Inspection on 02/11/05 for Hillside Nursing and Residential Home

This inspection was carried out on 2nd November 2005.

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... 15/05/06

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

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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 Jill Clarke Unannounced Inspection 2 November 2005 9.10 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 Residential Home DS0000024418.V262734.R01.S.doc Version 5.0 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 Residential Home DS0000024418.V262734.R01.S.doc Version 5.0 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 Hillside Residential Home DS0000024418.V262734.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th May 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 assessable path leading down to the adjacent home (Mellish House – owned by the same company) and car park. Hillside Residential Home DS0000024418.V262734.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second of 2 routine regulatory inspections, undertaken between 1 April 2005 and 31 March 2006. The inspection undertaken by the Lead Inspector for the home, and a Pharmacist Inspector, took place over 6 hours, on a Wednesday in November. The aim of this inspection was for the Pharmacist Inspector to review the home’s medication procedures, and for the second inspector to look at relevant standards, which had not been looked at during the first inspection (13 May 2005). Time was also spent to ensure that requirements and recommendations made following the last inspection had been addressed. During the inspection time was spent talking to 5 residents in private, to hear their views on what it was like living at Hillside. General feedback from residents was also obtained throughout the day. Time spent with 10 Members of staff, which included the Registered Manager, Deputy Manager, Care Assistants and Housekeeper. A tour was made of all the communal accommodation, laundry and a sample of 4 bedrooms, to check the condition of the décor, furniture and hot water temperatures. Records inspected included care plans, medication record, recruitment paperwork and staff rotas. Discussions during the day with people living at the home, and staff, identified that they preferred to be known as residents, rather than service users. This report respects their wishes. What the service does well: What has improved since the last inspection? The environment continues to improve as part of the homes 5-year refurbishment plan. Work undertaken included replacing broken coffee tables, repairing dining room chairs, replacing carpets, blinds and redecoration. Hillside Residential Home DS0000024418.V262734.R01.S.doc Version 5.0 Page 6 One resident pleased with the refurbishment said that “it feels more like a home”, another felt it was a “big, big improvement”. Since the last inspection, the patio area has been completed, which allowed residents to have safe access outside to the new eating areas. 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 Residential Home DS0000024418.V262734.R01.S.doc Version 5.0 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 Residential Home DS0000024418.V262734.R01.S.doc Version 5.0 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. Not all resident’s contracts were available for inspection, so checks could not be undertaken to ensure on admission residents had been given information, on the costs involved. EVIDENCE: Standards 1, 3, 4, and 5 were assessed as met at the last inspection see report dated 13 May 2005. Discussion with 1 resident confirmed that they knew of the costs involved in staying at the home. Another 2 residents asked, said that their family took care of the financial side. A sample of 2 residents records were checked to see if they contained copies of their contract. For 1 resident who was Social Care funded, there was a copy of the placing Authority contract, which gave a breakdown of costs. For the second resident there was no information. This was fed back to the manager who was unable to find the paperwork. They explained that there Hillside Residential Home DS0000024418.V262734.R01.S.doc Version 5.0 Page 9 had been a change in administrators, and although they knew the person would have been given a contract, they were unable to find it. Hillside Residential Home DS0000024418.V262734.R01.S.doc Version 5.0 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): 8 and 9. People using the service can expect staff to monitor their care, and take appropriate action to support their changing physical, and mental health needs. The homes current system of giving out and recording medication, could potentially lead to errors being made. EVIDENCE: Standards 7, and 10 were assessed as met at the last inspection see report dated 13 May 2005. Following major shortfalls identified during the last inspection, arrangements were made for the CSCI Pharmacist Inspector to join the Lead Inspector on this unannounced visit. The role of the Pharmacist Inspector was to look at the home’s system of administration and storing of residents medication. With their specialist knowledge, they were also able to support, and give constructive feedback to the home. Whilst watching 2 members of care staff give out medication, it was evident that they shared the process. This involved 1 carer checking the resident’s Hillside Residential Home DS0000024418.V262734.R01.S.doc Version 5.0 Page 11 medication against their Medication Administration Record (MAR) chart, and placing the medication into a medicine pot. The second carer, checked