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Inspection on 14/02/06 for Hillcrest (Smethwick)

Also see our care home review for Hillcrest (Smethwick) for more information

This inspection was carried out on 14th February 2006.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

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

Hillcrest provides a home to three service users, all of them have an active social life and are happy living at the home. "I love living here I don`t ever want to leave". The home is welcoming and has a very cosy domestic feel to it. Service users attend day centres, luncheon clubs and outings on a regular basis. The home works well in promoting the health and well being of it`s service users and ensures that they have appropriate health checks and screening.

What has improved since the last inspection?

The home has purchased a new washing machine since the last inspection, this ensures a more efficient method of cleaning clothing and that clothing is washed at temperatures that minimise the spread of infection.

What the care home could do better:

CARE HOME ADULTS 18-65 Hillcrest 13 William Road Smethwick West Midlands B67 6LN Lead Inspector Mrs Mandy Beck Announced Inspection 14th February 2006 09:30 Hillcrest DS0000004781.V283702.R01.S.doc Version 5.1 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Hillcrest DS0000004781.V283702.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Hillcrest DS0000004781.V283702.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Hillcrest Address 13 William Road Smethwick West Midlands B67 6LN 0121 429 4645 0121 429 2218 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Michael Jenkins Mrs Deborah Fatile Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Hillcrest DS0000004781.V283702.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. One service user identified in the variation report dated 11 November 2004 may be accommodated at the home in the category LD(E). This will remain until such time that the identified service users placement is terminated, The home may from time to time continue to provide care to service users who have lived in the home who have reached the age of 65 years of age. Once the placement is terminated the registration category reverts back to LD. 16th December 2005 2. Date of last inspection Brief Description of the Service: Hillcrest is a small Home providing accommodation and care for three adults with learning difficulties. The property is a traditional semi-detached house, well maintained, and situated in a residential area of Smethwick. There is a small driveway with on-road parking to the front of the Home. To the rear of the premises is a garden, with a lawned area and greenhouse. The Home benefits from close proximity to public transport routes. The ground floor of the house comprises a communal sitting room, kitchen, conservatory/dining area, a bedroom for one of the Residents and a laundry room. The first floor comprises two large bedrooms for Residents, a bathroom with toilet and a ‘sleeping in’ room/office used by Staff. The facilities are well maintained with décor and furnishings providing a warm, homely and comfortable ambience. Hillcrest DS0000004781.V283702.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection, which took place between the hours of 09:30 and 12:30, by one inspector. The judgments made in this report are based upon information provided by a pre inspection questionnaire completed by the home and through discussion with the registered owner and manager, service user and staff on duty. The inspection focussed on those key inspection standards which were not assessed during the previous inspection. The inspector would like to thank everyone at the home for their hospitality during this inspection. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Hillcrest DS0000004781.V283702.R01.S.doc Version 5.1 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hillcrest DS0000004781.V283702.R01.S.doc Version 5.1 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were assessed during this inspection. EVIDENCE: Hillcrest DS0000004781.V283702.R01.S.doc Version 5.1 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were assessed during this inspection EVIDENCE: Hillcrest DS0000004781.V283702.R01.S.doc Version 5.1 Page 9 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,14,15,16,17 Service users are enabled to maximise their independence, maintain appropriate relationships and have an active role within the home and their daily lives. Service users are encouraged to participate in education training and fulfilling activities. There is a varied choice of food prepared and service users have the choice about what they want to eat. EVIDENCE: All of the service users at Hillcrest have an active social life, all of them have the opportunity to attend day centres, luncheon clubs and day break meetings where they can meet with friends, learn practical life skills and indulge in their hobbies. There was evidence throughout the home of service users individual achievements, certificates were displayed for word processing, computing skills and one service user has completed a basic food hygiene and fire training course. Another service user has a fondness for rug making and has them in their bedroom. Whilst touring the home it is evident that service users bedrooms are personalised with their own belongings and they have a wide range of media to enjoy DVD’s, CD’s and television. The home has an activity programme which Hillcrest DS0000004781.V283702.R01.S.doc Version 5.1 Page 10 is tailored to meet the needs and wishes of the service users, their wishes are usually formally noted during the weekly service user meetings where they are encouraged to talk about things they would like to do and places they would like to go. Every year the service users go on holiday to Lloret de Mar on the Costa Brava during the inspection holiday photographs were seen clearly showing the enjoyment service users have whilst they are there. Family and friends are encouraged to visit the home and service users are enabled to choose whom they see and when, they have the opportunity to be able to receive their visitors in the privacy of their own rooms. Some of the service users have developed friendships outside of the home and look forward to meeting their friends at day centres or luncheon clubs. Routines within the home are flexible but do encourage all service users to take part. Service users are offered a key to keep their rooms locked during their absence, if this has been declined by the service user it is documented in their individual file and reviewed on a six month basis. During the inspection only one service user was present it was apparent that there was