Inspection on 14/10/08 for Hillside

This inspection was carried out on 14th October 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hillside 22/11/07

Hillside 20/11/06

Hillside 31/01/06

Hillside 12/09/05

Hillside 15/12/04

Hillside 28/07/04

Similar services:

Craigmore House

1 Lanark Close

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Hillside 33 Park Avenue Haltwhistle Northumberland NE49 9AU     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: Elaine Charlton     Date: 1 4 1 0 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 31 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 31 Information about the care home Name of care home: Address: Hillside 33 Park Avenue Haltwhistle Northumberland NE49 9AU 01434-322120 Telephone number: Fax number: Email address: Provider web address: hillside@athome.uk.net Name of registered provider(s): Name of registered manager (if applicable) Ms Barbara Raffel Type of registration: Number of places registered: At Home in the Community care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: 1 person may also have a physical disability Date of last inspection Brief description of the care home Hillside is a small home registered to provide personal care and support to five adults with learning disabilities under the age of sixty- five years. Nursing care is not provided. The property is a purpose-built bungalow. It is situated in a rural setting near to the town centre and all its amenities such as shops, pubs and restaurants. The bungalow is spacious. Each person has their own bedroom and they share the communal areas, which includes a kitchen/dining room and a lounge. One of the ground floor rooms is an office and bedroom for staff on sleepover duty. At the back of the bungalow is a very large garden. Hillside is part of the residential services provided by the voluntary organization At Home in the Community. Residents who are interested in coming to live at the home are provided with a Statement of Purpose and service user guide which describes the services and facilities provided by the home and how staff are trained to meet residents care and support needs. CSCI inspection Care Homes for Adults (18-65 years) Page 4 of 31 Over 65 0 5 Brief description of the care home reports are also available at the home detailing the quality of care provided by the home. Care Homes for Adults (18-65 years) Page 5 of 31 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: The quality rating for this service is 2 star, this means that the people who use this service experience good quality outcomes. An unannounced visit was made on the 14 October 2008. A total of three hours were spent in the home. Before the visit we looked at Information we have received since the last visit on 22 November 2007. Annual Quality Assurance Assessment (AQAA). The AQAA gives CSCI evidence to support what the service says it does well, and gives them an opportunity to say what they feel they Care Homes for Adults (18-65 years) Page 6 of 31 could do better and what their future plans are. How the home has dealt with any complaints and concerns since the last visit. Any changes to how the home is run. The provider’s view of how well they care for people. The views of people who use the service, their relatives, staff and other professionals who visit the service. During the visit we Talked with people who use the service, staff, and the manager. Looked at information about the people who use the service and how well their needs are met. Looked at other records which must be kept. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around the building to make sure it was clean, safe and comfortable. Checked what improvements had been made since the last visit. We told the manager what we found. 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. Care Homes for Adults (18-65 years) Page 8 of 31 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 9 of 31 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 10 of 31 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. People who want to move into the home are properly assessed and know that their individual needs, aspirations and beliefs can be met. Evidence: People who live in the home have their needs properly assessed before they need to make a decision about whether the home is suitable for them. The home carries out its own assessment as well as getting a copy of the care managers professional assessment. Families are encouraged to be involved in this process where appropriate. We looked at the assessment for the person most recently admitted to the home. This showed that their needs had been properly assessed and included information from a range of healthcare professionals. Care Homes for Adults (18-65 years) Page 11 of 31 Evidence: Before a person moves into the home they are able to spend time with the people who already live there, join them for a meal/activities and outings and stay over-night. The whole assessment and introductory process takes place over a period of time at a pace that suits the individual resident. Care Homes for Adults (18-65 years) Page 12 of 31 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. The home has adopted a person centred approach to care planning, that gives people the chance to make decisions and take risks that have been carefully reviewed. Evidence: Each resident has a care plan that is put together using information from their assessment and what staff know about them. They are involved in the decision making process and let staff know how they want their care providing. Staff have access to a lot of information about each person that lives in the home but the records are to be reviewed and updated so that old information can be archived. The new manager told us about the new format he is going to introduce for care plans. We saw evidence of this in the previous home he managed. Information and guidance is separated out into individual files, making it easy for staff to access. Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: People are consulted about what they want to do and when. Activities and routines are risk assessed to promote people getting involved in tasks like food preparation with a minimum of risk. We saw evidence of a good risk assessment about supporting a person to travel in a motor vehicle and to get out and about in the local community. In addition to the daily record sheet each resident has a daily diary. We saw some nice recordings in the daily diaries including expressions of achievement, for example was excellent at computer classes today. Care Homes for Adults (18-65 years) Page 14 of 31 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. Residents are part of the local community and enjoy appropriate leisure activities that bring them into contact with people they can make friends with. People are encouraged to make daily choices and decisions about how they live their life. Evidence: Three people who live in the home go to the Tynedale Centre for two days each week where they get involved in activities and educational opportunities like horse riding, swimming and getting out and about in the local community. The bungalow is set in the heart of the local community and residents are able to go shopping, to local pubs and coffee houses. The Health Centre is also just along the road. Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: Family and friends are welcome to visit the home and residents are supported to entertain visitors and to go to family houses for short stays. One person has had two holidays away this year in their family caravan. The organisation has a new policy for supporting people to take holidays. Destinations this year have included Robin Hoods Bay, Whitby and Centre Parcs. Some people are able to make hot and cold drinks and/or snacks for themselves, but need a little more support to be able to prepare the main meals. Residents are encouraged to be as involved as they wish or can safely be. Residents likes and dislikes are recorded and this includes activities they like taking part in such as drama, arts/crafts, music and the theatre. Care Homes for Adults (18-65 years) Page 16 of 31 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 personal and healthcare needs of people who live in the home are provided in a way and where they choose. People are supported to take care of their own medication when they wish or are able, but staff also take care of this. Evidence: The records we saw contained good information about the healthcare needs of the residents. They are able to see a range of healthcare professionals as they need or wish. This includes their GP, chirpodist, occupational therapist, physiotherapist, psychiatrist, people from the Speach and Language Therapy team and the Behavioural Assessment Intervention Team. Staff have access to good information that helps them to provide people with the care and support they need, and to be able to manage any behaviours that may challenge the normal routines of the home. Care Homes for Adults (18-65 years) Page 17 of 31 Evidence: Guidance is available in the home and to staff to help them understand the needs of people with a specific health diagnosis, for example downs syndrome and dementia, how they can expect people to respond and what signs to look for. We saw evidence of psychiatric input where peoples needs dicatate. As well as good evidence of the introduction of new professionals. Occupational and physiotherapists have assessed all the mobility needs of people living in the home and one person attends the Orthetic Clinic where they get shoes made so that they can stay mobile. Staff have received training in the safe handling of medication. We carried out a random check of medication held in the home and recording systems. No issues were identified. Care Homes for Adults (18-65 years) Page 18 of 31 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. People who live in the home are protected through policies, procedures and staff training. They are supported and encouraged to tell someone about any concerns they may have or if they are unhappy. Evidence: The organisation has a complaints procedure that encourages people to make staff aware of any concerns or complaints they have. As part of the staff induction staff receive training about the rights of people who have a learning disability. There is a simple format of the complaints procedure to help people who live in the home understand what they should do if they are unhappy. Neither the home or CSCI have received any complaints or concerns since the last inspection. Staff have received training in the Protection of Vulnerable Adults and know about their responsibility to report any poor practice or concerns they may become aware of. Staff who work in the home are required to have a Criminal Records Bureau check at an enhanced level to show that they do not have any convictions or cautions that may preclude them from working with vulnerable people. Care Homes for Adults (18-65 years) Page 19 of 31 Care Homes for Adults (18-65 years) Page 20 of 31 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. People live in a home that is spacious, comfortable, well equipped and clean, meeting their individual needs and reflecting their differing personalities. Evidence: People live in a spacious, well maintained bungalow, where they have their own bedroom and access to lots of shared space. The bungalow is located in the heart of the local community and has lots of garden space. Everyone who lives in the home has their own bedroom which they are able to personalise in their own way. Each bedroom has a wash hand basin, and there is easy access to bathroom, shower and toilet facilities. People are able to excercise choice about how their bedroom is decorated and furnished. One person is reluctant to part with things they have collected over the years so they have been provided with some outside storage to accommodate this. The vacant bedroom has been re-decorated and a new carpet is to be fitted before consideration is given to another person moving in. Care Homes for Adults (18-65 years) Page 21 of 31 Evidence: The entrance hall and hallways in the home are spacious and wheelchair user friendly. Communal space includes a lounge, dining room and large kitchen. The furniture in the lounge area has been well used, is faded and in need of replacement. The home has gas central heating and there is also an emergency portable gas fire and hob in case of power cuts. The kitchen is large but domestic in style and people who live in the home are able to use the area to make drinks and snacks if they wish. There is also a separate washing machine located in the kitchen that is used solely for laundering