Inspection on 07/04/09 for Hillside Lodge

This inspection was carried out on 7th April 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hillside Lodge 26/01/10

Hillside Lodge 20/05/08

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Hillside Lodge Spiro Close London Road Pullborough West Sussex RH20 1FG     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Beth Tye     Date: 0 7 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: Hillside Lodge Spiro Close London Road Pullborough West Sussex RH20 1FG 01798877700 01798875978 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Shaw Healthcare Ltd care home 60 Number of places (if applicable): Under 65 Over 65 0 60 dementia old age, not falling within any other category Additional conditions: 60 0 The maximum number of service users to be accommodated is 60. The registered person may provide the following category of service only: Care home with nursing (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age not falling within any other category (OP) Dementia (DE) Date of last inspection Brief description of the care home Hillside Lodge is a modern three-storey home registered to accommodate up to sixty people for personal care, dementia and nursing need. Each floor accommodates up to 20 residents who are allocated rooms dependant on their assessed need. The premises are owned by Shaw Healthcare Ltd and are built for specific purpose. The home is situated very close to shops and is on the outskirts of Pulborough village. The home has a new manager in post. Mr Antony Wosfold is in the process of registering with the Care Quality Commission. Care Homes for Older People Page 4 of 30 Brief description of the care home Fees range from approximately #360 (residential) to #829 (nursing) per week. Care Homes for Older People Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience Good quality outcomes. The unannounced inspection visit was carried out by Ms Beth Tye and Mrs Ann Peace on 7th April 2009. A pharmacy inspector, Mrs Suni Chotai, also assisted in the inspection process and looked at medication storage and dispensing within the home. The inspection was arranged to assist the Commission in assessing the homes compliance with the key standards of the national minimum standards for care homes for older people. Care Homes for Older People Page 6 of 30 Planning for the visit took into account information received on the service since the last inspection. The Annual Quality Assurance Assessment was returned to The Commission for Social Care Inspection (CSCI) and informed us of areas of improvement, which have been carried out and also identified areas for further improvement. Survey forms and comments received from people living in the home, relatives and members of staff also contributed to our planning. On the day of the visit the inspector spoke at length with the manager (new to post) and the deputy manager, and they provided relevant information. Residents living at the home, staff working at the home and visitors were spoken with to gain their views of the service, the majority of comments were positive and all residents spoken to said they like living at the home. Five sets of admission assessments and the individual plans of care for people living in the home were looked at. A case tracking exercise for these residents was undertaken to examine how their assessed needs were being met. Other records sampled included recruitment and training records for four members of staff, the record of complaints, quality assurance records and records relating to health and safety issues in the home. The premises were viewed including communal areas, kitchens, bathrooms and bedrooms. A number of interactions between people living in the home and staff, arrangements for lunch and medication dispensing and storage were observed. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 30 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is good To ensure residents needs can be met appropriately by the home, senior staff undertake a full assessment prior to admission. Each resident is provided with a written contract of terms and conditions, which is signed by all involved parties, so residents are clear about their rights within the home. This judgement has been made using available evidence including a visit to this service. Evidence: Senior staff including the manager assesses individuals prior to admission. When nursing care is required, a qualified nurse, most often the manager or his deputy, completes the pre admission assessment. Care Homes for Older People Page 10 of 30 Evidence: During the visit, pre-admission assessments were examined for six residents. These identified relevant areas of need including, nursing, mobility, communication, health and social needs. Files seen contained correspondence from external health professionals such as social services and health. Records demonstrated the information collated prior to admission is then translated into care plans and reviewed on a monthly basis by the manager. Risk assessments are in place for each of the residents and these contain information relating to their specific needs and assessed areas of risk. This promotes independence for residents in all aspects of daily living. Admissions are not made to the home until a full assessment has been completed and where relevant the necessary equipment has been purchased to meet specialist needs. All records are kept in a locked cabinet only accessible by care staff to ensure confidentiality. Residents spoken to confirmed they are given up to date information about the home prior to admission, including a Service Users guide and complaints procedure. It was noted that the current Statement of Purpose needs to be up dated with the new mangers details and the details of the Care Quality Commission. During feedback the manager stated he would ensure this was done at the earliest opportunity. During the visit one resident confirmed