Inspection on 07/09/06 for Hilldales

This inspection was carried out on 7th September 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 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

Hilldales 17/02/06

Similar services:

Clouds House

Closereach

Westcliffe House

Longreach

Chandos House

Cherry Orchards Camphill Community Ltd

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

CARE HOME MIXED CATEGORY MAJORITY ADULTS 18-65 Hilldales Hilldales 11 - 13 Oxford Park Ilfracombe Devon EX34 9JS Lead Inspector Dee McEvoy Key Unannounced Inspection 7th September 2006 11:00 Hilldales DS0000064816.V305390.R02.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 Hilldales DS0000064816.V305390.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 and 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. Hilldales DS0000064816.V305390.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hilldales Address Hilldales 11 - 13 Oxford Park Ilfracombe Devon EX34 9JS 01271 865893 01271 879357 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) Dr Htay Kywe Mrs Thida Oo Ms Lesley Jean Mason Care Home 56 Category(ies) of Past or present alcohol dependence (56), Past or registration, with number present alcohol dependence over 65 years of of places age (56), Mental disorder, excluding learning disability or dementia (56), Mental Disorder, excluding learning disability or dementia - over 65 years of age (56) Hilldales DS0000064816.V305390.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th February 2006 Brief Description of the Service: Hilldales is a care home providing services for 56 men and women experiencing past or present alcohol dependence and/or mental health problems. The home provides accommodation and support for residents within a mixed age category. The home consists of two large detached terrace houses, which have been connected by an adjoining corridor. Previously registered as two separate homes, Hilldales and Northview, the home is now registered as one under the name of Hilldales. Hilldales is an older style property, which is situated within easy access of Ilfracombe community resources. Accommodation is single occupancy and there are several communal areas around the home, including a pool table and library area. There is no lift at this home so residents need to be fairly mobile. Wheelchair users can be accommodated on the ground floors and assisted baths are available. The home has a mini bus and offers transport to residents for hospital appointments and other trips. The average cost of care ranges between £260.00 and £700.00 per week at the time of inspection. Additional costs, not covered in the fees, include chiropody, certain activities and outings, and personal items such as toiletries and newspapers. Current information about the service, including CSCI reports, is available to prospective residents. Hilldales DS0000064816.V305390.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Two inspectors completed this unannounced inspection over the course of seven hours. During the inspection the inspectors saw or spoke with most residents around the home. Six residents were case tracked, which helps us to understand the experiences of people using the service; others were spoken with at length. One relative was also met and spoken with during the inspection. Confidential surveys were sent to residents prior to the inspection to find out about their views on life at the home, 15 were returned to the inspector. 10 staff surveys were returned to the Commission ensuring that that their views were also heard. Feedback was obtained from four care managers, three GPs and four health professionals, including community mental health professionals and specialist nurses. The inspectors also toured the premises and a sample number of records were looked at which included care plans, medication records, staff recruitment files, service and maintenance certificates and fire safety records. As part of the inspection the manager completed a pre-inspection questionnaire, which provides general information about the service. Finally, the outcome of the inspection was discussed with the registered manager. What the service does well: The home provides a safe and well equipped environment for men and women who have mental health problems and those with alcohol dependency, who have experienced an unsettled and transient lifestyle. One resident told an inspector, “The home has done a good job of protecting me from myself”, another said, “My health is good since coming here”. Assessments and care planning are good and ensures that residents’ needs are clearly explored and documented. The staff team are generally well trained and committed to providing person centred care and choice. Residents’ health and personal care needs are well met. All health and social care professionals responding with CSCI comment cards were happy with the overall care provided to residents; one professional wrote, “Complex needs are well addressed at Hilldales”. Hilldales DS0000064816.V305390.R02.S.doc Version 5.2 Page 6 The overall management of the home is good; there are clear lines of responsibility, which ensure that residents and staff know who to talk to should any problems arise. The management ensure action is taken within agreed timescales to meet identified requirements. Residents and staff described the manager as “approachable”, “excellent” and “caring”. 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. Hilldales DS0000064816.V305390.R02.