Inspection on 11/07/06 for Hillcrest - Vernon

This inspection was carried out on 11th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hillcrest - Vernon 01/07/08

Hillcrest - Vernon 19/10/05

Hillcrest - Vernon 01/11/04

Hillcrest - Vernon 05/10/04

Hillcrest - Vernon 20/02/04

Hillcrest - Vernon 07/10/03

Hillcrest - Vernon 23/07/02

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

CARE HOME ADULTS 18-65 Hillcrest - Vernon 10 Maltravers Drive Littlehampton West Sussex BN17 5EY Lead Inspector Mrs M McCourt Key Unannounced Inspection 11th July 2006 09.00a Hillcrest - Vernon DS0000014568.V298732.R01.S.doc Version 5.2 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 - Vernon DS0000014568.V298732.R01.S.doc Version 5.2 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 - Vernon DS0000014568.V298732.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hillcrest - Vernon Address 10 Maltravers Drive Littlehampton West Sussex BN17 5EY 01903 716556 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) www.hillcrestcare.co.uk Hillcrest Care Limited Mrs Tania Helen Carter Care Home 14 Category(ies) of Learning disability (14) registration, with number of places Hillcrest - Vernon DS0000014568.V298732.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th October 2005 Brief Description of the Service: Hillcrest – Vernon is a care home registered to accommodate up to fourteen Service Users with learning disabilities. The Registered Provider is Hillcrest Care Ltd and the Registered Manager is Ms Tania Carter. The current scale of monthly charges ranges from £884.85 to £1,255.42. This information was provided on the Pre-Inspection Questionnaire. Additional charges are made for personal items, such as; clothing and toiletries with Service Users meeting the cost of some activities and complimentary treatments. The home is a detached property, situated in a small quiet residential street, just outside Littlehampton’s town centre. There is easy access to all community facilities, including local rail and bus stations. Accommodation is provided over two floors. On the ground floor there is a comfortable living room with a large T.V., a sensory room, art/quiet room, dining room, kitchen and three bathrooms and one shower room. Eight bedrooms are located on the ground floor for those people who require ground floor facilities. Patio doors lead from the lounge into a good sized multifunctional garden. The Service Users Guide and Statement of Purpose, which incorporates inspection reports, are both located at the home and are available to Service Users, staff, relatives and anyone else interested in the service. Hillcrest - Vernon DS0000014568.V298732.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A key unannounced inspection was undertaken by one Inspector on Tuesday 11th July 2006 and lasted a total of eight and a half hours. Pre-inspection planning took approximately three days. A full tour of the building took place and included the observation of Health and Safety matters, hygiene issues, decorative order and a general overview of the atmosphere created within the home. Four staff members and the Registered Manager were spoken to at the time of inspection. Case tracking was carried out by examination of relevant records and information held on the staff and residents. The Inspector was unable to talk to Service Users due to the nature of their disability, but was able to observe staff interaction. Policies and procedures were examined during the site visit. What the service does well: The Inspector was given a good example of where a member of staff had helped Service Users to vote in the recent general election. The staff member obtained information on the different political parties, converted that into a format the Service Users where more likely to understand and presented it in such a way as to help them make an informed decision. As a result, five Service Users chose to vote after being given this opportunity. The inspector was also given an excellent example of how the staff team have worked with a man admitted to the home one year ago and for whom life has since changed considerably. He has developed many skills, both physically and emotionally, and his progress is a direct result of the hard work and dedication of the staff team, who should be commended for their efforts. The home is committed to providing meaningful activities for all of the Service Users, including those who are unable to attend day centres or college placements. In house activities include hydrotherapy and horse riding. One of the Service Users has bought a hydrotherapy spa pool that is shared by other residents. A gazebo canopy has been put up over the top so that Service Users can enjoy the spa in the sunshine. Service Users gain lots of enjoyment from this facility and it is an excellent example of creativity by the staff team. Hillcrest - Vernon DS0000014568.V298732.R01.S.doc Version 5.2 Page 6 For those Service Users who enjoy gardening, the home has provided a raised vegetable bed where Service Users who use a wheelchair can get involved in growing vegetables. Observation of staff interaction by the Inspector found that Service Users are respected and their dignity upheld. The Inspector witnessed staff working with some very challenging and distressing situations. Staff remained calm and patient at all times. Discussions with staff revealed their enthusiasm and commitment to working with the residents living at the home, with some staff describing how important it is to make life for Service Users as enjoyable as possible. The staffing rota shows that there is a large number of permanent staff employed at the home, with some staff having been employed at the home for many years. In addition, the service has gone beyond the standard for NVQ percentages, as ten staff hold at least NVQ level 