Inspection on 13/03/07 for Hillingdon House

This inspection was carried out on 13th March 2007.

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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hillingdon House 29/07/08

Hillingdon House 22/01/08

Hillingdon House 24/11/05

Hillingdon House 24/11/04

Hillingdon House 21/06/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Pinta

Kestrel House, St Anne`s Opportunity Centre,

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

CARE HOME ADULTS 18-65 Hillingdon House 31 Salisbury Road Farnborough Hampshire GU14 7AJ Lead Inspector Peter J McNeillie Unannounced Inspection 13th March 2007 09:00 Hillingdon House DS0000011866.V330704.R01.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 Hillingdon House DS0000011866.V330704.R01.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 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. Hillingdon House DS0000011866.V330704.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hillingdon House Address 31 Salisbury Road Farnborough Hampshire GU14 7AJ 01252 542148 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) The Regard Partnership Limited Sharon Wilcox Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Hillingdon House DS0000011866.V330704.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th November 2005 Brief Description of the Service: Hillingdon House provides care to younger adults, who have learning disabilities and complex needs Service users are given help with all aspects of their lives but are encouraged to be as independent as possible. There are nine bedrooms, a kitchen, lounge, dining room and laundry facilities. Additionally the home has a conservatory backing on to a large garden creating more communal space. Hilingdon House is situated in a residential area, close to the main shopping centre in Farnborough. The home is close to public transport as well as having its own transport. Hillingdon House DS0000011866.V330704.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report was written after taking into consideration a number of sources of information /evidence including a site visit to the premises, previous reports examining residents /staff records, personal observations, talks with residents, staff, management, reading regulation 20 reports, responses to an internal annual satisfaction survey results from an in house quality survey responses to a pre inspection user survey by C.S.C.I. and responses by the manager to a pre inspection questionnaire. Following the last two inspections during which the key standards were last inspected requirements relating to residents contracts, risk assessments and the administration of medication were made. All previous requirements have been complied with. This key unannounced visit, which took place on 13/03/07 between the hours of 09.15am and 01.30pm, was the first inspection for the year 2006/07 and covered all of the designated key standards for younger adults. During the inspection the inspector who was assisted by the manager had the opportunity to discuss living and working in the home with a number of staff both individually and in groups but was only able to talk with some residents on a very simple level due to the verbal communication difficulties of the remainder. The results and findings contained in this report which looked at all of the key standards for care homes for younger adults will determine the frequency and type of future inspections. Current fees range from £1142 to £1627 per week. What the service does well: What has improved since the last inspection? Hillingdon House DS0000011866.V330704.R01.S.doc Version 5.2 Page 6 Following the previous inspection a requirement was made that “The registered person must ensure the necessary information is included in the contract between the service user and registered provider. Records seen indicated this requirement had been complied with. Following the last inspection a requirement was made that documentation must be in place when using bed rails. Any restrictions placed on individuals due to their high needs or physical abilities are now clearly recorded in the care plans in compliance with the previous requirement. Following the last inspection a requirement was made that “The registered person must ensure staff sign when they have administered ‘as required’ medication. This inspection indicated, medication administration records are clear and show that medicines are given and correctly recorded when required by trained staff and disposed of it line with the homes medication policy. The previous requirement has therefore been complied with. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Hillingdon House DS0000011866.V330704.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hillingdon House DS0000011866.V330704.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 5 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 system of assessing and identifying residents needs which ensures residents safety and that their assessed needs can be met. A previous requirement relating to residents contracts has been complied with. EVIDENCE: There have been no admissions since the last inspection. A sample of three residents files chosen at random by the inspector were viewed all of the records seen confirmed that no residents are admitted without a detailed assessment of needs and risk being carried out by the manager or another member of senior staff. Care staff and management informed the inspector that prior to a permanent place being offered, prospective residents would visit the home on a number of Hillingdon House DS0000011866.V330704.R01.S.doc Version 5.2 Page 9 occasions including overnight and weekend stays if possible. Files confirmed residents/residents representatives and if appropriate external health care professionals including care managers also contributed to the assessments process. All assessments of need and risk are reviewed on a regular basis. Following the previous inspection a requirement was made that “The registered person must ensure the necessary information is included in the contract between the service user and registered provider. Records seen indicated this requirement had been complied with. Hillingdon House DS0000011866.V330704.