Inspection on 30/08/05 for Hillsdon Nursing Home

This inspection was carried out on 30th August 2005.

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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Hillsdon Nursing Home 05/09/06

Hillsdon Nursing Home 18/01/06

Hillsdon Nursing Home 01/02/05

Hillsdon Nursing Home 20/09/04

Hillsdon Nursing Home 19/03/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

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 Hillsdon Nursing Home 37 Springfield Road Lower Parkstone Poole Dorset BH14 0LG Lead Inspector Marjorie Richards Unannounced Inspection 30th August 2005 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 Hillsdon Nursing Home DS0000049686.V249319.R01.S.doc Version 5.0 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. Hillsdon Nursing Home DS0000049686.V249319.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Hillsdon Nursing Home Address 37 Springfield Road Lower Parkstone Poole Dorset BH14 0LG 01202 742753 01202 740114 hillsdon1@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) Baselink Care Limited Mrs Alison Jane Thomas Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Hillsdon Nursing Home DS0000049686.V249319.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st February 2005 Brief Description of the Service: Hillsdon Nursing Home is a large detached property, situated in a residential area of Parkstone. The home is not far from local shops and amenities. Although these are not easily accessible on foot, a local bus route serves Parkstone, Poole and Bournemouth. Limited car parking for visitors is available at the front of the home, with additional parking on nearby roads. Hillsdon Nursing Home is registered to provide care to a maximum of 18 persons over the age of 65 years who are in need of 24-hour nursing and personal care. Accommodation is provided on ground and first floor levels with bedrooms, a lounge, staff areas, (office and nurses station) kitchen and laundry on the ground floor and further bedrooms on the first floor. The home has fourteen bedrooms and four of these are for shared use. Three bedrooms have ensuite facilities. There are sufficient communal bathrooms and toilets sited around the home in close proximity to bedrooms and the lounge. Access to the first floor is via a passenger lift and central stairway. The first floor has a divided level accessed by additional steps. A Stair-Matic stair climber is used to enable residents to access this level. The registered persons have undertaken much redecoration and refurbishment of the property since they became registered in August 2003. Building work is currently in progress, which will include the provision of further bedrooms and a new dining room. At present, access to the large rear garden can only be achieved via a steep flight of steps. However, plans are in hand for a substantial improvement of this area, creating an attractive facility, which will be available to all residents. Hillsdon Nursing Home provides 24-hour nursing and personal care, all meals, laundry and domestic services. Hillsdon Nursing Home DS0000049686.V249319.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 6.5 hours on the 30th August 2005. Mrs Thomas, the registered manager, was not on duty but the nurse in charge assisted with the inspection. Mr Graham Thomas also made himself available for much of the inspection, on behalf of Baselink Care Ltd, and this was appreciated. The main purpose of the inspection was to check that the residents living in the home were safe and properly cared for and to check on progress with the refurbishment and planned improvements to the home. A tour of the premises took place and a variety of records and related documentation was examined including the care records for six residents. Time was spent observing the interaction between residents and staff, as well as talking with fourteen residents, Mr Thomas, the Registered Nurse in charge, the staff on duty and two visitors to the home, in order to get a real feel of what it is like to live at Hillsdon Nursing Home. What the service does well: Written information about Hillsdon Nursing Home is available for prospective residents and their relatives or representatives, to let them know what they can expect from the home and help them decide if Hillsdon Nursing Home is right for them. Pre-admission assessments are carried out to ensure that only people whose needs can be met are offered places within the home. Prospective residents are informed of the outcome of these assessments in writing, so they are assured that their care needs can be met. Prospective residents and their relatives can visit the home in order to assess the quality of facilities and its suitability for their needs. A trial period is available. Every resident has a care plan, which sets out in detail the individuals care needs and the care that staff are expected to give. Care staff are supported in caring for residents by community healthcare professionals, such as GPs, district nurses, chiropodists, opticians etc. Residents feel that they are treated with