Inspection on 27/06/05 for Hillfield

This inspection was carried out on 27th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Hillfield 19/09/06

Hillfield 13/12/05

Hillfield 13/12/04

Hillfield 29/06/04

Hillfield 28/01/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Hillfield Hillfield Lane Stretton Burton upon Trent Staffordshire DE13 0BW Lead Inspector David Cowser Unannounced 27 June 2005 10:30 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. Hillfield E51-E09 S33181 Hillfield V235705 270605 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Hillfield Address Hillfield Lane Stretton Burton upon Trent Staffordshire DE13 0BW 01785 277088 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) Staffordshire County Council, Social Care and Health Directorate Mrs Philomena Palmer Care Home 40 Category(ies) of 3 DE registration, with number 40 DE(E) of places 1 MD 12 MD(E) 40 OP 40 PD(E) Hillfield E51-E09 S33181 Hillfield V235705 270605 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 3 Dementia DE - Both sexes minimum age 50 years on admission 1 Mental Disorder MD - mnimum age 45 years on admission Date of last inspection 13 December 2005 Brief Description of the Service: Hillfield House is a Local Authority home for 40 older people. The home is located in Stretton, a village on the outskirts of Burton on Trent. The home is close to shops and amenities and is served by public transport. The home is owned by Staffordshire County Council and operated by Staffordshire Social Services. The home is pleasantly situated with extensive grounds and adequate car parking. Accommodation is provided on two floors served with a shaft lift and comprises 40 single rooms. Ten single bedrooms have an ensuite facility. Twenty-three single bedrooms have a floor area less than 9.3sq.m. The home is registered in the following categories: Dementia, Mental Disorder, Physical Disability and Old Age. Services and facilities including laundry, catering and hotel services are good with adequate staffing levels. Activities, hobbies and entertainment all take place and are facilitated by designated staff. Transport is provided when required and also families and friends are encouraged to take part in activities and trips out. Care is provided in the home by teams of care assistants reporting to shift leaders and the care manager. Health service professionals such as District Nurse, Community Psychiatric Nurse and Physiotherapist are accessed when required and local GP’s and a pharmacist service the home. Special arrangements are in place with the NHS psychiatric services IRIS team who will respond to meet specific needs of mentally ill service users. Hillfield E51-E09 S33181 Hillfield V235705 270605 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This routine unannounced visit was made on the 27 June 2005 @ 10.30hrs. The inspection was undertaken using the National Minimum Standards for Older People as a reference. The total time spent for the inspection, including pre and fieldwork, amounted to 5.5hrs. The registered care manager was in charge of the home accompanied by a care team leader and five care assistants. The ancillary staff on duty included; cook, catering assistant, three domestic/laundry persons, and maintenance person. These staffing levels were adequate to meet the needs of current 26 residents in the home. The total of 26 elderly residents, aged between 60 and 99 years of age, included; 8 with a dementia related condition, 8 with a mental illness, and 10 people receiving personal care for needs associate with old age. The inspection included the following elements; a tour of the building, observation and inspection of records relating to provision of care, discussions with five residents, discussions with all the staff members on duty, observation and sampling of other services provided such as catering and laundry, and an inspection of the managerial aspects such as staffing issues, quality assurance and health & safety. Since the last inspection on 13 December 2004; there had been no changes to the management of the home, no complaints had been received and no additional visits had been necessitated. It was evident that aspects of care had been addressed well, with residents able to choose the home following an assessment and invitation to visit the home. Service user plans had been well written, based on the community care plans completed by social workers. Health, personal and social care needs had been met and well documented. Privacy, dignity and choice aspects for residents were being upheld. No complaints, incidents or reports of abuse of any kind had been received since the last inspection, and policies and procedures seen covered these issues. Three residents had attended an A&E department, and one resident had a pressure area. There had been six deaths since the last inspection. The home was fit for purpose and provided a safe environment for the residents and staff. A very homely atmosphere had been created, and the premised were clean, warm and tidy. Adequate areas for residents were provided including; communal space, dining/activity space, bathing/toilet facilities, and bedrooms. Services and facilities, including catering and Hillfield E51-E09 S33181 Hillfield