Inspection on 06/09/06 for Hillside Lodge

This inspection was carried out on 6th September 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 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 Lodge 11/09/07

Hillside Lodge 30/11/05

Hillside Lodge 17/06/05

Hillside Lodge 21/03/05

Hillside Lodge 25/08/04

Hillside Lodge 09/03/04

Hillside Lodge 17/07/03

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

CARE HOMES FOR OLDER PEOPLE Hillside Lodge Braeside Berwick Upon Tweed Northumberland TD15 2BY Lead Inspector Suzanne McKean Key Unannounced Inspection 6th September 2006 09:30 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 Lodge DS0000048297.V296320.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Hillside Lodge DS0000048297.V296320.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hillside Lodge Address Braeside Berwick Upon Tweed Northumberland TD15 2BY 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) 01289 307500 01289 308566 hillside.lodge@fshc.co.uk www.fshc.co.uk Tamaris Healthcare (England) Limited (wholly owned subsidiary of Four Seasons Health Care Limited) Mrs Margaret Shippen Care Home 50 Category(ies) of Old age, not falling within any other category registration, with number (50) of places Hillside Lodge DS0000048297.V296320.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Two named service users are under 65 years of age. The Commission for Social Care Inspection must be notified immediately should this service user leave the home so that this condition can be removed. 30th November 2005 Date of last inspection Brief Description of the Service: Hillside Lodge is a two-storey purpose built facility of traditional brick and tiled construction. The home is situated in a residential area of the town of Berwick. Car parking areas are provided at the front of the building giving level access to the home. There are grassed sitting areas, which can be used by residents and visitors. The surrounding area is predominantly residential. There are bedrooms and shared areas on both floors and there is a lift in the centre of the home near the entrance. All of the bedrooms are single occupancy with en-suites containing a toilet and hand basin. There are showers and bathrooms and toilets situated on each of the floors and dining areas and lounges of appropriate size to meet the number of resident in the home. The home charges fees of between £378.45 and £380.42 per week depending upon the needs and requirements of the individual residents. As the home provides nursing care the free nursing care element of the funding is provided in addition to the costs charged to the resident. The nursing care medium band is currently £83 pounds and the high band is £133. The home provides information about the service through the service user guide and a copy of the last inspection report from The Commission for Social Care Inspection is available in the entrance to the home Hillside Lodge DS0000048297.V296320.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over 9 hours by one inspector during two visits. It covered all of the core standards. Ten residents and six relatives were spoken to directly, although more were chatted to briefly. Three staff were spoken to and asked for their views. Four care plans, training records and the records for medication, staff files training, and health and safety records were examined. There were no requirements made during the last inspection and two recommendations. Both of the recommendations were met. One requirement was identified during the first visit of this inspection although this had been met by the second visit. What the service does well: What has improved since the last inspection? There were no requirements made at this inspection and only two recommendations identified. The record of social activity is now being completed in greater detail to show the variety of things going on in the home and who is involved. Following the last inspection the Manager purchase a large food processor to allow kitchen staff to prepare “pureed diets” more easily. Hillside Lodge DS0000048297.V296320.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Hillside Lodge DS0000048297.V296320.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hillside Lodge DS0000048297.V296320.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3, 4, & 6 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The Manager ensures that residents being admitted can have their needs met. She makes sure, before admission, that any equipment needed is available and that the staff have the skills to care for them safely. Residents and relatives are given information about the home prior to admission and are encouraged to visit and spend time looking around. All residents are given a written contract / statement at the time of admission. The home does not provide intermediate care. EVIDENCE: The care plans which were case tracked (detailed examination of specific residents care plans and discussion with the service users and named Key Worker/Nurse) contained the care manager assessments, which are carried out before admission and given to the home. Hillside Lodge DS0000048297.V296320.R01.S.doc Version 5.2 Page 9 The home had carried out a comprehensive assessment of the prospective residents needs prior to admission for planned placement. In the case of more urgent admissions staff speak to the social worker involved to get as much information as possible. The admission assessment for the service users whose care plans were examined, were detailed and contained the necessary information on which to base a plan of care. Records showed that the residents have been issued with a copy of the company contract / statement of contract. Hillside Lodge DS0000048297.V296320.