Inspection on 14/03/07 for Hillside Grange

This inspection was carried out on 14th March 2007.

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 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 Grange 23/02/09

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Hillside Grange Old Sunderland Road Felling Gateshead Tyne & Wear NE10 0BU Lead Inspector Mrs Eileen Hulse Unannounced Inspection 14th March and 4th April 2007 08:45 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 Grange DS0000069207.V331711.R02.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 Grange DS0000069207.V331711.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hillside Grange Address Old Sunderland Road Felling Gateshead Tyne & Wear NE10 0BU 0191 438 6000 0191 438 0191 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) Barchester Healthcare Homes Ltd Ms Pamela Dias Care Home 50 Category(ies) of Dementia - over 65 years of age (16), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (1), Old age, not falling within any other category (50), Physical disability over 65 years of age (6), Sensory Impairment over 65 years of age (6) Hillside Grange DS0000069207.V331711.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 31st January 2006 Brief Description of the Service: The home can provide personal care for 50 older people. This includes a separate area on the first floor that can care for people who have dementia. The home cannot provide nursing care. Hillside Grange is a two storey converted building in the Sunderland Road area of Felling in Gateshead. Churches, shops and other facilities are within easy reach of the home, although there are some fairly steep hills to negotiate, however, it is easy to get to by bus or car. The home has extensive lawned areas to the front and an enclosed patio area to the rear, which is used by service users. The main entrance at the front of the home has a number of steps but the entrance to the rear of the building has a ramped access. There is a lift to take people to and from the first floor. All of the necessary facilities are provided including an emergency call system and the bathrooms and WC’s are generally suitable for the people who live there. The weekly fees are £364.00 to £425.00 per week depending upon care needs. Additional charges are made for hairdressing, personal items, outings and newspapers. Hillside Grange DS0000069207.V331711.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection and took 9hrs 15mins to complete over two visits to the home and was carried out as part of the annual inspection programme. The Registered Manager was not present for any of the visits and some time was spent with the acting and Deputy Manager reviewing the progress of the service. Time was also spent talking with service users, their visitors and members of staff to get their views of the service. How care staff support the service users was observed throughout the visit and observation of the breakfast and lunchtime meals was made over the two visits. Information about the quality of life and care received by service users was collected using a system called ‘case tracking’. This involves following the care and experience of a group of service users by looking at care plans, talking with people, sampling records such as accident and fire records, medication taken by service users and the records. The requirements made in previous inspection reports were discussed with the Deputy Manager and discussions took place with other staff members who were on duty at various times throughout the visit. The judgements made are based on the evidence made available during the visit to the home and from information obtained from the home before the visit was made, which included the pre inspection questionnaire that was provided by the home Manager. This gave up to date information about the home to include within the report. Questionnaires completed by service users and their families also gave some insight on what it is like to live in the home. Comments of relatives included: • • • ‘My relative has been here a long time, I wouldn’t have a wrong word said about the staff they are lovely people’ ‘My relative enjoys her meals and just leaves what she cannot eat’ ‘There is always a kind word from staff when I arrive at the home’ What the service does well: Hillside Grange provides a good standard of care in a home that is comfortable and nicely furnished. The staff team are caring and committed and this is reflected in their everyday practice. Service users spoken with throughout the two days were very positive about the home and comments they made included: • ‘I have been here 10 years, its an ok place to live’ DS0000069207.V331711.R02.S.doc Version 5.2 Page 6 Hillside Grange • • • • ‘We get well looked after here’ ‘I like living here the staff are kind to me’ ‘I don’t get up until 10 because I like a lie in’ ‘I have lived here a lot of years and I think the staff are smashing’ What has improved since the last inspection? 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. Hillside Grange DS0000069207.V331711.R02.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 Grange DS0000069207.V331711.R02.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good assessments are included within the plans of care for all service users that help to form the basis of their care plan to ensure that before admission, the home is able to know if they can meet the care needs. The home does not provide intermediate care EVIDENCE: Detailed assessments are stored within the individual care plans. The assessment records show that service user’s care needs were assessed by a Care Manager and Manager of the service before their admission took place. The Acting Manager then explained that before an admission takes place, the Manager or deputy Manager visits the prospective service user in their own home or in hospital to ensure the needs can be met and the homes own assessment record is completed at this time and day visits to the home are Hillside Grange DS0000069207.V331711.R02.S.doc Version 5.2 Page 9 also offered to the prospective service user. A letter is then sent to the service user to confirm the care needs can be met or not met then both assessment records are used to formulate the plan of care. Service users that are self funding can also have the benefit of a Care Manager who can help when the service user is making a decision as to go into the home or not. Six weeks after admission, a review is held between the service users, care Manager, home Manager and the service user’s representative to decide if the service user wishes to continue living in the home on a permanent basis. Further reviews are then held every six months as well as annually with the Care Manager. Hillside Grange DS0000069207.V331711.R02.