Inspection on 19/09/06 for Hillscourt

This inspection was carried out on 19th 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

Hillscourt 30/01/06

Hillscourt 16/05/05

Hillscourt 07/01/05

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Hillscourt The Hillscourt Nursing Home 8-10 Pennsylvania Road Exeter Devon EX4 6BH Lead Inspector Rachel Doyle Key Unannounced Inspection 19th September 2006 10:00 X10015.doc Version 1.40 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 Hillscourt DS0000042993.V306626.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 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. Hillscourt DS0000042993.V306626.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hillscourt Address The Hillscourt Nursing Home 8-10 Pennsylvania Road Exeter Devon EX4 6BH 01392 431662 01392 433406 gt.care@btconnect.com 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) GT Care Services Ltd. Mrs Jenny Louise Mary Harry Care Home 27 Category(ies) of Old age, not falling within any other category registration, with number (27) of places Hillscourt DS0000042993.V306626.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Notice of Proposal to Grant Registration for staffing/environmental conditions of registration issued 7/6/94 To admit one named person outside the categories of registration as detailed in the notice dated 1st July 2005 The maximum number of persons accommodated at the home, including the named service user, will remain at 27 On the termination of the placement of the named service user, the registered person will notify the Commission in writing and the particulars and conditions of this registration will revert to those held on the 23rd June 2005 30th January 2006 Date of last inspection Brief Description of the Service: Hillscourt is a 27 bedded Home which is registered to provide nursing care for those aged over 65 years. It is an older property situated in Exeter close to amenities. There is a pavement ramp and wheelchair access. At the rear there is a level patio reached by a conservatory. The Home provides nursing care for 27 residents in individual rooms, which are divided between two floors with the upper floor split into two levels. There is a convenience store opposite, which is open 24 hours. There are no car-parking facilities but there is a multi-storey car park only 5 minutes walk from the Home and two hour parking in surrounding roads. The Home does not provide intermediate care. The average cost of care is £ 481-580 per week at the time of inspection. Additional costs, not covered in the fees, include hairdressing and personal items such as toiletries, newspapers and magazines and private chiropody and taxis. Current information about the service, including CSCI reports, which are accessible at the Home, is given to prospective residents/their representatives. The Service Users’ Guide and Statement of Purpose are available in the Home on request and a copy of the Home’s brochure is given to all residents on admission. Hillscourt DS0000042993.V306626.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on Tuesday 19th September 2006 from 10.00-16.30. There were 25 residents living at the Home with no vacancies at the time of the inspection. During the inspection the inspector case-tracked 3 residents, which helps us to understand the experiences of people using the service. A number of other residents were met and spoken with during the course of the day, nine in depth. The inspectors also spent a considerable time observing the care and attention given to residents by staff and took lunch with six residents. Staff were spoken with during the inspection, including care staff, ancillary staff and the owner and personnel development manager. Prior to the inspection surveys were sent to relatives to obtain their views of the service provided; 11 were returned. 18 resident surveys were returned. Staff were also sent surveys, 7 were returned. Health and social care professionals were also contacted prior to the inspection including GPs, community nurses and social workers, 3 were returned. All comment cards stated that people were satisfied with the overall care, which is commendable. The inspectors toured the premises freely, including all shared areas and the majority of residents’ accommodation. A sample number of records were inspected which included care plans, medication records/procedures, staff recruitment files, service and maintenance certificates and fire safety records. The inspector appreciated the time taken by the manager to assist with this inspection and found all staff very helpful on the day. At the time of the inspection most of the residents were in the lounge chatting and watching television. Later residents sat outside under the pagoda and chatted to staff. Some residents were relaxing in their rooms. What the service does well: All levels of staff work well as a team and there are good channels of communication. Staff are keen to learn and have worked hard to improve standards, treating residents with respect and kindness. The Home provides high quality care with competent staff in a well-decorated, pleasant and homey environment. All requirements and recommendations given by CSCI are fully addressed in a timely manner. The administration of medication provides a safe system, which does not place residents at risk. Hillscourt DS0000042993.V306626.R01.S.doc Version 5.2 Page 6 The Registered Provider has worked hard to set up an excellent quality assurance system at the Home and the Home is congratulated on achieving the Investor in People Award. 