who the medication was for, than gave it to the resident, and signed the MAR chart. The first carer remained with the medicine trolley whilst this was going on. The sharing of medicine administration tasks is considered less safe as it could lead to confusion and errors being made. Staff had not dated some of the eye drops containers, which have a limited life of 28 days, to identify when the container had been first opened. Therefore it was unknown how long the container had been open for. The medication trolley used to store and take medication around was found to be unsuitable, as it was not designed to carry the blister packs (which holds the medication) and staff were unable to get the trolley into the room, where the medication stocks were held. Medication records showed that 1 resident who had returned from hospital a week previously, without their medication, had not been given any by the home. This was fed back to the manager who took immediate action to collect the medication straight away. This led to discussions around improving communication between staff. Staff (10) had received training in ‘accessing, handling and administrating medicine’, from an external trainer. To support the home the Pharmacist Inspector wrote a separate more detailed report, a copy of which is available from the CSCI Suffolk Area office (Ipswich). During the inspection time was spent talking with 7 residents to hear the views on the level of care they receive, and if they felt this met their needs. Each of the resident’s level of care and support was different, but all felt that the home provided the level of care and support they needed/wanted. A sample check of 2 care plans – showed that information held , supported the level of care the resident said they required. Time was spent with the manager discussing the level of care for one resident, whose mental health needs had changed. A review of the medication they were on, and review of records held, identified that the resident was being treated for dementia, which is outside the homes registration category. The manager felt that the resident’s needs could be met at the home, and a Psychiatric Consultant was monitoring their care. The manager was informed that they would need to submit an application (if the resident stayed) to the CSCI, to include in their registration categories - 1 place for a resident with dementia. Hillside Residential Home DS0000024418.V262734.R01.S.doc Version 5.0 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 and 14. People using the service can expect a range of indoor activities to be organised. However, there are no regular external outings to support residents to access the local community. EVIDENCE: Standard 15 was assessed as met at the last inspection see report dated 13 May 2005. Time spent with the residents identified the different activities arranged by the home, which included a quiz the previous evening. One resident was heard asking staff when the next quiz was, as they had enjoyed it. Residents said that they had enjoyed the recent birthday celebrations for 2 of the residents, who were 102 and 103. A resident said that a “lady does activities every afternoon”. When asked what activities were on that day – the resident could not remember, but said that a list of the week’s activities was displayed on the information board, near the entrance. This led to discussions that it would be useful if a list could also be displayed in the lounge. Hillside Residential Home DS0000024418.V262734.R01.S.doc Version 5.0 Page 13 Residents spoken to in private, were asked if they were able to do what they wanted?. They replied, “not exactly as we are not allowed to go out on our own”. This led to discussions about their individual physical, and medical health, which could cause staff to be concerned if they went out without an escort. They agreed that someone should be with them, but said, “it would be nice to get out more”, and “that they have to ask all the time if you want to go out – don’t think that’s right”. Two of the residents said that they did not like to ask, as they were aware that the staff were busy. They said they would like to see regular weekly trips arranged, including going out 1 to 1 with a carer, saying they just wanted to “be outside and walk in the fresh air”. Another resident said that they would just like to be able to look around the shops. This was fed back to staff, who said that the closest shop was 15-minute walk away, and they found it was too much for the residents. This led to discussions about using a wheelchair or the home’s mini bus, which they shared with another home. Staff said that the mini bus was unusable, which was later confirmed as the bus was sitting in the car park, looking dirty and unserviceable. The manager confirmed that they could not use the bus, but also said that when it was serviceable, they had no staff who were willing to drive it. This led to discussions about contacting local agencies, to see if there were any other forms of transport available. Residents asked if they could get up, or go to bed when they wanted said “yes”, with 1 resident adding that you could “please yourself – it’s up to you when you want to go”. This was also confirmed during discussions with 2 other residents, who felt the homes routines were flexible. They also said that visitors could visit when they wanted. Staff had confirmed during previous inspections, that the only restriction on visiting was if the resident did not want the person to visit them. Hillside Residential Home DS0000024418.V262734.R01.S.doc Version 5.0 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. People