he visited the home and chose the room he wanted prior to admission. Visits and printed literature helps residents (and their families) to make an informed decision about moving to the home and what to expect. All residents have received a copy of their Terms and Conditions for the home, which they or their families had signed following admission. This informs residents of their rights and what to expect of the home. Care Homes for Older People Page 11 of 30 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is good. Care records set out residents needs in full. Health needs are met with the support of health professionals. Residents self-administer when assessed as safe to do so. Medication is managed safely by the home. Residents privacy and dignity is respected This judgement has been made using available evidence including a visit to this service. Evidence: Six residents care plans were examined as part of the case tracking process. Each care plan contains relevant details relating to the residents health needs and social well being. Information seen on care files was up to date and easily accessible. There was evidence to demonstrate the manager/senior staff undertake monthly reviews and up dates the care plans as changes occur. Individual risk assessments, Care Homes for Older People Page 12 of 30 Evidence: behaviour management plans and action points for staff are held on care files. This gives staff a better understanding of need and responses in addition to supporting residents to maintain independence safely where possible. Capacity and all aspects of care planning are agreed prior to admission and again during regular reviews, demonstrating that residents and their families are encouraged to participate in decision-making. Specialist health needs are referred to community-based professionals via the GP. This includes psychiatrists, occupational therapists, community psychiatric nurses and district nurses. Correspondence held in individual files supported this process and reflected that the home is pro-active in securing appropriate health care for individual need. Information on care plans demonstrated that specialist equipment had been purchased for individuals following their pre-admission assessment and before individuals moved to the home. Pressure-relieving equipment was seen in use when needed and the residents who needed nursing care had adjustable beds and air flow mattresses. Turn charts and air pressure monitoring charts were seen in residents bedrooms. However two mattresses of residents seen in their rooms were not set at the correct pressure. The manager was informed that it is good practice to put a label on the pump to ensure staff know what to set the inflation at and that this must relate to their residents weight and be re assessed every time they are weighed and checked following daily bed making. The manager stated this would be fedback to staff in the staff meeting the following day to ensure it was followed through and correct pressures were monitored. The home does use the services of a local GP surgery for all of the residents although we were told that residents could have a GP of their choice if they wished. At present District nurses visit the home to take blood tests from residents but we were told that there are plans to send the homes nurses on a course so that this could be carried out in house. Wound care folders were seen and found to be up to date with relevant policies and procedures in place. We saw a chiropodist visiting residents and the residents were taken to their rooms to have the treatment in private. Care Homes for Older People Page 13 of 30 Evidence: There is a system of named nurses or key workers who are allocated to residents to ensure continuity of care. Case tracking, feedback and discussion with the residents and their relatives confirmed good practice is maintained in the home and residents are treated with dignity and respect. We observed staff directly and indirectly and noted that they were friendly, caring and professional with the residents and the residents were at ease with the staff. One residents whose daughter was visiting had left the room for a short time the resident became quite distressed and two members of staff stopped by her chair to reassure her that her daughter would not be away long. The residents seen during the visit were very tidy in appearance wearing appropriate clothing with their nails and hair well groomed. Most residents were alert and cheerful. Staff were observed communicating with them in a caring and respectful manner. All residents spoken to said they were very well looked after they said staff are kind and caring and listen to and act on what they say. One resident on the dementia unit was very poorly on the day of our visit. They looked clean, comfortable and peaceful. We could see that the staff were looking after them very well although we asked why the resident had not been transferred to the nursing unit. We were told that the resident was used to the staff on the dementia unit, knew their voices and may have been distressed by the change. They informed us that they had re assessed the resident regularly to ensure they were still meeting their needs and records confirmed this. They had also spoken to the family and agreed not to move her from the environment she was familiar with. From this we could conclude that at the end of their lives residents and their families are consulted and cared for with sensitivity and respect. The Pharmacist inspector visited the home to access medicine management. She found overall the home has good medicine management policies which staff adhere to. The residents receive their medicines as prescribed. The records around medicine administration are good. There are three floors in the establishment and each floor has a medicine storage room, which is well equipped. Each floor has two trolleys, which are used at medicine times. The home keeps records of