Inspection on 10/11/08 for Hillside

This inspection was carried out on 10th November 2008.

CSCI found this care home to be providing an Good service.

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

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Extracts from inspection reports are licensed from CQC, this page was updated on 30/01/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Hillside 259A Coulsdon Road Caterham Surrey CR3 5QR     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Deborah Sullivan     Date: 1 0 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Hillside 259A Coulsdon Road Caterham Surrey CR3 5QR 01883341024 01883341350 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Yvonne Dalton Type of registration: Number of places registered: Mr Roshan Panchoo care home 2 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 2. The registered person may provide the following category/ies of service only: Care home only ? (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD) Date of last inspection Brief description of the care home Hillside was registered in July 2008.It is a small care home that is registered to accomodate two service users who have a learning disability. The home consists of two en suite bedrooms,a lounge,kitchen diner,upstairs bathroom and toilet and downstairs toilet.There is a staff office and a well kept garden,there is parking space off road at the front of the building. The town of Caterham is a short distance away and there is a bus stop very near the home. A range of day services and community colleges are available within the area. Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 2 Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was the first key inspection of Hillside,the service became registered in July 2008. The registered manager was unable to be present for the visit but the registered provider and the registered manager of another of the providers services were present. Short notice of the visit was given as the house is not currently fully staffed and no service users are in residence yet. During the visit the provider made available some policies and procedures and documentation that was to be used when the service becomes fully operational such as risk assessments and pre admission assessment. The house was toured and discussion took place with the provider and manager present about how the service would operate,for example how recruitment would take place,how it would be staffed and how care plans and activity progammes would be developed. Not all standards could be inspected on this visit and some of those Care Homes for Adults (18-65 years) Page 6 of 28 inspected have been assessed as partially met due to home not yet being fully operational. The weekly fee for the service will start at 1,500 pounds per week and a costing will be individually prepared for each service user. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information about the home is available to prospective service users and their representatives.Service users are encouraged to visit the home and spend time there before making the decision to move in. Needs are fully assessed before a place is offered and service users will only be admitted if the home is sure it can meet their needs. Evidence: The home does not have any service users living in it yet although the provider and one of the organisations managers have been undertaking assessments of potential service users referred to the service by care managers. The completed assessment of a potential service user that had recently taken place was available for inspection.The assessment document is comprehensive and holistic and information is gained from health and social care professionals,relatives and any other individuals involved,such as advocates.The assessment seen had been very thoroughly completed and a plan of care developed from it that was then proposed to the sponsoring authority along with Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: a costing. Information about the home is available for prospective service users and their representatives.There is a statement of propose and service users guide as well as a leaflet.The statement of purpose and service users guide contain the necessary information and can be made available in formats other than text. Prospective service users are welcome to visit the home and spend time there before making a decision about moving in. The provider said that the transition process will be tailored to suit the service users and can involve visits for short periods or longer periods such as overnight stays. A six weekly review will be held after a service user has moved in then reviews will be at least six monthly. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. An established care plan format is in place that is holistic and person centred. Risk assessment documentation is in place and risk assessments will be individualised. It is intended that service users will have opportunities to become involved in the daily running of the home. Evidence: No service users are in residence yet although the care plan prepared following a recent assessment of a service user considering moving in was well completed and included information on all areas of the service users life and how needs would to be met by the service and outside professionals.The ethos of the home is to enable service users to develop skills and achieve goals,it is intended they will participate in the daily running of the home and undertake tasks such as some cooking and cleaning. The provider said that the service users will be introduced to their keyworkers prior to Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: moving in and staff will spend time with them in their current settings so that they get to know them. The AQAA states that the home will promote needs and rights and will respect choices and focus on individual abilities and positive behaviours.Where service users need support with decision making and require an advocate,advocacy can be made available from a scheme that has been used for service users in the providers other homes. Risks will be assessed and individual risk assessments guidelines developed,sample risk assessment forms were available, such as for cooking or smoking. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The intent of the service is that individual activities programmes will be drawn up for each service user with their personal involvement. The provider has stated that the home will be flexibly run and service users will be offered choices. Menus will be prepared with the involvement of service users and dietary and cultural needs will be catered for. Evidence: The provider discussed the possible options for activities for service users.There are a range of community colleges and day services available and the likelihood is that Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: service users will have one to one staff support some of the time to support them at home and with activities.The AQAA states that outings will be arranged and at least one holiday a year will be offered.The provider discussed the need to develop individual programmes for each person focusing on their abilities and goals.The aim will be to support service users to maximise their potential. The provider intends to make a vehicle available and service users will be supported to use public transport as well. The AQAA states that visits from friends and families will be encouraged and the house routines will be flexible.Service users will be offered the opportunity to hold keys to their rooms. The provider said that menus will be prepared when service users move in with their involvement.Service users will be supported to help with meal preparation and if necessary specialist advice will be sought such as from a dietitian. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The provider of the service intends to provide personal and healthcare support to meet the needs of individual service users,respect their preferences for how personal care is delivered and make sure that their privacy and dignity are respected. Policies and procedures are in place for the safe administration of medication. Evidence: The evidence available is that service users will be appropriately supported with their personal and healthcare needs. The provider stated that gender preferences for the provision of personal care will be respected and staffing provided who will meet these. Service users will be registered with the local GP and the provider would refer service users to specialist health services such as community nurses,dietitians,speech and language therapists if they needed their involvement. Service users will have bedrooms with en suite facilities to allow for their dignity and privacy to be respected and there is also an upstairs bathroom they could choose to use. Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: Medication policies and procedures are in place and provision has been made for safe medication storage. As the home is small and there will not be large numbers of staff on duty at any one time all staff will have medication training,it is intended some staff will transfer from the providers other homes as well as new staff so existing staff may already have been trained to give medication. The provider said that individual guidelines will be compiled depending upon needs such as for PRN medication or the management of challenging behaviour. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a clear complaints procedure that is available for service users and others. Policies and procedures are in place to safeguard service users and protect them from abuse. Evidence: The home has a safeguarding vulnerable adults procedure in place and the provider said that all staff will have POVA training.New staff will receive the training within their induction. Other policies and procedures are in place to ensure that service users are kept safe such as moving and handling and whistleblowing.The complaints procedure is accessible to service users and others and explained in the service users guide. The rights of service users will be promoted,they will have access to an advocacy service and procedures are in place for the management of their finances. The provider stated that should a service user demonstrate behaviour that could cause risk to themselves or others procedures for staff to follow would be drawn up to mimimise this. Care Homes for Adults (18-65 years) Page 18 of 28 Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is comfortable and well furnished and decorated,bedrooms are attractive and they can be personalised. Future service users will benefit from living in an environment home that promotes normality and Independence. Evidence: The home is newly registered and has been refurbished and redecorated to a high standard. Downstairs there is a lounge with a television and a kitchen/dining room.The kitchen space allows room for future service users to access the kitchen equipment comfortably. The garden is attractive and safe,the laundry room is situated outside of the main house so laundry does not not need to be taken through areas where food is prepared,stored or eaten. The two bedrooms are a good size and very well decorated both have en suite facilities,one has a shower and one a bath.Service users will also be able to choose the shared bathroom if they wish. There is a small well equipped staff office and a downstairs toilet. It is intended bedrooms will be personalised by service users and if they would like a different colour scheme this will be respected. Care Homes for Adults (18-65 years) Page 20 of 28 Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The indications are that the home will be staffed with a staff team that is well supported and trained and is equipped to meet the needs of service users. The recruitment procedures to be used as explained by the provider indicate that service users will be protected by the procedures and the necessary staff checks will take place. Evidence: The home has a registered manager in post and staff will be made available to work at the home as soon as the service users who will be moving in are identified. The provider will be staffing the home with some experienced employees from their other services and pool of bank staff as well as recruiting for new staff. The provider said they will be providing the appropriate ratio as regards gender mix of staff depending upon who moves in and there is likely to be a certain amount of one to one staffing.There will be a waking member of staff on duty at night. The intention is that staff will meet service users before they move in either in their current homes or when they visit Hillside and keyworkers will be assigned before they move in. The manager discussed the organisations recruitment procedure.Applicants fill in an application form and are only interviewed if suitable references are received,all staff have a CRB check Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: and no staff start work before it is through.Staff will shadow experienced colleagues until they are competent to work alone and there is an induction period. The provider said that core training will be provided as well as specialist training such as on epilepsy or autism and that the manager will supervise staff and team meetings will be held. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is safe and a range of policies and procedures for the protection of service users and to ensure the safe and efficient running of the home are in place. An experienced registered manager is in post. Internal quality assurance is being developed. Evidence: The home has a registered manager who is experienced, has gained the NVQ 4 in care and is undertaking the registered managers award. The provider directly supervises the manager and will provide day to day support. The provider has put into place internal quality assurance processes and monthly Regulation 26 reports have been produced since the home was registered. The manager said that the views of service users and others will be gained through regular surveys and would plan the first for a few months after the service users move in. Policies and procedures are in place so that staff follow safe working practices and the environment has been made as safe as Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: possible,radiators are guarded or are thermostatically controlled and fire procedures are in place. The home is a non smoking environment. Although nobody lives there yet the decor allows for a warm and homely feel to the building. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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