a positive relationship between staff and service user. Each service user has housekeeping tasks they enjoy and participate in, such a vacuuming, helping to peel the potatoes for dinner and generally tidying their own bedrooms. Tuesday night is usually takeaway night at Hillcrest and majority of the time it is fish and chips. Other days service users meals are freshly prepared, there is no set menu but service users are offered four meals throughout the day. Mealtimes are flexible and are centred around service users activities. There is detailed information regarding the likes and dislikes of each individual service user and their weight is generally monitored on a monthly basis although there was no weight recorded for January this year, none of the service users are experiencing undue weight loss and their nutritional needs are re assessed as their needs change. “the food is nice, I like rice best but not curry they do nice rice”. Hillcrest DS0000004781.V283702.R01.S.doc Version 5.1 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,21 Service users are assisted with personal care in a manner they choose and they have access to health care facilities ensuring their health care needs are met. Each service user has an individual plan which details there wishes about their care during illness and in the final stages of their lives EVIDENCE: Each service user has an individual plan of care that details what kind of assistance they would like and need to meet their personal and health care needs. There are designated key workers for each service user and records that detail individual preferred routines. There is evidence that service users are provided with support from relevant professionals such as GP’s, Community learning disability teams, speech and language therapists and chiropody. The registered manager and staff have spoken to service users about their wishes regarding their care during an illness and in the final stages of their lives, this has been documented within the individual file of each service user. Service users can feel confident that there health care needs will be met whilst living at Hillcrest. Hillcrest DS0000004781.V283702.R01.S.doc Version 5.1 Page 12 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were assessed during this inspection EVIDENCE: Hillcrest DS0000004781.V283702.R01.S.doc Version 5.1 Page 13 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 The home is clean and generally well maintained. Service users live in a homely environment. EVIDENCE: The home is decorated in a style that gives it a very homely feel, all of the service users bedrooms have been decorated to their individual choice and preference and all have been personalised with there belongings. The lounge is well furnished, sofas have throws over them to protect the furnishings, there are lots of ornaments and mementoes from service users travels around the home. Since the last inspection the home has purchased a new washing machine, this ensures that all clothing is washed at correct temperatures to reduce the risk of cross infection for service users. The home is generally clean and tidy throughout but there are some general repairs that need to be completed. The flooring in both the toilet and bathroom needs to be replaced to reduce the risk of infection, and the tiling in the bathroom requires attention to remove the grouting and bath seal that are Hillcrest DS0000004781.V283702.R01.S.doc Version 5.1 Page 14 both worn and mildewed. The manager has indicated that these are to be addressed in the near future as part of the homes maintenance programme. Hillcrest DS0000004781.V283702.R01.S.doc Version 5.1 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were assessed during this inspection EVIDENCE: Hillcrest DS0000004781.V283702.R01.S.doc Version 5.1 Page 16 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39 Service users can be assured that the home is run in their best interests. There is a process of self-monitoring that underpins development within the home. EVIDENCE: At present the home completes service user questionnaires on a monthly basis and these are kept within the service users individual files. In addition to this the manager holds weekly meetings with them to gain their views about life at hillcrest and encourage the service users to discuss any problems or wishes they may have. There is evidence that stakeholders within the community are consulted about the home and it’s progress in achieving it’s aims but these need to be formalised, an action plan developed and then published for all interested parties. The manager is currently in the process of producing a newsletter with plans to publish every six months. It was suggested that the results of Hillcrest DS0000004781.V283702.R01.S.doc Version 5.1 Page 17 questionnaires be published in the newsletter along with an action plan to demonstrate their commitment to self monitoring and development. Hillcrest DS0000004781.V283702.R01.S.doc Version 5.1 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 x ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 X 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X X X LIFESTYLES Standard No Score 11 3 12 X 13 X 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X 3 X X 2 X X X x Hillcrest DS0000004781.V283702.R01.S.doc Version 5.1 Page 19 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 YA24 Regulation 23(2)(d) Requirement The registered provider and manager produces a planned maintenance and renewal programme for the home that includes 1) the replacement of the flooring in the toilet downstairs 2) the replacement of the bathroom flooring 3) the grouting and bath seal are replaced and mildew is addressed The registered manager needs to further develop the quality assurance system within the to demonstrate a clear reviewingaction-planning cycle and that meets all of the requirements of standard 39 Timescale for action 01/05/06 2 YA39 24 01/05/06 Hillcrest DS0000004781.V283702.R01.S.doc Version 5.1 Page 20 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 YA18 Good Practice Recommendations The registered manager should consider formulating a specimen signature and initials sheet, so that staff members entries in service users notes can be identified The temperature is recorded when checking the water temperature not just a signature. 2 YA42 Hillcrest DS0000004781.V283702.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Halesowen Record Management Unit Mucklow Office Park, West Point, Ground Floor Mucklow Hill Halesowen West Midlands B62 8DA 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 DS0000004781.V283702.R01.S.doc Version 5.1 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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