respect and their right to privacy and dignity is promoted at all times. Residents are treated with sensitivity and respect at the time of their death. Open visiting arrangements are in place, so residents are able to maintain contact with visitors whenever they wish. A balanced and varied selection of food is served and residents speak highly of the meals provided. We have a very good cook. She is very obliging and if Hillsdon Nursing Home DS0000049686.V249319.R01.S.doc Version 5.0 Page 6 you dont fancy what is on the menu, she will willingly prepare something else. We have very good meals, all freshly prepared . I really enjoy my food. I dont have a large appetite, but I look forward to mealtimes since coming here. Residents are confident that complaints would be listened to and dealt with appropriately. The home has a comprehensive Adult Protection policy in place and staff have received training to ensure residents are protected from possible abuse. Considerable investment in the refurbishment of the home is resulting in an attractive, well-maintained and comfortable environment for residents, where Baselink Care Ltd is seeking to provide high standards. Bedrooms are comfortably furnished and individually personalised by their occupants. Hillsdon Nursing Home is clean throughout and there are no unpleasant odours. Residents and visitors said, The home is always nice and clean”. Mrs Thomas heads a team of enthusiastic staff, most of whom are experienced in caring for people. Residents speak highly of the staff, We are blessed with very good staff. Most of them are really exceptional people. I do what I can for myself, but the staff are always there when I need them. The home regularly reviews its performance and seeks the views of residents, staff and relatives to ensure the home is run in the best interests of residents. Feedback from quality assurance questionnaires is available in the Information File in the entrance hall to the home. Comments include, Well run, happy and caring atmosphere. The high quality of care and friendly atmosphere greatly contribute to the well-being of all residents. What has improved since the last inspection? What they could do better: Hillsdon Nursing Home DS0000049686.V249319.R01.S.doc Version 5.0 Page 7 There is only limited recorded information available about residents social, cultural, religious and recreational interests and needs. Without this, it is difficult to ensure that activities provided by the home are tailored to meet individual needs. Some residents feel they would like a little more in the way of activities. At present, there are few opportunities for those residents who remain in their rooms due to general frailty etc. Consideration must be given to ways of engaging those residents less able to make autonomous decisions. Mr Thomas says steps are being taken to find out what residents really want and to provide sufficient suitable activities. 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. Hillsdon Nursing Home DS0000049686.V249319.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Hillsdon Nursing Home DS0000049686.V249319.R01.S.doc Version 5.0 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 the following standard(s): 1, 3 and 5. Standard 6 is not applicable at Hillsdon Nursing Home. Information provided about Hillsdon Nursing Home and a thorough admissions procedure allows prospective residents to make informed decisions about admission to the home and ensures that only those whose needs can be met are offered places there. The home assures prospective residents in writing that their needs can be met. Prospective residents and their relatives have opportunities to visit the home in order to assess the quality of facilities and its suitability for their needs. EVIDENCE: The Statement of Purpose and Service User Guide contain all of the information required about the home and its facilities. The Service User Guide gives a good indication of what a resident can expect from the home. These documents are available in every residents bedroom. They can also be viewed in the entrance hall by any visitors to the home, as part of an Information File containing the Statement of Purpose, Service User Guide, contract, feedback from Quality Assurance questionnaires and copies of the last two inspection reports. Hillsdon Nursing Home DS0000049686.V249319.R01.S.doc Version 5.0 Page 10 Individual care records are kept for each resident and two of these were examined for recently admitted residents. Prior to moving to Hillsdon Nursing Home, care needs are fully assessed. A comprehensive form has been developed for this purpose and the manager generally carries out all preadmission assessments. A letter of confirmation is then written to the prospective resident so that they may feel fully assured their care needs will be met. The information contained in pre-admission assessments and also any assessments supplied by Social Services, is then used to draw up a detailed plan of care. Prospective residents and their relatives are encouraged to visit Hillsdon Nursing Home to assess the facilities