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Individual Needs and Choices Lifestyle Personal and Healthcare Support Concerns, Complaints and Protection Environment Staffing Conduct of Management of the Home Scoring of Outcomes Statutory Requirements Identified During the Inspection Adults 18 – 65 (Standards 1–5) (Standards 6-10) (Standards 11–17) (Standards 18-21) (Standards 22–23) (Standards 24–30) (Standards 31–36) (Standards 37-43) Older People (Standards 1–5) (Standards 7, 14, 33 & 37) (Standards 10, 12, 13 & 15) (Standards 8-11) (Standards 16-18 & 35) (Standards 19-26) (Standards 27-30 & 36) (Standards 31-34, 37 & 38) Hilldales DS0000064816.V305390.R02.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 (Adults 18 – 65) and Standards 1 – 5 (Older People) are: 1. 2. 3. Prospective service users have the information they need to make an informed choice about where to live. (OP NMS 1) Prospective users’ individual aspirations and needs are assessed. No service user moves into the home without having been assured that these will be met. (OP NMS 3) Prospective service users’ know that the home that they choose will meet their needs and aspirations. Service Users and their representatives know that the home they enter will meet their needs. (OP NMS 4) Prospective service users’ have an opportunity to visit and “test drive” the home. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. (OP NMS 5) Each service user has an individual written contract or statement of terms and conditions with the home. Each service user has a written contract/statement of terms and conditions with the home. (OP NMS 2) 4. 5. The Commission considers Standard 2 (Adults 18-65) and Standards 3 and 6 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA 1 & 2 OP 1 & 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information about the home is available for prospective residents, which enables most to make an informed choice before moving into the home. Admissions to the home are generally well managed and comprehensive assessments ensure that individual needs are met. EVIDENCE: The home has a comprehensive statement of purpose to help prospective residents and care managers decide if the home is ‘right for them’. The majority of residents responding with surveys (11) said they had received enough information about the home before moving in. Due to the admission process of Hilldales DS0000064816.V305390.R02.S.doc Version 5.2 Page 9 some residents, for example unplanned or emergency admissions, information available does not always inform choice but gives residents an idea of what the home offers. The Statement of Purpose has been up-dated recently and the manager told the inspectors that all residents would be receiving a copy. Prospective residents’ needs are carefully assessed before moving into the home to ensure the home can meet their requirements. Pre-admission assessments were seen for six residents; these contained relevant and valuable information about individual needs. Most contained important personal information about past life experiences and important life events, enabling staff to relate appropriately to the resident. Four residents spoken with felt that they would now benefit from more independent living accommodation and one felt that the home was no longer appropriate to meet their needs. Two residents said they did not regularly see care managers for reviews. These issues need to be considered at a formal review with care managers, as the home’s manager does not have the authority to make such decisions or arrangements. The manager was made aware of individuals wishing to explore other accommodation and support and agreed to contact the relevant social services department to ensure that reviews were organised. Hilldales DS0000064816.V305390.R02.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6-10 (Adults 18-65) and Standards 7, 14, 33 & 37 (Older People) are: 6. Service users know their assessed and changing needs and personal goals are reflected in their Individual Plan. The Service Users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users make decisions about their lives with assistance as needed. Service Users are helped to exercise choice and control over their lives. (OP NMS 14) Service users are consulted on, and participate in, all aspects of life at the home. The home is run in the best interests of service users. (OP NMS 33) Service users are supported to take risks as part of an independent lifestyle. The service users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users know that the information about them is handled appropriately and that their confidences are kept. Service Users rights and best interests are safeguarded by the home’s record keeping, policies and procedures. (OP NMS 37) 7. 8. 9. 10. The Commission considers Standards 6, 7 and 9 (Adults 18-65) and Standards 7, 14, and 33 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA 6, 7 & 9 OP 7, 14 & 33 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Detailed care plans and staff knowledge ensure that residents’ health and personal care needs are met. Residents are supported to make decisions about their lives and good consideration is given to the management of individual risks. EVIDENCE: Most residents confirmed that care plans are developed with their input and records looked at had been signed by residents to confirm their participation. Care plans contained good details of individual needs and how they should be Hilldales DS0000064816.V305390.R02.S.doc Version 5.2 Page 11 met. Detailed personal statements provide information about residents’ interests, preferences and family relationships ensuring that emotional, social and psychological needs are understood and met. Care plans had been reviewed regularly or when changing needs were identified, to ensure information was accurate and reflected resident’s individual needs. Staff