Inspection on 11/07/05 for Hillersdon Court

This inspection was carried out on 11th July 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

Hillersdon Court 12/06/07

Hillersdon Court 01/08/06

Hillersdon Court 01/11/05

Hillersdon Court 16/11/04

Hillersdon Court 17/06/04

Hillersdon Court 23/09/03

Similar services:

Springfield House

The Shelley

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Hillersdon Court 18 College Road Seaford East Sussex BN25 1JD Lead Inspector Nigel Thompson Unannounced 11 July 2005 9:30 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. Hillersdon Court H59 H10 S21137 Hillersdon Court V218043 170505 stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Hillersdon Court Address 18 College Road Seaford East Sussex BN25 1JD 01323 897706 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) Mr James Lord Mrs Kathleen Waller Care Home 20 Category(ies) of Old age, not falling into any other category (OP) registration, with number 20. of places Hillersdon Court H59 H10 S21137 Hillersdon Court V218043 170505 stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1 The maximum number of service users to be accommodated is twenty (20). 2 That service users must be aged sixty five (65) years or over on admission. Date of last inspection 16 November 2004 Brief Description of the Service: Hillersdon Court is registered to provide residential care and support for up to twenty older people. The premises comprise of a large detached house, which has been extended over the years. The home is situated close to the shops and railway station in Seaford town centre and within walking distance of the seafront. Service user accommodation comprises of seventeen single rooms and one double room, eleven of which have en suite facilities. All rooms are fitted with a call bell system. The proprietors of Hillersdon Court also own Bybuckle Court, another care home for older people situated in the Seaford area. Hillersdon Court H59 H10 S21137 Hillersdon Court V218043 170505 stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over five hours in July 2005. It found that the majority of the twenty-two National Minimum Standards that were assessed had been met and the overall quality of care provided was good. Service users and relatives spoken to during the inspection expressed satisfaction with the home, the staff and the service provided. A tour of the premises took place and documentation, including service users’ files was inspected. Three of the service users’ relatives, three of the staff on duty and five of the fifteen residents were spoken to. What the service does well: What has improved since the last inspection? Specific information for prospective service users has been significantly improved. As required, the home’s ‘Statement of Purpose’ and ‘Service Users’ Guide’ have been reviewed and updated since the previous inspection. Hillersdon Court H59 H10 S21137 Hillersdon Court V218043 170505 stage 4.doc Version 1.20 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Hillersdon Court H59 H10 S21137 Hillersdon Court V218043 170505 stage 4.doc Version 1.20 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 Hillersdon Court H59 H10 S21137 Hillersdon Court V218043 170505 stage 4.doc Version 1.20 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, 2, 3, 4 & 5 Prospective service users and their relatives are provided with sufficient information to decide whether the home is able to meet their specific needs. There is a potential risk for service users as their individual care and support needs are not always assessed before they move into the home. EVIDENCE: The home’s ‘Statement of Purpose’ and ‘Service Users’ Guide’ have been reviewed and updated, as required since the previous inspection, However, in two service users’ files that were examined, there was no evidence of a pre-admission assessment having been carried out prior to the individual moving into the home. There was also very little structure or organisation to the files, including the care plans, and it was noted that the ‘Contract of Residence’ had not been fully completed or signed. Hillersdon Court H59 H10 S21137 Hillersdon Court V218043 170505 stage 4.doc Version 1.20 Page 9 Each prospective service user is invited to the home for a look around. During their visit they will have the opportunity to meet existing service users and members of staff. All potential service users are initially admitted on a trial basis for four weeks. The deputy manager confirmed that this period is to establish whether their assessed needs can be met within the home. It was also emphasised how important it is that the individual is happy in the home and comfortable and compatible with other service users. Emergency and unplanned admissions are not accepted at Hillersdon Court. Hillersdon Court H59 H10 S21137 Hillersdon Court V218043 170505 stage 4.doc Version 1.20 Page 10 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, 8, 9 & 10 Service users’ care plans are not consistently well maintained or regularly reviewed and amended to reflect an individual’s changing needs. Policies and procedures for the control and administration of medication are effective with clear and comprehensive systems being in place to ensure service users’ medication needs are met. EVIDENCE: As previously documented, service users care plans that were examined were found to be disorganised and lack structure. This had the effect of making information less accessible and