Inspection on 07/09/05 for Hillcroft Residential Care Home

This inspection was carried out on 7th September 2005.

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

The inspector 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 Residential Care Home 26/06/08

Hillcroft Residential Care Home 30/11/07

Hillcroft Residential Care Home 07/02/07

Hillcroft Residential Care Home 23/06/06

Hillcroft Residential Care Home 01/11/05

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 Residential Care Home 16-18 Long Lane Aughton Ormskirk L39 5AT Lead Inspector Pauline Randles Unannounced 07 September 2005 09:45 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Hillcroft Residential Care Home F57 F08 S63777 Hillcroft V247605 070905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Hillcroft Residential Care Home Address 16-18 Long Lane Aughton Ormskirk L39 5AT 01695 422407 01695 420866 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Raycare Limited Mrs Susan Valentine Care Home 29 Category(ies) of OP - Old age (29) registration, with number of places Hillcroft Residential Care Home F57 F08 S63777 Hillcroft V247605 070905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 29 service users in the category of OP - (Old age, not falling within any other category). 2. The service employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 3. Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidelines which may be issued through the Commission for Social Care Inspection regarding staffing levels in care homes. 4. The registered manager must undertake training on the prevention of abuse for vulnerable adults within the 3 months of registration. Date of last inspection 11 January 2005 Brief Description of the Service: Hillcroft is a home providing personal care and accommodation for 29 older people. It is a privately owned home and is situated in the village of Aughton just off a main road, which provides easy access to Ormskirk, where there is a range of community and leisure facilities. The home is a two storey building with a newer purpose built extension and provides a mix of single and shared accommodation. Eighteen bedrooms have en-suite facilities. There are two lounges, one of which has a combined dining room, a separate dining room and conservatory. There is a passenger lift. The gardens are well maintained and easily accessible. Hillcroft Residential Care Home F57 F08 S63777 Hillcroft V247605 070905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection at Hillcroft was unannounced and took place over a period of six hours. This was the first inspection since the new owners had taken over the premises. There were twenty eight residents living at the home on the day of inspection. One resident was in hospital. The registered manager, three members of staff, three service users and a visitor were spoken to. During the inspection the premises were viewed, records and procedures examined and recreational activities observed. What the service does well: What has improved since the last inspection? The statement of purpose had been revised to ensure up to date information was available for residents and their representatives. Staff records were being adequately maintained and the process for accessing Criminal Records Bureau disclosures was in keeping with requirements to ensure the suitable appointment of new staff. Radiators had been guarded to improve safety of residents and, where appropriate, allow them to control their own heating level. Hillcroft Residential Care Home F57 F08 S63777 Hillcroft V247605 070905 Stage 4.doc Version 1.40 Page 6 As a means to further develop staff competence additional staff members were taking National Vocational Qualifications (NVQ) and the Registered Manager was undertaking the Registered Managers’ Award (RMA). To improve clarity and safety the fire risk assessment had been reviewed and rewritten in the manner previously recommended. 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. Hillcroft Residential Care Home F57 F08 S63777 Hillcroft V247605 070905 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Hillcroft Residential Care Home F57 F08 S63777 Hillcroft V247605 070905 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 and 3 The availability of detailed information about Hillcroft and a thorough assessment of care need prior to admission had ensured that prospective residents had only been accepted to live at Hillcroft if it was their informed choice and the service was able to meet their assessed needs. EVIDENCE: To ensure prospective residents and their representatives had access to full information about Hillcroft the statement of purpose had been reviewed following the previous inspection and more recently updated to include details of the new proprietor and manager of the home. A copy of the revised document must be forwarded to the Commission for Social Care Inspection when completed, as agreed, for record purposes. Assessment of needs prior to admission were thorough including risk and health care assessments in order to be certain that the home was the right choice for the prospective resident and had the provision required to meet presenting needs. When asked about her views on the service received and whether it met her expectations one resident said “the home has been fine although there have been a number of changes.” Hillcroft Residential Care Home F57 F08 S63777 Hillcroft V247605 070905 Stage 4.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7 and 8 Daily records of care provision have not been written in an acceptable manner leading to the possibility of inappropriate and inaccurate responses to service users needs. Assessments of risk are not sufficiently thorough and have led to unauthorised restrictive practice. EVIDENCE: All aspects of health, personal and social care needs had been taken into account in development of care plans that guided care service activity. The level and type of service provided for each resident had been reported on a daily care plan record as a basis for review of the care plan. It was noted on one file examined that complaints had been recorded on the care plan record but had not been dealt with through the formal complaints process. Also on three of the files examined subjective comments had been made by staff. Training had not been provided in relation to the recording of information. Two residents spoken to were