2, two staff are currently completing NVQ and two staff are due to start in September, leaving only four staff members who have chosen not to obtain the qualification. The Inspector considered it good practice that the home provides each new member of staff, including domestic staff, with a training and development portfolio. Individual staff are given £2 to choose and buy their own folder, making it more personalised. The portfolio includes pre and post training questionnaires to track learning objectives, NVQ information, training certificates, training plans, a comprehensive induction and an experience log of ‘first time’ experiences. This is an interesting concept whereby staff write a small summary of a new experience that they have encountered in their dayto-day work. On discussion with staff it was good to hear them talk about all the new skills they were picking up along the way. The home invests heavily in training its staff team. An administration assistant devises a training matrix on an annual basis, identifying individual needs. Staff spoken with confirmed that they are happy with the amount of training they receive and are knowledgeable about many issues, including adult protection procedures. Finally, from observations and discussions with staff, Service Users do benefit from a well run, clear, concise management structure. The Inspector was told that the manager is approachable and supportive, whilst the home itself is a nice place to work, with an easy going and relaxed atmosphere. Hillcrest - Vernon DS0000014568.V298732.R01.S.doc Version 5.2 Page 7 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 - Vernon DS0000014568.V298732.R01.S.doc Version 5.2 Page 8 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 - Vernon DS0000014568.V298732.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 4 and 5. The outcome for Service Users was found to be good. Prospective Service Users individual needs are assessed prior to admission. The home should ensure a signed contract between the home and the Service User is in place, detailing breach of contract. EVIDENCE: Statement of Purpose and Service Users Guide were both received prior to the field visit. The Service Users Guide is written in symbol format and includes; how to complain, information about the home, fees charged, rights, activities and so on. The Statement of Purpose is not readily accessible to Service Users, but can be provided if asked for. A copy of the Service Users Guide is kept on personal files. Admissions procedures are in place and are very detailed, giving step-by-step instructions when considering a Service User’s suitability. Hillcrest - Vernon DS0000014568.V298732.R01.S.doc Version 5.2 Page 10 Care management assessments are done prior to moving in, although some can take a long time to be received from the placing authority. The home has their own form of assessment, which is comprehensive and covers mobility, personal care, communication and so on. From the assessment process, separate support plans are put in place. Although Service Users have a contract on their file, it does not cover what constitutes a breach and has not been signed by either the home or the Service User or their representative. The document has been produced using the Widget programme, following recommendation by a previous Inspector. The Registered Manager said that despite this, the Service Users accommodated at the home would not be able to understand the contract. Some Service Users have an agreement from their placing authority, the comprehensiveness dependant on which authority placed them. Two out of the three files looked at did not detail what constitutes a breach in contract. Not all Service Users have a care manager due to shortage of resources. Hillcrest - Vernon DS0000014568.V298732.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. The outcome for Service Users was found to be good. The home supports Service Users to take responsible risks within the scope of their disabilities. Observation of staff interaction found that they do respect the rights of Service Users. EVIDENCE: It is not possible for Service Users to be involved in drawing up care plans, but the home does encourage relatives and family members to provide as much information as they can during the admission process. Care plans are reviewed regularly. Specific risk assessments were found to be in place, covering; drowning, slipping, being in the kitchen, use of the spa bath, choking and so on. Hillcrest - Vernon DS0000014568.V298732.R01.S.doc Version 5.2 Page 12 A risk assessment form was sent with the Pre-Inspection Questionnaire. The form is detailed, requesting comprehensive information about the risk identified. The Inspector was of the opinion that it was a good example of what information should be gathered when considering risks. Manual handling care plans and risk assessments are also kept in Service Users’ daily files, making them constantly accessible to staff. Local advocacy services have been used for specific matters, the Registered Manager gave an example of a Service Users who had financial matters to deal with and required independent advice and help. Some Service Users are also involved in ‘Speak About’ – a self advocacy group, set up to be run by people, for people with learning disabilities. The Inspector was given a good example of where a member of staff had helped Service Users to vote in the recent general election. He obtained information on the different political parties, converted that into a format the Service Users where more likely to understand and presented it on a large display area. Five Service Users voted after being given the opportunity. A confidentiality policy is in place and a code of confidentiality is signed by each staff member at the time of induction, then held on their individual