spoken with had a good understanding of residents’ needs and appeared keen to promote person centred care, choice and autonomy. Residents spoken with and the majority responding with comment cards felt well cared for. One resident told an inspector, “Staff know how I’m feeling”, another said, “Staff understand me and my ways”. All health and social care professionals were happy with the care provided at the home and felt that staff demonstrated a clear understanding of the needs of the residents. Residents spoken with and 13 responding with surveys felt they could make daily decisions about how they spent their time; one told the inspector, “I like to be out and about” and “There’s lots of freedom here.” Residents were seen to move freely around the home, spending time in their chosen place and seeking the company and activity they preferred. Any restrictions or limitations are discussed, agreed and recorded prior to admission, for example restrictions on the use of alcohol, access to tobacco and personal allowances. As discussed, the manager has agreed to contact care managers to ensure reviews are carried out for residents who expressed a desire to explore alternative accommodation and support (Refer to standard 3). Residents are supported to take risks as part of an independent lifestyle, for instance the majority of residents enjoy a high degree of autonomy and choice and choose how to spend their day and who to associate with. Risk assessments seen in residents’ files had been completed and provided comprehensive information, describing what was to be done to manage or reduce the risks identified, including self-harm and risk to others. Staff and the manager demonstrated a good knowledge of individual residents needs, risks, preferences and choices and how these are met. CCTV has been installed since the last inspection and monitors the entrance and exit areas of the home only. The manager said this had been installed in response to an incident and had reduced the risk to wandering unaccompanied residents who need supervision. Hilldales DS0000064816.V305390.R02.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 (Adults 18-65) and Standards 10, 12, 13 & 15 (Older People) are: 11. Service users have opportunities for personal development. 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. (OP NMS 12) Service users are able to take part in age, peer and culturally appropriate activities. 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. (OP NMS 12) Service users are part of the local community. Service users maintain contact with family/ friends/ representatives and the local community as they wish. (OP NMS 13) Service users engage in appropriate leisure activities. 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. (OP NMS 12) Service users have appropriate personal, family and sexual relationships and maintain contact with family/friends/representatives and the local community as they wish. (OP NMS 13) Service users’ rights are respected and responsibilities recognised in their daily lives. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users are offered a (wholesome appealing balanced) healthy diet and enjoy their meals and mealtimes. Service users receive a wholesome appeaing balanced diet in pleasing surroundings at times convenient to them. (OP NMS 15) 12. 13. 14. 15. 16. 17. The Commission considers standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 10, 12, 13 and 15 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA 12, 13, 15 16 & 17 OP 10, 12, 13 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Hilldales DS0000064816.V305390.R02.S.doc Version 5.2 Page 13 Social activities are provided and offer some stimulation and interest and residents are supported to maintain valued and fulfilling occupation and education opportunities. Residents are supported to maintain contact with family and friends, and to develop new relationships, where appropriate. Meals provided offer variety and choice and take into account residents’ needs and preferences. EVIDENCE: Staff spoken with were keen to focus on the individual skills and abilities of residents to ensure that residents can be as independent as possible, for example, several residents benefit from light domestic responsibilities around the home. One resident said, “I enjoy having something to do and being useful”. One resident is supported to maintain a voluntary job in the town and two residents are completing college courses. Two other residents said they would like the opportunity to “earn a wage”. Residents use facilities in the local town such as beaches, shops, swimming pool, library and museums. Where appropriate residents are encouraged to use practical life skills such as taking responsibility for keeping bedrooms clean or doing their own laundry. The home has developed an activities programme, which includes trips, games, such as darts and dominoes, and a pampering day. Other recreational facilities at home include a library space, pool table, dartboard and cable TV. During the inspection three residents said that activities did not always meet their preferences or expectations; cost was cited as a restriction on some trips, which could have been enjoyed. A recent trip had been enjoyed by a number of residents but one resident was surprised to be told the cost following the trip. Another resident said, “I get bored at times”. The manager and staff are keen to continue to develop leisure activities for residents and regularly ask residents to put new ideas forward. Visitors to the home, including relatives and professionals, said they felt welcome to visit the home and that the staff communicated well with them. Residents said they could have visitors anytime; restrictions are outlined in the Statement of Purpose. One visitor spoken with during the inspection described the home as ‘friendly and welcoming’. Care plans contain important family birthdays and staff will assist residents to maintain contact. Residents said food was varied, and they could request alternatives if they didn’t like the menu option. Most residents were happy with the food provided; two Hilldales DS0000064816.V305390.R02.S.doc Version 5.2 Page 14 residents had mixed comments about the food. A seasonal menu is available and the home provides three meals a day, including a cooked breakfast. Tea, coffee and snacks, such as homemade cakes are always available. The chef was spoken with and is always happy to try new things and develop menus with the residents. Hilldales DS0000064816.V305390.R02.