unable to recall seeing their care plan notes so were unaware of the subjective comments made. A more objective and factual approach to the process of recording information and enabling resident accessibility must be introduced to improve accuracy of detail and response. Hillcroft Residential Care Home F57 F08 S63777 Hillcroft V247605 070905 Stage 4.doc Version 1.40 Page 10 Residents confirmed that they received health care services if required. One resident said the nurse came after she’d had a fall whilst two other residents said services came when “I need them”. A record of visits that had been made to residents by healthcare professionals and a report of any accidents had been maintained providing a means of tracking any recurring conditions or concerns. An issue of concern was that bed rails had been installed in two rooms one without completion of a formal risk assessment and both without liaison with district nursing services that could mean an inappropriate use of physical restraint had been introduced. It was acknowledged that one resident had taken a bad fall and the bed rails had been introduced as a means of minimising the risk of falling again. However the process of assessing risk on this occasion had not been sufficiently thorough to ensure protection from restrictive practices. An immediate requirement notice was issued in this regard. Hillcroft Residential Care Home F57 F08 S63777 Hillcroft V247605 070905 Stage 4.doc Version 1.40 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 and 13 The current level of activities at the home does not reflect service users interests or expectations. The visitors’ policy upholds the rights of residents to choose whom they see, where and when, and protects the security of the premises. EVIDENCE: Residents spoken to said there were “very little” social activities available. Other comments included “there is an occasional musician” and “we went to Blackpool a couple of years ago.” Two residents said they visited a local luncheon club that they enjoy. Another two residents spoken to asked for more outings, possibly to the theatre. The manager said that outings had been arranged previously and declined but there were no records available. Staff members confirmed that they are involved in games, sing along and gentle exercise with residents but again these are not detailed in writing or recorded. It is a requirement that residents are consulted about preferred activities including outings that are planned, promoted and participation recorded as a response to their identified needs. Residents spoken to said that visitors are made welcome, are always offered refreshments and a private area if needed. One resident said “all my visitors know the staff now and we choose who we see.” A relative also confirmed that Hillcroft Residential Care Home F57 F08 S63777 Hillcroft V247605 070905 Stage 4.doc Version 1.40 Page 12 she is encouraged to visit and made welcome when she does. Staff members confirmed in discussion an understanding of the visitors’ policy and how this operates in practice to ensure security of the premises and uphold the rights of the residents. A relative visiting at the time of inspection confirmed her mother who was unwell was well cared for and that she was always made welcome and comfortable when visiting. Hillcroft Residential Care Home F57 F08 S63777 Hillcroft V247605 070905 Stage 4.doc Version 1.40 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 The current method of managing complaints does not ensure that residents are confident that their complaints are listened to and acted upon. EVIDENCE: The complaints procedure that appears in the statement of purpose and on a notice board in the hallway meets requirements. However the practise of management of complaints had not followed the procedure. The complaints log mentioned in the procedure had not been established. It was also noted that a number of complaints had been recorded on a residents’ care plan record and these had not been acknowledged as complaints or dealt with through formal processes. Staff members when asked were unsure where the formal procedure was and what it said. Also when asked about the process for making a complaint one resident said “I’m not sure” whilst another resident said “ I would ask my daughter to deal.” Hillcroft Residential Care Home F57 F08 S63777 Hillcroft V247605 070905 Stage 4.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 25 and 26 The premises were effectively and hygienically maintained to provide a safe and secure home for residents. EVIDENCE: The premises when viewed were seen to be well maintained, clean and hygienic and suitable for the purpose. An up to date daily maintenance record was examined and a rolling programme of refurbishment was in place. More than one resident said everywhere is kept clean. Other comments included “my room is kept nice.” Since the previous inspection all radiators had been guarded in a manner that enables residents to control the temperature in their own room whilst being safe from the possibility of scalding. Fire doors are no longer wedged open. Acoustic door guards had been fitted to protect residents from the risk of fire. Water temperature checks had been carried out and safety notices were posted at suitable points in the building to ensure safety from hot water. Residents spoken to said “no worries, everything is safe” and “plenty of staff here, doors lock.” Hillcroft Residential Care Home F57 F08 S63777 Hillcroft V247605 070905 Stage 4.doc Version 1.40 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 28, 29 and 30 Staff morale was high and there was a strong sense of effective teamwork. Progress had been made in attaining an increase in the number of staff trained to NVQ Level 2. Development of training opportunities at foundation level would further increase competency of staff. Recruitment and selection procedures ensured that only people suitable to work in care services had been appointed thereby providing safe support and protection of residents. EVIDENCE: When interviewed staff members were extremely positive about working at Hillcroft. Comments made included “its great to work here” and there is “a really good team spirit.” Discussion with staff members and sight of training records also confirmed that the home had a strong commitment to training the workforce to suitable levels of national vocation qualification