all medicines received, used and disposed off. There is a book to record medicines, which have been spoilt. Keeping these records means that all medicines can be accounted for. Medicine administration process follows safe practice. Medicine administration record charts were checked and in the main good records were kept. When medicine is not Care Homes for Older People Page 14 of 30 Evidence: given a code is entered in on the chart to indicate the reason for not giving the medicine. On some but not all occasions some more detail was entered on the back of the chart to give a fuller explanation for not giving the medicine. Controlled drugs were checked and found to be in order. Staff on the non nursing unit receive training from the pharmacist and also in house training on medicines. The information on the use of medicine to be taken only when needed lacked detail. This means that there may not be consistency in the use of this medicine. People would be supported to manage their own medicine if they wished to. Two people out 54 were managing their own creams. There was no risk assessment around this activity in the care plan. There is an area of improvement needed around the documentation of any selfadministration to give staff details of the exact process and any for medicine prescribed for only when needed. This documentation should be person centred and would allow for a consistent approach in the use of the medicine. The deputy manager stated she would talk to staff about improving the detail of notes taken, in line with the pharmacist recommendations. Care Homes for Older People Page 15 of 30 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is Good. Residents are able to make decisions and choices in their lives. A range of activities is offered to residents. Residents are encouraged to maintain contact with family and friends and links with the local community are maintained. Residents are offered a varied diet of good home cooked food. Dietary intake must be recorded daily for each resident in line with their assessed needs. Catering staff must all have the relevant training and qualifications to fulfil their roles. Requirements have been made in respect of these areas. Evidence: Activities are organised at the home on a daily basis, offering stimulation to those residents who are less able to explore interests outside the home. These include art and crafts, pampering sessions, music, quizzes, bingo and entertainment. Activities are displayed on community notice boards and in rooms. The home also publishes a monthly newsletter, which outlines forthcoming events within the home. Care Homes for Older People Page 16 of 30 Evidence: Residents who suffer from dementia are provided with more specialist activities relevant to their needs and capacity. These include reminiscence work, gardening and crafts. We saw staff carrying out a variety of activities during the visit which included armchair ball games and gentle exercise. Poster advertised an outside entertainer and one that had been booked was a keyboard player singer. There was also a poster advertising a Quiz night with drinks and snacks. The home has a small cinema room for residents to watch films on a big screen television. One member of staff had bought her dog to work and we could see that residents loved it being around. One relative spoken to during the visit stated the home was excellent in all areas but if she could improve anything it would be that more organised trips out were arranged The manager confirmed that there were few organised trips due to lack of activities staff. However one full and one part time post for activities co-ordinators have now been filled and both workers were due to start the following Monday. Following this, the manager said he intends for each resident to undergo an in depth social assessment which will enable workers to provide activities and leisure pursuits specific to individual interests. Residents will also benefit from more one to one time with workers and participate in more organised trips out. One resident was spoken to and confirmed the home had provided him with gardening equipment, grow bags and a small green house. He was delighted that this enabled him to keep up his long term passion for gardening. Other residents confirmed that they could choose what they want to do in respect of social events and also what times they go to bed and get up in the morning. Flexibility in the home enables individuals to have choice and express a preference in their daily routines. Residents and relatives confirmed that the visiting arrangements for the home are open and visitors can come and go as they please and are made welcome by the staff. Residents meetings are held once a month and relatives meetings every three months. These meetings give the residents and their families the opportunity to comment on how they view the home and contribute to decision-making. Staff escort residents to community events and appointments as required. The menu offered at Hillside Lodge offers a wide range of balanced, home cooked food. The cook takes in to account the preferences of residents and specialist dietary needs. Residents confirmed they can choose where they want to eat, either in the dining area, lounge or bedrooms. This promotes choice for the residents and provides an Care Homes for Older People Page 17 of 30 Evidence: opportunity for them to eat what and where they prefer. In the main, food is served in separate dining rooms on each floor of the home so staff can monitor and assist as required. The meals served on the day of the visit were Lancashire Hotpot or Pasta Bolognaise. Residents seemed to enjoy the food. During observation of the lunch time meal, it was noted that on the dementia unit some meals were taken away untouched. This was despite some care plans stating that residents were to be supervised and encouraged to eat. Records seen during the visit showed that most residents had