Inspection on 12/03/09 for Hillcrest Residential Care Home

This inspection was carried out on 12th March 2009.

CSCI found this care home to be providing an Good service.

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 Residential Care Home 13/03/07

Hillcrest Residential Care Home 16/03/06

Hillcrest Residential Care Home 05/07/05

Hillcrest Residential Care Home 22/02/05

Hillcrest Residential Care Home 28/09/04

Hillcrest Residential Care Home 11/03/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Hillcrest Residential Care Home 12 Hill Top Road Leeds West Yorkshire LS12 3SG     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Valerie Francis     Date: 1 2 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Hillcrest Residential Care Home 12 Hill Top Road Leeds West Yorkshire LS12 3SG 01132639002 F/P01132639002 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Sandra Eastwood,Mr John Eastwood Name of registered manager (if applicable) Mrs Susan Kettlewell Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: THe registered person may provide the following category of service only: Care Home only, Code PC. To service users of the following gender: Either. Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category, Code OP, maximum number of places 19 Dementia, Code DE, maximum number of places 4 The maximum number of service users who can be accommodated is: 19 Date of last inspection Brief description of the care home Hillcrest is situated in the Armley suburb of Leeds. It is a detached, period property, which has been adapted to provide accommodation, without nursing, to nineteen older people, of either sex, over the age of 65. Many of the features of the property have been retained and add to the character of Care Homes for Older People Page 4 of 25 care home 19 Over 65 0 19 4 0 Brief description of the care home the building. There are gardens and a patio area to the rear of the building and some car parking is available, the main gate to the home has a security code to gain entrance to the home and the grounds. There are two communal lounges and a dining room, both of which are well furnished in a domestic and homely style. The home is on four levels, three of which are accessible to residents. People with limited mobility have access to a passenger lift or a stair lift.The home is close to local shops, public houses and other amenities and there is good access to public transport to the city centre. Copies of previous inspection reports are available in the home. Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced visit to the home by one inspector, which lasted about six hours. We were accompanied by an Expert by Experience from the organisation Help the Aged. An expert by experience is a person who, because of their shared experience of using services, is able to help us get a better picture of what it is actually like for people using services. During the inspection all of the key standards were looked at to assess the standard of care that people receive. An Annual Quality Assurance Assessment (AQAA) was completed by the home and this information was used as part of our findings of this inspection visit. Surveys were sent to people and staff. During the visit we looked around the home, spoke to people who live at the home, staff, visitors, manager and one of the owners. Care plans, risk Care Homes for Older People Page 6 of 25 assessments, health care records meeting minutes, staff recruitment, training records and the premises were looked at. Fees that applied at the time of this inspection were ranging from 405 pounds and 55 pence to 426 pounds and 87 pence a week. Hairdressing, chiropody and newspaper and magazines are not included in the fees. However, the proprietor does supply some magazines on a daily basis. Feedback was given to the manager and the owner. We have reviewed our practice when making requirements to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use the service are not being put at significant risk or harm. In future if a requirement is repeated it is likely that enforcement action will be taken. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who want to use the service have access to up to date information about the service and they are assessed before they move in. Evidence: The home has a statement of purpose and service user guide which has recently been updated, this gives people who want to use the service good information about the home and the service it provides. The home carries out a care needs assessment and they try to get an up to date core assessment for any one wanting to move into the home. This ensures that the home can meet all the identified care needs of the person. We looked at the care file of someone who had recently moved into the home, and we found that an assessment of their care needs was carried out and also the home had been given up to date assessment information from the referring agency. Care Homes for Older People Page 10 of 25 Care Homes for Older People Page 11 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have care plans that are in line with their personal needs and wishes. Peoples medication is handled safely. Evidence: We looked at three peoples care plans and we found that everyone had a care plan which identified their needs. Each persons care file had their photograph, for easy identification. When we spoke to people and their relatives they said that they had been involved in putting care plans together. One visitor told us that if there was any change in their relatives care needs then the care plan would be altered, to make sure they get the care they needed. The manager told us that care plans are reviewed regularly and that