Inspection on 16/03/07 for Hillcroft (Lancaster) Nursing Home

This inspection was carried out on 16th March 2007.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Hillcroft (Lancaster) Nursing... 13/02/06

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Hillcroft (Lancaster) Nursing Home Westbourne Road Lancaster Lancashire LA1 5DX Lead Inspector Mrs Joy Howson-Booth Unannounced Inspection 16 March 2007 9.15 X10015.doc Version 1.40 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 Hillcroft (Lancaster) Nursing Home DS0000066641.V324052.R02.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 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. Hillcroft (Lancaster) Nursing Home DS0000066641.V324052.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hillcroft (Lancaster) Nursing Home Address Westbourne Road Lancaster Lancashire LA1 5DX 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) 01524 63107 01524 389413 Hillcroft (Carnforth) Limited Mrs Elaine Fallowfield Care Home 20 Category(ies) of Dementia (10), Old age, not falling within any registration, with number other category (10) of places Hillcroft (Lancaster) Nursing Home DS0000066641.V324052.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 20 service users to include *up to 10 service users in the category of OP (Old age not falling within any other category ) *up to 10 service users in the category of DE (Dementia) 13th February 2006 Date of last inspection Brief Description of the Service: Hillcroft Lancaster is a Care Home with Nursing, situated close to the railway station and all the amenities of Lancaster centre. It provides full nursing care for 20 persons in ground and first floor accommodation. There is access for wheelchair and semi-mobile service users and a passenger lift is in place. All bedrooms are decorated and furnished to a good standard. There are currently two lounge/dining areas and a separate quiet lounge. There are adequate toilets and assisted bathrooms. Trained nurses are on duty at all times. The home is well maintained with well kept garden areas around the building. There is adequate parking space for visitors. The current range of fees are from £520.00 and are based on assessed needs. Further details over fees can be obtained from the registered manager of the home. Hillcroft (Lancaster) Nursing Home DS0000066641.V324052.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the first site visit and was unannounced so the registered providers, registered manager, staff and residents were not aware of the visit. The site visit was carried out by the inspector for the service and a specialist Pharmacist Inspector. The site visit forms part of the overall inspection for the home which makes sure people are being cared for properly and to make sure the home is a safe place for people to live in. As well as the site visit, judgements have been made about the service based on information supplied by the registered manager. Comment cards were made available to service users, relatives and GP surgeries. Four responses were received from GP’s which were positive about the care provided. One response was received from a relative who also was very satisfied with the care provided. The site visit took place over one day and included taking time to sit and speak with residents, spending time observing staff on duty performing the day-today care tasks, speaking with staff, speaking with five relatives/visitors to the home. As well as this, a selection of documents were examined. The home’s registered manager was on holiday but the locum manager and general manager made themselves available during the inspection to answer questions and provide additional information. The inspector looked around parts of the home, including communal rooms, a small number of personal rooms, bathrooms and toilets. The tour also provided an opportunity to find out about the improvements made since the last inspection and to see if the home was a comfortable, clean and safe for people to live in. Additional information was also supplied from a pre-inspection questionnaire completed by the registered manager. The site visit was positive with everyone welcoming, friendly and co-operative during the visit. What the service does well: Hillcroft (Lancaster) provides a pleasant and homely environment which has a relaxed and friendly atmosphere. The registered manager and staff try hard to make sure equal care is given to all residents, considering their individual choices and preferences, and giving equal support to all, irrespective of their race, gender, disability, sexuality, age religion or beliefs. A relative comment card stated “Hillcroft treats all its residents with dignity. All staff know all the residents names and treat them with respect.” Hillcroft (Lancaster) Nursing Home DS0000066641.V324052.R02.S.doc Version 5.2 Page 6 The registered manager works at the home on a full-time basis which gives an opportunity to talk with the residents and pick up immediately on any concerns or issues. There is equal consideration given to all prospective employees, with both male and female staff being employed. Training and development programmes are offered to all members of staff. The home has a very low turnover of staff with a number of staff having worked at the home for sometime. The home employs a number of qualified nurses to undertake formal nursing care. In addition, information from the home stated that 90 of the care staff are trained to National Vocational Qualifications (NVQ) Level II. This means that residents are cared for by suitably qualified and experienced staff. The carers were friendly and understood the personal needs of each resident. At the time of the visit the inspector saw friendly and caring exchanges between the staff on duty and the people living at the home, with each resident being treated as an individual and given the time and attention needed. Whilst all