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Inspection on 14/04/05 for Hillcrest Residential Home

Also see our care home review for Hillcrest Residential Home for more information

This inspection was carried out on 14th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Mrs Hope who is very dedicated and caring manages the home. The care staff are all approachable and friendly. The recording in the daily statements about residents in the home is good and shows what care had been provided and by whom. Care staff were seen to be respectful and preserve dignity. Relatives, visitors including a GP and staff spoken with all spoke positively about the home. One resident found everything about the home acceptable, but particularly liked having a choice of evening meal.

What has improved since the last inspection?

All the requirements made about the environment at the last inspection have been dealt with. New carpets have been laid and level access to the toilets has been made. One person that was out of the homes registered category had moved to a home that could meet their needs. The manager had recruited more staff to care for the residents this included a senior carer. The roter showed improvements in ensuring two care staff were on shift through out the day more frequently than previously reported. There were more times when the manager was additional to the two care staff. One resident felt the staffing levels were `fine`.

What the care home could do better:

The home has two major weaknesses. Firstly staffing matters, the home desperately needs to recruit a Cook. Two care staff cannot care for 13 people, cook and clean at the same time. Staff need to be appropriately recruited including references and CRB (Criminal Records Bureau) to ensure residents are in safe hands. Staff must have induction training, access to NVQ and supervision to ensure the staff are competent to care for older people. One relative felt that there was not always enough staff and the manager worked too hard. In the previous seven weeks Mrs Hope had only four days off. Secondly, assessments before residents move into the home must be conducted to ensure the home can meet their needs and ensure the home is not going out of category and admitting people who staff cannot care for. The home now has two people out of category. And the inspector believes the long term needs of one resident may not be met due to lack of staff training and knowledge about mental health and learning disability. These issues are being addressed by the CSCI. Activities of the residents were neither planned nor devised in conjunction with the residents needs and preferences. It was suggested that one member of staff doing her NVQ 3 could develop this and take a lead on ensuring activities are programmed.

CARE HOMES FOR OLDER PEOPLE Hillcrest Residential Home 14 Northgate Street, Bury St Edmunds Suffolk IP29 4PJ Lead Inspector Claire Hutton Unannounced 14 April 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 Residential Home I54-I04 S24417 Hillcrest V224457 050414 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Hillcrest Residential Home Address 14 Northgate Avenue, Bury St Edmunds, Suffolk, IP32 6BB 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) 01284 760774 01284 760774 none Mr Christopher Hope and Mrs Magda Hope Mrs Magda Hope Care Home 13 Category(ies) of Old age, not falling within any other category registration, with number (13) of places Hillcrest Residential Home I54-I04 S24417 Hillcrest V224457 050414 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: None. Date of last inspection 22/12/04 Brief Description of the Service: Hillcrest Residential Home is a privately run care home based in a Victorian property that has been extended and adapted to provide residential care since 1997. Hillcrest is registered under the provisions of the Care Standards Act 2000 to up to accommodate 13 older persons. The home is located in a quiet residential area of Bury St. Edmunds. It is close to a small shop that is accessible to some residents. Hillcrest provides two single bedrooms and one double bedroom on the ground floor along with nine single bedrooms on the first floor. Access to the first floor is by stair lift. There is a step between the lift and the bedrooms which may prove difficult for service users with mobility difficulties. One of the bedrooms benefits from the provision of en-suite facilities. There are two communal assisted bathrooms and five assisted toilets within the home. Residents have access to a lounge that overlooks the pleasant garden with seating provided. There is also a separate dining room on the ground floor. Smoking is not permitted at the home. Hillcrest Residential Home I54-I04 S24417 Hillcrest V224457 050414 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The purpose of this inspection was to follow closely developments at the home since the four inspections at the home in the last inspection year. Two of these inspections were additional inspections. The inspection was unannounced and started at 10.45 a.m. It took place over six hours during the late morning, lunch and afternoon. The inspector spoke with two residents separately, two relatives separately, four members of care staff and the manager. The manager showed the inspector around the communal parts of the home and empty bedrooms. Two residents showed the inspector their