gained weight since admission to the home and weight and dietary needs are recorded on individual care plans. However, daily nutritional intake is not being fully recorded on daily record charts. This means the home is not able to demonstrate the residents were receiving the nutrition they needed. A requirement has been made in respect of this. The inspectors spoke to the cook during the visit who was covering for the main chef whilst she was on annual leave. Although she had prepared a nutritious home cooked meal for the residents, she stated she did not have basic training in hygiene or food handling. A requirement has been made to ensure all staff within the home under-take the necessary training for their roles and responsibilities (see staffing). Care Homes for Older People Page 18 of 30 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is good Residents who use this service or their representatives are able to express concerns, and have an access to an effective complaints procedure. Residents are protected from abuse and have their rights protected. This judgement has been made using available evidence including a visit to this service. Evidence: The home has a complaint procedure, which is outlined in the statement of purpose and displayed in the home. Complaints are recorded and investigated with feedback to complainant within 28 days with the actions taken. All residents and visitors spoken to said they knew who to complain to and that they would do so if they thought it appropriate. During the visit the complaint book was seen and four complaints had been recorded since the last inspection. All had been dealt with appropriately within procedural Care Homes for Older People Page 19 of 30 Evidence: timescales. Staff induction and training records indicated that all staff receive training in safeguarding vulnerable adults. Staff spoken to, (including ancillary staff on duty) did know what to do if they suspected abuse. Staff personnel files seen during the visit, were in good order and held all appropriate checks and references. This ensures residents are safeguarded from risk of harm. Information on advocacy services is displayed and is accessed if needed. Care Homes for Older People Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is excellent The home offers a high standard of comfort and facilities for the people who live there. Bedrooms are all individually personalised and the home is clean, pleasant and hygienic. This judgement has been made using available evidence including a visit to this service. Evidence: It was evident from the visit that Hillside Lodge is decorated and maintained to a high standard. The home is modern and built for purpose. The premises are laid out over three floors with a staff team designated to each floor. Communal areas are furnished with flowers, ornaments and pictures, which give the environment a homely feel. The standard of cleanliness and furnishing throughout the home is high. Residents and relatives commented on the cleanliness and lovely decor of the home. Private accommodation is decorated and furnished to a high standard to suit the needs Care Homes for Older People Page 21 of 30 Evidence: of individual residents. Residents are encouraged to personalise their own bedrooms to give them a sense of ownership. The majority of the bedroom doors have automatic closure fitted which would close in the event of a fire. The dining rooms on each floor are attractively presented. There are also separate modern kitchen areas on each floor so staff can prepare snacks and drinks as needed, away from the main kitchen area. In addition to en-suite facilities the home has shared toilets, which provide ample facilities to the residents. There are hoists, bath aids and specialist nursing equipment to promote the independence of those who require assistance with personal care and nursing needs. Anti bacterial soap was evidenced at shared sinks. Laundry and sluice facilities are provided. Policies and procedures are in place for infection control, and all of the staff have attended relevant training for infection control and health and safety procedures. This promotes good practice in the area of safety and welfare for the residents and reduces the risk of infection spreading within the home. There is a passenger lift for residents with limited mobility to access all floors of the house. All radiators throughout the home have been covered. Records indicated that the temperature of the baths are taken before bathing residents to prevent risks of scalding. A call bell system is provided in every room so staff can attend an emergency situation swiftly, should it arise. The maintenance log showed all maintenance was completed as required on a regular basis. This means the residents environment is kept safe and well maintained at all times. Care Homes for Older People Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is Good There are sufficient staff on shift to meet the residents needs appropriately. Residents in the home are supported by a committed, caring and trained staff team. Recruitment records are in good order. Staff work hard to maintain a safe environment for the residents. This judgement has been made using available evidence including a visit to this service. Evidence: Recruitment policies and procedures are in place, to ensure staff employed by the home have the necessary skills and experience to fulfil their roles. CRB checks, terms and conditions and reference checks were seen on file for staff members. This ensures that residents are protected in the home. It was concluded from examining the duty rotas, speaking to staff, residents and relatives that current staffing levels are now sufficient to fully meet the needs of residents. The home does use agency staff to cover shifts but the majority of the staff at the home are employed on a permanent basis. This promotes consistency of care for the residents. Care Homes for Older People Page 