Inspection on 15/05/06 for Hillside Nursing and Residential Home

This inspection was carried out on 15th May 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 Nursing and Residential... 16/05/07

Hillside Nursing and Residential... 02/11/05

Hillside Nursing and Residential... 12/05/05

Hillside Nursing and Residential... 28/01/05

Hillside Nursing and Residential... 11/11/04

Hillside Nursing and Residential... 15/01/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Hillside Residential Home 20 Kings Hill Great Cornard Sudbury Suffolk CO10 0EH Lead Inspector John Goodship Key Unannounced 15th May 2006 10:00 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 DS0000024418.V294422.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. DS0000024418.V294422.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Hillside Residential Home Address 20 Kings Hill Great Cornard Sudbury Suffolk CO10 0EH 01787 372737 01787 319506 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) Stour Sudbury Limited Mrs J Warner Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places DS0000024418.V294422.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd November 2005 Brief Description of the Service: Hillside Residential Home is owned by Stour Sudbury Limited, part of the Caring Homes organisation. The home is a large detached building located in a residential area on the outskirts of Sudbury. Although there are no shops within walking distance, there is a Public House located close by, and the town of Sudbury offers a range of shops and amenities. The home is located on 2 floors, with bedrooms, communal toilets, bathrooms, lounge and dining room on each floor. There is a passenger lift and stairs to the first floor. All 40 single rooms have a wash hand basin, with 24 also having en-suite toilet. There is a patio/decking area, with a wheelchair accessible path leading down to the adjacent home (Mellish House - owned by the same company) and car park. Fees: £331 - £500 pw DS0000024418.V294422.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first inspection of the home under the Commission’s new procedure “Inspecting for Better Lives”. As much time as possible was spent talking to residents to gather their opinions about how they lived and how well they were cared for. The manager was present throughout the visit, which lasted 6.25 hours. The inspector toured the building and spoke to the staff as well as residents. There were no relatives visiting during the inspection although four had completed Comment Cards. Any comments have been incorporated into the appropriate section of this report. What the service does well: What has improved since the last inspection? Following requirements and advice from the Commission’s pharmacy inspector in November 2005, the home has changed its drug administration procedures to ensure the safety of residents. These procedures are now audited fortnightly by the manager to ensure they are being followed. The competence of staff is re-assessed annually. Food safety has been improved by the introduction of the new legal requirement for hazard analysis of the whole catering operation. This is regularly monitored by the manager to ensure compliance. All checks are now recorded. An additional sixteen hours has been added to the staffing of the laundry staffing to improve the quality of this service. DS0000024418.V294422.R01.S.doc Version 5.1 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. DS0000024418.V294422.R01.S.doc Version 5.1 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 DS0000024418.V294422.R01.S.doc Version 5.1 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): 1,2,5. Standard 6 is not relevant to this home. Quality in this outcome area is good. Information which is provided to prospective residents is up-to-date. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents’ survey forms confirmed they have received contracts as required by Standard 2. One resident said they had visited the home before making their mind up to come and live there. The Statement of Purpose and the Service Users’ Guide were last revised in March 2006 as part of an application for a variation. However the fees were incorrect. The manager revised that page while the inspector was there. DS0000024418.V294422.R01.S.doc Version 5.1 Page 9 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. Quality in this outcome area is good. Residents can expect staff to monitor their care needs and take appropriate action. Medication procedures now protect the safety of residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A sample of care plans were examined. These showed a similar format throughout, conforming to a policy of regular, usually monthly, reviews. One resident confirmed they were involved in care planning and the annual reviews. Care plans recorded this. Appropriate risk assessments were complete and were reviewed monthly. There were the appropriate consents as well as a record of the visits by health professionals. All residents were subject to the Malnutrition Universal Screening Tool, which collates information on a persons body mass index, weight loss and the presence of acute disease. One residents care plan had a nutrition plan, with aims and objectives and care interventions. It was dated 10 April 2006 and was reviewed on 1st May 2006. DS0000024418.V294422.R01.S.doc Version 5.1 Page 10 A second residents plan recorded that the monthly record of their weight showed that it had remained stable for the last three months. The one resident who was bedfast was under supervision by a dietician from the local General Hospital. This was recorded in the care plan. A Stand-aid had been identified by staff as equipment needed to assist in moving and handling. The home’s manager had made a request for this to the Regional Manager. One resident described how staff supported them to dress in the morning although they were able to wash themselves. The staff “are always willing to help and are supportive.” The Commission’s pharmacy inspector had visited the home in November 2005 following major shortfalls identified at the previous inspection. A number of requirements and recommendations were made. The opportunity was taken at this visit to confirm that all procedures and records now met Standard 9. The manager presented the records of the fortnightly audit, which they carried out. This was done with a checklist format and included a ’Corrective action sheet’ where necessary. The manager also gave each member of care staff responsible for administering drugs an annual competency assessment. An example for a senior carer was examined. There were now two drug trolleys for the rounds, a new one for the ground floor, and the existing one for the first floor. A sample of Medication Administration Record (MAR) sheets showed no gaps in signatures for administered medication. Part of the midday medication round was observed. Two