people and their relatives were involved in the process. This was confirmed by two relatives visiting. We found staff to be very aware of the importance of maintaining the privacy and dignity of people in their care. Staff were also aware of the difficulty of doing so when people are sharing a bedroom. Relatives told us that they felt staff make sure that people living in the home are Care Homes for Older People Page 12 of 25 Evidence: treated with respect at all times. Medications are well managed with good records kept. The home has a safe handling of medication policy in place. Medications are ordered in accordance with the Royal Pharmaceutical Society Guidelines. We observed staff taking care with administering medication.The deputy manager carries out regular monitoring of medication administration records to make sure people get their medication and that records are signed by staff administering medication. This is to ensure that people are safe. Care Homes for Older People Page 13 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have the opportunity to engage in social and recreational activities and are encouraged and supported to pass time doing what they prefer . A choice of menu is provided with further choice if they wish. Evidence: We saw that people were encouraged to take part in activities in and out of the home. Such as going out for a walk in the grounds and to local shops if they were able. We were also told that there are visiting entertainers who engage people in singing and entertainment. On the day of the inspection one persons relatives had taken them out for coffee and shopping. They told us that since their mother moved into Hillcrest she had made friends with other people and joined in the activities, which previously she would not have done. One member of staff had been designated as the activity coordinator. There were plans in place for the designated staff to attend an activity organisers course, so that people have access to a member of staff who can engage them in meaningful activities, to keep them stimulated. A relative said the home had asked them about their mothers past life, which they felt Care Homes for Older People Page 14 of 25 Evidence: was good, for staff to have some background information about the person they are caring for. It was obvious that people like to join in activities, we saw people having fun and laughing during an activity with staff. One person told us that they had the choice of joining in but preferred not to. People told us that they were happy with the home and that staff are always willing to help. Visitors also commented on the way in which staff delivered care to their relatives, saying they were good and gave them time when they were helping them. One person said mum is much happier since she moved into Hillcrest. During mealtime we saw that people were given help from staff if they needed it, food was cut up if people needed that level of assistance. People said the food was good and that they were able to have something different if they did not like what was being served. We saw that one person had been offered a sandwich instead of the hot meal that was served. We were told that this was what she had asked for. Although people had their weight checked there was no evidence that people have had a nutritional risk assessment, that could identify if they were at risk of malnutrition. Care Homes for Older People Page 15 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People know how to complain and are confident their complaints would be listened to. People are protected from abuse by the homes procedure and staff training. Evidence: People and their relatives know how to complain and feel confident that if they had any concern or complaints they will be listened to and taken seriously. Visitors told us if they had any concern they would speak to the manager and know that she would make sure something gets done or try to resolve the problem. The home has a complaint procedure which is readily accessible to people and their visitors. No complaints had been made to the CSCI in the last twelve months. However, there has been one safeguarding referral, which the home dealt with appropriately by involving other agencies and following their procedure and that of the multi- agency referral system for safeguarding adults. Staff have had training on safeguarding adults which ensures that they understand their role and responsibilities in reporting any concerns or suspicions of abuse. It was clear from discussions with staff that they know what to do if there is a Safeguarding issue. Care Homes for Older People Page 16 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is comfortable, clean, well equipped and suitable for people living in the home. Evidence: The home provides people with a comfortable environment which is well maintained. People have access to three sitting areas, one is mainly used as a dining room. However, people can have their meals where they want but they are encouraged to eat in the dining room. During our inspection of the premises we found that most bedrooms had been refurbished thus providing people with rooms that are of a good standard especially those on the top floor. The home has one shared room and some rooms have ensuite facilities. There are three bathrooms available to people one of which has a shower, one of the bathrooms is equipped with a bath for the use of people requiring assistance. There is a passenger lift and a stair lift giving people easy access to rooms on all floors. We found that the water flow of some taps were slow to a trickle, the owner said he was aware of this and was working with the plumber to resolve this problem. One