living at the home, can expect any concerns they have to be listened to, and acted on in an appropriate manner. EVIDENCE: Standards 18 were assessed as met at the last inspection see report dated 13 May 2005. The home’s complaint policy is included in the resident’s information files, and a copy is displayed on the homes information board. Since the last inspection, the Manager confirmed that no complaints had been made directly to the home. On the 30 September 2005, a complaint was made direct to the CSCI, by a relative, who raised concerns over the home not maintaining their staffing levels (see section Staffing – of this report), which was upheld. A summary of the complaints report (Additional Inspection in Response to a Complaint, Ref: 298), is available to the general public from the CSCI Suffolk Area Office, Ipswich. Residents spoken to during the inspection, felt comfortable to raise any concerns directly with the staff, or with their relatives. Hillside Residential Home DS0000024418.V262734.R01.S.doc Version 5.0 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, 21, 22, 23, 24, and 26. The standard of the environment continues to improve, however the homes bathing and showering facilities do not meet all residents needs. EVIDENCE: Two residents visited in their bedrooms, agreed that the rooms were “nice” and met their needs, 1 resident had brought in their own armchair. All bedrooms looked at, had been personalised, with family photographs, and pictures and ornaments. Residents and relatives had raised concerns during previous inspections over the poor standard of the internal environment, and safety issues over the garden area and patio. A large new patio made out of wood has now been built to the back of the home, which gave residents ramped access to safe seating areas. Residents thought it looked good, when asked if they used it, 1 resident said that they had found it too hot in the summer. The home has now fund raised and Hillside Residential Home DS0000024418.V262734.R01.S.doc Version 5.0 Page 16 purchased seats and sunshades for residents, and their visitors’ use. To meet fire regulations a wheelchair accessible pathway has been built, which leads from the patio/decking area, down the steep hill, onto a pathway leading to the adjacent home (which residents would be evacuated to in a fire) and car park. Residents were still not able to use the grass area to the side of the home, as it is on an incline, but the Manager felt that this might be addressed during planned building works. A walk around the home showed, since the last inspection the home had continued improving the décor, replacing carpets, window blinds and coffee tables. The bright fresh paintwork and new carpets, showed up the areas of the home, which are still to be refurbished, which included the entrance stairs and downstairs dining room. The manager said that stained, worn carpets are due to be replaced, once redecoration work had been completed. Feedback from residents was very good, over the on-going improvements. Comments include “ décor is lovely”, “Big big improvement”, “lovely wallpaper so much lighter – so much more like home”. Since the last inspection residents said that the handyperson had left. The Manager confirmed that they had been able to recruit another person, who is due to start soon. One resident spoken to said that they missed the Handyperson, who they felt was “hard working”. The hot water supplied to 2 residents’ bedrooms were found to be hot at 45°C. Records showed that hot water supplied to the baths had also been recorded at 45°C. Although not scalding, the water could be too hot for some residents. The home was asked to check what the individual hot water thermostats were set at, and reset it to be within the range 41-43°C. During the complaint visit (6 October 2005), it was identified that the staff had been placing dirty laundry – directly onto the laundry floor. At the beginning of this inspection, the laundry area was checked, and identified that staff were following safe infection control procedures. Arrangements have also been made to re-train staff and update their knowledge, in reducing the risk of any infection being passed around the home. Residents were asked if they felt the home was clean replied “oh yes” staff “are always around – keep it clean”. One resident who was asked if the home had suitable bathrooms and toilets replied “No” saying that they were unable to take a shower and “wished they really could”. Further discussion with the resident and staff identified that due to the resident’s physical problems, they were unable to get into the assisted bath chair. They said the resident had been able to use the only shower up to a few months ago, but could no longer lift their leg up to be able to step into Hillside Residential Home DS0000024418.V262734.R01.S.doc Version 5.0 Page 17 the shower. The resident said that they relied on a “strip wash”, and repeated that they would really like to be able to shower. With the resident’s permission this was fed back to the manager, who confirmed that the step was high. They said even before, when the resident was able to lift their leg high enough, they had to have a special risk assessment undertaken. This was due to their poor mobility, which made it difficult for them to get in and out the shower. The manager was asked if they could look into the situation, and seek advice as to what action could be take, to reposition the shower, or provide a suitable ramp. A resident said that although they “paid extra to have a bath”, the bath could not be used, as it had no method of assisting the