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 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 well-developed system of planning and reviewing care which is person centred, ensures residents needs are met within a risk management policy and involves residents /residents representatives or relatives in decisions that affect them. . EVIDENCE: All of the residents of the home are dependant on others for their physical and social care. All have very high care needs and rely on a range of communication methods. A sample of four residents records selected at random by the inspector were viewed. Hillingdon House DS0000011866.V330704.R01.S.doc Version 5.2 Page 11 Comprehensive care plans produced in a dual written/ pictorial format and based on assessments of need, risk and the particular wishes and aspirations of the residents were available. Records indicated all plans are reviewed monthly and amended to reflect the changing high care needs and communication difficulties of the residents. Residents rights to take risks is seen as fundamental, any restrictions placed on individuals due to their high needs or physical abilities are clearly recorded in the care plans in compliance of a requirement made following the last inspection and reviewed on a regular basis to ensure they are still relevant to the residents needs and abilities. Hillingdon House DS0000011866.V330704.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The social activities family contacts and the provision of varied and nutritious meals were well managed and reflected service users interests and choices. Hillingdon House DS0000011866.V330704.R01.S.doc Version 5.2 Page 13 EVIDENCE: Records viewed, comments from staff and notices seen confirmed a full range of both in house and community based activities and social opportunities were available to residents. Communication with the majority of residents was almost impossible, however, the inspector did manage to obtain confirmation from some residents that there was always something to do and they enjoyed taking part in activities. At the time of the inspection four residents attended day centres, four were in receipt of one to one additional support from an outside agency and others extra support in house. Activities currently on offer include, shopping, swimming, ten tin bowling, social clubs, pubs, theatres/cinemas, horse riding, arts and crafts, disco nights, bingo nights and cooking the items purchased when shopping. Apart from social; activities residents are also involved in assisting in the house, cooking, and washing up washing clothes. All activities which staff and management confirmed that residents could choose whether or not to participate are only undertaken following a risk assessment. There is no restriction on visitors, family and friends are encouraged to visit often and residents supported if possible to spend time at home. A detailed menu that reflects resident’s choice produced in both written and pictorial format was available. Residents are encouraged to assist with the preparation of meals the times of which are flexible and designed to meet the day-to-day needs and activities of residents. Assistance with feeding if requires is available as is the provision of special diets but only when agreed after consultation with an appropriate health care professional. Hillingdon House DS0000011866.V330704.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. 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. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Satisfactory arrangements are in place, ensuring the personal emotional, health care and medication needs of residents are met. EVIDENCE: Guidelines seen and staff/management comments indicated choice was being exercised by residents in respect of all aspects of their lives and providers of personal services, bedtimes, clothes, food, gender of carer, GP, dentist optician and key worker being quoted as examples. During the inspection the inspector observed staff inter acting with residents. It was clear that staff held residents in high esteem and treated them with respect dignity, and affection dealing with often difficult and potential explosive situations in a calm, firm, and planned manner. Hillingdon House DS0000011866.V330704.R01.S.doc Version 5.2 Page 15 Records seen indicated that any special medical or health or social care needs would be provided following consultation with the appropriate professional, these might include learning disability teams, doctors, district nurses and care managers. All residents are registered with the same local medical practice where approximately four doctors are available. The inspector was informed residents are able to consult a doctor of whatever gender they prefer. Following the last inspection a requirement was made that, records must be completed when drugs/medication is administered. This inspection found, medication administration records are clear and show that drugs and medicines which are securely stored are given and correctly recorded by trained staff and disposed of it line with the homes medication policy. The previous requirement has therefore been complied with. All residents are encouraged and supported to assume responsibility for their own medication. Following a risk assessment, due to the risk to the individual no resident is currently self-medicating. Hillingdon House DS0000011866.V330704.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has clear policies and procedures in place which ensures residents are able to complain and are protected from abuse . EVIDENCE: A whistle blowing and Adult Protection Policy and Procedure have been implemented to work in tandem with the procedure produced by Hampshire County Council. All management staff spoken to demonstrated they were aware of the procedure to follow should they witness or suspect the abuse of a resident. The complaints procedure, which was also included in the service users guide included information on how to contact The Commission for Social Care Inspection (C.S.C.I), was seen, as was record of complaints, which included time scales within which complaints must be dealt. The record and pre inspection documentation indicated there have been no complaints since the last inspection. Due to the problems of communication the inspector was not able to ascertain with any certainty whether residents felt comfortable in discussing any Hillingdon House DS0000011866.V330704.R01.S.doc Version 5.2 Page 17 concerns they had with the homes manager but staff did state they felt confident in discussing issues with management on behalf of any resident. Hillingdon House DS0000011866.V330704.