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 – 21 (Adults 18-65) and Standards 8 – 11 (Older People) are: 18. 19. 20. Service users receive personal support in the way they prefer and require. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users’ physical and emotional health needs are met. Service users’ health care needs are fully met. (OP NMS 8) 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. Service users, where appropriate, are responsible for their own medication and are protected by the home’s policies and procedures for dealing with medicines. (OP NMS 9) The ageing, illness and death of a service user are handled with respect and as the individual would wish. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. (OP NMS 11) 21. The Commission considers Standards 18, 19 and 20 (Adults 18-65) and Standards 8, 9 and 10 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA 18, 19 & 20 OP 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal care is offered in such a way as to ensure residents’ privacy and dignity is maintained. The health needs of residents are met with evidence of good multi-disciplinary working taking place on a regular basis. There are good systems in place to ensure the safe management of medication. Hilldales DS0000064816.V305390.R02.S.doc Version 5.2 Page 16 EVIDENCE: Staff spoken with demonstrated a clear understanding of residents’ personal and emotional care needs. The benefit of this knowledge was evident from some of the positive relationships, which have developed between them. Residents spoken with were generally happy with the care and support provided, one told an inspector, “Staff are very respectful”. The home works closely with G.Ps, community mental health team and community nurses to ensure that residents’ health needs are met. During the inspection, staff and the manager were seen to discuss concerns with health professionals where necessary and act on the advice given. All health professionals contacted were happy with the overall care at the home, including the management of medication. Two residents talked about how much their health had improved since moving to the home and one visitor described the improvement in the general health of their relative since their admission. Another resident said, “They look after you here”. Staff administering medication have undertaken training to ensure that safe practice is maintained. Medicines are securely stored and an accurate record of administration is kept. A community pharmacy report undertaken in May 2006 found satisfactory standards. Hilldales DS0000064816.V305390.R02.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22-23 (Adults 18-65) and Standards 16-18 & 35 (Older People) are: 22. 23. Service users feel their views are listened to and acted on. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted on. (OP NMS 16) Service users’ are protected from abuse, neglect and self-harm. Service users legal rights are protected. (OP NMS 17) Also Service users are protected from abuse. (OP NMS 18) Also Service users financial interests are safeguarded. (OP NMS 35) The Commission considers Standards 22-23 (Adults 18-65) and Standards 16-18 and 35 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA 22 & 23 OP 16, 18 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints system, with evidence that residents feel that their concerns or complaints would be listened to and acted on. Residents are protected from abuse by well-informed staff and systems are in place to ensure that residents’ personal monies are managed correctly. EVIDENCE: The home has a clear complaints procedure, which is posted around communal areas and a copy of the complaints procedure can be found in the Statement of Purpose. All residents spoken with knew how to raise concerns or complaints and felt confident that the manager and staff would listen and act where possible. 14 of the 15 residents responding with surveys knew how to make a complaint. No complaints have been received by the home or the Commission in relation to the service. Hilldales DS0000064816.V305390.R02.S.doc Version 5.2 Page 18 All staff receive adult protection training as part of induction to ensure they are aware of the action to be taken should they have any concerns. Staff spoken with demonstrated a good understanding of adult protection issues and confirmed that they would challenge any poor practice. Nine residents spoken with and 10 responding with surveys said they felt well cared for and were “always” treated well by staff. Residents’ comments included, “The staff are very good” and “I feel more secure than ever”. Residents are assisted to manage their finances where necessary and any restrictions on access to monies is agreed and documented in care plans. Since the last inspection steps have been taken to tighten the system for ensuring residents’ personal monies are well managed. Storage is secure and good clear records are kept of all transactions. Hilldales DS0000064816.V305390.R02.