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. Hillscourt DS0000042993.V306626.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Hillscourt DS0000042993.V306626.R01.S.doc Version 5.2 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 the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a good admission and assessment process, which ensures that the Home can meet their needs. EVIDENCE: The owner said that the Home rarely has an empty bed and was clearly aware of the importance of good assessment to ensure that the Home could meet prospective residents’ needs. One resident had been regularly reviewed and health care professionals consulted as the Home were conscious that another placement may have become more appropriate for them. The manager visits prospective residents at home or in hospital and all three assessments looked at were detailed. The Home also showed that they actively gather information from any relevant health professionals prior to admission especially for those residents who come from out of area. One health professional commented that the Matron was always happy to visit prospective residents in hospital to assess them. Hillscourt DS0000042993.V306626.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and welfare needs of residents are well met with good evidence of multidisciplinary working taking place. Health and personal care needs are generally recorded well in care plans although improvement should be made in documenting more clearly what actions need to be taken, progress details and issues relating to some aspects of health care to ensure consistency. Medication administration systems are well managed, promoting residents’ good health. Residents’ privacy and dignity are met and promoted by staff and the management team. EVIDENCE: Three care plans were looked at as part of the case-tracking process. These have a new format. These are generally good with clear assessments, Hillscourt DS0000042993.V306626.R01.S.doc Version 5.2 Page 10 preferred name details and focus on maintaining independence and personal choices. Reviews were done monthly. There was good attention to dignity such as residents’ likes and dislikes, when they liked to go to bed and choosing clothes. Care was seen to be given as stated in the care plan such as use of specific aids. Risk assessments were complete and relevant. All care plans showed regular liaison with appropriate health care professionals. One health care professional commented that the Home always reported any significant changes about residents’ care to them whilst another health care worker felt that ‘Hillscourt was an excellent nursing home’. Some areas need improvement. Details about some identified issues were brief i.e. ‘unwell’, ‘breathlessness’, ‘hygiene needs met’ without any expansion of what actions need to be taken. Daily notes were sometimes unrelated to identified issues in the care plan. Records about wound care were found but these were lost within daily notes so that progress of a wound and dressings were hard to follow. Other statements such as ‘several open sacral sores, observe’, were not specific enough about size, type and severity. One resident had a urinary catheter, which had fallen out. They said that they had had to wait excessively for a health worker to visit to replace it. The relative also commented on this. The resident said that a staff member had asked them if they had passed water when in fact this resident would never be able to do this due to their condition and would suffer from retention and pain. This should have been an urgent referral. The care plan did not state why this resident had a catheter. It is noted that otherwise there was evidence of good catheter care. All residents spoken to said that they had discussed their plan with staff and were happy with the contents. Residents looked well cared for and wearing appropriate clothes. A relative said that staff had shown a resident ‘lots of care and loving attention’. All residents spoken to felt that their needs were well met, other than the above incident. Comments included ‘the girls are lovely’, it’s a smashing home’, ‘everything is good, I couldn’t fault it’ and ‘there is nothing I would change’ and ‘wonderful care’. A staff member said that staff did not leave residents alone in the bath and the upstairs bath did not have a call bell within reach from the bath. The medication system was discussed. There is a mobile drugs trolley and this is taken around the Home to each resident as medication is administered. Staff were seen to ensure that medication is taken by residents before being signed for by staff. MARS sheets were all correct, including any hand written transcriptions and there is photographic identification of all residents with a list of their formally used names and preferred names. Storage is well managed and all medication was in date. Hillscourt DS0000042993.V306626.