V235705 270605 Stage 4.doc Version 1.40 Page 6 laundry, were well provided. Health and safety aspects had been given a high priority and no shortfalls were noted. Alterations are due to take place in the home, and seven residents have been relocated to other L.A. homes to facilitate this work. Staffing levels and skill mix had been adequate to meet the assessed needs of the existing residents. Recruitment and retention of staff aspects were good with little staff turnover. Staff training had been given a high priority, with induction training being followed by NVQ training, and staff had received regular supervision. The home appeared to be managed well by a competent care manager. General management aspects were good with quality assurance taking place. Records had been correctly filed and stored. Assurances were given regarding the positive financial viability of the home, and that the Local Authority adopted suitable accounting/business procedures. No requirements against the standards were made on the last report, and this was repeated during this inspection. The recommendations previously made; provision of smaller bedrooms, continue with staff training programme, and review of night staffing levels, are all currently being addressed. What the service does well: The home provides a very good standard of residential care, for people with dementia related conditions and moderate mental illness, in a homely atmosphere. Staff interaction with residents was very good and there was a high level of satisfaction from the residents. To support the above, very positive comments were made to the inspector by; five residents, seven relatives, two district nurses and a visiting social worker. The inspector observed the care being delivered and the excellent interaction between staff and residents. A discussion took place with staff on duty, who gave a good account of how they were meeting the needs of the residents. Their documentation of care delivery was seen as very good and meaningful. Hillfield E51-E09 S33181 Hillfield V235705 270605 Stage 4.doc Version 1.40 Page 7 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Hillfield E51-E09 S33181 Hillfield V235705 270605 Stage 4.doc Version 1.40 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Hillfield E51-E09 S33181 Hillfield V235705 270605 Stage 4.doc Version 1.40 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 Individual health, personal and social cares needs had been established and were being met by staff, which individually and collectively had the necessary skills and experience. EVIDENCE: The documentation seen, and a discussion with residents/representatives, evidenced that residents had been assessed prior to admission and they had been enabled to make a choice about the home. All involved had the opportunity to visit the home prior to choosing to stay. Two residents spoken to had visited the home, and had a meal prior to deciding to stay, and this was seen documented within the care plans. The community care plans provided by the social worker, as part of the individual needs assessment process, were seen within the service user plans. Residents asked confirmed that they had been fully involved and were in agreement with the assessments. The records seen and a discussion with the staff evidenced that care staff, individually and collectively, had the necessary experience and skills to meet the assessed needs of the current service users. Hillfield E51-E09 S33181 Hillfield V235705 270605 Stage 4.doc Version 1.40 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 The assessed health and personal care needs of residents were being met, and had been well documented, with good standards of care being delivered. There was a safe system for the receipt, storage, administration and disposal of medicines. Residents were treated with respect, privacy and dignity, during the caring process. EVIDENCE: Five service users, and seven relatives spoken to, all commented very positively about the care being provided. One daughter told the inspector that compared to other homes that she was visiting relatives in this was far superior. The service user plans and associated documentation was well written, meaningful and reflected the current condition of residents. The documentation seen and a discussion with both residents and staff members evidenced that health and personal care needs were being well met. NHS facilities and professionals including community nurses, medical consultants and clinical nurse specialists had all been accessed when required, Hillfield E51-E09 S33181 Hillfield V235705 270605 Stage 4.doc Version 1.40 Page 11 and these events were seen recorded. A local GP practice and a local pharmacist service the home, and there is a good working relationship with them. Records of their visits and outcomes were seen documented. The community psychiatric IRIS team had been accessed when required. The home had a very good relationship with the NHS services. Two visiting district nurses told the inspector of the very good working relationship with the home. The medicines within the home, medication administration records, controlled drugs book and drugs returned book, were all checked and no errors were noted. It was observed that a safe