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 (Adults 18-65) and Standards 19-26 (Older People) are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users live in a safe, well-maintained environment (OP NMS 19) Also Service users live in safe, comfortable surroundings. (OP NMS 25) Service users’ bedrooms suit their needs and lifestyles. Service users own rooms suit their needs. (OP NMS 23) Service users’ bedrooms promote their independence. Service users live in safe, comfortable bedrooms with their own possessions around them. (OP NMS 24) Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Service users have sufficient and suitable lavatories and washing facilities. (OP NMS 21) Shared spaces complement and supplement service users’ individual rooms. Service users have access to safe and comfortable indoor and outdoor communal facilities. (OP NMS 20) Service users have the specialist equipment they require to maximise their independence. Service users have the specialist equipment they require to maximise their independence. (OP NMS 22) The home is clean and hygienic. The home is clean, pleasant and hygienic. (OP NMS 26) The Commission considers Standards 24 and 30 (Adults 18-65) and Standards 19 and 26 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA 24 & 30 OP 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of the environment within and around the home is generally good, providing residents with a clean, comfortable and well-maintained place to live. Hilldales DS0000064816.V305390.R02.S.doc Version 5.2 Page 20 EVIDENCE: There are several comfortable communal areas around the home and the décor and furnishings are generally good. All bedrooms are single occupancy and those bedrooms visited were homely and had been personalised by residents. The home is well maintained with two full time maintenance people working daily on site to address long term projects such as redecoration and any daily maintenance needs. The home was clean throughout and free from offensive odours. 10 residents responding with surveys said it was “always” like this, 4 said it was “usually” like this. The provider is currently reviewing the position of the laundry facilities, which is not ideal at present. Staff were seen to have the necessary equipment to maintain infection control, such as gloves and aprons and had undertaken training. Hilldales DS0000064816.V305390.R02.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 (Adults 18-65) and Standards 27 – 30 & 36 (Older People) are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users are supported by competent and qualified staff. Service users are in safe hands at all times. (OP NMS 28) Service users are supported by an effective staff team. Service users needs are met by the numbers and skill mix of staff. (OP NMS 27) Service users are supported and protected by the home’s recruitment policy and practices. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users’ individual and joint needs are met by appropriately trained staff. Staff are trained and competent to do their jobs. (OP NMS 30) Service users benefit from well supported and supervised staff. Staff are appropriately supervised. (OP NMS 36) The Commission considers Standards 32, 34 and 35 (Adults 18-65) and Standards 27, 28, 29 and 30 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA 32, 34 & 35 OP 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Competent and qualified staff support residents well. The home operates a robust recruitment procedure ensuring that residents are safeguarded from harm. EVIDENCE: Residents who spoke with the inspectors confirmed that there was sufficient staff on duty to meet their needs and recognised how hard the staff work at the home, one resident said, “We have good staff that are over worked”. One resident felt that some staff were better than others. Hilldales DS0000064816.V305390.R02.S.doc Version 5.2 Page 22 The pre-inspection questionnaire showed that 70 of staff had achieved a nationally recognised qualification (NVQ 2 or above); this is to be commended. Staff spoken with felt well supported and had a good knowledge of residents’ needs. Health and social care professionals responding to CSCI surveys felt that staff had a good understanding of residents’ needs. Staff confirmed that they were never expected to care for people outside of their area of expertise. Two staff commented on the training opportunities provided by the home, one said, “The training here is very good”. Another described a thorough induction period. Since the last inspection the manager has contacted the local college to register staff interest in the planned NVQ training, which reflects the Drug and Alcohol National Occupational Standards {DANOS}. In the meantime, several staff have attend a mental health and alcohol awareness study day; one staff member told an inspector “It was a very useful day”. Some staff have been issued with DANOS handbooks in preparation for formal training to ensure they are aware of the specific issues affecting residents. Recruitment files for two staff were looked and contained the necessary information to ensure the protection of residents. Hilldales DS0000064816.V305390.R02.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 (Adults 18-65) and Standards 31-34, 37 & 38 (Older People) are: 37. Service users benefit from a well run home. 