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are encouraged to maintain their independence, exercising choice and taking control of their lives. Although there is some evidence that the Home provides some activities for some residents, this is not regular, creative or providing adequate stimulation and interest for people living at the Home at present. The meals in this Home are good, offering both choice and variety and catering for special dietary needs in a sensitive manner. EVIDENCE: The Home does not have an allocated activities organiser and staff are responsible for meeting residents’ social and leisure needs. There is an activities programme but this is not always followed. All residents spoken to, who did not choose to spend the majority of time in their room, felt that they were bored and that there was little to do although they had enjoyed the events that had been provided such as a trip to the pub, sitting in the garden, videos, reading and writing letters. Care plans had some good details about residents’ individual social histories but this information was not used to Hillscourt DS0000042993.V306626.R01.S.doc Version 5.2 Page 12 provide appropriate occupation on a regular basis. There were no records of activities offered to individual residents and four said that they just sat watching television in the lounge all day. However, there is a lovely atmosphere at the Home and staff were seen to have a good rapport with residents, chatting with them other than during tasks. Residents all said that they were able to make choices about how they spent their day saying that they could do what they wanted. One resident was able to go out when they liked, another had a lie in sometimes and choices were given relating to meals, where to eat and where they spent their time. All residents spoken to said that the meals were very good. One resident with a special diet is provided with a creative diet. Food is nutritious and often home-made. Portions were good and choice was given with an alternative if a resident asked. The Home’s communal area consists of a large conservatory area and a smaller quiet lounge. There is no allocated dining room and residents eat either in their rooms, on lap tables or at two fold out tables, which are put up at meal times in the lounge areas. Meals were well presented. Four residents did comment that although they were happy with the eating arrangements it would be nice if the tables were then laid up with place mats, napkins and condiments etc rather than just receiving your plate and cutlery on a bare table. All residents said that their relatives were able to visit at any time and relatives were seen popping in and out. The Home was also helping one resident visit a relative up country, which they were pleased about. Hillscourt DS0000042993.V306626.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and relatives are confident that they are listened to and their concerns acted upon. Residents are protected from the risk of abuse or harm. (see NMS 29) EVIDENCE: Protection of Vulnerable Adults training is booked with external trainers. All staff have attended. The Practical Guide was visible in the office. Staff were aware of this and the topic of Protection of Vulnerable Adults is included regularly in staff meetings. The use of bed rails needs to be clearly documented and discussed with the multidisciplinary team. All residents spoken to felt that they were well cared for and that they were listened to by the manager and staff. There is a comprehensive complaints policy, which is easily accessible. None of the 11 relatives who returned comment cards had made a complaint. The owner said that concerns were written in the handover book and acted on immediately as they arise. They have a good relationship with relatives and this is very visible at the Home with an open door policy. All the staff have notepads, which they use to document any relatives or residents concerns so that they are not forgotten. Hillscourt DS0000042993.V306626.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are provided with safe and comfortable surroundings giving residents an attractive and homely place to live. EVIDENCE: The standard of the environment within the Home is excellent. Residents said that they were pleased with the ongoing decoration and recent improvements and felt involved in any changes. Rooms are decorated to a high standard with clear thought as to how a resident would want the room to feel and Manual Handling issues. Residents had fans if they wished and lovely shelves for their toiletries. Each resident is given a calendar by the Home to hang in their room on arrival. A detailed written maintenance programme was seen and there is a maintenance man who works 60 hours a week. Rooms that are vacated are refurbished to a high standard. There are plans for further improvement and two extra bedrooms in the near future. Wheelchair use is monitored by the Provider and discussed in staff meetings to ensure that Manual Handling and Safety issues are adhered to. Staff meeting minutes were seen and information Hillscourt DS0000042993.V306626.R01.S.doc Version 5.2 Page 15 was handed out to all staff as good practice reminders. Reporting any maintenance needs is included in staff job description and these are addressed in a timely way. There are good risk assessments and action plans, especially addressing the use of wheelchairs by staff. There is a good infection control policy and adequate equipment to promote hygiene. There are clear policies for laundry and soiled linen, which staff were observing. A new sluice has been very successful and the entire premises smelt fresh and hygienic. The Home was also clean throughout. Hillscourt DS0000042993.V306626.R01.S.doc Version 5.2 Page 16 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents benefit from having skilled, experienced and friendly staff who have a good understanding of their needs. Residents are not thoroughly protected from the risk of abuse or harm by a robust recruitment procedure. EVIDENCE: The Home has a positive and pro-active approach to staff training and the personnel development manager is responsible for ensuring that mandatory training is up to date. It was suggested that a system be introduced to enable these to be more easily inspected other than looking