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from living in an environment which was clean, homely, free from adverse odours and equipped with a large number of specific aids and adaptations designed to maximise the independence, comfort and safety of the residents. There are however health and safety issues with regard to the ground floor. EVIDENCE: During a tour of the building it was noted fire safety arrangements were all being observed. The inspector however did highlight trip hazards on the ground floor from the hallway to the dining room/kitchen area where there were a number of small Hillingdon House DS0000011866.V330704.R01.S.doc Version 5.2 Page 19 steps, which are a risk to residents and staff. During the visit the inspector tripped up the steps. The problem is further compounded when staff have to push and pull wheelchairs over these obstacles, some staff reported they were unable to navigate this area with one resident in particular who uses a large heavy wheelchair. A similar problem is encountered in using a purpose built ramp outside due to its steepness. A health and safety risk assessment has been carried out but no plans were available as to when how and when the problem was to be eliminated apart from instructions when using the outside ramp to ensure there was two persons involved. The inspector was informed this was not always possible. In the view of the inspector there is a risk to health of both residents and staff if the current situation remains unaltered. The tour of the building also highlighted a bathroom on the ground floor was showing signs of wear and tear. This bathroom, which had also been commented on in recent regulation 26 reports by external management, will soon require attention. This matter will be reviewed at a future visit to the home. The building, which (apart from previous reservations) was generally fit for its stated purpose, accessible, safe, well maintained free from adverse odours met residents individual and collective needs. Appropriate infection control measures were in place and staff had received training in the prevention of spread of infection. Following professional assessments a number of aids and adoptions had been provided including hoists, ramps, wheel chairs, special beds and grab rails Furniture was comfortable and homely and in keeping with the décor. Hillingdon House DS0000011866.V330704.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32 34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s needs are met by sufficient numbers of well trained and supported staff who are recruited and selected using a procedure designed to protect all residents. EVIDENCE: At he time of the inspection this deployment of staff met residents needs. As previously mentioned in this report a number of residents attend day centres and others receive personal one to one support from an external agency. Care staffs were observed to carry out their duties in a calm unhurried manner-taking time to talk with and assist individual residents. It was confirmed by the manager that staffing levels are closely monitored to reflect the changing / assessed needs of residents and would be increased /decreased as required. Hillingdon House DS0000011866.V330704.R01.S.doc Version 5.2 Page 21 The inspector viewed three staff files, which included evidence that all staff are employed in accordance with a robust recruitment and selection procedure designed to protect residents. This involves the completion of an application form, the signing of a rehabilitation of offenders declaration, an interview, satisfactory Criminal Record Bureau, Protection of Vulnerable Adults and reference checks followed by the satisfactory completion of an in house induction training and probationary period of employment. Files seen also included a copy of a job description, a contract and training records covering all aspects of care, including, care and administration of medication, manual handling, basic first aid, health and safety, risk assessment, P.O.V.A. basic food hygiene, fire safety, managing difficult behaviour and epilepsy. Apart from updates on some of the above future training also includes Makaton and communication. Only 10 of staff are qualified to N.V.Q. level 2 in care. The inspector was informed arrangements are currently being undertaken to improve this percentage. This matter will be reviewed at a future visit to the home. Hillingdon House DS0000011866.V330704.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. 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 home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management of the home ensures the health, safety and welfare of residents and staff are promoted and the home is run in the best interests of the residents whose views about living in the home are formally sought. EVIDENCE: The service is well managed by the manager who been registered since the last inspection. Hillingdon House DS0000011866.V330704.R01.S.doc Version 5.2 Page 23 Staff who confirmed they were fully aware of their responsibilities and towards residents confirmed management has an open door policy, and encourages them to share any concerns or ideas they have better the service. An annual service quality audit involving residents, external health and social care professionals and residents relatives/representatives is carried out and results published. A sample of the results for 2006 indicated 95 of care managers were satisfied where their client lived, 94 of residents were satisfied with their care and support and 92 of relatives were satisfied with the care and support available. All of the above are an improvement on the published 2005 results. The results of surveys form the basis of an improvement action plan and a corporate written undertaking to continue to improve all services. A health and safety policy and procedure was in place which protects staff and residents by ensuring the maintenance of a safe working environment including the regular maintenance and servicing of equipment/ machinery in use within the premises. During the visit apart from previous reservations expressed in this report no additional obvious hazards to health and safety were seen. Protective clothing, gloves, control of substances hazardous to health (COSHH) assessments, risk assessments, equipment servicing and accident records were available as were records to confirm all staff have receive training in the techniques of moving and handling first aid health and safety and the procedures to follow in the event of fire, including evacuation. The home has a laundry procedure and a washing machine, which is capable of disinfecting soiled items. All of the hot water supplies to baths were fitted with thermostatic controls set at 43 degrees centigrade and all radiators and hot pipes were covered. Hillingdon House DS0000011866.V330704.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 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 OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Hillingdon House DS0000011866.V330704.R01.S.doc Version 5.2 Page 25 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 YA24 Regulation 23(1) a (2) a Requirement The registered person shall produce an action plan and forward it to C.S.C.I. detailing how and when they will resolve the health and safety environmental issues as described in standard of this report. Timescale for action 04/05/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Hillingdon House DS0000011866.V330704.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Hillingdon House DS0000011866.V330704.R01.S.doc Version 5.2 Page 27 - 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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