rooms. Records were also examined. What the service does well: What has improved since the last inspection? All the requirements made about the environment at the last inspection have been dealt with. New carpets have been laid and level access to the toilets has been made. One person that was out of the homes registered category had moved to a home that could meet their needs. The manager had recruited more staff to care for the residents this included a senior carer. The roter showed improvements in ensuring two care staff were on shift through out the day more frequently than previously reported. There were more times when the manager was additional to the two care staff. Hillcrest Residential Home I54-I04 S24417 Hillcrest V224457 050414 Stage 4.doc Version 1.20 Page 6 One resident felt the staffing levels were ‘fine’. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Hillcrest Residential Home I54-I04 S24417 Hillcrest V224457 050414 Stage 4.doc Version 1.20 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 Residential Home I54-I04 S24417 Hillcrest V224457 050414 Stage 4.doc Version 1.20 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) 3 and 4 People who use this home cannot be assured that an accurate pre admission assessment will be completed therefore they cannot be sure that their needs can be appropriately met. EVIDENCE: There had been two new admissions since the last inspection at the home. Evidence of assessed needs were examined. In one case the assessment had been completed after the resident had moved into the home based on the discharge letter from the hospital. The manager stated that she had visited the person in hospital before their discharge but had not recorded her findings. The resident was too unwell to talk with the inspector. In the other case the resident had information supplied about their needs, but this showed that the person had mental health problems and a mild learning disability and needed little if no personal care. The care plan depended upon outside services and family support and the person was a permanent resident in a care home. Therefore, the manager had admitted one person out of category to the home and had not detailed in a plan about how the staff at the home would meet the specific needs. Hillcrest Residential Home I54-I04 S24417 Hillcrest V224457 050414 Stage 4.doc Version 1.20 Page 9 At previous inspections to the home two people with the diagnosis of dementia were found to be resident at the home. On this visit to the home one person remained and the other had been moved onto another home. The implication for residents who are admitted out of category are that their needs may not be met and that that would probably have to move on to alternative accommodation that could meet their needs. This causes undue stress on individuals and their families at what can be a difficult time. Hillcrest Residential Home I54-I04 S24417 Hillcrest V224457 050414 Stage 4.doc Version 1.20 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) 7,8,10, Residents can be assured they will be treated with respect and privacy will be upheld. They will be given good access to healthcare, but follow up to assessments within the home may be poor. EVIDENCE: The care plan for two service users were seen. These were based around the activities of daily living along with information on mental and physical health and a nutritional assessment. One plan stated a history of falls but did not go on the show how the home and staff how to prevent a reoccurrence of falls. Neither plan had information on social care needs in terms of what social life was had before coming into care or preferred. There was evidence of reviews including health care staff and good recording by care staff on care provided. Staff were seen to ensure the privacy and dignity of residents when going to the bathroom and during a consultation with the GP. A GP was visiting at the time of inspection and he gave positive feedback about good communication with the home, privacy to see residents, appropriately Hillcrest Residential Home I54-I04 S24417 Hillcrest V224457 050414 Stage 4.doc Version 1.20 Page 11 managed medication and that he was satisfied with the overall care at the home. Medication was not inspected in detail as a previous inspection showed significant progress and compliance in this area. However, the medication fridge that was located in the dining room had a broken lock. The manager confirmed that two care staff had recently undertaken medication training with Boots the Chemist. Certificates were requested but none had been sent as yet. Hillcrest Residential Home I54-I04 S24417 Hillcrest V224457 050414 Stage 4.doc Version 1.20 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 and 15 The home positively promotes contact with family and friends. A wholesome balanced diet was on offer, but with limited choice. Residents cannot be assured that the home will maximise choice and opportunity. EVIDENCE: Two sets of relatives were visiting during the inspection and both were spoken with. Both sets of relatives took the resident out from the home on a regular basis. One relative stated the family visited most days and felt that the home met the needs of their relative. Mention was made of the lack of English speaking staff and the lack of staff on occasion. Lunch was observed being served up. There was sufficient quantity of chicken