resident get in. Staff confirmed that 2 residents bedrooms had baths in, which could only be used if they could get in and out independently. This led to discussions about using mobile bath seats, so residents could use their own bath. For residents requiring an assisted bath seat, staff confirmed that only 2 bathrooms, 1 on each floor, offered this facility. The home has a good sized disabled toilet on the ground floor, but the toilet close to bedroom 45, was not seen to be suitable for residents to use. Staff confirmed that resident using a walking frame would be unable to close the door. The chain to flush the toilet was too short (resulting in the need to be able to lift an arm up) there was no wash hand basin, the toilet seat appeared low, and the towel rail was rusty. The walls were in need of redecoration, the trap door to the ceiling was wide open, and there were cobwebs on the ceiling. A resident raised concerns over their ‘sash windows, which would not hold up properly when open. The resident said the handyperson had tried to fix the problem, but was unable to “screw the latch into place due to the rotting wood”. This was fed back to the Manager, who said they had someone checking the state of the windows, and would ensure the window is looked at. Hillside Residential Home DS0000024418.V262734.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 and 29. The home is not always following safe recruitment procedures, which could put residents potentially at risk. EVIDENCE: Standards 28 and 30 were assessed as met at the last inspection see report dated 13 May 2005. On the 30 September 2005, a complaint was received by the CSCI, raising concerns that the home was not maintaining their staffing levels during the evening, and overnight. This led to an unannounced inspection being carried out on the 6 October 2005. The relative making the complaint was also concerned that the home was not using Agency staff to ensure staffing levels were maintained. It was identified that the person complaining was correct, and on some of the shifts, the staffing levels on the evenings and nighttime was reduced. The home was asked to take immediate action to ensure there was enough staff on duty at all times. Time spent with the manager and staff during this inspection, confirmed that the home is now using regular Agency staff to cover any shortfalls. This was also confirmed by looking at the current weeks staffing rotas. The home is also actively recruiting to fill vacant hours and build up their own ‘bank’ staff, who can be used to cover shifts, especially last minute sickness. Hillside Residential Home DS0000024418.V262734.R01.S.doc Version 5.0 Page 19 This led to discussions with the manager over their responsibilities as Registered Manager, to monitor the staffing levels, and take appropriate action. Time spent with residents, identified their concerns over the staffing levels, informing the inspector that there had only been 2 staff on night duty – instead of 3. This led to further discussions, about a complaint being made, and since visiting the home; the staffing levels at night had been kept at 3. Residents still felt that “half the time” there was enough staff, and felt there should be at “least 2 more staff on” duty. Further discussions identified that staff helped them when they asked, and they had not been left waiting. Residents were concerned that staff worked too hard, and were very busy at times. This also linked in to residents feeling guilty about asking staff to take them out, and would rather have staff ask them. Rotas showed that staffing levels were set at 6 carers in the morning, 5 in the afternoon/evening and 3 overnight. The Managers hours and those of the Activity Co-ordinator were in addition to these. During the complaints investigation, it was also identified that care staff, were serving the evening meal, making drinks, and loading the dishwasher. This was due to the home being unable to cover the kitchen during the evening. Staff were also responsible for washing, drying and sorting the residents laundry, as they had no laundry assistant. The owners were asked to look into the situation and ensure that they had sufficient domestic hours. Although 1 member of staff had laundry assistant on their name badge, the person said that this was not their job, which was confirmed by the manager. The manager said that they had been given no budget to recruit a laundry assistant. The home had been able to recruit a part time Cook, which would reduce the need for staff to cover in the kitchen. To check that the home was following safe recruitment procedures, 2 recently recruited staff files were checked, plus 1 member of staff who was due to start work at any time. It was identified that 2 of the 3 files did not contain a 2nd written reference. There was no copy of the member of staff’s Food Hygiene certificate (which was important for one of the posts), although the Manager said that they had seen it. The home had obtained Prevention of Vulnerable Adults (POVA) First checks for all 3. The home was asked to take action to chase up the reference of the person who had started work without a second reference, which they did during the inspection. Hillside Residential Home DS0000024418.V262734.R01.S.doc Version 5.0 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 35 and 38. People handing over monies for safekeeping, can expect the money to be kept securely, and detailed records, of all expenditures kept. EVIDENCE: Standards 31, 32,and 34 were assessed as met at the last inspection, see report dated 13 May 2005. Standard 38 was assessed as having minor shortfalls, and