files. Hillcrest - Vernon DS0000014568.V298732.R01.S.doc Version 5.2 Page 13 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): 12, 13, 15, 16 and 17. The outcome for Service Users was found to be excellent. Service Users are supported to access a range of activities despite their level of disability and are encouraged to regularly visit local community facilities and events. Service Users are offered a healthy diet, which is maintained by the employment of a cook. EVIDENCE: It was not possible to have discussions with any of the Service Users at Vernon due to their level of disability. Those accommodated at the home have complex, severe health issues and learning disabilities. The Inspector did manage to speak with one Service Users briefly who was waiting to go to a local day centre. When asked if he liked it there he replied that he did. Hillcrest - Vernon DS0000014568.V298732.R01.S.doc Version 5.2 Page 14 Three Service Users attend college placements, ten Service Users attend day centres regularly and in-house activities are provided for the two who remain at home. In house activities include hydrotherapy and horse riding. One of the Service Users has bought a hydrotherapy spa pool and had it sited in the garden with a fixed hoist beside it to assist people in and out. On the day of inspection a gazebo canopy was put up over the top so that Service Users can enjoy the spa in the sunshine. Service Users gain lots of enjoyment from this facility and it is an excellent example of creativity by the staff team. Service Users are encouraged to access the local community, visiting; shops, the library, hairdressers, pubs, leisure centre, restaurants and so on. The Registered Manager told the Inspector that the town’s recent carnival was enjoyed by those who attended. All but one Service User attends an annual seven-day holiday, instead, that particular individual is taken on regular, short weekend breaks. The Inspector became aware of a situation where cultural needs may not be being met. This was discussed at the time with the Registered Manager, who agreed to explore individual needs, which may or may not reflect the family’s wishes. The inspector was given an excellent example of how the staff team have worked with a man admitted to the home one year ago and for whom life has changed considerably. He has developed many skills, both physically and emotionally, and his progress is a direct result of the hard work and dedication of the staff team, who should be commended for their efforts. The home does provide opportunities for people to meet others through either day centres and/or colleges attended, or via the ‘Speak-about’ group that some attend. From observation of staff interaction the Inspector was of the opinion that Service Users are respected and their dignity upheld. The Inspector witnessed staff working with some very challenging and distressing situations. They remained calm and patient at all times. On talking with staff members the Inspector was pleased to hear of their dedication and commitment to working with the residents living at the home, with staff describing how important it is for them to make Service Users lives as enjoyable as it can be. Hillcrest - Vernon DS0000014568.V298732.R01.S.doc Version 5.2 Page 15 Menus looked at by the Inspector showed meals to be varied, nutritional and balanced. Records are kept of meals eaten by Service Users, and are kept on individual daily files. On the day of inspection the cook was preparing the evening meal, which consisted of several different types of quiche. These were all home made, using fresh ingredients. The cook is employed for six afternoons each week, Monday to Saturday, with staff cooking the Sunday roast. Hillcrest - Vernon DS0000014568.V298732.R01.S.doc Version 5.2 Page 16 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 and 20. The outcome for Service Users was found to be good. Specific care assessments, support plans and annual reviews are in place and reviewed regularly. There are some minor medication discrepancies that require attention. EVIDENCE: Service Users are supported to express their individuality. Person Centre Planning (PCP) training is offered to staff and some have attended the courses. However, on discussion with the Registered Manager the Inspector was told that it appears to be the ‘in-thing’ at the moment and she is not sure how committed people are to it. Assessments are in place for specific health issues, and Health Action Plans have been carried out for all Service Users by their G.P. Future health appointments are put into the home’s diary. Monitoring and reviewing of specific health conditions does take place, with detailed records being held on Hillcrest - Vernon DS0000014568.V298732.R01.S.doc Version 5.2 Page 17 individual files. Service Users have both a personal file that holds all relevant information about them and the specific needs they require and in addition, a daily file that is used to monitor, record and review on a day-to-day basis. Medication is stored securely in a large metal cabinet that is fixed to the wall. The home has a pharmacy contract with Boots and uses their dosage system. On examination of MAR sheets the Inspector found some gaps in signing. Two prescribed medications were not listed anywhere on the MAR sheet. Liquid medication was in need of dating and rectal diazepam should be stored below 22 c. Medication for a Service User who attends a day centre twice a week has not been administered at lunch-time for at least 7 weeks. The day centre will not give medication unless it is in a blister pack. However, this situation should have been rectified some time ago. The Registered Manager agreed that the matter needs to be addressed immediately. Hillcrest - Vernon DS0000014568.V298732.R01.S.doc Version 5.2 Page 18 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): 