casserole and vegetables to feed all residents in the home. There was artic role for pudding. The four weekly menus were examined. Food offered was English home style cooking. Each day there was a main meal at lunch time with a vegetarian option. No one had the vegetarian option and one resident said she did not know what was for lunch, but would have the same as everyone else. The record of meals eaten by the resident only recorded what was eaten for teatime. Breakfast was cereal, toast, porridge and an egg if requested. Each residents breakfast and drink preference was recorded for staff to follow. Hillcrest Residential Home I54-I04 S24417 Hillcrest V224457 050414 Stage 4.doc Version 1.20 Page 13 The dining room was small tables of three and four people, two people ate in the lounge on trays. Tables had cloths, salt and pepper, cutlery and cups and saucers as well as a glass and a jug of juice. This created a pleasant setting. The fridge contained uncovered and undated food. Vegetables for the next day had already been prepared. The cupboard contained Tesco value brand tins and dry good. The one resident spoken to about the meals said they were fine and that for tea time there was a choice of what could be had. During the inspection a floor game was initiated by care staff and played with the residents. This game had prizes of fruit and chocolate that the residents appeared to enjoy. Staff spoken with said that other activities offered included a lady who visited to do seasonal projects with the residents that included gardening, music and crafts. Trays of sprouting sunflowers were in the dining room. A trip to Abby Gardens was being planned for the warmer weather. The ‘library lady’ called during the inspection and changed books for some residents. Hillcrest Residential Home I54-I04 S24417 Hillcrest V224457 050414 Stage 4.doc Version 1.20 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) 18 People who use this home cannot be assured that the necessary recruitment safeguards have been completed and their safety protected. EVIDENCE: The recruitment records for four staff were examined and these showed that the appropriate checks including Criminal Record Bureau (CRB) and references had not been undertaken prior to staff undertaking duties. Hillcrest Residential Home I54-I04 S24417 Hillcrest V224457 050414 Stage 4.doc Version 1.20 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) 19, 21, 22, 23, 24, 25, 26. The people who use this service can be assured that recent and significant improvements in the environment have increased safety and comfort. However they cannot be sure that this will be monitored. EVIDENCE: Eight environmental requirements from previous inspections had been actioned. A new carpet had been laid in the main entrance and stairs, with level access to the toilets being achieved. Room 1 had been decorated and a new carpet laid. The en-suite door in this room was not able to open due to the pile of the new carpet. The en-suite was a little chilly and did not have any source of heating. The manager said the carpet in bedroom 7 had been replaced, but there was a strong odour of urine. The floor covering in the shower room had been replaced with good non-slip flooring. Bath hot water was tested and was well within safe limits. Used razors were in the bathroom. The manager stated that the hoists on the baths had recently been service and that she had evidence of the visit. No toilet roll was in two toilets. The home had run out and was using paper towels. The inspector Hillcrest Residential Home I54-I04 S24417 Hillcrest V224457 050414 Stage 4.doc Version 1.20 Page 16 activated the call bell in a toilet and care staff were quick to respond. One downstairs toilet had a rusty toilet seat with paint peeling and the ventax was full of dust and fluff. Bars of soap were on the sink and terry towels were used to dry hands. One toilet had an override lock in case of emergency the other toilet door lock had been disabled with an object pushed into the lock. The shower room had a space on the wall where a broken mirror had been removed and not replaced. There was plenty of clean linen in the linen cupboard. Residents at the home showed two bedrooms to the inspector. Other empty rooms were seen. All had the required furniture to make it comfortable. Some rooms were more personalised than others and therefore were more homely. A resident was seen to be helped use the stair lift by her relative. One member of staff said most residents required help with the stair lift. No instructions for use signs were posted on the wall. One staff member said she had been instructed by the manager on how to use the stair lift. No care plans seen had an assessment on individual use and support required to use the stair lift. The laundry room was out the back of the home. The inspector was shown through the kitchen down some steps and to the laundry room. The laundry was well equipped and suitably laid out. Commodes were also cleaned here and then transported back through the home in a large sealed bag. There was seating in the garden, but no residents were using it at the time of inspection. The lawn was long and needed cutting. Hillcrest Residential Home I54-I04 S24417 Hillcrest V224457 050414 Stage 4.doc Version 1.20 Page 17 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 and 30 People who use this service cannot be fully assured that there