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10, 11 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Individual care planning is undertaken and the care is being delivered in line with these plans. The residents are having their needs met. Residents feel that the staff treat them with respect and maintain their privacy so far as possible when delivering care and throughout their daily life. The residents received their prescribed medication in line with safe working practices. Medicines are well managed and safely disposed of when necessary. The staff provide sensitive care and support relatives at the time of resident death using specialist advisors as necessary. EVIDENCE: All residents’ case tracked had an individual plan of care. This is based on the admission assessment and is then added to during the placement. Four care plans were examined and were completed to a good standard. There were relevant risk assessments and care planning for the prevention of falls, Hillside Lodge DS0000048297.V296320.R01.S.doc Version 5.2 Page 11 nutrition, wound care, moving and assisting, continence promotion and mental health. The plans showed that they are regularly reviewed and updated and that reviews are regularly held with residents and their representatives. The care plans showed that the residents have access to all NHS services and facilities. There was a good range of pressure relieving mattresses in use for the prevention of pressure sores. There are currently no resident who have pressure damage. The recording of the nursing action taken for wound care of a resident who was admitted with a wound (now healed) was good with evaluations being dated and signed. Daily recording of the care being delivered was up to date and in good detailed. The home has good links with the clinical specialists in the area and evidence was in the care plans that these are used for specific advice in relation to end of life care. The staff have received additional clinical training so that they can prevent residents from needing to be re-admitted into hospital for some procedures e.g. replacement of gastrostomy tubes. Residents interviewed confirmed that the staff treat them with respect and contacts between staff and residents through the day was judged to be polite and courteous but friendly. A resident interviewed on the day said the staff are always helpful” and “I couldn’t manage if the staff weren’t as friendly as they are”. The system for managing medicines is appropriate. Staff record the medicines being ordered. The prescriptions are then checked on receipt from the General Practitioners and are then sent to the Chemist for dispensing. The medicines are then again checked against the records when received into the home so that any errors can be picked up. The home has a contract with a Pharmacist, which includes giving advice as necessary. No residents are currently managing their own medication. The treatment room was tidy and well organised. Hillside Lodge DS0000048297.V296320.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Residents are satisfied with the flexibility of their routines for daily living, which are appropriate to meet their cultural, social, religious and recreational interests and needs. Arrangements for residents to maintain contact with their family and friends and the local community are suited to each individual’s needs and vary accordingly. The food being served offers a nutritious and balanced diet with choice and variety. The catering staff work hard to accommodate individual residents’ needs within the restrictions of multi-occupancy living. EVIDENCE: Residents spoken to confirmed that they are encouraged to take control of their daily routines in simple but important ways including the time they get up, what and when they eat and how they spend their time. They also confirmed that they are able to make choices about how they spend their day and said they were satisfied with the activities available. Some organised activities are available and staff said that residents are able to choose whether Hillside Lodge DS0000048297.V296320.R01.S.doc Version 5.2 Page 13 or not they are involved. However, due to the dependency level of some of the residents a number of the activities offered are less active and provided on a more one to one basis. The home employs an activities co-ordinator for 15 hours per week. She has organised a weekly programme of activities offering differing opportunities. The social programme is now being developed to offer individualised activities for the residents in line with their social assessment. The records of the activities provided are now more detailed and include some outings, the weekly tea dance, bingo and entertainers. The residents’ bedrooms were personalised reflecting individual choices and preferences and three residents asked about their bedrooms said they were happy with the decoration. Residents have visitors at any time and are able to use their own rooms, or the lounges to receive them. Four relatives spoken to on the day confirmed that they are welcomed to the home. Relatives are given information within the residents’ guide about visiting arrangements. Residents said they were satisfied with the arrangements for visitors and that staff welcome them. Hillside Lodge DS0000048297.V296320.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. A complaints policy is in place, which is known to residents, relatives and staff. It describes the system for managing complaints. The residents are protected from abuse by staff training, recruitment and selection and effective documentation. EVIDENCE: The complaints procedure is available in the service users guide and a copy is displayed in the home. The record of the complaints was examined. There have been three complaints recorded in the last 12 months. The record of complaints was detailed including the response to the complainant improvements made in relation to the issues raised. Four of the residents spoken to understood how to make a complaint, and chow it would be dealt with. Three visiting relatives were aware of the complaints procedure but had not needed to use it. Staff are given protection of vulnerable adults training both as part of the inhouse training package and from the training programme. Written guidance is in place regarding the protection of vulnerable adults through detailed policies and procedures. Staff knew about the guidance and could identify the action they would take if they were made aware of, or had any concerns themselves, regarding this issue. Hillside Lodge DS0000048297.V296320.