22 and 23. The outcome for Service Users was found to be good. Service Users are protected from abuse, neglect and unnecessary self-harm. EVIDENCE: The Commission has not received any complaints in respect of this service. The complaints policy and procedure were both available and are up-to-date. A complaints file contains written responses to each complaint and there have been no new complaints received since the previous inspection. Records examined during the inspection demonstrated that all staff had received training in recognising signs of abuse and further discussions confirmed that they were fully aware of how to report any concerns. The Inspector asked the Registered Manager if there was a forum for raising concerns before they become a complaint. She said that there is not but if a concern was brought to her attention she would inform the person of the complaints policy. Hillcrest - Vernon DS0000014568.V298732.R01.S.doc Version 5.2 Page 19 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, 25, 27, 28, 29 and 30. The outcome for Service Users was found to be excellent. Service Users live in a homely, comfortable and safe environment. It is nicely decorated throughout and is well maintained. EVIDENCE: The Inspector conducted a tour of the building that started on the ground floor in the staff office. Five bedrooms were looked at and were all found to be hygienically clean and well maintained. They were all furnished to suit individual and personal taste, despite the necessary equipment in place to cater for specific physical disabilities. Some bedrooms are fitted with ceiling track hoists, a profiling bed or electrically controlled sink (to adjust height) for example. Most of the rooms were decorated to a good standard, but obviously some had scuff marks visible on walls due to the constant use of wheelchairs. Hillcrest - Vernon DS0000014568.V298732.R01.S.doc Version 5.2 Page 20 The dining room was functional and had just been decorated. There is a large blackboard mounted on one of the walls where the manager said details of meals are written up each day. The kitchen is large and well maintained by the cook who works there six afternoons per week. It was clean and tidy, although there were some food items in the fridge that had not been labelled (jars of mayonnaise, jam, etc). Fridge/freezer temperatures had not been done on the wipe board system for a few days, although it was acknowledged that the cook, who usually takes responsibility for recording these, had been off. A nearby larder is used to store dry goods and this was found to be in good order. The lounge is a good size and has also just finished being painted, which made it look bright and clean. From the lounge Service Users can access the conservatory area and this is used partly as storage and as one-to-one space for arts & crafts work with Service Users. The garden has a raised vegetable bed where Service Users who use a wheelchair can get involved in gardening. There are currently cucumbers, carrots, sunflowers and spring onions growing. The garden is long, following the contours of the house round to the back where there are fruit trees is accessible to all due to the wide concrete path in the centre. The garden is looked after by a gardener who visits one day each week to keep it well maintained. There is a hot tub/Jacuzzi plumbed into the garden, complete with a fixed hoist beside it to assist Service Users to get in and out. The Inspector considered this to be a creative initiative by staff, and was pleased to learn about the enjoyment Service Users obtain from using it. Bathrooms, shower rooms and toilets were all clean, bright and well maintained, with one of the bathrooms just having renewed its floor covering the day before. The home employs a maintenance person who visits on a daily basis. Hillcrest - Vernon DS0000014568.V298732.R01.S.doc Version 5.2 Page 21 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): 32, 33, 34, 35 and 36. The outcome for Service Users was found to be excellent. Service Users are supported and protected by the home’s robust recruitment policy and practices. Service Users are supported by a competent and a well qualified staff team. EVIDENCE: The staffing rota was sent with the Pre-Inspection Questionnaire and showed that there is a large number of permanent staff employed at the home. Start dates show that some staff have been employed at the home many years, with only a small number being taken on within the last eighteen months. Five staff work on an early shift, five on the late shift, with one staff member working a mid-shift four days per week. Two waking night staff cover the night shift. In the day the rota enables a ratio of two-to-one and one-to-four upstairs. Hillcrest - Vernon DS0000014568.V298732.R01.S.doc Version 5.2 Page 22 The in-house induction programme is very comprehensive and should be filled in over a two-week period. It covers emergency procedures, aims & objectives, conditions of employment, recording systems, health & safety, training, policies/procedures, adult abuse and challenging behaviour. The Inspector examined three files. These contained job descriptions, job application forms, interview records, code of confidentiality statements, CRB checks and three references for each staff member commencing employment. The home has met the standard for NVQ percentages, as ten staff hold at least NVQ level 2, two staff are currently completing NVQ and two staff are due to start in September. Four staff do not want to study the qualification. Recruitment records were looked at and were found to contain all the necessary documents to ensure the safety of Service Users. Hillcrest require managers to attend a recruitment selection course in order to be ‘licensed’ before being allowed to recruit staff. Each new member of staff, including