through each separate staff file. Staff have achieved a variety of qualifications and relevant knowledge is shared in order to be able to meet residents’ needs. Following all training staff complete feedback forms and assess competency. NVQ is encouraged. The Investor for People Panel commented in their report ‘senior management are undertaking NVQ 4 and it is good to see staff training linked to specific educational and professional needs with measurable outcomes’. Certificates are displayed and staff said that they feel valued. A health professional commented that staff are always very helpful, knowledgeable about residents and friendly and that relatives had reported that they felt supported by the management. All residents spoken to praised Hillscourt DS0000042993.V306626.R01.S.doc Version 5.2 Page 17 the staff saying that they were ‘wonderful’ and ‘very kind, do everything for me’. There are clear guidelines as to the appropriate staffing levels required at the Home to meet residents’ needs during the night shift, with regular resident dependency and safety reviews and staff skill mix with reference to the fire department requirements. Three staff recruitment files were looked at. Two files did not contain two references and two did not have a copy of the Criminal Record Disclosure check. Staff must not be working unsupervised until the Home has received satisfactory clearance. Hillscourt DS0000042993.V306626.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is leadership, guidance and monitoring systems in place to ensure that residents receive consistent quality care in a safe environment. EVIDENCE: The Home is a member of the Registered Homes Association and the Provider often uses them for advice. They have a positive attitude to inspections and have an open and transparent relationship with CSCI and timely responses to inspection reports. The Home works in partnership with Croner (employment law). The Home has achieved the Investors in People Award, which is commendable. There is a clear Quality Assurance system, which includes annual resident and relative surveys. Residents are able to fill out a detailed questionnaire anonymously if they wished or with help from their Hillscourt DS0000042993.V306626.R01.S.doc Version 5.2 Page 19 representatives. Results are then analysed and any negative comments discussed in staff meetings and an action plan followed. Three residents’ finance records were inspected. Records appeared correct and the Home ensures that residents do not go without by using a petty cash system as appropriate. However, it was not possible to physically check that residents’ money kept in the tallied with records as it is kept communally. All residents’ money must be kept separately. The owner assured he inspector that they did carry out a complete audit regularly. There is a clear management structure including the owner, matron, senior nurse team leader, personnel development manager and maintenance manager. Staff said that there was good communication and there was obviously a good rapport between staff and the management team. Mandatory training was up to date as were fire checks. All windows were fitted with restrictors for safety and radiators were covered. Baths have thermostatic controls to avoid scalding. The Home are currently updating their electrical certificate. Hillscourt DS0000042993.V306626.R01.S.doc Version 5.2 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. 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 2 X X 3 Hillscourt DS0000042993.V306626.R01.S.doc Version 5.2 Page 21 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. 1. Standard OP29 Regulation 19 Requirement The Home must ensure that all documentation listed in Schedule 2 of the Regulations is held in respect of anyone working at the home. (This refers to references and CRBs) Timescale for action 19/12/06 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. Refer to Standard OP7 Good Practice Recommendations It is recommended that documentation relating to wound care shows clearly the progress and action taken and health professional input so that staff are clear as to the action needed to promote good tissue viability. It is recommended that care plans clearly show the actions needed to meet all residents’ needs and that information is available for staff to ensure that all these needs are met. It is recommended that all staff are aware that residents should be offered privacy in the bath as they wish if a risk assessment does not indicate otherwise and that all bathrooms have call bells accessible from the bath. 2. OP7 3. OP10 Hillscourt DS0000042993.V306626.R01.S.doc Version 5.2 Page 22 4. OP15 5. OP18 6. OP35 It is recommended that as the dining tables are not permanent that more attention is made to ensuring that mealtimes are an enjoyable occasion in a congenial setting and that residents are regularly asked if they would like to sit at the table. It is recommended that bed rails are used only following a multidisciplinary team discussion and involving the resident as able to ensure that the use is appropriate for each individual and that the risk of the bed rail is considered. It is recommended that residents’ money is kept separately and not pooled when kept at the Home. Hillscourt DS0000042993.V306626.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY 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 Hillscourt DS0000042993.V306626.R01.S.doc Version 5.2 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. 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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