are adequate numbers of experienced and trained staff on duty to meet their needs. EVIDENCE: The recruitment records for four staff were examined and were found not to adhere to the regulations. Serious omissions such as taking up references and doing a criminal records check was not processed in all four cases. A discussion with the manager about a minimum POVA (protection of vulnerable adult) check discovered that this was not done and the manager was unaware of how to access one. Interviews in private were held with four staff who said they had learnt to care from experience at the home. No first aid training or manual handling training had been received. The manager confirmed that no TOPPS induction training for care staff had been received. The manager did say that two staff had received medication training from Boots and they were awaiting the certificate as evidence. One current first aid certificate was seen. One member of care staff was undertaking her NVQ 3. All staff on duty at the care home were spoken with. The home employs most carers from overseas and understanding and speaking fluent English was a problem in some cases. There has been previous concerns that the manager had been working excessive long hours and covering care shifts for most of her time. The last Hillcrest Residential Home I54-I04 S24417 Hillcrest V224457 050414 Stage 4.doc Version 1.20 Page 18 seven weeks worth of roters were examined. During that time, the manager had only four days off work. The majority of these shifts worked were from 08.00 until 20.00 each day. The manager stated she feels responsible for the lack of competent staff and works extra to ensure the safety of residents. There had been previous concerns about the lack of care staff on duty. In the seven weeks examined twenty two shifts had one carer and the manager working and no additional staff employed. Therefore as well as caring the jobs of manager, cook and cleaner would have to be covered. Hillcrest Residential Home I54-I04 S24417 Hillcrest V224457 050414 Stage 4.doc Version 1.20 Page 19 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, 36, 38 The intentions of Mrs Hope are good, however not all the responsibilities of the manager are being discharged fully and therefore residents are being placed at risk. EVIDENCE: The manager was helpful to the inspector and along with staff comment and relative comment concludes that her approach is one of kindness and a genuine wish to care for older people. Staff and relatives found her approachable and that she listened. Mrs Hope confirmed that she was progressing with her Registered Managers Award and had completed one unit and expecting her assessor to visit her soon at Hillcrest. Hillcrest Residential Home I54-I04 S24417 Hillcrest V224457 050414 Stage 4.doc Version 1.20 Page 20 However, the high number of repeated statutory requirements and serious concerns stated within this inspection report indicates that the home is not being managed appropriately. This was particularly the case with respect to the staffing situation and pre assessment information. The main factor shown from the roter was the excessive long hours that Mrs Hope was working as a carer. Given the size of the home some time could be spent as a carer but not the majority of her time. The residents can not be said to be benefiting from the ethos, leadership and management of the home due to the above information. Staff spoken with said that they had staff meetings – the last being four months ago and that Mrs Hope kept them informed of any changes with residents therefore their belief was that this was adequate supervision. In respect of health and safety issues the manager is responsible for ensuring the residents are kept safe and free from harm as far as possible. Some environmental precautions were in place such as: restriction on the hot water in baths to prevent scalding, covers on radiators to prevent burns and window restrictors to prevent anyone falling from a window. Therefore, the manager had a good sense of keeping a safe environment, but does need to ensure the matters relating to the stair lift are actioned. Staff and their role in health and safety was a concern. Staff stated that they had not and the manager confirmed that Topps induction training had not been completed . Therefore, care staff did not have training in moving and handling, health and safety, fire safety, emergency first aid, safe food handling and infection control. All of which is designed to keep residents safe. Hillcrest Residential Home I54-I04 S24417 Hillcrest V224457 050414 Stage 4.doc Version 1.20 Page 21 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. Where there is no score against a standard it has not been looked at during this inspection. 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 x x 1 1 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 2 14 x 15 2 COMPLAINTS AND PROTECTION 2 x 1 2 3 3 2 1 STAFFING Standard No Score 27 1 28 1 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 2 1 2 x x x 2 x 1 Hillcrest Residential Home I54-I04 S24417 Hillcrest V224457 050414 Stage 4.doc Version 1.20 Page 22 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 3 Regulation Requirement Timescale for action immediate 2. 4 3. 7 4. 