staff were involved, with one of them dispensing and signing and the other checking and maintaining the security of the drugs. Following a new admission during the inspection, a member of staff was seen recording all the medication, which the person had brought in with them. The manager reported that in line with company policy the pharmacy supplier was changing. There was a local branch nearby so there should be no reduction in the level of service. Training records included certificates of staff who had passed medication training both by the pharmacy supplier and by an external training agency. It was noted that the staff used one of the communal rooms for their breaks. They said that they also used this room for writing the daily report and care plan updates. There was one resident in the room with the staff when the inspector joined them. There were few spare chairs left. DS0000024418.V294422.R01.S.doc Version 5.1 Page 11 It should be possible to find a private area for staff breaks and for report writing that does not interrupt the residents’ use of a communal area, nor risk infringing privacy and confidentiality. DS0000024418.V294422.R01.S.doc Version 5.1 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): 12,13,15. Quality in this outcome area is good. There are many opportunities for residents to participate in activities. More action could be taken to enable residents to make trips outside the home. Stricter auditing of food safety ensures that residents receive a safe catering service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home had a dedicated activities organiser who worked each weekday afternoon. They had developed a varied programme for the week, which split the time up into small segments to retain interest and participation. The activities on the day of inspection was scheduled for half and hour of general conversation about the topics of the day, arts and crafts for an hour and a half, tea and cakes, bingo for three-quarters of an hour and board games for the same length of time. The organiser said that by far the most popular and bestattended session were the sing-a-longs. Activities took place in the first floor dining room. The inspector noted that the person who had been admitted that day was attending the session. The organiser helped to introduce this person to the others who appeared to welcome them and chat to them. There were photographs in the room of residents in the Easter bonnets which they had made. DS0000024418.V294422.R01.S.doc Version 5.1 Page 13 One resident told the inspector “I really enjoy the activities”. “Are we going out on trips in the summer?” The manager stated that she was hoping to borrow the minibus from another home to enable these trips to happen. However no firm arrangements for the staffing and driving of this minibus had yet been made. Other activities planned for the summer included a clothing sale, quiz night (very popular according to residents), a tea dance, a BBQ, and visiting singers. Visitors were always welcome in the home. Several residents described how often their visitors came, to the inspector. One resident described how they had made friends with some regular visitors to another resident. “They always come over and chat to me.” The kitchen staff were preparing lunch, which was either liver, pasty or corned beef. The cook said they had several people on a diabetic diet, and one person who required their meal to be liquidised. Care staff were observed serving the meals in the two dining rooms in a helpful and unhurried way. The food looked appetising and was of sufficient quantity. One person required their meat to be cut up, but then all present were able to continue their meal unaided. One resident told the inspector that “the food is nice, particularly the steak and kidney pudding”. Following a very critical report from the Environmental Health Officer in March 2006 concerning the system of food safety management at the home, the manager had instituted a programme of regular checks on catering records and Hazard Analysis and Critical Control Points records. These checks were recorded and were filed in an Audit file with other quality checks. DS0000024418.V294422.R01.S.doc Version 5.1 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): 16,17. Standard 18 has been assessed as met at a previous inspection. Quality in this outcome area is good. Residents and relatives can be assured that their concerns and complaints will be investigated and action taken. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There had been one complaint to the manager in March from a relative concerned about the amount of items stored in a resident’s room. These were moved to a storeroom. The relative wrote on their comment card that they had made “a small complaint which had been dealt with in a caring, considerate and speedy way”. The whistle-blowing policy was examined and was correctly worded to assure staff of their right to confidentiality. Residents who wished to vote had been registered for postal votes. DS0000024418.V294422.R01.S.doc Version 5.1 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): 19,20,21,22,23,24,26. Quality in this outcome area is adequate. The home has a rolling programme to improve the decoration, fixtures and fittings. There are some areas that need this urgently. Sometimes maintenance requests take some time to be actioned. The shortage of assisted bathrooms or shower rooms reduces the choice to residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The provider was planning to increase the size of the home by 3 beds overall. A formal application would be made to the Commission when the building was further advanced. It had been noted at the last inspection that some of the wooden sash windows were not working properly as they were rotting. The manager stated that a replacement programme would be undertaken as part of the extension plans. DS0000024418.V294422.R01.S.doc Version 5.1 Page 16 The laundry floor was dirty and the covering was not over the whole floor and the flooring provided was not impermeable. This was a potential hazard. The walls had been repainted, and sorting racks had been built in. However, one relative commented that their relative’s clothes sometimes went astray. They suggested this was because the staff did not have the time to sort out the washing. The home had recently increased the staffing of the laundry by 16 hours to improve the quality of this service. The home had stopped using the automatic dosage system for the washing machines. According to the manager, this had not washed the clothes properly. It was not possible to talk to the laundry assistant as they were off sick, and were leaving shortly. Care staff were covering. This would not be satisfactory except as an emergency measure, as no additional care staff were rostered on duty. Previous inspection reports have noted that few of the bathrooms