table cloths and tea towels. There is a separate laundry/utility area that is well equipped and gives staff access to the outside where they can hang laundry to dry. All substances used in the process of washing clothes and bedding are kept securely. We saw that all areas of the home were clean, tidy and fresh. Care Homes for Adults (18-65 years) Page 22 of 31 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. People who live in the home know that they are helped and supported by staff who are properly recruited and trained to help them do their job in a safe way. Evidence: We looked at the records for four people who work in the home. These showed that people had been properly recruited and checks had been carried out to confirm that they were who they said they were and that they had no convictions or cautions that would preclude them from working with vulnerable people. Staff files would benefit from the introdution of a sheet that records when references have been requested and received, when POVA First and Criminal Records Bureau checks have been carried out. There is a full time and a part time vacancy at the home. Recruitment in this rural area is sometimes difficult so the organisation has engaged an employment agency who are going to put on a recuitment day. Staff receive regular, recorded supervision, and we saw evidence of good follow up and additional training where issues had arisen. Care Homes for Adults (18-65 years) Page 23 of 31 Evidence: Individual staff members have delegated areas of responsibility. These include menu preparation and the ordering of cleaning products. We saw evidence that staff had access to training that included infection control, moving and handling, safe handling of medication, fire safety, first aid. It was not clear whether the individual staff training records were completely up to date. The manager said he was going to check the records and arrange any necessary refresher training. Care Homes for Adults (18-65 years) Page 24 of 31 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. People live in a home that is run in an open and inclusive way and in their best interests. Some health and safety checks need to be updated, but most records are up to date and of a good standard helping to keep people safe. Evidence: This inspection took place on the new managers first full day in the home. He has previously been the registered manager of one of the organisations other homes in the area. He is a qualified manager and experienced in working with people who have a learning disabilty. We carried out a random check of monies held in the home on behalf of residents. Each person has their own bank account, and only small amounts of money are kept in the home on their behalf. All records and monies seen were up to date and correct. We saw staff following proper procedures when getting money out for people who were going out for lunch. Care Homes for Adults (18-65 years) Page 25 of 31 Evidence: Quality assurance questionnaires are sent out and returned to the organisations headquarters. This is an annual practice that helps the organisation gather information from residents, relatives and other interested stakeholders about the quality of care provided in the home. Servicing and maintenance arrangements are in place for equipment and systems within the home. Everything was up to date with the exception of the portable appliance tests for small electrical equipment. The manager told us that they were looking for a new contactor to carry out this work. We checked fire and accident records kept in the home. All were up to date except for the recording of checks on fire equipment and lights. There were some gaps in the monthly recordings. The provider had not made a regulation 26 visit to the home since April 2008. These are a monthly requirement and should be supported by a report of who the person spoke to, what they saw and any actions they identified. At the moment the person carrying out the regulation 26 visit merely signs a register to say they have been to the home. Care Homes for Adults (18-65 years) Page 26 of 31 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 27 of 31 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 1 6 15 Service user plans must be 14/02/2009 reviewed and put into a more user friendly format so that staff have easy access to all the information and guidance they need. This will mean that people who live in the home have access to all the information to make sure that residents receive the right care and support. 2 24 23 The well used and faded settees in the lounge area must be replaced for the comfort of the residents. This will mean that people have access to comfortable seating in the area where they relax. 14/01/2009 3 32 18 Staff training records must be brought up to date and any necessary refresher training identified and arranged. 14/01/2009 Care Homes for Adults (18-65 years) Page 28 of 31 This will mean that staff working in the home and supported and trained to do their job, helping to keep residents safe. 4 42 13 Fire safety checks must be carried out and recorded as specified by the Fire Authority. This will help keep people who live and work in the home safe. 5 42 13 CSCI must be provided with evidence that the portable electrical applicances being used in the home have been safety checked. This will help keep people who live and work in the home safe and reduce the risk of fire. 6 43 26 Visits by the provider must 14/12/2008 be made on a monthly basis and the outcome recorded to show who they spoke to and what they found. This will support quality assurance systems and the safety and well being of people who live in the home. 14/12/2008 14/12/2008 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 1 34 Consideration should be given to introducing a record sheet in staff files so that it is easy to check when references were sent for and received, if POVA First and CRB checks Care Homes for Adults (18-65 years) Page 29 of 31 have been carried out. This will help to protect people who live in the home and provide good evidence that recruitment and selection procedures are being properly followed. Care Homes for Adults (18-65 years) Page 30 of 31 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. 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. 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