system was in place, and that the comprehensive medicines policy documentation seen was being complied with. The documentation seen evidenced that only senior care staff administered medicines. Certificated training had been completed for the senior staff involved. No resident was ‘self medicating’, but locked facilities were available. During the inspection it was observed that privacy and dignity were being afforded to residents, and there was very good interaction with staff. Care staff were seen knocking on doors before entering. Four residents told the inspector that they were treated with respect, and that the staff were very good. Hillfield E51-E09 S33181 Hillfield V235705 270605 Stage 4.doc Version 1.40 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 Residents were satisfied with their lifestyle in the home, and they had been able to exercise choice and influence decisions affecting them. Contact had been maintained with relatives and friends of residents. Opportunities to access the local community had been made available. Catering aspects were very good with balanced nutritious meals being served, along with resident consultation and choice. EVIDENCE: Several residents told the inspector that their views had been listened to, and that they had been able to influence some aspects of the running of the home e.g. mealtimes, menus, beverage facilities for visitors. These comments had been documented along with the feed back from the resident/relatives questionnaires, and they had been acted upon. Contacts had been maintained, where possible, with relatives and friends and this was seen documented. Residents spoke of their visitors and their involvement with the home. Numerous visitors attended the home during this inspection, and seven told the inspector of the good links and communication with them. Trips out to the community had been well organised and transport provided. The activities were organised by a designated member of staff and residents spoke of the good work that she had done. The residents spoken to Hillfield E51-E09 S33181 Hillfield V235705 270605 Stage 4.doc Version 1.40 Page 13 confirmed that information had been circulated regarding future events and activities and they could choose about participation. Several residents spoke of their satisfaction with the meals and choices offered. The menus and catering records were examined and evidenced that the dietary requirements of residents were met. The records evidenced that residents’ needs with diabetes, and special diets, had been met. The cook when asked said that fresh good quality food from local suppliers was delivered on a weekly basis, the records seen confirmed this. Adequate supplies of fresh vegetables and fruit were also seen. The mid day meal seen was well presented and met all nutritional requirements. The cook spoke to each resident on a daily basis to establish his or her choice of food for the day, and this was seen documented. The inspector sampled the mid day meal and it was very good, meeting all requirements. Several residents were unable to make a decision regarding choice of meal, due to their current condition, and the inspector saw them being assisted by staff who were knowledgeable of their likes and dislikes. Hillfield E51-E09 S33181 Hillfield V235705 270605 Stage 4.doc Version 1.40 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 Complaints or grumbles are listened to and resolved. The home policies, procedures and staff training, protected residents from aspects of abuse. EVIDENCE: An examination of the complaints book, the relevant policy and procedure documentation, and a discussion with staff and residents, evidenced that complaints and grumbles were listened to and dealt with in the correct manner. Since the last inspection no complaints had been recorded or brought to the attention of this commission. Many ‘thank you’ and complimentary cards were seen from appreciative relatives. No incidents of neglect or abuse of any kind has been reported. The policy documentation seen, and a discussion with staff confirmed that residents are protected from all forms of abuse. Documentation seen evidenced that the above issues had been discussed at length during staff induction, training and on-going supervision. Hillfield E51-E09 S33181 Hillfield V235705 270605 Stage 4.doc Version 1.40 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) 19,26 The home provides a safe and well-maintained environment for residents. The home was clean and hygenic, warm and tidy, and had a very comfortable atmosphere. The premises are fit for purpose, though several bedrooms have a floor area less than 9.3sq.m. EVIDENCE: A tour of the building, and a check on the maintenance documentation, verified that the premises were fit for purpose, clean warm and tidy. The duty rosters evidenced that adequate ancillary staff were employed. Staff when asked told the inspector of their knowledge on infection control, and showed him the relevant documentation. Adequate hand washing facilities were available throughout the home. The laundry and sluice facilities were seen to be fully compliant. The records evidence that maintenance of the premises was being given a high priority. Hot water temperature checks, and emergency