Inspection on 20/11/06 for Hillside

This inspection was carried out on 20th November 2006.

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

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hillside 14/10/08

Hillside 22/11/07

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 09/07/2008.

CARE HOME ADULTS 18-65 Hillside 33 Park Avenue Haltwhistle Northumberland NE49 9AU Lead Inspector Karena M.Reed Key Unannounced Inspection 20th November 2006 11:45 DS0000000670.V302791.R01.S.doc Version 5.2 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 DS0000000670.V302791.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 Adults 18-65. 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. DS0000000670.V302791.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hillside Address 33 Park Avenue Haltwhistle Northumberland NE49 9AU 01434 - 322120 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) At Home in the Community Ms Barbara Raffel Care Home 5 Category(ies) of Learning disability (5) registration, with number of places DS0000000670.V302791.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 1 person may also have a physical disability Date of last inspection 31st January 2006 Brief Description of the Service: 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 in close proximity of the town centre and all its amenities such as shops, pubs and restaurants. Nursing care is not provided. The bungalow is spacious. Each person has their own bedroom and there are sufficient bathing and lavatory facilities for the use of residents. Residents also have access to a very large garden. Fees payable for living at the home at the time of inspection in October 2006 are £803.29 to £1149.81. Additional charges are payable for hairdressing, transport, toiletries and eating out. 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 reports are also available at the home detailing the quality of care provided by the home. DS0000000670.V302791.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This site visit was unannounced and took place over three hours. A partial tour of the premises took place and a sample of records were inspected which included: The Statement of Purpose and service user guide, 4 care plans, the fire log, accident book, admission/discharge book, complaints record, 2 personal allowance records, 3 staff files, staff communication book, staff and resident meeting minutes. The manager, two support workers, 3 residents and a relative were spoken to at the time of inspection. A questionnaire was also completed by the home before the inspection to provide information. Comment cards were also sent to residents and other people involved with the home who may be able to comment about the running of the home. No comment cards were returned. Case tracking was carried out where certain residents were spoken to and their records were examined. What the service does well: What has improved since the last inspection? A regular supervision system has been established for managers’ so senior managers’ provide support to them in carrying out their job. A bathroom/shower room has been decorated. DS0000000670.V302791.R01.S.doc Version 5.2 Page 6 The level of staff training continues to improve. Several staff members have achieved National Vocational Qualifications. 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. The summary of this inspection report can be made available in other formats on request. DS0000000670.V302791.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000000670.V302791.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has up to date information to provide to prospective residents about the home and its facilities but it is only available in the written word. The home collects enough information about the needs of residents before they move in to help ensure staff are aware of the amount of care and support needs of the resident as they settle in. Staff receive training to give them the knowledge and insight to help understand the needs of residents and to provide the necessary levels of care and support to individual residents. EVIDENCE: The Home’s Statement of Purpose and service user guide were examined and they contained the necessary information as required by the Care Homes Regulations 2001. Records for four of the residents showed that when they were admitted to the home an assessment of their care needs had been carried out before their admission. The resident and relevant people who knew the person were DS0000000670.V302791.R01.S.doc Version 5.2 Page 9 involved in the initial assessment. This information and the care manager’s assessment of the resident’s care needs were used to ensure all the needs of the resident could be met by staff. The records contained a range of information. The pre inspection questionnaire showed staff receive training so that they know how to meet the specialist needs of the residents. Staff have received the necessary statutory training: Fire Training, Moving & Assisting, Food Hygiene, Safe Handling of Medication, First Aid, Personal safety, Protection of Vulnerable Adults and National Vocational Qualifications. Developmental training to give staff more insight into the needs of residents includes: safety awareness and break away techniques, communication, understanding autism, behavioural approaches, supervisory development and Learning Disability Awareness as part of new staff induction . DS0000000670.V302791.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There are adequate arrangements in place to ensure that residents’ health and social care needs are met. Residents are encouraged to be involved in decision- making and to communicate and make their views known. Staff support residents to take risks as part of independent living. EVIDENCE: There are detailed assessments in the residents’ care plans. Personal support needs are documented and give instructions to staff on how to support people in tasks such as washing, bathing, dressing, communicating and carrying out any assessed tasks to help promote the independence of the DS0000000670.V302791.R01.S.doc Version 5.2 Page 11 person. There is not an up to date system of reviewing the changing care needs of residents as care plans are not updated regularly. Residents care records showed that they have access to external health care services. GPs and Community Nurses were regularly consulted for advice and treatment. Records show residents are assisted to access chiropody, dental and optical services at least annually or as often as required. Residents are asked individually and consulted about decisions involving themselves and the running of the home. The home promotes the independence of the resident and provides whatever levels of supports are required and to take risks in order to live a more fulfilled lifestyle. Up to date risk assessments were not in place in residents care records. DS0000000670.V302791.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents take part in age, peer and culturally appropriate activities. Residents are part of the local community. Residents are encouraged to have appropriate personal, family and sexual relationships. Residents’ rights and responsibilities are recognised in their daily lives. Residents are offered a healthy diet. DS0000000670.V302791.R01.S.doc Version 5.2 Page 13 EVIDENCE: Conversation and observation of residents and staff showed staff support residents to acquire skills and become more self sufficient in aspects of every day living. Residents may attend day care services or enjoy individual therapeutic activities within the community. Residents all pursue their own individual hobbies and interests e.g keep fit, arts and crafts, watching football, drama, bowling, cooking, swimming, Snoezellen, walking, going for drives, cinema and theatre trips. Residents have also holidayed in Scotland, Carlisle and Penrith . They also enjoy meals out, socializing with residents of other homes, visiting the local pub, shopping and some attend a weekly evening club. Within the home residents bedrooms are equipped with their own televisions, music centres, books and whatever is of interest to the resident. Residents care plans and case records detail any family involvement. Conversation with staff also provided evidence that residents are encouraged to maintain contact with family and friends, staff providing the necessary levels of support for them to do so. Residents are asked individually daily what they wish to eat. A light snack is available at lunch times and a cooked meal is served in the evening. The menus are revised with the help of the residents. On the day of inspection corned beef hash, carrots and peas followed by yoghurt was available for tea. DS0000000670.V302791.