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care plans do have some information on service users needs that will guide the staff to ensure that their individual needs are met, however, more detail needs to be included and they need to be regularly monitored and evaluated to ensure that all staff are aware of any necessary changes to the pattern of care. The healthcare needs of the service users are met and therefore service users are protected with good practices in place. EVIDENCE: The care plans are divided into sections with a front index so that information is accessed easily to both service users and staff. Hillside Grange DS0000069207.V331711.R02.S.doc Version 5.2 Page 11 Each care plan has a contents page with a photo of the service user, a personal information page, a physical health page that details the physical and health needs and strengths of the service user and gives information regarding allergies, diet likes and dislikes etc. The care plan includes a pen picture of the service users life history that gives detail about the service user before moving into a care home and how they chose to live their lives, this information forms the basis of the care plan. The social interests section informs staff what they like to do and states past interests, activities of daily living and what the service user can do independently. Some of the documents were not fully completed, for example, one area stated that a service user was storing food but there was no guidance to staff on how this practice can be managed. Another example was a service user needed referral to a dietician on the 1/2/07 due to health issues identified by the hospital, there was no management plan regarding this area of care, monitoring or evaluation therefore staff are not guided to ensure the service user is getting the care that has been professionally identified. Each area of the care plan details the identified need, the goal to achieve and the action that is to be taken by staff to achieve the goal and all the care plans examined evidenced they are signed and dated by the service user or their family or representative. Monitoring and evaluation sheets are used to monitor the care plans, however, there is some confusion about recording in these areas of the care plan. One evaluation record detailed that a service user had been seen by a chiropodist to remove a corn, this information should be recorded in the monitoring of the care plan. A monitored dosage medication system is used and only staff that have completed the ‘Safer handling of medication’ training is allowed to administer medication. A medication round was witnessed following the midday meal. There were no issues and the medicines were given to service users safely. The records were completed and signed by the staff member as each medication was given out. The district nurse’s work in close contact with the staff in the home in both training and in treatment of the service users and service users have a choice of GP when they are admitted into the home. The home has recently implemented incident and accident recording records, whenever an incident occurs, the record is sent to head office. An analysis of the information is completed and Managers of the homes in the company are then given the information who is to be involved in the investigation. Hillside Grange DS0000069207.V331711.R02.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are offered the opportunity of participating in social activities, however, the activities programme still needs to be reviewed so that the activities offered matches service users expectations and lifestyles. There are no restrictions on visiting the home by relatives, friends and members of the local community. This ensures service users have the right to choose when they want to receive visitors. Service users receive good, well-presented meals, however, service users are not able to choose portion sizes. This can help to promote the general health and well being of service users. EVIDENCE: The activity coordinator has recently resigned and a new activity co-ordinator has been employed. Her duties will commence when criminal records bureau checks have been completed. Activities in which service users have participated in are recorded within the care plans, however, the records do not Hillside Grange DS0000069207.V331711.R02.S.doc Version 5.2 Page 13 detail which service users have been asked to participate, who has refused or how meaningful the activity has been. The acting Manager is currently implementing new records to ensure that all service users are included in the activities planning and this information is to be included. Comments from service users about the activities included: ‘I like to spend time in my room with my music, I love my cassettes’ ‘They have trips but I choose not to go on them’ ‘We sometimes have singers and the other day we watched Easter parade on the big screen’ The home is currently working with the company nutritionalist and service users to change the menus. The company have introduced a new book ‘Cooking with Care’ and some of these dishes will be implemented within the menus. The dining arrangements in place are pleasant, tables were well set with tablecloths, placemats, condiments, milk jugs, sugar basins and serviettes and there was a menu on each table. The meals were pleasantly presented, however, service users are still not being given any choice on the amounts of food they are being served with. Service users chatted with each other throughout the meal and were given sufficient time to sit and enjoy their meal without being hurried. In the unit caring for people with dementia, staff were observed to help and support service users in a dignified and respectful manner and sat with them to give this support. Service users made various comments about the meals they receive: ‘We get some good meals’ ‘We are not asked what we want until we get to the table, ‘The meals could be better, the food is heaped up and it puts you off before you start’ ‘The meals are really good, we always get a choice’ ‘Occasionally the meals are not very hot’ Hillside Grange DS0000069207.V331711.R02.