lighting/fire alarm tests were seen up to date and correct. There are no outstanding issues known from the Fire Prevention or Environmental health departments. Hillfield E51-E09 S33181 Hillfield V235705 270605 Stage 4.doc Version 1.40 Page 16 Alterations and upgrading work is planned for the home. Seven residents had already been relocated in anticipation of this work. Two months have elapsed and the work should now be started as soon as possible to enable the residents to move back into their home. Hillfield E51-E09 S33181 Hillfield V235705 270605 Stage 4.doc Version 1.40 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) 27,29,30 The assessed needs of service users had been met by an adequate number of suitably trained staff. Recruitment procedures had been correctly addressed which had contributed to the protection of service users. Staff training had been given a high priority. EVIDENCE: The duty rosters seen, and a discussion with the care team leader and the staff, evidenced that adequate numbers of staff had been on duty to meet the needs of the existing service users. Staffing levels were being maintained as at 1st April 2002 and following a discussion with the manager and her staff it was agreed that the shift cover was adequate for the existing residents needs. Staffing rosters were checked and were in order. An examination of the rosters evidenced that in addition to the registered care manager the following care staff had been maintained or exceeded: Daytime 1 manager 3 care assistants Night time 1 manager sleeping 2 care assistants awake Adequate ancillary staff had been provided each week. Two residents asked stated that staff were available when they wanted them, and that the staff were capable. Hillfield E51-E09 S33181 Hillfield V235705 270605 Stage 4.doc Version 1.40 Page 18 The records seen evidenced that in addition to the manager the home employed 29 care assistants, of which 9 (31 ) were trained to NVQ level 2 or above. The homes recruitment policy, procedures and documentation were examined and recruitment issues had been handled correctly. Staff had been subject to POVA/CRB comprehensive checks, and these were seen recorded. Staff asked stated that they had job descriptions and contracts of employment. Training had been given a high priority and the training records of individuals were seen. The records evidenced that care assistants had benefited from ‘in house’ and external training which had covered the needs of the registered client group. Staff told the inspector that they had been afforded the time off and encouraged to study. Training had been provided for staff in the awareness and management of dementia related conditions, and staff outlined this to the inspector. Hillfield E51-E09 S33181 Hillfield V235705 270605 Stage 4.doc Version 1.40 Page 19 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) 33,35,38 The home appeared to be well managed and quality assurance was in place. Financial aspects were correctly addressed and recorded, with safeguards to residents. Health and safety issues had been given a high priority and managed well. EVIDENCE: From observations made, discussions with service users and staff, it was evident that the home was being run in the interests of service users. Quality assurance, including feedback from residents and their representatives, was seen documented. Documentation seen evidenced that the views of visiting professionals had also been established, and included in the review process. A check on the records and a discussion with both residents and representatives evidenced that all service users had the opportunity to handle their own finances and all residents and families had chosen to do so. Day to Hillfield E51-E09 S33181 Hillfield V235705 270605 Stage 4.doc Version 1.40 Page 20 day monies of residents were checked and money held reconciled with the ledger. Inventories of valuables and belongings brought into the home were seen recorded. No health and safety issues were noted during this inspection, including a tour of the home. The documentation seen for checks and examination of plant and equipment was all correct and up to date. The staff spoken to confirmed that health and safety issues are given a high priority. Hillfield E51-E09 S33181 Hillfield V235705 270605 Stage 4.doc Version 1.40 Page 21 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 x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 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 3 x 3 x x 3 Hillfield E51-E09 S33181 Hillfield V235705 270605 Stage 4.doc Version 1.40 Page 22 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 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 OP19 OP28 Good Practice Recommendations The planned alterations work should be commenced as soon as possible, to allow residents to return to their home. NVQ training should continue for care staff (currently 30 level2) Hillfield E51-E09 S33181 Hillfield V235705 270605 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Stafford - Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 Hillfield E51-E09 S33181 Hillfield V235705 270605 Stage 4.doc Version 1.40 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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