available, meet other residents and staff and have an opportunity to discuss their particular care needs. Mr Thomas said that prospective residents are welcome to spend a day, or part of the day in the home and a trial period of four weeks is also available. Although basic information about a trial period is available, e.g. in the contract, it is suggested that further information detailing the opportunities for prospective residents to visit the home, sample meals etc, as well as arrange a trial period etc, be included in the Service User Guide, to fully reflect current good practice. Hillsdon Nursing Home DS0000049686.V249319.R01.S.doc Version 5.0 Page 11 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, 10 and 11 Hillsdon Nursing Home has a care planning system in place, which ensures that staff have the information necessary to meet the health and personal care needs of residents. However, there is insufficient recorded information about residents social care needs, so it is difficult to assess if these needs are being met. Health needs are well met, with evidence of good support from community health professionals. Residents are treated with respect and their privacy and dignity is promoted at all times. Residents are treated with sensitivity and respect at the time of their death. EVIDENCE: Six care plans were examined and these detailed the particular health and personal care needs of each resident and the staff assistance necessary to ensure these needs are met. Information about social, cultural, religious and recreational interests and needs is currently more limited so it is difficult to assess if these are being met. However, Mr Thomas is aware of this and has plans to introduce life histories for each resident, which will provide more Hillsdon Nursing Home DS0000049686.V249319.R01.S.doc Version 5.0 Page 12 information about each residents background, interests etc and detail their social care needs. All health and care recording sheets examined were up to date and contained good detailed recording, demonstrating information on person centred care. Evidence was seen to show that care plans are regularly reviewed and updated where necessary. Information recorded in the care plan is followed through by staff. For instance, one care plan notes that the resident enjoys listening to the radio. On visiting this residents bedroom, the radio was playing music in the background, which the resident found soothing and relaxing. Some highly dependent residents were observed in their rooms and they appeared comfortable and well cared for. Two of these residents said that staff were always attentive to their needs. Equipment for pressure relief was in place. Daily charts for these residents were examined and they evidenced recording on regular repositioning, fluid intake, etc. Specialist support was accessed as necessary e.g. the Palliative Care Nurse. Staff spoken with confirmed there was good information and communication on residents needs. Records demonstrate that residents have access to GPs, dentists, physiotherapists, chiropodists, etc and attend hospital appointments as necessary. This was confirmed in discussion with residents and staff. Risk assessments are in place and appropriate steps are taken to ensure any of the risks identified are minimised. Staff were observed throughout the inspection to be treating residents with courtesy, patience, kindness and respect. Staff always knocked at bedroom doors and toileting activities were carried out discreetly. Residents commented: The staff are very kind here, we are well looked after. They never get cross, even when I am so very slow. We are well treated. The staff are always cheerful and courteous towards me. The staff have to have patience to put up with me, but they do it with humour and goodwill. Residents are able to go to their rooms at any time, thereby offering an opportunity to be on their own if they wish, or allowing privacy for any visitors or personal care needs. One resident spoken with in her room said her choice to spend most of her time in her room was respected by staff, although they did encourage her to socialise and would readily assist her into the communal lounge if she so wished. Other residents commented: I can go to my room whenever I like. We can come and go as we please. If we want to be private in our own rooms, we can be, although some of us have to share. Where rooms are shared, screening is available to help protect the Hillsdon Nursing Home DS0000049686.V249319.R01.S.doc Version 5.0 Page 13 residents privacy. It was evident from looking at the care plan of a recently deceased resident that the individual’s comfort was considered paramount. The care provided was well detailed and relatives and a close friend had been kept informed of the situation. Health care professionals, including the Palliative Care Nurse, had provided support to the home’s staff. The home has a comprehensive death and dying policy in place. Hillsdon Nursing Home DS0000049686.V249319.R01.S.doc Version 5.0 Page 14 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 and 15 The