was re-assessed during this inspection. To check that the home had safe procedures in place for looking after residents money, 3 residents monies were checked against the home’s records. The check identified that the home kept detailed records, and the money was held securely. All 3 residents monies held for safekeeping was checked against their individual account records, and found to be correct. Staff confirmed that their home’s insurance covered up to £200 per person. Hillside Residential Home DS0000024418.V262734.R01.S.doc Version 5.0 Page 21 Time spent with 1 resident confirmed that they would go to the office and collect their money when they wanted. Prior to the last inspection, a relative raised concerns that there were not enough coffee tables for the residents to put hot drinks on. The relative also raised concerns that some of the coffee tables that were in use were unsafe. Both concerns were upheld and the home took action to purchase more tables. The ‘sturdy’ tables were seen in the lounges, and residents said they looked good, and were seen using them to place their hot drinks on. Concerns were also previously raised about the lack of outside access for residents, as the patio they had then was unsafe. This was due to there being no railings, or fence, to prevent a resident walking/falling off it – onto the steep bank. Work started just before the last inspection, had now been completed. The large wooden patio/decking area runs along the back of the home, is edged with a woodened fence in-keeping with the design, and has ramped access leading to a seating area. Following consultation with the Fire department, the home had also included fire exits and pathway leading to the adjacent home (Mellish House). This would also be used to safely evacuate residents out to the adjacent home, in the case of an emergency. The company organise an annual quality assurance survey, the results of which are used as part of their business plan to develop the service. The results of the current survey will be fully discussed at a future inspection. Hillside Residential Home DS0000024418.V262734.R01.S.doc Version 5.0 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 2 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 2 X 2 2 3 3 X 3 STAFFING Standard No Score 27 2 28 X 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X 3 Hillside Residential Home DS0000024418.V262734.R01.S.doc Version 5.0 Page 23 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP2 Regulation 5 (1) (b) Sch 3 (4) 13 (2) (4) Requirement The home must ensure that they have copies of residents contracts held on file, and available for inspection. The registered person must review current medicine administration practice ensuring safe procedures are followed for the administration of medicines The registered person must take steps to ensure medicines of limited life on opening are handled in a way which would ensure they are safe for administration at all times The registered person must take steps to ensure full records for the non-administration of medicines are maintained at all times. Timescale for action 11/12/05 2 OP9 07/12/05 3 OP9 13 (2) (4) 07/12/05 4 OP9 13 (2) (4) 07/12/05 5 OP12OP13 16 (2) (m) The home after consulting with 15/01/06 residents, must write to say what action they will be taking to ensure residents are supported to have regular contact with the local community. Hillside Residential Home DS0000024418.V262734.R01.S.doc Version 5.0 Page 24 6 OP21OP22 23 (2) (j) (n) Where a resident, due to Health 01/02/05 and Safety reason, or their Physical needs, are unable to use the shower/assisted bath. The home must look/seek advice at what alternatives or adaptations can be made, to support the resident to be able to bath or shower. The home must write to the CSCI to inform them how they are managing the home’s laundry system. This should include any identified budgets and dedicated staffing hours. 07/12/05 7 OP27 18 (1) (b) 8 OP29 19 (1) Schedule 2 The home must be in receipt of 2 02/11/05 written references (which they have taken reasonable steps to validate), before staff commence employment. 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 OP9 Good Practice Recommendations It is recommended that consideration is given to obtaining a medicine trolley suitable for transporting and securing both racks of MDS blister packs and other prescribed medicines currently in use. It is recommended that further auditing of medication records against medicines available for administration is conducted by a senior member of staff in order to promptly identify discrepancies arising and take remedial action to improve medicine record-keeping and administration practice It is recommender that the home contacts local charities and transport links, to identify what transport is available DS0000024418.V262734.R01.S.doc Version 5.0 Page 25 2 OP9 3 OP13OP12 Hillside Residential Home 4 OP19 for the home to rent or access. This is to ensure residents can be offered regular access to the local community. It is recommended that once the new maintenance person has started employment, that the home undertakes an audit of the home to identify what maintenance work need to be undertaken, this should include window closures and re-regulating hot water thermostats to within the range of 41 to 43°C. Hillside Residential Home DS0000024418.V262734.R01.S.doc Version 5.0 Page 26 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 Hillside Residential Home DS0000024418.V262734.R01.S.doc Version 5.0 Page 27 - 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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