the residents have a range of differing care needs, they are encouraged to maintain their lifestyles as much as they are able to do so. Visitors to the home are always made welcome and are able to visit at any time. Information supplied by the home confirms that there are a range of policies and procedures which ensure residents are provided with the care they need and respects their rights irrespective of their race, gender, disability, sexuality, age, religion or beliefs. The home is well maintained and homely with communal rooms being accessible to the residents. For the bedrooms upstairs there is a passenger lift for the residents to use. There are a range of aids and adaptations for use within the home to help maintain residents’ independence and dignity. Those residents’ rooms seen during this site visit were well maintained and homely. Residents are also encouraged to bring in treasured personal items to personalise their rooms. Communal rooms are well maintained and provide a homely and comfortable environment for the residents to use. During the site visit, a number of residents were seen and spoken with and all appeared to be well cared for and content. As well as this a lengthy observation of staff undertaking care tasks was carried out where a number of very positive interactions taking place. Five relatives/visitors were spoken with who confirmed the care provided was good. Comments included “the care and understanding of staff is excellent. This home is a jewel”. All the GP comment cards confirmed they are satisfied with the level of care provided. Hillcroft (Lancaster) Nursing Home DS0000066641.V324052.R02.S.doc Version 5.2 Page 7 From talking with the residents and staff on duty it is clear all work hard to ensure the home is maintained to a high standard and the registered manager is approachable for any ideas and suggestions that would improve the service. 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. The summary of this inspection report can be made available in other formats on request. Hillcroft (Lancaster) Nursing Home DS0000066641.V324052.R02.S.doc Version 5.2 Page 8 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 Outcomes Statutory Requirements Identified During the Inspection Hillcroft (Lancaster) Nursing Home DS0000066641.V324052.R02.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 3 and 6 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. The system for assessment of prospective residents in the home is very comprehensive and enables a judgement to be made as to whether the home can meet identified needs. EVIDENCE: The home (in line with the three other homes in the company) has a care plan system called “Care Pathways”. This means that following the initial enquiry from either Social Worker, Health professional or relative the manager will undertake a person visit to meet the prospective resident and complete a “care menu”. It is from this initial information that a care pathway menu is completed and an initial care pathway plan put in place. Hillcroft (Lancaster) Nursing Home DS0000066641.V324052.R02.S.doc Version 5.2 Page 10 Paperwork for a recent admission was examined and showed that all the required information had been gained by the home’s manager prior to admission. There is also in place an admissions procedure which outlines for staff how people who are admitted to the home need to be given time, information and made to feel comfortable. The procedure also outlines that the new resident is to be given choice of whether they wish to stay in their room (with refreshments), their relatives are to be made welcome and regular monitoring to take place. Discussions with staff confirmed that they are aware of this admissions procedure and get to know details of new residents, initially from verbal information at hand-over but then from the care pathways which are available to read. One member of staff also said that they find out information over residents likes, dislikes, routines, etc. from either talking with the resident themselves or from speaking with their relatives. This home does not provide an intermediate care facility. Hillcroft (Lancaster) Nursing Home DS0000066641.V324052.R02.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 and 11 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. A quality of care is provided to the residents which means their health and personal care needs are generally met and residents are treated with dignity and respect. Medication systems are generally satisfactory but some practices have the potential to place residents at risk. EVIDENCE: Care pathways were examined (case tracked) for three residents and these gave clear information about the residents’ needs and how these are to be met. The home promotes equality by treating people as individuals and ensuring that diversity needs such as impaired mobility and functional are appropriately met. Hillcroft (Lancaster) Nursing Home DS0000066641.V324052.R02.S.doc Version 5.2 Page 12 Discussions with residents confirmed that they are very happy with the care provided and staff always treat them with dignity and respect. Importantly, residents also confirmed that the care staff are kind and caring. A comment card was received from a relative also confirmed that they feel residents are treated with dignity and respect. As well as this, a lengthy time span was spent closely observing staff undertaking their daily care of the residents. Observations noted that staff responded sensitively and respectfully to residents needs and interactions between staff and residents were positive. A number of examples of very good practices were seen although a couple of training areas were noted. All the observations were passed onto the general manager. Five visitors to the home were spoken with and all said that the care provided was to a very good or excellent standard. On relative commented “the care and understanding of staff