information recorded about individual residents social, cultural, religious and recreational needs is limited, making it difficult to assess if their needs and expectations are fully met. Open visiting arrangements are in place, so residents are able to maintain contact with visitors as they wish. Residents are encouraged to maintain contact with family and friends and the wider community. There is a high standard of meal provision at Hillsdon Nursing Home with choices offered and individual specialist diets and preferences well catered for. EVIDENCE: Current activities at Hillsdon Nursing Home include a variety of board games, watching videos of old films and listening to music. Mr Thomas says entertainment is arranged on a fortnightly basis. A notice in the entrance hall gave details of a singer booked to entertain residents on the 3rd September 2005. Mr Thomas says staff also read items from newspapers to residents, to keep them up-to-date with what is happening in the world. There are few opportunities for activities for those residents who remain in their rooms due to general frailty etc. Consideration must be given to ways of engaging those residents less able to make autonomous decisions. Hillsdon Nursing Home DS0000049686.V249319.R01.S.doc Version 5.0 Page 15 At present, care plans contain only limited information about residents background, social history, previous hobbies and interests etc. Mr Thomas is looking to prepare life histories, which will help to ensure that the activities on offer at Hillsdon Nursing Home can then be tailored to meet the individual needs, preferences and expectations of residents. Residents commented, There is not a lot going on. We have to provide our own entertainment here, like reading a book or watching television. I would not want to play bingo all the time, but it would be nice if there were things to do sometimes. I suppose many of us are not up to much, but I do try to keep fit by walking around the place. It would be nice to have some magazines to look at. A minister from the local church visits the home on a monthly basis and provides communion for all that require it. Residents and relatives confirm that visiting times at Hillsdon Nursing Home are unrestricted. Residents records and the visitors book demonstrate contact with family and friends as well as visits by professionals. Several residents are able to go out of the home with their families. A coin-operated telephone is available and two residents have had their own telephones installed in their bedrooms so they can keep in touch with relatives. At present, there is no dining area available at Hillsdon Nursing Home. Residents eat meals in the lounge or in their bedrooms. However, the building work currently in progress includes the provision of a dining room, which will greatly improve the communal facilities. Lunch on the day of inspection was roast beef, Yorkshire pudding, roast potatoes, broccoli, swede and cabbage. This was followed by apricots and ice cream. The cook demonstrated knowledge of individual likes/dislikes and said alternatives could always be provided to suit individual taste and preference. These include jacket potatoes and a variety of omelettes and salads. Specialist diets such as soft diet, diabetic and puree diet are well catered for. Thought and care had been given to the presentation of these meals, e.g. with elements of the puréed meal presented separately on the plate. The menu shows that residents enjoy a healthy, well-balanced diet. Fresh fruit and vegetables are used wherever possible and good supplies were available. Residents spoke highly of the food provided and the following comments were received: We have lovely food here and plenty of it. I really enjoy my food. I dont have a large appetite, but I look forward to mealtimes since coming here. I think the meals are generally of very good quality. We have good English cooking, no foreign food here. We have a very good cook. She is very obliging and if you dont fancy what is on the menu, she will willingly prepare something else. We have very good meals, all freshly prepared . Hillsdon Nursing Home DS0000049686.V249319.R01.S.doc Version 5.0 Page 16 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 and 18 A system is in place for dealing with any complaints. Residents are confident complaints would be listened to and dealt with appropriately. The home has a comprehensive Adult Protection policy in place to ensure residents are protected from possible abuse. All but the newest member of staff have received training in adult protection issues, to ensure a proper response to any suspicion or allegation of abuse. EVIDENCE: The home has a complaints policy and procedure that is included in the Service User Guide provided to all residents in their bedrooms. A copy of the complaints policy is also available to visitors in the entrance hall. The home has received many compliments giving thanks for the kindness, care and dedication shown and these are available to read in the Compliments File, which is also kept in the entrance hall. For example, I would like