Inspection on 10/10/06 for Hillside

This inspection was carried out on 10th October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Hillside 27/02/06

Hillside 16/11/05

Hillside 10/03/05

Hillside 24/08/04

Hillside 16/01/04

Hillside 15/09/03

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

CARE HOMES FOR OLDER PEOPLE Hillside 21 Adlington Road Wilmslow Cheshire SK9 2BJ Lead Inspector Ms Julie Porter Key Unannounced Inspection 10:30 10th October 2006 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 Hillside DS0000006634.V304506.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. Hillside DS0000006634.V304506.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hillside Address 21 Adlington Road Wilmslow Cheshire SK9 2BJ 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) 01625 523351 manager@hillsidecare.com Mr Donald Mark Stockton Ms Dorothy Evans Care Home 19 Category(ies) of Old age, not falling within any other category registration, with number (19) of places Hillside DS0000006634.V304506.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th February 2006 Brief Description of the Service: Hillside is a 19-bedded care home for older people, situated in its own grounds in a quiet residential area of Wilmslow. It was extensively renovated and refurbished in 2002 and has 17 single bedrooms, four of which have en suite facilities, and one shared room which is currently being used as a single room. There are six communal toilets, three bathrooms and a shower. Accommodation is provided on two floors, and there is a passenger lift, stair lift and staircase giving access between the floors. There are three shared lounges and a dining room on the ground floor. There are pleasant gardens surrounding the home. The home charges between £475 and £505 per week for residential care. This information was provided on the pre-inspection questionnaire completed by the manager and submitted to CSCI on 14 August 2006. Hillside DS0000006634.V304506.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on 10 October 2006. Three residents, one relative and four staff including the owner and the manager were spoken with during the inspection. Two residents’ care plans were inspected; one member of staff and a number of the homes records were seen. The visit also included a tour of the premises. What the service does well: What has improved since the last inspection? Improvements have been made to the décor of the home to ensure residents continue to live in a comfortable homely environment. The complaints log is being used effectively to ensure that the home continues to strive in providing a service that matches the residents’ expectations. Hillside DS0000006634.V304506.R01.S.doc Version 5.2 Page 6 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. Hillside DS0000006634.V304506.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 Hillside DS0000006634.V304506.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): 1,3,6 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. There are processes in place to enable potential residents and their relatives to find out about and visit the home so that they can be sure the home meets their needs. EVIDENCE: There is written information about the services the home has to offer. Information is also available on an intranet website so potential residents and their families, can make a choice regarding a move to the home. One resident spoken with said that although she did not have an opportunity to visit because of her ill health before she moved to the home, she knew of the home and had arranged to move there herself. Another resident said that she and a family friend had visited a number of homes in the area before she chose to move to Hillside. The home obtains care needs assessments undertaken by social workers and/or health workers before the manager meets the potential residents and Hillside DS0000006634.V304506.R01.S.doc Version 5.2 Page 9 completes the homes own assessment. The homes own pre-admission assessment includes; health and personal care needs, diet including likes and dislikes, medication, sight, hearing and oral health, mobility, and a falls risk assessment. Two residents plans were inspected and provided clear thorough information about the resident needs. The home does not provide intermediate care. Hillside DS0000006634.V304506.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is excellent. This judgement has been made using the available evidence including a visit to this service. Residents’ needs and health care needs are continually monitored to ensure they receive the best possible care. EVIDENCE: Two residents’ care plans were inspected and informed staff of the action to take to ensure that the residents’ needs are met. Evidence was available to show that the residents and/or families had been involved during the initial stage of planning their care. The home manager continues to monitor the residents care needs monthly, one resident spoken with said that the manager regularly discusses with her if she is happy with the support she has. Improvements could be made to the documentation to demonstrate that residents when they able are included in reviewing the support they need. All residents are registered with local doctors surgeries. Comments received from one G.P were positive, “Well run. Good communication with staff and good client care.” The home maintains good links with community health services and a record is kept of visits made by doctors, nurses and other health care professionals. On Hillside DS0000006634.V304506.R01.S.doc Version 5.2 Page 11 the day of the inspection a community nurse was in the home to give the “flu” injection to residents. One resident was heard speaking to the manager and stated that she did not wish to have