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents do receive support in the way they prefer and require. There are arrangements in place to ensure that service users’ health care needs are met. Systems are in place for residents to retain and administer their own medication where appropriate. EVIDENCE: Four care plans and case records were inspected. The daily records detailed the care and support required for different needs. They reflected the changing needs of service users. One care plan did not record the needs and the care and support provided by staff in order to support a person with particular emotional needs. DS0000000670.V302791.R01.S.doc Version 5.2 Page 15 Records showed when residents had seen health professionals eg doctors, community nurses, etc. Records also showed when residents had seen opticians and dentists. Staff receive training before they administer medication to residents. A system is in place to oversee the medication of residents if they should retain and administer their own medication. DS0000000670.V302791.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaints procedure was available to remind people coming into the home of their right to complain. Residents are protected from abuse. EVIDENCE: There is a complaints procedure in a public place to inform people visiting the home of how they could complain if necessary. Residents have access to a complaints procedure that assists and supports them to bring any matters to the attention of staff outside of the home in case they felt uncomfortable bringing any complaints or concerns to the attention of staff within their home. The home keeps a record of complaints. Three complaints have been received by the home since the last inspection that are being dealt with by the home. As part of staff induction staff receive training about the rights of people with learning disabilities. DS0000000670.V302791.R01.S.doc Version 5.2 Page 17 Staff have received training about Protection of Vulnerable Adults and Prevention of Abuse. Staff have received training about working with behaviour that may be challenging. DS0000000670.V302791.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents live in a homely, comfortable and safe environment however the premises are showing signs of wear and tear. There is a good standard of hygiene around the home. EVIDENCE: There is a limited programme of redecoration around the home currently. The home is clean and well furnished however the hallway and dining room are in need of decoration due to wear and tear in the household. Residents’ bedrooms are bright and comfortable and well furnished. They are comfortable and very well equipped with personal possessions of the resident. DS0000000670.V302791.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,35,36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents’ needs are met by the numbers and skill mix of staff. Systems are in place to ensure residents are in safe hands. Residents are protected by the home’s recruitment policy and practices. Staff are trained to meet the care needs of residents. A system of supervision is in place for all staff working at the home. EVIDENCE: Examination of staff rotas and discussion with the person in charge and members of the staff team showed that the numbers of staff are as follows: 7.30am- 7.00pm 3 support staff DS0000000670.V302791.R01.S.doc Version 5.2 Page 20 4.00pm-10.00pm 9.00am-11.00pm 2 support staff to following day 1 sleep in staff member. These numbers include the manager. Staff rosters showed that some days of the week the numbers of staff reduce depending upon the residents’ activities. Staff members carry out cooking and cleaning with the help of residents where possible. The necessary checks are being carried out prior to the workers being appointed. CRB checks are carried out before a person is appointed. Staff stated that they enjoyed working in the home and were observed to be kind, caring and respectful to residents. Residents commented they liked living at the home. Staff receive LDAF Learning Disability Award Framework as part of their induction. Staff said and their records showed that they also receive advice and /or training in other areas. Staff have received Fire Training, Moving & Assisting, working with behaviour that may be challenging, person centred planning, First Aid, Safe Handling of Medication and National Vocational Qualifications & Protection of Vulnerable Adults training. Staff receive supervision every two months from the manager. A system is in place for managers’ of the Organization to receive regular supervision from a member of the senior management team. DS0000000670.V302791.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,41,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a very well run home. Residents and staff benefit from the ethos, leadership and management approach of the home. There is a good standard of record keeping. The health, safety and welfare of residents are promoted and protected. DS0000000670.V302791.R01.S.doc Version 5.2 Page 22 EVIDENCE: The person in charge has not completed the Registered Manager’s award yet but hopes to complete it in 2007. Discussion and observation maintain that she puts the needs of the residents first and promotes an ethos amongst staff of involving staff and residents in decision making within the home. Residents living at the home have lived there for several years and the staff advocate for residents where necessary as well as using external advocates to speak up for them. Documents detailing fire safety, risk assessments in the environment, water temperatures, financial records and statutory records were all up to date apart from the system for recording residents financial accounts did not contain two signatures. Staff training relating to health and safety was up to date and training being planned to renew any that required updating. DS0000000670.V302791.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 3 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 2 x LIFESTYLES Standard No Score 11 3 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x 3 3 x DS0000000670.V302791.R01.S.doc Version 5.2 Page 24 NO Are there any outstanding requirements from the last inspection? 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 2 3 4 Standard YA6 YA9 YA24 YA33 Regulation 15(2)c Requirement Timescale for action 01/02/07 01/02/07 31/03/07 31/01/07 Care plans must be updated at least 3 monthly. 14(2)(a)(b) Risk assessments must be updated and reviewed regularly. 23(2)(d) The dining room and hallway must be decorated. 18(1)(a) Staffing levels must be reviewed. 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. 2 Refer to Standard YA37 YA41 Good Practice Recommendations To continue studying for the Registered Manager’s award. To obtain two signatures when dealing with residents finances. 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