to express my thanks for giving my relative the most wonderful and loving care during her last 18 months. One complaint has been received by the home since the last inspection and this has been referred to the Commission for Social Care Inspection and is currently being investigated. Contact with residents demonstrated they would feel able to voice a complaint and felt that their concerns would be taken seriously, and acted upon. Comments included: Hillsdon Nursing Home DS0000049686.V249319.R01.S.doc Version 5.0 Page 17 I am very happy here and have never had to complain about anything”. If I had any worries about anything, I would tell the lady in charge. If I had any complaints, I would tell Mr Thomas and I know he would put things right. The home has a comprehensive Adult Protection policy in place to protect residents from possible abuse. This makes reference to the Department of Health No Secrets document, which is also available to staff. All except one member of staff have received training in Adult Protection issues to ensure a proper response to any suspicion of abuse. Adult Protection training for the new member of staff is being arranged. Hillsdon Nursing Home DS0000049686.V249319.R01.S.doc Version 5.0 Page 18 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, 20, 22, 24 and 26 Considerable investment in the upkeep and refurbishment of the home is resulting in an attractive, well-maintained and comfortable environment for residents, where standards are constantly improving. The home currently provides only limited access to communal space, but this will change when building and improvement work is completed. The home provides suitable adaptations and equipment to allow residents to maximise their independence. Bedrooms are comfortably furnished and individually personalised to suit their occupants. Hillsdon Nursing Home is clean with no unpleasant smells, making daily life more pleasant for all in the home. EVIDENCE: Inspection of the premises confirmed that routine maintenance of the building and equipment is being carried out. The home has undergone a programme of refurbishment and building work is currently in progress to create a new dining room, add bedrooms and re-site the laundry. Since the last inspection, new fire doors have been fitted, all bedrooms have been redecorated and a new alarm call system installed. This allows residents to summon staff assistance whenever required. All calls are logged so the manager can ensure response Hillsdon Nursing Home DS0000049686.V249319.R01.S.doc Version 5.0 Page 19 times are satisfactory. Hot water temperatures at baths were tested and found to be close to the recommended temperature of 43C, to prevent any risk of scalding. Records demonstrate regular servicing of equipment, such as hoists, passenger lift and Stair-Matic. Fire records show appropriate checks being carried out on the fire warning system, emergency lighting and fire fighting equipment. Records also show that fire training and fire drills are being carried out at the required intervals, to ensure that staff are fully aware of what to do in the event of fire. Staff later confirmed this. Hillsdon Nursing Home currently has only limited access to communal space. The lounge is situated on the ground floor and is comfortably furnished. Building work is now underway to create a separate dining room. At present, the large garden at the rear of the home is not accessible to residents due to a steep flight of steps. The garden in itself is also steeply sloping. However, Mr Thomas has plans to improve access to the garden and create a large decking area where residents may sit and enjoy the view. The premises have been previously assessed by an Occupational Therapist and the long-term recommendations arising from the assessment will be fully complied with upon completion of the building work. Specialist equipment has been provided in accordance with individual need. One resident commented on the skill and care taken by staff when using the hoist to assist with their mobility needs. Each resident has a moving and handling care plan to ensure staff are aware of the equipment and handling techniques necessary to assist residents. A tour of the building confirms that residents bedrooms are comfortably furnished and personalised to varying degrees. Residents commented, “I like to stay in my room. I am very comfortable here”. My bedroom has been redecorated, which is very nice. “There have been a lot of changes since the new owners took over. I have a lovely new bed”. Inspection of the premises demonstrated the home was maintained to a good standard of hygiene and cleanliness. Contact with residents and visitors confirmed, The home is always nice and clean”. The laundry has recently been re-equipped with two new washing machines and two tumble dryers. Suitable facilities and procedures are in place in respect of sluicing equipment and the disposal of clinical waste, to help control the of risk infection. Hillsdon Nursing Home DS0000049686.V249319.R01.S.doc Version 5.0 Page 20 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 