Inspection on 07/06/05 for Hillcrest House Limited

This inspection was carried out on 7th June 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 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 House Limited 02/10/07

Hillcrest House Limited 30/10/06

Hillcrest House Limited 28/11/05

Hillcrest House Limited 01/12/04

Hillcrest House Limited 15/06/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Hillcrest House Barbican Road East Looe Cornwall PL13 1NN Lead Inspector Alan Pitts Announced 07 & 08 June 2005 10:00 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 House D52-D04 S46312 Hillcrest V226087 780605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Hillcrest House Address Barbican Road East Looe Cornwall PL13 1NN 01503 263489 01503 264448 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) Hillcrest House Limited Ms Sharon Jane Keast Care Home 88 Category(ies) of Dementia - over 65 years of age (31), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (31), Old age, not falling within any other category (57), Physical disability (57), Physical disability over 65 years of age (57), Terminally ill (57), Terminally ill over 65 years of age (57) Hillcrest House D52-D04 S46312 Hillcrest V226087 780605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30/11/04 and 01/12/04 Brief Description of the Service: Hillcrest House offers care and accommodation to elderly people in need of care by reason of old age. The home has two units, the General Unit that provides nursing care for up to 57 people and Trevena which provide care for up to 31 older people who have mental health problems or dementia. The home is situated on the outskirts of Looe and has scenic views over the surrounding countryside and sea. There is a small group of shops within walking distance of the home. The home is a modern building, purpose built to provide care and accommodation. Hillcrest House D52-D04 S46312 Hillcrest V226087 780605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. All the service users and visitors spoken with at the time of the inspection told of flexible, individually focused care, which is all the more commendable given the relatively large size of the home. Management structures are clearly defined and the comments of service users and visitors reflect effective everyday management and communication. What the service does well: What has improved since the last inspection? What they could do better: Hillcrest House D52-D04 S46312 Hillcrest V226087 780605 Stage 4.doc Version 1.30 Page 6 The home could show to greater effect the involvement of service users or their representatives in care plan reviews. The home could make more use of the information obtained from quality assurance questionnaires. 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 House D52-D04 S46312 Hillcrest V226087 780605 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Hillcrest House D52-D04 S46312 Hillcrest V226087 780605 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 3, 4, 5, 6 All potential service users are properly assessed. Communication between the home and service users or their relatives is good. EVIDENCE: The Statement of Purpose is comprehensive and kept under review. A service user’s guide was available within the entrance to each unit. This was clearly written and provided details of the environment Each service user is admitted following a full assessment. The assessment is undertaken either at home or in their current place of residence. The pre-admission assessment forms the basis of an individual care plan. Where another professional undertakes the assessment, the home retains a copy of this assessment. Detailed pre-admission assessments, care plans and staff-training files indicate that the home is meeting specialised individual needs. There is input from other professionals such as Consultants, community nurses, dietician, McMillan nurses, speech therapists etc. Equipment is evident for the safe moving of service users. Hillcrest House D52-D04 S46312 Hillcrest V226087 780605 Stage 4.doc Version 1.30 Page 9 An activities organiser is employed providing specialist input into activities aimed at service users with dementia. Resources are available within the home to promote activities, interests and hobbies. The majority of service users come to the home directly from hospital so that choosing and viewing the home is generally the responsibility of families or other close relatives. Some service users do have respite stays before making the final decision to move into the home and have the opportunity to make pre-admission visits. This home does not provide Intermediate Care. Hillcrest House D52-D04 S46312 Hillcrest V226087 780605 Stage 4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 9, 10 Concern for the welfare and rights of the service users was evident from the comments of staff, service users and visitors and observation of the staff at work. EVIDENCE: Each service user has a detailed care plan, based upon the pre-admission assessment and risk assessment. The care plans on the general unit were seen to be comprehensive and provide clear instruction to staff. There was less clarity in the documentation on Trevarna Unit, but this was being rectified even before the inspection was finished. The Registered Manager should ensure that service users or their representatives are involved in the review of care plans. Only the latter comment prevents the home from achieving top marks for care plans. Risk assessments are full and detailed, and identify risks/problems and an action to reduce the risk. Risk assessments include medication risks and the risk of falling. There is input from other professionals as appropriate. An activities organiser is employed providing specialist input into activities aimed at service users with dementia. The home has a medication policy and procedure in place. Qualified nurses administer all medication. Controlled medicine is stored and recorded Hillcrest House D52-D04 S46312 Hillcrest V226087 780605 Stage 4.doc Version 1.30 Page 11 according to pharmaceutical guidelines. The home has systems in place that enable staff to record the effect of medications on individual service users and report any concerns to the GP. Oxygen cylinders are stored with appropriate signs in place. Service users feel they are treated with respect and their right to privacy is upheld. Service users are addressed by their preferred name, which is recorded within the individual admission plan. Staff were observed to treat service users with respect and it was noted that staff pay extra attention to privacy and dignity when entering bathrooms and toilets. Respect for the service users was evident throughout and in all aspects of the inspection. Hillcrest House D52-D04 S46312 Hillcrest V226087 780605 Stage 4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 Service users and relatives were complimentary about the quality of life and standard of care offered at Hillcrest House, and is a credit to the hard work of the staff and management. All the service users and visitors spoken with said that they (the service users) could determine their own lifestyle within the confines of their care needs. EVIDENCE: The service users individual care plan has a detailed section regarding their interests. Visiting is encouraged and the visitors the inspector