domestic staff, (cook and cleaner) are given a training and development portfolio on their first day of work. Interestingly they are given £2 to go choose and buy their own folder, making it more personalised. The portfolio includes pre and post training questionnaires to track learning objectives, NVQ information, training certificates, training plan, a comprehensive induction and an experience log of ‘first time’ experiences. This is an interesting concept whereby staff write a small summary of a new experience they have encountered in their day-to-day work. On discussion with staff it was good to hear the new skills they were picking up along the way. It is a great reflection tool and the Registered Manager said it was useful to bring to appraisals or when applying for promotion. Staff must take the portfolio to their supervision sessions and prove that they are being kept up-to-date. The administration assistant devises a training matrix on an annual basis, identifying individual needs. Further training needs and wishes are discussed within supervision. Staff spoken with were very happy about the amount of training they receive. Two staff had been employed by the company for one year or less and had been on many different courses. Training includes mandatory and specific subjects, with staff accessing a wide range of courses. Staff are supervised on a regular basis, every four to six weeks. The Inspector saw a supervision timetable that shows supervision sessions to be scheduled in Hillcrest - Vernon DS0000014568.V298732.R01.S.doc Version 5.2 Page 23 very regularly, although there had been a lapse in recent weeks due to leave and sickness. Staff spoken with confirmed that they do receive regular supervision that it is supportive and useful. Hillcrest - Vernon DS0000014568.V298732.R01.S.doc Version 5.2 Page 24 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): 37, 38, 40, 41, 42 and 43. The outcome for Service Users was found to be good. Service Users and staff benefit from a well managed home. The home should develop a quality assurance tool to ensure the views of people involved in the home are sought. Health, safety and welfare practices are good and provide protection for Service Users and staff. EVIDENCE: The Registered Manager is Tania Carter who has 15 years experience of working in the learning disabilities field. She holds NVQ level 4 and the RMA. She is also a manual handling trainer and LADAF assessor. Hillcrest - Vernon DS0000014568.V298732.R01.S.doc Version 5.2 Page 25 Ms Carter has a clear job description and her own portfolio for training. She is currently undertaking a computer course to improve her IT skills. On discussion with staff, the Inspector was told that the manager is approachable and supportive. Another member of staff said that the home is a nice place to work, with an easy going and relaxed atmosphere. The home used to send out questionnaires following the monthly regulation 26 visits. However this has not been done for several months now. Annual surveys used to be published, with the results made available, but again this has not been carried out recently. Records are kept in good order, are secure and are up to date. Policies and procedures are in place and up-to-date. They were reviewed in February 2006. Mandatory training is provided for all staff, including Health & Safety, food hygiene, fire, etc. There is evidence of Health & Safety monitoring, with generic risk assessments in place covering, bathing, stress, food safety, fire and so on. Window restrictors were seen on upstairs windows. RIDDOR is in place with one incident (10.2.06) reported to HSE from which the Environmental Health Department visited the premises. The incident was also sent to CSCI under regulation 37. The home has a contract with Chiltern for all of its serviceable equipment, such as; hoists, ceiling track hoists and so on. Comprehensive fire records are kept, and show that drills, equipment testing and risk assessments are carried out regularly. The home has a contract in place for all fire equipment to be serviced. There is also a good system in place for ensuring all staff attend their required amount of fire drills each year. Health and Safety is included in all staff inductions. Hillcrest - Vernon DS0000014568.V298732.R01.S.doc Version 5.2 Page 26 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 3 3 x 4 3 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 x 27 3 28 4 29 4 30 3 STAFFING Standard No Score 31 x 32 4 33 4 34 4 35 4 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 x 4 x LIFESTYLES Standard No Score 11 x 12 3 13 4 14 x 15 3 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 2 x 4 x 2 3 3 3 4 Hillcrest - Vernon DS0000014568.V298732.R01.S.doc Version 5.2 Page 27 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 YA20 Regulation 13(2) Timescale for action The registered person shall make 31/08/06 arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. Requirement 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 YA5 Good Practice Recommendations The Registered Manager develops and agrees with each prospective Service User a written and costed contract/statement of terms and conditions between the home and the Service User. 5.2 (v) – The contract specifies rights and responsibilities of both parties, and who is liable if there is a breach of contract. 39 – Effective quality assurance and quality monitoring systems, based on seeking the views of Service Users are in place to measure success in achieving the aims, objectives and Statement of Purpose of the home. 2 YA39 Hillcrest - Vernon DS0000014568.V298732.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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 - Vernon DS0000014568.V298732.R01.S.doc Version 5.2 Page 29 - 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!