23 of 30 Evidence: The relatives and staff spoken to during the visit confirmed that staffing had significantly improved as agency workers are used less and regular staff are now known to residents. This was supported by staff when spoken to about individual residents. They were knowledgeable about individual needs and their responses were in line with care plan requirements. The manager also confirmed he has recently had a large recruitment drive and has appointed several new full time staff members. He is currently awaiting CRB checks before agreeing start dates for some, others are already in post. This will continue to improve staffing levels and consistency of care practice within the home. People using the service and their relatives feedback that the staff in the home meet needs very well and are very committed. One relative stated that the home and the people who work here are wonderful, I couldnt ask for better care for my mother. Records show that staff complete a four day induction at the start of their employment, then go on to undertake a mandatory training programme appropriate to the needs of residents. Staff also, undertake more specialist training in respect of health care needs such as dementia and mental health issues. The cook at the home (who was covering in the main cooks absence) spoke with inspectors. Evidence seen confirmed that she had completed basic mandatory training in respect of her role and responsibilites. All staff members spoken to during the visit, demonstrated commitment and enthusiasm for their roles and most had a good understanding of the residents health and social care needs. Staff members knew the residents individual preferences and were confident in their roles and responsibilities. Care Homes for Older People Page 24 of 30 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is Good. There is a full time manager in post at Hillside but he has not yet completed the registration process with the Commission. A requirement has been made in respect of this. Service users financial interests are safeguarded. The health, safety and welfare of residents are promoted and there are good administration and record keeping systems in place to support this. This judgement has been made using available evidence including a visit to this service. Evidence: The inspector noted considerable improvement in respect of requirements made at the last inspection. Care Homes for Older People Page 25 of 30 Evidence: The home has a full time manager and deputy manager in place. The manager has not yet been registered with the Care Quality Commission as his application is still underway. The new manager is a qualified mental health nurse with management experience in the NHS. The deputy manager has had several years experience managing residential homes. A team leader oversees each floor of the home, with the support of management. Staff and relatives spoken to stated they found the management very approachable and easy to talk to another said of the manager he is very hands on, he gets involved and has a good grasp of what staff and residents need. Both managers emphasised their willingness to support staff and get involved (when needed) in day to day practice issues in order to ensure the home runs smoothly. The manager expressed his enthusiasm at making further improvements to the home to improve its current quality rating. A number of new staff members have recently been recruited to Hillside and are either in post or awaiting CRB checks. Feedback from staff, residents and relatives, rotas and recording in the home demonstrated that this has considerably improved the permanent staffing levels within the home and reduced the use of agency. This has improved practice in the home and provides consistency of care to residents. Previous requirements from the last inspection have now been met. Residents were observed expressing their views confidently and staff responded with consideration and respect, reflecting a positive ethos within the home. The home seeks the views of involved parties through regular staff, residents and relative meetings. Minutes of these meetings are kept on file within the home. Records demonstrated that staff are provided with regular supervision no less than six times annually. In addition staff are required to attend regular staff meetings to discuss practice issues and give them the opportunity to contribute towards decisions made within the home. There are administrative systems at the home to promote all aspects of health and safety. The inspector examined health and safety records including fire checks, accident book, maintenance checks, water temperatures and environmental risk assessments. Records required to be kept by legislation were in good order and up to date. All care records are kept in a locked cupboard to maintain confidentiality. The policy of the home is not to manage the financial affairs or handle large sums of money for the residents and any expenditure on the residents behalf is billed to their Care Homes for Older People Page 26 of 30 Evidence: representative to manage for them Shaw Healthcare has quality assurance procedures in place, which are used to inform the business plan. Questionnaires are sent out annually and the results once published, are available to any involved parties. Care Homes for Older People Page 27 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 28 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 15 17 The registered person must ensure staff maintain suitable daily records relevant to individual need Nutritional records are not kept up to date in line with care plan requirements 30/07/2009 2 31 8 The person managing the home must be registered with CQC The current manager has not yet registered with the Commission. 30/07/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 29 of 30 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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