competence. Approximately a third of care staff had achieved NVQ Level 2. Five additional staff members were undertaking NVQ level 2 and three staff members were undertaking Level 3. When the present training has been completed Hillcroft will have over 50 of staff qualified and competent to carry out their job to the required national vocational standards. One resident when interviewed about staff competence and training said staff members “seem to” know their job, whilst another said “some aren’t trained in moving.” From examination of records and discussion it was noted that staff Hillcroft Residential Care Home F57 F08 S63777 Hillcroft V247605 070905 Stage 4.doc Version 1.40 Page 16 members had been trained by the manager and senior staff of the home in moving and handling as part of their induction into safe working practices. It is recommended that additional training in moving and handling processes be provided as an element of foundation training to ensure full and continuing competence in this task. Recruitment procedures and methods of maintaining personnel records had improved as required following the previous inspection. Although no new staff had commenced since the current registered manager had taken over a commitment was expressed not to start any new employees without full Criminal Records Bureau clearance. These improved practices will help to ensure that new staff members are suitable to work in care services in the provision of support and protection of residents. Hillcroft Residential Care Home F57 F08 S63777 Hillcroft V247605 070905 Stage 4.doc Version 1.40 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 and 38 The system for consultation of residents was effective and assured residents that views expressed were heard and acted upon. Safe working practices would be improved through the introduction of revised policies, procedures and the retention of relevant records on the premises. EVIDENCE: Residents when asked whether they were consulted about the service provided said that they were. Comments made included “ I feel confident I will be listened to” and “anything you raise they will take to carers or have a meeting.” It was also confirmed by residents that the manager and the proprietor ask frequently after the welfare of individual residents. Records indicated that comments had been recorded and forwarded to the Commission for Social Care Inspection (CSCI) on a monthly basis. Staff members advised that training in safe working practices had taken place during induction and records confirmed this to be the case. Some staff had Hillcroft Residential Care Home F57 F08 S63777 Hillcroft V247605 070905 Stage 4.doc Version 1.40 Page 18 also completed distance learning courses relating to control of infection and safe handling of medication to improve their skills and knowledge. New policies and procedures were being developed in relation to safe working practices. Accident records were examined and cross- referenced with care plan records that evidenced an appropriate response and follow up had been made. Safety notices were posted in suitable points throughout the building. Potential hazards had been noted as they had occurred and were dealt with through the maintenance system to ensure ongoing safety. Servicing and maintenance records were up to date apart from those relating to gas and electrical testing. The current certificates were not available on the premises at the time of inspection so there was no evidence that the annual checks had been carried out and appliances were safe. Work was continuing to be undertaken in response to requirements of the water regulators. When the work has been completed and approved a copy of the certificate issued by United Utilities will be forwarded to the CSCI to confirm compliance with requirements. Hillcroft Residential Care Home F57 F08 S63777 Hillcroft V247605 070905 Stage 4.doc Version 1.40 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 x COMPLAINTS AND PROTECTION 3 x x x x x 3 3 STAFFING Standard No Score 27 x 28 2 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x x x x 3 x x x x 2 Hillcroft Residential Care Home F57 F08 S63777 Hillcroft V247605 070905 Stage 4.doc Version 1.40 Page 20 NO 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 OP1 Regulation 6 (a) (b) Schedule 1 15 (2) (a) Requirement A copy of the revised Statement of Purpose must be forwarded to the Commission for Social Care Inspection (CSCI) when completed. Staff members must receive guidance relating to care plan recording that ensures reports are written in a style that is factual, objective and accessible to the resident. Bed rails must only be installed following a formal risk assessment completed in liaison with the resident or their representative and district nursing services. When completed the risk assessments must be forwarded to the CSCI by the date agreed. Residents must be consulted about the type of recreational activities they prefer and arrangements made to enable them to particpate in activities of their choice. A complaints register must be established in which all complaints are recorded and responded to within the given timescales. Timescale for action 15.10.05 2. OP7 15.10.05 3. OP8 13 (6) (7) Immediate requiremen t. Action to be completed by the 16/9/05 !.11.05 4. OP12 16 (2) (m)(n) 5. OP16 22 (3) (4) 15.10.05 Hillcroft Residential Care Home F57 F08 S63777 Hillcroft V247605 070905 Stage 4.doc Version 1.40 Page 21 6. OP38 13 (4) (a) (c) Certificates confirming compliance with gas, electrical and water safety regulations must be forwarded to the CSCI by the date indicated or sooner if available. 15.10.05 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. Refer to Standard OP28 OP30 Good Practice Recommendations 50 of care staff should achieve National Vocational Qualification (NVQ) Level 2 by 31st December 2005. Training in moving and handling, at a foundation level, should be provided for care staff. Hillcroft Residential Care Home F57 F08 S63777 Hillcroft V247605 070905 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Levens House Ackhurst Business Park Foxhole Road, Chorley Lancashire, PR7 1NW 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 Hillcroft Residential Care Home F57 F08 S63777 Hillcroft V247605 070905 Stage 4.doc Version 1.40 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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