy. The home is decorated and furnished to a very good standard, with good quality furnishings that are comfortable. Communal areas of the home include lounge, activity room and a sensory room. The activity room was not viewed during this inspection however the lounge was homely and comfortably furnished and the sensory room provides an ideal place to relax or as staff advised sometimes happens to play and dance to some loud music. The registered manager introduced the inspector to some of the residents who were relaxing in their rooms. All have single bedrooms, which have en-suite Hillcrest DS0000012813.V264323.R01.S.doc Version 5.0 Page 16 toilet facilities. Bedrooms were well decorated, comfortably and appropriately furnished for the needs of the individuals. The registered manager advised that residents that are able had been involved with choosing the décor and soft furnishings. Hillcrest DS0000012813.V264323.R01.S.doc Version 5.0 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): This standard was not assessed during this inspection. This standard was not assessed during this inspection. EVIDENCE: This standard was not assessed during this inspection however at the time of the inspection there were sufficient staff to meet the needs of residents. Comments received from relatives confirm that they are happy with the staffing levels and one described the home as very caring with good staff. Hillcrest DS0000012813.V264323.R01.S.doc Version 5.0 Page 18 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): 39, 41 Managers and staff demonstrate a commitment to reviewing and maintaining high standards of care. EVIDENCE: The registered manager confirmed that the quality assurance process involves seeking views from relatives about the standard of care. Questionnaires are sent out to relatives before and after resident’s reviews, which are carried out every six months. Discussion throughout the inspection confirmed that constant efforts are made to review, maintain and where possible improve the standards of care provided. Records are kept in good order, in general recording is clear and supports the care provided. The need to ensure that records of injuries are sufficiently detailed in all cases including records of events that have occurred on family visits was discussed. Hillcrest DS0000012813.V264323.R01.S.doc Version 5.0 Page 19 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X 3 X Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X 3 X 3 X 3 LIFESTYLES Standard No Score 11 3 12 X 13 X 14 3 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X X X X X X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Hillcrest Score 3 X X 3 Standard No 37 38 39 40 41 42 43 Score X X 3 X 3 X X DS0000012813.V264323.R01.S.doc Version 5.0 Page 20 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Hillcrest DS0000012813.V264323.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB 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. 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