and 29 Hillsdon Nursing Home is well staffed with an enthusiastic workforce that works positively with residents to enhance their lifestyles. The home makes sure that appropriate checks are carried out prior to any new employment commencing, to ensure the protection of residents. EVIDENCE: Examination of the staff rota and observation throughout the inspection demonstrates there are a sufficient number and skill mix of staff to meet the present needs of residents. Mrs Thomas heads a team of staff, most of whom are experienced in caring for people. A qualified nurse is on duty at all times. On the day of inspection the following staff were on duty: 8.00am – 2.00pm = 1 registered nurse and 4 health care assistants; 2.00pm – 8.00pm = 1 registered nurse and 3 health care assistants; 8.00pm – 8.00am = 1 registered nurse and 1 health care assistant. The home also employs a cook and domestic staff. Staff, residents and visitors spoken with felt that the staffing levels were satisfactory. Relationships between staff and residents were directly and indirectly observed throughout the course of the inspection. They were friendly and relaxed, whilst remaining professional. Staff appeared enthusiastic in their work. One Hillsdon Nursing Home DS0000049686.V249319.R01.S.doc Version 5.0 Page 21 member of staff commented, I enjoy my work here. I think we all get on together and care for the patients really well. Residents commented, The staff seem happy in their work, nothing is too much trouble for them. We are blessed with very good staff. Most of them are really exceptional people. I do what I can for myself, but the staff are always there when I need them. The home has now implemented a thorough recruitment procedure based on equal opportunities and ensuring the protection of residents. The two files examined showed that appropriate documentation is in place. Where staff are coming from abroad, the files demonstrate that appropriate information is gathered about the right to work in the UK and any possible restrictions on that work. Hillsdon Nursing Home DS0000049686.V249319.R01.S.doc Version 5.0 Page 22 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): 33 and 35 The home regularly reviews its performance and, wherever possible, seeks the views of residents, staff and relatives to ensure the home is run in the best interests of residents. Residents are assured of sound management of their financial interests. EVIDENCE: Mr Thomas says he feels it is important to have regular contact with residents in order to make sure that the home is meeting their needs and operating in their best interests. Quality Assurance questionnaires are also given to residents, relatives and representatives. Feedback from these is available in the Information File in the entrance hall. Comments from those that have been returned include: - Well run, happy and caring atmosphere. The high quality of care and friendly atmosphere greatly contribute to the well-being of all residents. Any problems are always resolved quickly and efficiently. Hillsdon Nursing Home DS0000049686.V249319.R01.S.doc Version 5.0 Page 23 Mr Thomas is planning to provide quality assurance questionnaires for other visitors to the home. In order to protect residents, Mr Thomas says it is the policy of the home not to have any involvement in their personal finances. Therefore, all residents who are unable or do not wish to handle their own affairs, have a relative or other representative to deal with their finances etc. The home never handles residents monies but pays for services such as chiropody and hairdressing and keeps a record of what is owed. Receipts are kept for any expenditure and given to the relatives concerned. This amount is then invoiced to relatives or representatives for payment every three months. Hillsdon Nursing Home DS0000049686.V249319.R01.S.doc Version 5.0 Page 24 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 3 X 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X 3 X 3 X 3 STAFFING Standard No Score 27 3 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X X Hillsdon Nursing Home DS0000049686.V249319.R01.S.doc Version 5.0 Page 25 Are there any outstanding requirements from the last inspection? YES 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 7 Regulation 15(1) and 15(2) Requirement All aspects of each resident s health and welfare needs, including social care needs, must be recorded and regularly reviewed. The registered persons must consult residents about their interests and provide a suitable programme of activities. Consideration must also be given to ways of engaging those residents less able to make autonomous decisions Timescale for action 31/12/05 2 12 16(2) (m) and (n) 12 31/12/05 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 Hillsdon Nursing Home DS0000049686.V249319.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 Hillsdon Nursing Home DS0000049686.V249319.R01.S.doc Version 5.0 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. 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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