bedroom carpet was rippled, this could be a potential trip hazard to the person living in the room and others, this was brought to the attention of the owner who said he would look at this to make it right. The laundry room is furnished with a sluice cycle washing machine to make sure infection control is not compromised. The paint on the laundry walls was peeling and needed repainting. We Care Homes for Older People Page 17 of 25 Evidence: saw that communal bathrooms and toilets had hand washing facilities, liquid soap and paper towels. We were told that plans are in place for these to be fitted in peoples bedrooms, as part of infection control. People have access to the grounds where they can sit out safely during the good weather. The grounds have been tarmac, which meant that people did not have access to a traditional garden with plants. We found the home to be tidy and cleaned to a good standard, we did not detect any unpleasant odour. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported and protected by the recruitment polices and practices at the home. Staff are provided with good opportunities for training and appropriate checks are carried out on all staff to ensure that people are safe. Evidence: At the last key inspection there was a recommendation for the service provider to look at the staffing levels in the home. The manager told us that both herself and the owners monitored the staffing levels and they feel that there is enough staff to meet the number and the assessed needs of the present people living at the home. If there was a need for an increase in the staffing levels this would be done. All staff spoken to during the inspection were enthusiastic about their work and felt that they provide a good standard of care to people and that they are well supported by the management team and the training that they are given. We looked at three staff recruitment files. One staff member had recently been employed but a CRB disclosure had not been received back. We were told that this person was working with another member of staff at all times until they get the full CRB. All staff have had a protection of vulnerable Adults (POVA) first check carried out and Care Homes for Older People Page 19 of 25 Evidence: all other staff had a (CRB) Criminal Record Bureau check. The home has an introduction process which all new staff undertake, this ensure that they know the home and their responsibilities. It was clear from discussion with staff that they were keen on training and they took every opportunity to attend any training on offer. All staff have had training on health and safety and infection control. There are regular updates for these courses to make sure both people and staff are safe. There are over 50 percent of care staff with an (NVQ) National Vocational Qualification level two and above. We spoke to one member of staff who lives a fair distance from the home, she told us that she loves the job and everyone is very friendly. Staff told us that they were one team putting peoples care needs first. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is properly managed and maintained in the best interests of the people who use the service. Evidence: The home is managed by the registered manager who is suitable qualified, two deputy managers and two senior care workers. The owners are actively involved in the day to day running of the home. Prior to this inspection the home completed an (AQAA) Annual Quality Assurance Assessment Self Assessment, which was submitted to the CSCI. This identifies what the home considers they do well and sets out any plans they have for improvement over the next twelve months. The home has a quality assurance system in place. Surveys are sent out twice a year to people, relatives and professionals involved in the home. We were told that the outcome is discussed with people in their meetings and relatives on one to one during reviews or visits to the home. We were also told that the information is used to Care Homes for Older People Page 21 of 25 Evidence: develop an action plan for future development of the home. Staff told us that the management team is committed to getting peoples views and opinions about life in the home, by having regular meetings with them or discussion on a daily basis. The manager said they look after small amounts of money for some people, but they do not manage peoples finances, this is undertaken by people if they have the capacity, relatives, solicitor or friend on their behalf. When we looked at the records we saw that they were up to date. All transactions were listed, and receipts were available for money spent on peoples behalf. The home have good systems in place for staff recruitment, induction and formal supervision. The maintenance records we looked at were up to date and showed that equipment is maintained and serviced at the required intervals. There are systems in place for recording and monitoring accidents, so that any possibility of accidents can be recognised and risk assessment carried out with arrangements put in place to reduce the potential risk. People and their relatives were very positive about the manager and the staff team, all who were spoken to indicated that the home provides a good standard of care to people living there, and they had no concerns. One visitor told us that they felt that it was an appropriate placement for their relative. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 14 Some consideration should be given for people to have a nutritional risk assessment carried out so that any risk identified will have a plan of action to be taken making sure people are not at risk. Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!