a flu injection. The manager offered advice regarding the benefits, but supported the resident in making her own decision not to have the “flu” injection. Both residents care plans inspected provided evidence that the residents weight is monitored. The home has a policy relating to medication administration, residents are supported to self-administer medication subject to a risk assessment. Records identified that staff had received training relating to medicines administration in July 2005. Medication storage and the records of medicines received and administered were inspected and were being maintained appropriately. Staff were observed throughout the visit talking to residents with respect and knocking on bedroom doors. A public telephone is available for residents although a number of residents have had telephones for their private use fitted in their bedrooms. Hillside DS0000006634.V304506.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. Residents lead very active lives both in and outside the home and are encouraged to make choices so they maintain some control within their ability and their independence. EVIDENCE: A number of activities are arranged in the home organised by the staff such as card games, jigsaws, bingo and magnetic darts. On the day of the inspection a very competitive game of carpet bowls was underway between thirteen of the seventeen residents and three visitors to the home. Vocalists make regular appearances and these evenings appear to be very popular. Routines in the home are flexible to suit the needs of the residents. Residents were seen coming and going throughout the day and confirmed that they get up and go to bed when they want. Meals and mealtimes are provided to suit the residents. The manager confirmed that visitors are always welcome in the home and one visitor spoken with confirmed this. Family and friends are encouraged to spend time with residents in the home and the manager confirmed that meals could Hillside DS0000006634.V304506.R01.S.doc Version 5.2 Page 13 be arranged with a little notice. One resident said that staff always bring her visitors a drink “you don’t even have to ask.” Residents are encouraged to manage their own finances for as long as possible. When that is no longer possible family, friends or legal advisors are appointed. Information was available in the home regarding advocacy services. Two residents spoken with talked enthusiastically about life in the home, although they said it was different to living in their “own place” they liked having company and felt safe because people where around. One resident said that the owner of the home often speaks with her asking if he can make any improvements or changes to the service offered. Lunch was observed on the day and was seen as a social activity, was unhurried and pleasant. Individual likes, dislikes and dietary needs are acknowledged and met. Hillside DS0000006634.V304506.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17,18 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. The home has an effective complaints procedure and staff have received training regarding adult protection to ensure residents are protected from harm. EVIDENCE: The home has a written complaints procedure available to residents and relatives. The manager confirmed that no formal complaints regarding the home or its service have been received. One resident said that staff encouraged them to “speak up” for themselves, concerns, complaints and suggestions from residents are recorded and evidence was seen that all care staff; the management and the cook are involved in promoting a positive outcome for the residents. Two residents said that they never feel that anything they ask for is too much trouble. The owner of the home regularly monitors the complaints log and informs staff regarding their performance in achieving residents’ wishes. One resident on the day was spoken with and was spending time in her room, this was discussed with her and she said normally she would spend time with others but she was waiting for a call from her solicitor and preferred to do this in private. All residents in the home are registered to vote should they wish to do so. Hillside DS0000006634.V304506.R01.S.doc Version 5.2 Page 15 Staff had completed training in relation to adult protection at the last inspection and reference material is available in the home. Evidence was seen that new staff are informed about protecting vulnerable adults as part of their induction. Hillside DS0000006634.V304506.R01.S.doc Version 5.2 Page 16 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): 19,20,21,22,23,24,25,26 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. The home is clean and well maintained to ensure that the residents live in a homely, comfortable environment. EVIDENCE: On the day of the inspection the home was clean, fresh and well maintained throughout. The owner continually monitors the quality of the furnishings and fittings of the home internally and externally. New items of furniture have been bought and the lounge, two bedrooms and the hallway between rooms 3 and 4 have been decorated. Outside the access ramp and the fire escape has been painted and the driveway to the home has been resurfaced. The inspection involved a tour of the building and some of the bedrooms. Those seen were well furnished and had been personalised by the resident with small items of their personal possessions. One resident spoken with who had Hillside DS0000006634.V304506.R01.S.doc Version 5.2 Page 17 recently moved to the home, said that she was waiting for a larger bedroom to become available and that the owner was kindly storing some of her personal belongings until the move was possible. The manager confirmed that this discussion regarding a move had