Inspection on 28/04/06 for Hillside

This inspection was carried out on 28th April 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 23/01/06

Hillside 24/11/05

Hillside 12/01/05

Hillside 15/10/04

Hillside 13/01/04

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

CARE HOME ADULTS 18-65 Hillside 45 Gainsborough Road Henley On Thames Oxfordshire RG9 1SY Lead Inspector Catherine Kane Unannounced Inspection 28th April 2006 12:00 Hillside DS0000013217.V292140.R01.S.doc Version 5.1 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 DS0000013217.V292140.R01.S.doc Version 5.1 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. Hillside DS0000013217.V292140.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Hillside Address 45 Gainsborough Road Henley On Thames Oxfordshire RG9 1SY 01491 577169 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) haroon@caretech-uk.com Caretech Community Services Limited Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Hillside DS0000013217.V292140.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd January 2006 Brief Description of the Service: Hillside is a semi-detached house situated in a residential area of Henley on Thames. The home is registered for three people with a learning disability. The home has a cosy lounge, dining room, kitchen and two bathrooms. There is a small garden to the back of the house. Each resident has their own bedroom; one with some adaptations on the ground floor and two others on the first floor. The home is run and managed by CareTech Community Services Ltd, a national organisation with experience in providing services for people with a learning disability. The fees for this service range from £941.03 to £1002.36 per week. Hillside DS0000013217.V292140.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the service was an unannounced ‘Key Inspection’. The inspector arrived at the service at 12.00 noon and was in the service for more than 5 hours. It was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s owner or manager, and any information that CSCI has received about the service since the last inspection. The inspector asked the views of the people who use the services and other people seen during the inspection or who responded to questionnaires that the Commission had sent out. The inspector looked at how well the service was meeting the standards set by the government and has in this report made judgements about the standard of the service. She spoke with the manager and staff on duty and was present while residents had lunch. She also looked at residents’ care plans, staff files and other records kept in the home and made a tour of the premises. What the service does well: What has improved since the last inspection? A new person centred care planning process has been introduced. A new manager has been appointed and this should assist with providing continuity of care. Hillside DS0000013217.V292140.R01.S.doc Version 5.1 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 DS0000013217.V292140.R01.S.doc Version 5.1 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 Hillside DS0000013217.V292140.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admission procedure is good although not tested, as there have been no new admissions to the home. EVIDENCE: It is important to make sure that the home is the right place, the wishes of all the people who already live in the home are carefully considered and that the staff team have the right skills and systems in place before offering a place to any new resident. Hillside DS0000013217.V292140.R01.S.doc Version 5.1 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a care planning system in place to provide staff with the information they need to satisfactorily meet residents’ care needs. EVIDENCE: All three residents’ care records were selected for inspection and in each case the files had all the relevant information and were neat and well organised. Work was well underway on the introduction of a new person centred planning system and had been completed for two residents. This is to be commended. From the evidence seen by the inspector and comments received, the inspector considers that this service would be able to provide a service to meet the needs of individuals of various religious, racial or cultural needs An assessment of high risk at night for one resident had been regularly reviewed with no change noted. However, from discussions with staff and care notes seen in the home, there has been an increase in incidents and staff had concerns about the sleeping in care staff being able to respond appropriately to Hillside DS0000013217.V292140.R01.S.doc Version 5.1 Page 10 resident’s needs at night. The inspector strongly recommends that this night time risk assessment should be kept under review and the appropriate measures taken to keep residents safe at all times. Hillside DS0000013217.V292140.R01.S.doc Version 5.1 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Opportunities for residents to take part in a variety of interesting activities and to keep in touch with family and friends are good. EVIDENCE: Two residents were able to communicate with the inspector about things they like to do during the day. Both regularly attend a local day service and they indicated with sign language that they enjoy this. One resident when asked what their favourite activity was said, “I like bowling”. Notes kept in the home indicated that both residents have many opportunities to take part in a variety of activities. Another resident spends the majority of their time at home, in the company of staff, and was seen to enjoy one to one contact time with staff and occupying them self with their selection of favourite tactile objects. One resident speaks with their mother daily by telephone, helped by staff. A record of how staff support residents to keep in touch with their family and friends was seen during the inspection. Hillside DS0000013217.V292140.R01.S.doc Version 5.1 Page 12 At the time of the inspection a resident’s birthday celebration plans were being made. Residents’ annual holidays were also being planned. Residents were involved in planning both events. The inspector was present at lunchtime. Two residents at home at the time and staff on duty shared a sandwich snack lunch. A freshly cooked meal is served in the evening. Residents indicated to the inspector that the food served is nice. A varied menu is provided and residents’ special dietary needs are catered for. Residents are included in aspects of menu planning and staff have a book with recipes for popular meals that residents enjoy. Hillside DS0000013217.V292140.R01.S.doc Version 5.1 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Systems to meet residents’ personal care and healthcare support needs are good. Systems for the storage of residents’ medication seen during the inspection were poor. EVIDENCE: Essential information needed by staff to be able to provide personal and health care support was included in residents’ files. Staff help residents to look after their own medication and see they get to see their local GP and other community healthcare services when needed. The inspector saw how the home helped one resident to access specialist healthcare support when this was needed. This