is excellent. This home is a jewel”. Discussions with staff about the needs of the three residents selected for case tracking confirmed that they have a very good understanding of their individual needs. Staff also felt there was good communication about needs, via handovers, meetings, care pathways and they felt supported by the nurses and manager of the home. One member of staff said “There are always enough carers on duty and I feel we are fully supported by managers. I really enjoy working here”. The home has introduced the Liverpool Care Pathways for residents who may be in their final hours of life. Liverpool Care Pathways is a system which ensures that the care needed at the final stages of life are treated as no less important than other care tasks. Any decision regarding end of life care is taken within a multidisciplinary setting and involves both the resident (if they are able to do so) and their relatives, the resident’s GP and any other professional who may be involved. This means that the wishes of the person can be respected (e.g. religious and/or cultural) and met and any unnecessary interventions are stopped, with only necessary (e.g. pain relief) interventions taking place. This ensures that the resident is provided with their chosen level of input, according to their personal and religious preferences, which is dignified and pain free. Relatives are welcomed and supported by the manager and staff during these circumstances and are able to spend as much time as they wish with their relative. An in-depth inspection of the medication systems in the home was undertaken by a Pharmacist Inspector. The Pharmacist inspector noted that generally the administration, record and storage arrangements were satisfactory but there were specific areas of concern that were pointed out to the general manager. The general manager advised that the concerns would be addressed promptly. Hillcroft (Lancaster) Nursing Home DS0000066641.V324052.R02.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 and 15 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Activities, social contact and meals are good which means the residents are provided with a good quality of lifestyle EVIDENCE: Discussions with residents and their relatives confirmed that individual routines can be followed and these are ascertained at the time of the assessment and following admission. Records examined evidenced that a number of in-house activities are provided and recorded, along with whether the resident enjoyed the activity or not. The home also organises outings for the residents - recently a number of residents were taken out to a champagne lunch. Other outings are also organised for residents. Observations during the inspection noted that in the lounge for people with dementia, a number of residents had very good interactions with staff, Hillcroft (Lancaster) Nursing Home DS0000066641.V324052.R02.S.doc Version 5.2 Page 14 although some residents had little or no contact with staff during the observational time span. Observations of the second lounge were made following lunch so this was a much quieter period. Some residents were waiting to visit the hairdresser, three residents were involved with a member of staff doing a crossword and later a video was put on. Discussions with the general manager stated that the registered manager of the home was still developing activities but had made improvements to date. This is clearly an area for continual review and development, particularly for the frail nursing residents, to ensure that all residents are offered a range of stimulating activities according to their needs, wishes and interests. It was also confirmed that both a priest and minister visit the home on a regular basis, providing communion and religious support to residents as needed. Relatives/visitors who were spoken with confirmed that they are made very welcome, are included to share a meal, can visit at any time (and do so) and feel the care provided is “excellent”. Residents spoken with confirmed they are able to make choices about their daily to day activities and staff were able to provide examples of how they give residents choices. Observations during the time span also evidenced that staff offered residents choices. As with the other homes in the Hillcroft group, this home has now had the input of the Head Chef who has revised all the menus to provide an excellent standard of food. The menus are organised over a four-week rota and provide clear examples that a range of choices are provided. Residents spoken with confirmed they enjoyed the food provided. Observations of the lunchtime meal also confirmed that meals are well presented, with special diets being catered for appropriately. It was also seen that residents were supported in a sensitive and appropriate way and were enabled to enjoy their meal in an unhurried way. The chef was also spoken with who confirmed that a good quality of food is always provided, with fresh meat and vegetables being purchased from local suppliers. Hillcroft (Lancaster) Nursing Home DS0000066641.V324052.R02.