spoke with confirmed there are no limitations on visiting. An activities co-ordinator is employed by the home. Information regarding arranged activities is provided for service users and their families on notices posted around the home. Staff were observed occupying service users, stimulating their interests and encouraging others to join in. Service users commented that they determined their own lifestyle and that staff were pleasant, and helpful at all times. Visitors to the home repeated these comments. Service users are enabled to choose the time they get out of, and go to bed. Meal times are flexible. Service users maintain contact with family/friends/representatives and the local community as they wish. Visitors are welcomed to the home, as detailed in the service users guide, and were present during the inspection. A visitor’s Hillcrest House D52-D04 S46312 Hillcrest V226087 780605 Stage 4.doc Version 1.30 Page 13 book is available in the entrance porch. There are communal areas available for receiving visitors as well as private accommodation areas. Visitors that service users receive are recorded within the daily recording. Service users are supported as to which visitors they wish to see. Service users are encouraged to partake in community activities and are supported by transport being provided if necessary, carers will also support service users to utilise local shopping facilities or go for a walk within the local area. The home organises trips for service users who choose to partake of this service. Service users are made aware of their right to access their own records and a policy and procedure is in place in accordance with the Data Protection Act 1998. Service users and staff stated that choices regarding personal preferences were afforded, (i.e. bedtimes, clothing worn, daily routine). Hillcrest House D52-D04 S46312 Hillcrest V226087 780605 Stage 4.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 17, 18 Service users and visitors confirmed that they would feel able to approach the staff or the management of the home if they had a concern. EVIDENCE: Service users confirmed that they received their mail unopened and were able to participate in the recent government elections. Comprehensive policies and procedures regarding all types of abuse, restraint and adult protection are in place. These subjects form part of induction training for all staff. One service user commented “they treat you like a person”. Hillcrest House D52-D04 S46312 Hillcrest V226087 780605 Stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 21, 26 Standards of cleanliness are high, with a proactive approach to the prevention of infection evident. EVIDENCE: Bathrooms and toilets were clean and odour free. All bedrooms have en-suite facilities. Inspection of the laundry showed that there are systems in place to prevent cross infection. Industrial machines are in use. The floor covering in the laundry has been replaced. No odours were noted in the general unit with all areas appearing clean. Where odours were noted in Trevana unit, these were isolated to an area of the main lounge. Alcohol solution is provided at the entrance to all units and visitors are encouraged to use this before entering. There is an active maintenance programme with three maintenance staff employed by the home. Since the last inspection the home has purchased a new dishwasher, combi-oven and washing machine. Hillcrest House D52-D04 S46312 Hillcrest V226087 780605 Stage 4.doc Version 1.30 Page 16 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, 28, 29, 30 There is a clear commitment to staff training, which is further enhanced by the provision of placements for student nurses at the home. A robust employment procedure is in operation. EVIDENCE: On both days of the inspection it was considered that an appropriate number and skill mix of staff were on duty. Staff were observed to be carrying out their duties in an unhurried and calm fashion and service user comments supported this observation. There are 34 care staff employed, of which approximately 53 have achieved NVQ Level 2 or above. There are comprehensive staff personnel files including a record of Criminal Records Bureau checks. Two student nurses from Plymouth University were complimentary about their experience at Hillcrest House, the support and mentorship of the staff. All new staff undergo an in-house induction and, unless previously completed, a National Training Organisation compliant induction programme. The home is also considering the introduction of additional external materials. Hillcrest House D52-D04 S46312 Hillcrest V226087 780605 Stage 4.doc Version 1.30 Page 17 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) 31, 32, 33, 36 This is an established home with an experienced Registered Manager. There is a clear managerial hierarchy and appropriate policies and procedures are in place. EVIDENCE: The registered manager has been at the home since 1987. The Registered Manager is a registered nurse and has completed the NVQ Level 4 management diploma. The Registered Manager is involved in the day-to-day running of the home and there is clear and strong managerial leadership. The organisational structure of the home demonstrates how responsibility is delegated to Heads of Departments, and this is displayed and provided to all service users and representatives. A further two staff have also completed the NVQ Level 4 management diploma. An annual quality assurance questionnaire is used, and a quality policy is in place. The results from the questionnaires are collated. The Registered Hillcrest House D52-D04 S46312 Hillcrest V226087 780605 Stage 4.doc Version 1.30 Page 18 Manager should make arrangements to publish the findings of the quality assurance questionnaires. There is an annual development plan. Managers currently undertake supervision sessions with all staff. A record is kept on the each unit of supervision with 2 signatures (1 of manager and 1 of employee). A main record of all supervisions is kept and, as discussed, it is suggested that this be enhanced by the addition of staff initials. On going training is provided for all staff. Hillcrest House D52-D04 S46312 Hillcrest V226087 780605 Stage 4.doc Version 1.30 Page 19 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 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x COMPLAINTS AND PROTECTION x x 3 x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x 3 3 3 3 2 x x 3 x x Hillcrest House D52-D04 S46312 Hillcrest V226087 780605 Stage 4.doc Version 1.30 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. 1. 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. 1. 2. Refer to Standard 7 33 Good Practice Recommendations The Registered Manager should ensure that service users or their representatives are involved in the review of care plans. The Registered Manager should make arrangements to publish the findings of the quality assurance questionnaires. Hillcrest House D52-D04 S46312 Hillcrest V226087 780605 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection John Keay House Tregonissey Road St Austell Cornwall PL25 4AD 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 House D52-D04 S46312 Hillcrest V226087 780605 Stage 4.doc Version 1.30 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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