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a detailed complaints policy and procedure. This provides service users and their families or representatives with the information they need should they have a concern or complaint about the service. Gateshead Local Authority adult protection procedures are used by the home and this helps to protect service users from any possible abuse situations. EVIDENCE: The complaints policy and procedure was reviewed and updated in September 2006 and all service users have been given a copy of the new procedure. Some parts of the procedure have been improved, if a complaint is received by a member of staff on duty, then the senior member of staff completes the information from the complainant and this information is then passed onto the home Manager to deal with. The procedure also includes details on how people can make a complaint and how the home will deal with the complaint and the timescale it will take for the complaint to be investigated. There is a complaints book that is used to detail all complaints that are made about the service, it details who made the complaint, the date, the concern made and the action taken to address it. The home do now also record any compliments made, a number of complimentary cards and letters have been Hillside Grange DS0000069207.V331711.R02.S.doc Version 5.2 Page 15 received by the home from families. When discussing complaints with service users and relatives they stated: ‘I know who to see if I am not happy, I would go to the gaffer, mind I haven’t seen her for ages’ ‘I couldn’t complain about a thing’ ‘I love living here, cannot think of anything to complain about’ ‘If I have a concern about my relative the home is quick to put it right’ All staff currently employed have received protection of Vulnerable Adults training by the company trainer. In talking to staff, they were able to discuss what they knew about POVA training and were clear about the procedures to be followed should an abuse situation arise whilst they were on duty. A POVA concern has recently been reported within the home and the company are currently investigating all issues concerning this. Hillside Grange DS0000069207.V331711.R02.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well decorated and furnished and this ensures a comfortable and pleasant environment for service users to live in. The home is clean and hygienic and this promotes a positive image for service users and ensures they remain safe. EVIDENCE: Some alterations to the upstairs unit are now complete. The dining room and lounge have been altered into one area to give service users more space to move around the unit freely. These areas have been redecorated and refurbished throughout with new carpets and new flooring. The furniture and curtains have also been replaced. Hillside Grange DS0000069207.V331711.R02.S.doc Version 5.2 Page 17 Work is being undertaken in the gardens surrounding the home to enable both staff and service users to enter a garden competition organised by Barchester Healthcare Homes. Hillside Grange DS0000069207.V331711.R02.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels have been increased and the new staffing levels should ensure there are enough staff to meet the needs of the service users. The home have not achieved fifty per cent of the care staff with an NVQ qualification. This does not ensure that staff are trained and competent to give sufficient support to service users. EVIDENCE: The service employs twenty-eight care staff and currently twelve of these staff have attained an NVQ qualification at levels two and three. The staff training matrix evidences that staff attend training courses on a regular basis and recent training includes nine staff completing ‘The safer handling of medication’. All mandatory training such as moving and handling and fire training have been reviewed and they are up to date. Staff have good training programmes in place, however, further training is required to make sure that 50 of the staff team will hold a care qualification. New staffing levels ensure there are now three staff on every shift to make sure the care needs are met and extra staff hours have been given to allow the senior care staff more time to complete the individual care plans. Hillside Grange DS0000069207.V331711.R02.S.doc Version 5.2 Page 19 In talking with staff throughout the visits, they were very positive about the home and comments they made included: ‘This is my first time working in care and I’m really enjoying it, I have had loads of training in first aid, customer care and fire besides other training’ ‘I love my job, everybody works as a team’ ‘I like working in the unit upstairs’ ‘We get good training and we are treat in a fair manner at all times’ Hillside Grange DS0000069207.V331711.R02.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good staffing systems have been put into place in the absence of the home Manager. This ensures some consistency for the people who live in the home. The home does not have a quality assurance system or quality monitoring in place and therefore cannot measure the aims and objectives that the service states they will provide in the statement of purpose. Risks to the health and safety of service users, visitors and staff are minimised. Hillside Grange DS0000069207.V331711.R02.S.doc Version 5.2 Page 21 EVIDENCE: In the absence of the Manager, the deputy Manager and a Manager from another service are ensuring the day to day running of the home continues. The home is generally kept clear of hazards to the health and safety of everyone in the home. Risk assessments are completed and regularly reviewed and staff have received health and safety and moving and handling training. However, during one of the visits, a member of staff was bringing a service user in a wheelchair from the hairdressers with one of the wheelchair footrests missing. This was notified to senior staff at the time of the visit. Hillside Grange DS0000069207.V331711.R02.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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X X 3 Hillside Grange DS0000069207.V331711.R02.S.doc Version 5.2 Page 23 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 OP7 Regulation 15 Requirement Detailed information must be included within the care plans to ensure all care needs are met A programme of activities must be developed appropriate for service users (Previous timescale of 01 Feb 2005 not met) Dining arrangements must be reviewed to include choice when being offered meals (Previous timescale of 15 Feb 2006 not met) 50 of staff must hold a qualification by the end of 2005(Previous timescale of 31 Dec 2005 not met) The Manager must implement a quality assurance system (Previous timescale of 15 May 2006 not met) Timescale for action 01/07/07 2 OP12 16 01/08/07 3 OP15 12 01/07/07 4 OP28 18 01/08/07 5 OP33 24 01/08/07 Hillside Grange DS0000069207.V331711.R02.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Hillside Grange DS0000069207.V331711.R02.S.doc Version 5.2 Page 25 Commission for Social Care Inspection South Shields Area Office 4th Floor St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: 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 © 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 Grange DS0000069207.V331711.R02.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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