was well recorded by staff in the resident’s notes. During the inspection the inspector observed a cardboard box containing residents’ medicines kept in the office/sleep in room, which had the door open. Hillside DS0000013217.V292140.R01.S.doc Version 5.1 Page 14 Residents’ medicines must be kept safely stored at all times. An immediate requirement to address this was made. Hillside DS0000013217.V292140.R01.S.doc Version 5.1 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has a clear protection from abuse policy and the complaints procedure is good, but the way the home has responded to a recent complaint and protection issue was poor. EVIDENCE: The manager related that she has received one complaint. Information relating to the complaint was not available for inspection. The manager must provide CSCI with full details of the complaint received and the actions taken. The Commission has received no information relating to complaints in the last year. During the inspection the inspector was made aware of a reportable incident. The manager did not fully comply with the procedures expected in relation to the Oxfordshire Multi-agency Codes of Practice for the protection of vulnerable adults. The manager must report in accordance with the CareTech policy, Oxfordshire Multi-agency Codes of Practice and Care Homes Regulations, this and any future incidents, without delay, that fall within the protection of vulnerable adults. Hillside DS0000013217.V292140.R01.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The overall standard of décor and furnishings throughout the home is adequate and the standard of cleanliness is good. EVIDENCE: The home is a semi-detached family house situated in a residential area and is in keeping with neighbouring properties and comes across as a modern family home. The internal décor would benefit from refreshing in some areas. Furnishings are satisfactory except in the kitchen, which is functional but timeworn. The manager must provide details of the programme of maintenance and renewal for the home to keep both the external and internal areas in a good state of repair. During the inspection the inspector was made aware that special measures were in place to limit the spread of infection. Information, antibacterial handwash etc were made available for staff. Hillside DS0000013217.V292140.R01.S.doc Version 5.1 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The arrangements for the induction of staff and training are good with staff demonstrating a clear understanding of their roles. The systems for recruitment, selection and performance management of staff who work in this home are generally good. EVIDENCE: Two staff commented that staff morale has improved since the new manager has started. Since the last inspection two new staff members have joined the staff team, one transferred from another CareTech home. Two staff have transferred to other CareTech homes. Staff have a good understanding of residents’ support needs and communication methods. The relationships between staff and residents are good. A recently appointed member of staff related what they had covered from the comprehensive induction programme and they were clear about their role. The inspector viewed staff files for two staff sampled at random. These were well organised and contained the necessary documentation. Hillside DS0000013217.V292140.R01.S.doc Version 5.1 Page 18 A senior CSCI manager has undertaken an audit of Criminal Records Bureau (CRB) disclosures made on staff and stored at the CareTech head office. The following recommendations were made. All CRBs with a criminal record should be reviewed by one person who is a senior manager within CareTech. All staff with a CRB showing a criminal record must have a query sheet. The query sheet or other form should provide greater detail as to the evidence, risk assessment and reasons for the decision to appoint or not. As is the case Protection of Vulnerable Adults (POVA) First should only be used when the risk not to do so is serious for the service users. However any person appointed under POVA First should be asked to sign that they do not have a criminal record over and above their answers within their application forms. The manager provided details of the range of training opportunities to enable staff to do their job. Hillside DS0000013217.V292140.R01.S.doc Version 5.1 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The management arrangements are adequate. EVIDENCE: A new manager has been appointed and has confirmed that they have begun the application process to apply to CSCI for registration. The new manager receives support from the local CareTech area manager. The inspector receives copies of the proprietors’ representative’s monthly visit reports. Well maintained health, safety and welfare records are kept in the home and were made available for inspection. Hillside DS0000013217.V292140.R01.S.doc Version 5.1 Page 20 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 2 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 2 X 3 X X 3 X Hillside DS0000013217.V292140.R01.S.doc Version 5.1 Page 21 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. Standard YA20 Regulation 13(2) Requirement The responsible person must ensure that residents’ medicines are kept safely stored at all times. The responsible person must provide CSCI with full details of complaints received and the actions taken. The responsible person must report in accordance with the CareTech policy, Oxfordshire Multi-agency Codes of Practice and Care Homes Regulations any incident that falls within the scope of adult protection. The responsible person must provide details of how they plan to ensure that a programme of maintenance and renewal for the home to keep both the external and internal areas in a good state of repair. Timescale for action 28/04/06 2 YA22 22(8) 31/05/06 3 YA23 37(1)(e), (g) 31/05/06 4 YA24 23(2)(b) 30/06/06 Hillside DS0000013217.V292140.R01.S.doc Version 5.1 Page 22 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 YA9 Good Practice Recommendations The inspector strongly recommends that the night time risk assessment for one resident at high risk should be kept under review and the appropriate measures taken to keep residents safe at all times. All CRBs with a criminal record should be reviewed by one person who is a senior manager within CareTech. All staff with a CRB showing a criminal record must have a query sheet. The query sheet or other form should provide greater detail as to the evidence, risk assessment and reasons for the decision to appoint or not. As is the case POVA First should only be used when the risk not to do so is serious for the service users. However any person appointed under POVA First should be asked to sign that they do not have a criminal record over and above their answers within their application forms. 2 YA34 Hillside DS0000013217.V292140.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Oxford Area Office Burgner House 4630 Kingsgate, Cascade Way Oxford Business Park South, Cowley Oxford OX4 2SU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Hillside DS0000013217.V292140.R01.S.doc Version 5.1 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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