were suitable for the needs of the residents. In fact there were only two usable assisted baths in the home. One of these was not large enough for the manoeuvring of a person in a wheelchair. Other bathrooms were only used as WCs, as the baths in those rooms were only of the domestic type without appropriate handling equipment. A shower room was unusable as it had a high step-over tray. The national minimum standard for homes registered since April 2002 requires one assisted bath per 8 residents. A properly designed shower room, sometimes known as a wet room, can be included in the ratio. However homes were permitted to be registered with the bathrooms they had in 2002, provided that number did not decrease. It appeared that the provision of assisted bathing facilities had not developed to meet the changing needs of the residents. The Commission would expect that the improvement in assisted bathroom provision could be addressed during the planned extension project. The WC next to room 45 was extremely small, and inaccessible to any resident with a walking aid. There was no wash hand basin or alternative form of hand cleansing. The inspector noted that parts of the home were extremely hot. This was commented upon by the staff also. The manager stated that they had asked for the thermostats to be checked but this had not yet happened. The bedrooms which were visited all showed evidence of being personalised by the occupant, with the decor, photos, pictures, television and radios. DS0000024418.V294422.R01.S.doc Version 5.1 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): 27,29. Standards 28 and 30 have been assessed as met at the previous two inspections. Quality in this outcome area is good. The home can now demonstrate safe recruitment procedures, which protect residents. The number of staff rostered on duty is sufficient to support the needs of the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staff rota for the week was examined. All shifts were planned with the appropriate staffing levels. The number of care staff rostered and present on the early shift on the day of the inspection was sufficient for the needs of the residents. A member of staff volunteered to come in from off-duty to cover a last minute withdrawal from duty due to sickness. This confirmed the home’s plan discussed at the last inspection that, once all vacant hours were filled, this would enable short notice gaps in the rota to be filled by in-house staff. The home had no current care vacancies. There was one vacancy for a part-time kitchen assistant. Three out of the four comment cards received from relatives said that there were always sufficient staff on duty. Two residents said there was “always” staff available when needed, and one said there was “usually” staff available when needed. DS0000024418.V294422.R01.S.doc Version 5.1 Page 18 During the inspection, an external trainer arrived to give two members of staff (including one from the adjacent home) food hygiene refresher training. The files for recently recruited staff were examined. All contained the correct documentation and pre-employment checks. Training records showed that there was a full induction and training programme for each person, with a Skills For Care log with dates and signatures. The home had some staff accommodation on and off site as it recruited people from abroad particularly the Philippines and Poland. The staff from overseas who were on duty during the inspection demonstrated they had sufficient command of English to communicate with residents. It was noted that the staff used one of the communal rooms for their breaks. They said that they also used this room for writing the daily report and care plan updates. There was one resident in the room with the staff when the inspector joined them. There were few spare chairs left. It should be possible to find a private area for staff breaks and for report writing that does not interrupt the residents’ use of a communal area, nor risk infringing privacy and confidentiality. DS0000024418.V294422.R01.S.doc Version 5.1 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): 36,37. All other standards have been assessed as met during the two previous inspections. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be assured that there is a system for obtaining their views on the running of the home. A process of staff supervision protects residents, although the schedule has slipped. EVIDENCE: There was a programme of staff supervision, but not all staff were up-to-date with their scheduled sessions. The provider company had a system of monthly audits by the Regional Manager, with a full audit of the home annually. The latest one was dated May 2006. It required an assessment of all areas of the operation of the home, together with any remedial action required. DS0000024418.V294422.R01.S.doc Version 5.1 Page 20 The provider also issued an annual questionnaire to residents. The latest one went out in January 2006. Only three were returned and no particular issues were raised. There was a notice in the dining room advertising the monthly residents and relatives’ meeting. The manager reported that no relatives attended the last one, so it became a discussion with the residents. The inspector’s discussions with residents showed that they were most appreciative of the work and attitude of the staff. DS0000024418.V294422.R01.S.doc Version 5.1 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 3 3 X X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 2 2 2 2 3 3 2 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 X X X X X 2 3 X DS0000024418.V294422.R01.S.doc Version 5.1 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 OP10 Regulation 12 (4)(a) Requirement The registered person must ensure that residents have access to communal areas at all ties, and that privacy and confidentiality are maintained. The registered person must produce an action plan to the Commission showing how the ratio of assisted bathrooms/shower rooms will be improved. The registered person must ensure that the heating system and its controls are maintained at all times. The registered person must provide an hygienic and complete covering for the laundry floor. The registered person must report to the Commission on how the WC next to room 45 can be made suitable for use. Timescale for action 30/06/06 2. OP21 23(2)(j) 31/07/06 3. OP25 23(2)(p) 30/06/06 4. OP26 13(3) and 16(2)(j) 23(2)(j) 30/06/06 5. OP26 30/06/06 DS0000024418.V294422.R01.S.doc Version 5.1 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP36 Good Practice Recommendations The registered person should ensure that the staff supervision schedule is kept up-to-date. DS0000024418.V294422.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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 DS0000024418.V294422.R01.S.doc Version 5.1 Page 25 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!