taken place and would be put into place at the next opportunity. There is an above average amount of shared space, including dining room, lounges and conservatory, for the residents to use. On the day of the inspection residents and visitors were seen moving about the home freely and making full use of the home. The home has a stair lift to the first floor and a passenger lift. Handrails are fitted along the corridors to assist residents with mobility. Bathrooms are fitted with equipment to assist residents with bathing. Service contracts were available to ensure continued safety of residents and staff. Hillside DS0000006634.V304506.R01.S.doc Version 5.2 Page 18 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 good. This judgement has been made using the available evidence including a visit to this service. The home has robust recruitment processes to ensure staff are suitable for the work they are employed and staff training so that the residents are safe. EVIDENCE: During the inspection a discussion was held with the owner and the manager regarding the staffing levels in the home. The homes routines and the support needs of the residents after 6p.m. were reviewed and the manager gave assurances that if residents needs were to increase the staffing levels in the home would reflect this. The manager and the staff are confident that the residents’ needs are met within the current staffing arrangements. The information provided before the inspection stated that 57 per cent of staff (eight of the fourteen) in the home have achieved NVQ level 2 or above. Of the remaining six staff four are now doing NVQ level 2; one member of staff is undertaking NVQ level 3 and the deputy manager has started NVQ level 4 in management. The home has a strong commitment to staff training and they staff view this positively, recent updates in training includes 1st Aid; Moving and handling, fire training, medication administration, infection prevention, continence advice and specialist areas such as understanding Parkinson’s disease. Staff confirmed that they are paid to attend training events. Hillside DS0000006634.V304506.R01.S.doc Version 5.2 Page 19 The home has only employed one new member of staff since the last inspection. This staff file was reviewed as part of the inspection and containing information as required by Schedule 2 of the Care Homes Regulations for Older People. The manager or the manager and senior member of staff interview all prospective employees, following appointment a comprehensive record of all matters covered during induction was available along with certificates of any training achieved. Hillside DS0000006634.V304506.R01.S.doc Version 5.2 Page 20 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): 31,32,33,34,35,36,37,38, Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. The owner and manager are aware of their responsibilities in respect the dayto-day running of the home to ensure the residents are well cared for and kept as safe as possible. EVIDENCE: The manager of the home is registered with the Commission for Social Care Inspection and has a wealth of experience of managing this home. The owner and manager work each day in the home but have very clear defined areas of responsibility that ensures the smooth running of the home. One relatives comment card stated, “this care home is one of the best run and cleanest…. Run to a high quality.” Hillside DS0000006634.V304506.R01.S.doc Version 5.2 Page 21 Residents, visitors and staff were seen throughout the day speaking with the owner and manager in an open and relaxed manner. The owner and manager conducts quality audits of the home using, external agencies to advise on the premises. Regular reviews of the homes policies and procedures are in place. Information is obtained from residents regarding their satisfaction with the services through the annual questionnaire, the complaints procedure and informal meetings with residents and visitors. Evidence was seen in the staff meeting minutes giving staff the opportunity to comment about the home. These processes inform and annual report and the homes five year plan to measure the success of the home in meeting the aims as established in the homes statement of purpose. Insurance certificates and public liability insurance as in place for the home. The manager confirmed that no money is held on account for any resident in the home. The manager of the home conducts formal supervision with all staff in the home on a regular basis. Informal supervision/advice and observation of staff is undertaken by the senior staff on duty in respect of good practice. All staff undertake regular and ongoing mandatory training relating to health and safety. Information provided by the manager before the this visit indicated that up to date safety certificates were in place for the following: • • • • • • Fire equipment Gas installation Electrical wiring Passenger lift Emergency call systems Bath hoists A full fire risk assessment of the premises was completed on 1 March 2006 and the owner has responded promptly to all the recommendations. The accident record was inspected and was being maintained appropriately. Hillside DS0000006634.V304506.R01.S.doc Version 5.2 Page 22 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 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 4 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 3 3 Hillside DS0000006634.V304506.R01.S.doc Version 5.2 Page 23 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP31 Good Practice Recommendations The registered manager should achieve NVQ level 4 in management. Hillside DS0000006634.V304506.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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. 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