9 14 (1)(b & Before admission of any resident c) to the home: a full assessment written by a suitably qualified professional must be obtained and; a detailed pre-admission assessment must be conducted. This is necessary to ascertain the needs of any prospective service users fully. (This requirement is repeated from the inspection of 22nd September 2004.) 10(1), The manager was for the third immediate 13(4), time requested to apply for a variation to the homes 14(2), 15(2) & registration to accommodate one 18(1) named resident with dementia. (This requirement is repeated from the inspection of 22nd September 2004.) 15(1) Residents needs must be set out immediate in a care plan therefore, this must include a strategy for fall prevention where falling has been identified and individual social needs must be ascertained and documented. 13(2) Medication must be kept secure, immediate therefore the lock on the medication fridge must be I54-I04 S24417 Hillcrest V224457 050414 Stage 4.doc Version 1.20 Page 23 Hillcrest Residential Home repaired. 5. 12 16(2)(n) A suitable programme of activities at the home, designed in full consultation with the residents must be provided. (This requirement is repeated from the inspection on 22nd September 2004.) Community contact for residents must be ascertained and their wishes acted upon, especially those residents with little relative contact. Two lunch time choices must be known by residents in advance for them to make their choices. (This requirement is repeated from the inspection on 9th June 2004). Residents must be protected from potential harm as far as possible. Criminal record bureau checks must commence and references must be taken up before employment begins. As a minimum POVA 1st checks must be in place before employment is commenced. Maintenance at the home must include: - adjustment to the door on the en-suite in room one to allow it to close - replace the broken mirror in the shower room. Residents must have suitable lavatories therefore: - toilet rolls must always be provided, - the toilet seat that is rusty with peeling paint must be replaced - door locks must be fully functional. Hillcrest Residential Home I54-I04 S24417 Hillcrest V224457 050414 Stage 4.doc Version 1.20 Page 24 31/05/05 6. 13 12 (3) 14 (1)(c & d) 12(2&3) 31/05/05 7. 15 immediate 8. 18 7, 9 ,19 immediate 9. 19 23 (2)(b&d) 31/05/05 10. 21 13(3) & 23(2)(j) immediate 11. 22 & 38 23(2)(n) Residents must have safe access to all parts of the home therefore: - appropriate safety signs and instructions for use must be clearly displayed at each end of travel. - residents must be risk assessed to ascertain whether they are able to use the stair lift safely without assistance. - Where residents require help, staff should be trained in its use and the best way to assist the resident. immediate 12. 25 23(2)(p) 13. 26 13(3) & 16(2)(j) All parts of the home must be kept warm. The ensuite in room one must have an appropraite heat source. The home must be clean and hygienic therefore: - liquid soap and paper towels must be provided in communal bathrooms and lavatories and remove communal bars of soap, hand towels. - Razors must be individual and not kept in individual areas. - The odour of urine must be eliminated from room 7. - The vent in the toilet must be cleaned. - Laundry and commodes must not pass through the kitchen or any food preparation area. Residents needs must be met by the numbers and skill mix of staff therefore, two members of care staff must be on duty throughout the waking day, immediate immediate 14. 27 10(1) & 18(1)(a) immediate Hillcrest Residential Home I54-I04 S24417 Hillcrest V224457 050414 Stage 4.doc Version 1.20 Page 25 15. 28 18 (c) (i) 16. 29 7,9,19 17. 30 & 38 18(c) (i) (ii) available at all times to attend to care tasks. In addition to these two staff members, a separate staff member must be available to attend to the kitchen duties. Residents must be in safe hands at all times therefore a minimum of 50 of staff must have NVQ 2. Residents must be protected by the homes recruitment policy and practice therefore the manager must ensure all checks required by this regulation are in place. Staff must be trained and compent to do their job therefore: - all staff must have induction training within the first six weeks of appointment. - A training and profile. - a minimum of three days training per year. The home was not being effectively managed therefore an agreement must be reached and adhered to as to the amonut of management hours verses care hours that Mrs Hope works per week. This must be a minimum of 3 days per week purely as manager. staff must be appropriatly supervised therfore care staff must receive formal suprevision at least six times a year. 31/12/05 immediate immediate 18. 31 and 32 12 & 13(6) immediate 19. 36 18 (2) immediate 20. 21. Hillcrest Residential Home I54-I04 S24417 Hillcrest V224457 050414 Stage 4.doc Version 1.20 Page 26 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. Refer to Standard 12 Good Practice Recommendations One person, such as the member of staff doing her NVQ 3 should take responsibility for developing the activities within the home. Hillcrest Residential Home I54-I04 S24417 Hillcrest V224457 050414 Stage 4.doc Version 1.20 Page 27 Commission for Social Care Inspection St Vincents House Cutler Street Ipswich IP1 1UQ 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 Residential Home I54-I04 S24417 Hillcrest V224457 050414 Stage 4.doc Version 1.20 Page 28 - 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!