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. (OP NMS 31) Service users benefit from the ethos, leadership and management approach of the home. Service users benefit from the ethos, leadership and management approach of the home. (OP NMS 32) Service users are confident their views underpin all self-monitoring, review and development by the home. The home is run in the best interests of service users. (OP NMS 33) 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 homes record keeping, policies and procedures. (OP NMS 37) Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping policies and procedures. (OP NMS 37) The health, safety and welfare of service users are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (OP NMS 38) Service users benefit from competent and accountable management of the service. Service users are safeguarded by the accounting and financial procedures of the home. (OP NMS 34) 38. 39. 40. 41. 42. 43. The Commission considers Standards 37, 39 and 42 (Adults 18-65) and Standards 31, 33, 35 and 38 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA 37, 39 & 42 OP 31, 33, 35 & 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents benefit from the management and leadership of the home, which are good. Hilldales DS0000064816.V305390.R02.S.doc Version 5.2 Page 24 The home has good formal quality assurance processes to ensure that residents can influence the development of the service. Health and safety within the home is promoted meaning residents live in a safe environment. EVIDENCE: The registered manager has the required qualifications and experience and is competent to run the home. She is pro-active and demonstrated an awareness of current developments in health care, training and regulation. The manager and provider work hard to improve the service and provide an increased quality of life for the residents. One resident told an inspector, “They listen to me” and recognised the investment in the home to ensure improvements. There is a strong ethos of being open and inclusive and the general atmosphere in the home is positive. Residents and staff met and spoken with had a high regard for the manager, describing her as “a lovely lady”, and “she is great”. Staff felt well supported to do their jobs and were happy in their work. Residents and staff felt the manager was accessible and approachable. The home operates a variety of quality assurance systems, including a robust complaints and recruitment procedure and staff training and staff supervision. Residents and staff said that regular meetings are held and people are encouraged to express opinions about the care provided and the general running of the home. One resident told an inspector, “I give my opinion freely!” Residents complete satisfaction questionnaires twice a year exploring their views on the service provided and other relevant services such as social services and care management. The home also conducts general surveys about menus and activities. Action is taken by the home to ensure that requirements identified in CSCI inspection reports are met and improvements made within agreed timescales. Staff spoken with and information in the pre-inspection questionnaire confirmed that mandatory training such as manual handling, first aid, fire safety and infection control had been undertaken to ensure continued safe practice. The manager has ensured that action has been taken to meet the new fire safety regulations, emergency fire action plans are in all residents’ bedroom and those residents spoken with confirmed that fire drills are held and that they know what to do in the event of fire. This work is to be commended. A Devon Fire & Rescue inspection in April 2006 found satisfactory standards within the home. A range of servicing and maintenance records was seen at this inspection, including gas and electrical certificates; all were satisfactory. Hilldales DS0000064816.V305390.R02.S.doc Version 5.2 Page 25 To enhance health and safety hot water temperatures are controlled at a safe level and all windows have been fitted with restrictors to prevent harm to residents. It was noted that restrictors had been disabled in one bathroom and bedroom on the first floor. The manager agreed to address this immediately. A recent visit by environmental health found satisfactory standards but made one recommendation around the storage of eggs. This has been acted upon. It order to further maintain good standards and reduce risks to food safety it is recommended that a fly screen be installed within the kitchen. Hilldales DS0000064816.V305390.R02.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. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 CONCERNS AND COMPLAINTS Standard No Score 22 3 2 3 4 5 3 3 X X 23 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 X ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT Standard No Score 37 4 38 X 39 4 40 X 41 X 42 3 43 X LIFESTYLES Standard No Score 11 X 12 2 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Hilldales Score 3 3 3 X DS0000064816.V305390.R02.S.doc Version 5.2 Page 27 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. Standard Regulation Requirement Timescale for action 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 YA12 Good Practice Recommendations It is recommended that activities and educational opportunities be developed further with residents and any cost for trips, outings etc are made clear to residents. It is recommended that a fly screen be fitted in the kitchen to ensure good standards are maintained. YA42 Hilldales DS0000064816.V305390.R02.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Devon Office Unit D1 Linhay Business Park Ashburton Devon TQ13 7UP 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. Hilldales DS0000064816.V305390.R02.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. 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