specific details often difficult to locate. It was also evident that care plans do not always contain sufficient detail regarding action to be taken by staff. In January, one service user had been identified as having a pressure sore. However despite regular visits by the district nurse, to clean and dress the area, there was no reference made to this in the progress and evaluation notes or details of any intervention by care staff. Hillersdon Court H59 H10 S21137 Hillersdon Court V218043 170505 stage 4.doc Version 1.20 Page 11 Following the service user being admitted to hospital, with a chest infection and difficulties with swallowing, it was noted that there was no record of the GPs recent visit to the home, on the appropriate chart. Policies and procedures relating to the handling and control of medication were found to be accurate and generally well maintained. One service user has responsibility for the storage and handling of her medication and has signed a ‘self medication disclosure’. Another resident, who has also signed this form, maintains control for her own inhalers. In each case, risk assessments have been carried out and the deputy manager confirmed that both situations are closely monitored. As part of their induction programme, all staff receive instruction on the principles of dignity and respect. This was evident, during the inspection, from direct observation of staff interacting sensitively and professionally with service users. This was further reinforced by comments from service users and relatives, during the inspection: ‘My wife used to be here. It was good then and it’s good now’. ‘It’s very comfortable here, as you can see, and everyone is very friendly’. Hillersdon Court H59 H10 S21137 Hillersdon Court V218043 170505 stage 4.doc Version 1.20 Page 12 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, 13, 14 & 15 Social activities and meals are both well managed, creative and provide daily variety and interest for people living in the home. EVIDENCE: As part of individual care planning, the social and recreational interests of service users are assessed and recorded. However, it was noted that in some cases there is insufficient information recorded. A person’s interests or preferences were described as: ‘Likes music’ or ‘Likes games’. It is recommended that, as part of the assessment process, more detail is obtained and recorded, to enable an individual’s social care needs to be more appropriately met. Hillersdon Court H59 H10 S21137 Hillersdon Court V218043 170505 stage 4.doc Version 1.20 Page 13 Visiting is unrestricted at Hillersdon Court, although service users’ friends and relatives are politely requested to avoid mealtimes. Service uses are able to choose whom they see, where and when. Varied, balanced and nutritious meals are provided, reflecting service users’ choice and preferences. The cook confirmed that service users are consulted and directly involved in compiling the four-week rolling menu. Although the standard of meals provided at the home remains high and service users spoken to during the inspection expressed overall satisfaction with the food they receive, there were some concerns highlighted regarding the days when the cook does not work. This is more significant following the recent departure of an established member of the care staff, who regularly covered in the cook’s absence and who was clearly very popular. It is recommended that serious consideration be given to appointing a part time cook, to ensure current high standards are maintained. Hillersdon Court H59 H10 S21137 Hillersdon Court V218043 170505 stage 4.doc Version 1.20 Page 14 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 & 18 The open and inclusive atmosphere within the home enables service users, staff and visitors to feel able to express any concerns, confident that they will be listened to. Service users are safeguarded from abuse through robust policies, procedures and relevant staff training. EVIDENCE: Hillersdon Court retains a very comfortable, homely and inclusive atmosphere. Service users, visitors and members of staff spoken to during the inspection confirmed that they would have no hesitation speaking to the manager or deputy manager or making a complaint if necessary, and each person was confident that they would be listened to. ‘The manager and her staff are very approachable and always have time for you’. A clear, simple and accessible complaints procedure is displayed in the entrance hall. The home has a copy of the East Sussex guidance notes on the Protection of Vulnerable Adults and has produced its own relevant policies, including ‘whistle blowing’ for the advice and guidance of staff. The deputy manager confirmed that members of staff are made aware of such key policies and procedures as part of their induction training programme. Hillersdon Court H59 H10 S21137 Hillersdon Court V218043 170505 stage 4.doc Version 1.20 Page 15 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, 20, 21, 23, 24, 25 & 26 Service users benefit from living in a safe, clean and generally well maintained environment. However some furniture in communal areas and residents’ rooms is now looking worn and is showing signs of neglect. EVIDENCE: Service user accommodation was found be clean and generally well maintained, however it was noted that furniture in some rooms is now looking worn and neglected and should be replaced. It was evident that many of the rooms have been personalised, with pictures, family photographs and other small items of furniture and personal belongings, to reflect individual taste, choice and preference. Residents spoken to during the inspection were generally satisfied with the home and their individual rooms: Hillersdon Court H59 H10 S21137 Hillersdon Court V218043 170505 stage 4.doc Version 1.20 Page 16 ‘I’m very happy with my room’. ‘It’s clean and comfortable. – What more could you want?’ There are sufficient baths and toilets throughout the home. Eleven of the service user’s rooms are fitted with en-suite toilet and washbasin facilities. An assisted bathroom is situated on each floor. It was noted that these rooms are now in need of redecoration and refurbishment. The possibility of converting a second, first floor, unassisted and still currently unused bathroom into a shower room has been considered for some time and was discussed with the manager during a previous inspection. Such a conversion would clearly be of benefit to the more independent service user. Two bath seats are to be upgraded and replacements are understood to be on order. The light and spacious lounge provides a comfortable focus for many of the daily recreational and leisure activities in the home and clearly meets the individual and collective needs of the service users. A pleasant dining area provides a relaxed, homely and sociable setting for meal times. Hillersdon Court H59 H10 S21137 Hillersdon Court V218043 170505 stage 4.doc Version 1.20 Page 17 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) These standards were not assessed on this occasion. EVIDENCE: Hillersdon Court H59 H10 S21137 Hillersdon Court V218043 170505 stage 4.doc Version 1.20 Page 18 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 Current quality monitoring systems are inadequate and do not ensure that service users’ needs are being met and care standards maintained. EVIDENCE: The lack of any direct or regular involvement of the registered provider in the running of the home has been noted for some time. However following this inspection when, due to personal circumstances, the registered manager was unavailable, it became evident that service users and visitors now have very little contact with the owners and the staff receive minimal support from them. This is an unsatisfactory situation, which possibly has evolved through the proprietors’ commitments to ‘outside interests’ but which now needs to be addressed. It is a legal requirement that, in circumstances such as this, where the proprietors are not in ‘day to day charge’ of the home that they will visit at Hillersdon Court H59 H10 S21137 Hillersdon Court V218043 170505 stage 4.doc Version 1.20 Page 19 least once a month, unannounced, inspect the premises (including the furniture and fittings), speak with service users and staff and prepare a written report on the conduct of the home. A copy of this report is then to be supplied to the CSCI. Hillersdon Court H59 H10 S21137 Hillersdon Court V218043 170505 stage 4.doc Version 1.20 Page 20 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. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 2 2 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 3 COMPLAINTS AND PROTECTION 3 3 2 x 2 3 3 3 STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 2 x x x x x Hillersdon Court H59 H10 S21137 Hillersdon Court V218043 170505 stage 4.doc Version 1.20 Page 21 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 2 Regulation 5 (1) (b) Requirement It is required that each service user is provided with a written contract, including statement of terms and conditions, at the point of moviing into the home. It is required that service users are only admitted into the home on the basis of a full needs assessment and that that assessment is regularly reviewed. It is required that the service users plan sets out in detail action to be taken by care staff to ensure the health, personal and social care needs of the individual are met. It is required that the service users care plan be reviewed at least once a month and updated to reflect changing needs. It is required that the incidence of pressure sores, their treatment and outcome are recorded in the service users care plan. It is required that the provider visits the home at least once a month to inspect the premises, monitor the conduct of the home and prapare a written report. A Timescale for action 31.08.2005 2. 3 14 (1) (2) 31.08.2005 3. 7 15 (1) 31.08.2005 4. 7 15 (2) 31.08.2005 5. 8 17 (1) (a) Schedule 3 (n) 26 (1,2,3,4 & 5) 31.08.2005 6. 33 31.08.2005 Hillersdon Court H59 H10 S21137 Hillersdon Court V218043 170505 stage 4.doc Version 1.20 Page 22 copy of this report is to be forwarded to the CSCI. 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 14 21 24 Good Practice Recommendations It is recommended that a more detailed assessment of an individuals recreational interests and social care needs be undertaken and recorded. It is recommended that bathrooms throughout the home be refurbished and redecorated and two identified bath seats be replaced. It is recommended that items of old, worn and neglected furniture be replaced and upgraded. Hillersdon Court H59 H10 S21137 Hillersdon Court V218043 170505 stage 4.doc Version 1.20 Page 23 Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Hillersdon Court H59 H10 S21137 Hillersdon Court V218043 170505 stage 4.doc Version 1.20 Page 24 - 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. 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