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Concerns can be voiced and staff are trained in safeguarding adults which means that residents are protected. EVIDENCE: The general manager confirmed that the complaints procedure remains the same and meets with the requirements of the Care Homes Regulations. Information supplied by the home states that no complaints have been received by the home. The Commission has not received any complaints about the home. Comment cards received from GP surgeries all confirm they have not received any complaints about the care provided. A comment card received from a relative stated that they were not aware of the home’s complaints procedure, although a copy of the complaints procedure was seen on display in the home. Discussions with staff confirmed there is a good understanding of what to do should a complaint be made to them. Hillcroft (Lancaster) Nursing Home DS0000066641.V324052.R02.S.doc Version 5.2 Page 16 As one of the Hillcroft group of homes, there are robust procedures in place for recognising and responding to any safeguarding adult concern. Previous discussions with the Hillcroft group’s training manager confirmed that safeguarding adults is covered in both the home’s own 3 day induction programme and through other training. The home’s procedure needs updating to reflect the guidance in “No Secrets”/new local safeguarding protocols. Discussions with staff on duty confirmed that they have received training in safeguarding adults and, from questioning they have a good understanding of what constitutes abuse and the importance of safeguarding residents in the home. Staff spoken with confirmed that any incident or concern would be reported to the manager of the home or the general manager. Hillcroft (Lancaster) Nursing Home DS0000066641.V324052.R02.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 and 26 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Residents live in a well-maintained and safe environment which provides a pleasant and homely place for them to live in. EVIDENCE: The home has recently undergone a complete refurbishment, with all communal areas being redecorated and refurbished. There is an ongoing maintenance programme to ensure the home continues to provide a high quality environment. Hillcroft (Lancaster) Nursing Home DS0000066641.V324052.R02.S.doc Version 5.2 Page 18 The home was toured with a sample of personal bedrooms being seen. All the communal rooms are well decorated, furnished to a high standard and providing a pleasant environment for the residents to live in. Individual rooms have been personalised with treasured possessions to make them familiar and homely. There is a secure garden which is accessible by residents, although this is generally with staff support. There are no CCTV cameras in use in the home. There is a dedicated housekeeper and maintenance section to ensure any requirements made by the environmental health are addressed promptly. There is an infection control policy and procedure in place and training records evidenced that staff have accessed infection control training. The registered manager confirmed that a requirement made at the last inspection has been addressed as the home now has a new laundry. Hillcroft (Lancaster) Nursing Home DS0000066641.V324052.R02.S.doc Version 5.2 Page 19 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 and 30 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. The level and calibre of staff is very good. Residents are safeguarded as their care is provided by a staff team who are vetted, qualified and competent. EVIDENCE: Staff Records were examined for the three latest new starters at the home. These evidenced that all the required checks are carried out prior to commencement of employment at the home. The home’s equal opportunities policy is reflected in their employment as there are both male and female staff, aged between 18 and 65, including overseas carers working at the home. Staff were asked about staffing levels and stated that there is sufficient staff on duty to meet the needs of the residents. Relatives spoken with and the comment card returned also confirmed that there is always sufficient staff on duty. The Hillcroft group have a Clinical Supervisor who organises training, including a formal 3 day induction training programme for all new staff. More recently, the Hillcroft group has set up a dedicated training room at their Lancaster Hillcroft (Lancaster) Nursing Home DS0000066641.V324052.R02.S.doc Version 5.2 Page 20 home to enable staff to undertake their training courses in a more formal setting. In addition, a comprehensive range of in-house training and accesses external training courses as training needs dictate. Information supplied by the Clinical Supervisor confirmed that a range of training courses have been attended by staff at the home, with a range of future training planned. Staff files examined evidenced ongoing training with copies of certificates. Staff spoken with all confirmed that there is ongoing training provided. A new member of staff confirmed that they had attended the 3-day induction programme before starting work at the home and had found this very useful. Hillcroft (Lancaster) Nursing Home DS0000066641.V324052.R02.S.doc Version 5.2 Page 21 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35, 36 and 38 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The residents live in a home that is well managed and provides a safe and comfortable environment for them to live in. EVIDENCE: The manager of the home has recently been registered with the Commission. She fulfils the requirements for registration, with a great deal of experience in both nursing and management. Staff spoken with all confirmed that they feel the home is well managed - “Elaine is very approachable”. Hillcroft (Lancaster) Nursing Home DS0000066641.V324052.R02.S.doc Version 5.2 Page 22 As with the other homes in the Hillcroft group, this home has now set up a relatives support group. The support group is made up of both current relatives and relatives of people no longer at the home and provides a support, information and social function. The group meets on a 3 monthly basis, with input from both one of the Directors, the General Manager and the manager of the home. There is a financial cost to these meetings which is met wholly by the company. A recent meeting was held at a local hotel when 23 people (including relatives from another Hillcroft home) attended. The General Manager confirmed that the quality assurance systems used in the other Hillcroft homes have been introduced to this home, these include external and internal auditing, the use of ‘non-compliance forms’ which are used to identify issues so that appropriate action can