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. The home is clean and well organised and the staff are knowledgeable regarding the ways to prevent the risk of cross infection in the home. The environment is well decorated and maintained. Good records are maintained of the health and safety practices and maintenance of the building and facilities. EVIDENCE: A tour of the home was conducted both with staff and alone; the home is clean and was odour free on the day. The residents’ who were asked about their bedrooms said they were happy with the decoration and that they were kept clean by the staff. The bathroom and toilet areas were tidy and clean. The laundry was clean, organised and well equipped. The sluices were tidy, clean and odour free and the disinfectors operational. Hillside Lodge DS0000048297.V296320.R01.S.doc Version 5.2 Page 16 Staff were observed to follow infection control policies throughout the day. Appropriate equipment was available except that the gloves being used by staff were not appropriate for providing personal care. This restricts the ability of staff to make sure that control of infection procedures are adequate. Advice was sought from the Communicable Disease Team regarding the type of gloves needed. These gloves were available in the home. Additional supplies were purchased and all staff issued with them and given written guidance for their use. On the second visit staff were using them appropriately. The kitchen area was clean and well organised and there is an up to date cleaning schedule which identifies all areas to be cleaned, how often they are completed and who was responsible for undertaking it. Hillside Lodge DS0000048297.V296320.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. The home has an effective recruitment and selection system, which ensures that residents are cared for by competent staff and are in safe hands. The training programme is up to date for all staff and a significant amount of training is being given to the staff in health and safety, statutory and clinical areas of practice. EVIDENCE: Staff records examined are completed in line with the company policies and procedures, including two references and a completed application form. The requirement to have a CRB and POVA check in place is applied to all of the staff in the home. On the day of the visit there were sufficient staff on duty according to the needs of the residents in the home. This was the Manager, two qualified nurses (one of which was the Deputy Manager), five carers, two domestic, the cook, one kitchen assistant, and the administrator. The training records maintained by the Manager to allow her to plan for training was examined, it was very clearly maintained and offered a good system. There is a significant amount of training in both statutory and clinical areas of practice and all staff are now receiving training in line with the company policy and statutory requirements for moving and handling and fire training. Hillside Lodge DS0000048297.V296320.R01.S.doc Version 5.2 Page 18 Staffing rotas are now being produced monthly, which allows staff to maintain a work life balance. The Manager can also plan for covering shifts when sickness occurs. She is currently recruiting care staff and this will offer a greater flexibility and should ensure that other staff do not need to cover additional shifts to often. Hillside Lodge DS0000048297.V296320.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. The Manager, Mrs Shippen, has systems in place to manage the home effectively taking into account the needs and wishes of the residents. The home effective health and safety systems, which include staff training and risk assessments. Resident’s personal finances are managed appropriately. EVIDENCE: There is a system in place to review health and safety in the home involving the staff for which records are available. Records were examined of the staff meetings, which take place regularly, and the contents of these suggest that there is broad spectrum of relevant issues discussed. Those staff unable to attend are required to access to the notes from the meetings to ensure they Hillside Lodge DS0000048297.V296320.R01.S.doc Version 5.2 Page 20 are up to date with the information they need. The Manager also facilitates meetings with the relatives and residents as appropriate. Mrs Shippen continues to consult the residents, staff and other interested parties to review the service provided and manage the staff in a way to improve care delivered. There have been resident and relative questionnaires last year and they are due again in the near future. Regular audits are carried out in a number of areas. These include Medication; care planning and nursing documentation, kitchen, and domestic audits. These are ongoing and are used for quality assurance at both the local home level and by the company. The personal records kept in the home of residents who are receiving assistance to manage their finances were examined and are detailed, logical and appropriate. Receipts were in place for purchases made on behalf of residents and signatures of either two staff or one and the service user were in place. There is a system in place to review health and safety in the home involving the staff for which records are available. Training records are in place and are up to date. Hillside Lodge DS0000048297.V296320.R01.S.doc Version 5.2 Page 21 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 3 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Hillside Lodge DS0000048297.V296320.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP26 Regulation 13 (3) Requirement There must be suitable and sufficient gloves and aprons available for staff use to improve the control of infection procedures. Timescale for action 01/10/06 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 Lodge DS0000048297.V296320.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 Lodge DS0000048297.V296320.R01.S.doc Version 5.2 Page 24 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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