be taken. Feedback is also sought from residents, relatives and external healthcare professionals. The registered provider also visits and tours the home on a regular basis. Residents meetings are held for those that are able to participate – minutes of these were read during the inspection. Staff confirmed that staff meetings are held on a regular basis (including separate meetings for qualified nurses, senior carers, ancillary staff). Staff spoken with said they are provided with copies of minutes and, importantly are asked for ideas and suggestions to improve the home. Policies and procedures have recently been reviewed for this home, with generic policies and procedures (where appropriate) being introduced from the Hillcroft group systems. Staff spoken with confirmed they have access to these policies and procedures for reference. Information supplied by the home confirmed that all residents receive their personal allowance monies and records are maintained for these. For those people who do not handle their own financial affairs these are managed by solicitors, families or via the residents own account. Hillcroft has exacting and significant financial procedures to ensure the resident’s financial interests are protected. The general manager confirmed that all new residents are provided with a breakdown of their individual fees, along with what the home provides, as required in the Care Homes Regulations 2001. A general statement regarding this is included in the home’s Service User Guide. Although not a key standard, some supervision records were accessed during the inspection but these did not evidence that supervision is provided 6 times a year. Confirmation was received from the registered manager that “all staff have had supervision at least once this year”. Advice is given that the National Minimum Standards require staff to have supervision at least 6 times a year. Hillcroft (Lancaster) Nursing Home DS0000066641.V324052.R02.S.doc Version 5.2 Page 23 Information supplied by the registered manager confirmed that regular maintenance and servicing takes place on equipment and facilities within the home. The general manager confirmed that a fire risk assessment has been carried out and information supplied stated that the last fire drill was held in December 2006. In addition, a new fire system has been installed in the home. Staff spoken with confirmed that they are down to do update fire safety training later in the month. A requirement at the previous inspection required that all staff be provided with the mandatory training. The registered manager confirmed that all the staff have now had this mandatory training. Discussions with staff confirmed that they have been given training in moving and handling, fire safety, first aid, food hygiene and infection control. This was also supported by training certificates seen and a training log submitted by the registered manager. However, it was observed that a number of residents were being moved in wheelchairs without any footplates. The manager was advised that this poses a risk to the residents and asked to ensure all footplates were installed on the wheelchairs. This was attended to during the inspection but would suggest that some refresher training in moving and handling residents in wheelchairs is required. The accident forms were seen and all appeared accurately completed and followed through. It was stated that an audit on accidents is carried out on a monthly basis but there is no evidence that this is carried out. The manager was advised to ensure accident records are “signed off” when audited for this purpose. The general manager confirmed the home has received the new bed rail guidance from MHRA. Information supplied by the Clinical supervisor confirmed that Skills for Care (TOPSS) induction and foundation training is accessed for new staff. Hillcroft (Lancaster) Nursing Home DS0000066641.V324052.R02.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 4 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 2 10 3 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 X 3 Hillcroft (Lancaster) Nursing Home DS0000066641.V324052.R02.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? no 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 OP9 Regulation 13(2) Requirement Medicines must be correctly received, stored, administered, recorded and disposed of to ensure they are given to residents correctly Timescale for action 30/04/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP7 OP37 OP7 Good Practice Recommendations Residents (or their representative) should be involved in their care pathways and these documents should evidence that involvement Daily records for residents should be maintained evidencing the daily care provided Care pathways should provide more information over behavioural or other management “triggers” so that staff are clear about what support is required by the individual resident concerned. The activities programme should continue to be developed so that a range of activities based on individual likes, interests and abilities are provided The home’s current abuse policy and procedure should be DS0000066641.V324052.R02.S.doc Version 5.2 Page 26 4. 5. OP12 OP18 Hillcroft (Lancaster) Nursing Home 6. 7. 8. OP36 OP18 OP38 reviewed so that it reflects current local protocols in safeguarding adults and the document “No Secrets” Formal supervision should be provided to staff at least 6 times a year Staff should ensure that residents wheelchairs have footplates when in use unless, following a risk assessment, the care pathway indicates otherwise The accident monitoring should be signed off once the accident forms have been checked Hillcroft (Lancaster) Nursing Home DS0000066641.V324052.R02.S.doc Version 5.2 Page 27 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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. 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