Inspection on 05/03/09 for Hillside Residential Care Home

This inspection was carried out on 5th March 2009.

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

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

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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 Residential Care Home 21 Adlington Road Wilmslow Cheshire SK9 2BJ     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: Maureen Brown     Date: 0 5 0 3 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 26 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 26 Information about the care home Name of care home: Address: Hillside Residential Care Home 21 Adlington Road Wilmslow Cheshire SK9 2BJ 01625523351 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Caroline Laura Timmons,Mr Donn Frederick Timmons care home 19 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The registered person may provide the following category of service only: Care home only - Code PC To people 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 - Code OP The maximum number of people who can be accommodated is: 19. Date of last inspection Brief description of the care home Hillside is a care home providing care and accommodation for up to nineteen older people. It is a privately owned family run business. The home is in situated in Wilmslow and is close to the shops and other public amenities. It is also within easy access to main road networks. 0 Over 65 19 Care Homes for Older People Page 4 of 26 Brief description of the care home Hillside is a two-storey building, with accommodation on both floors. There are stairs, a stair-lift and passenger lift access to the first floor. Some of the bedrooms are en-suite. The grounds and gardens are accessible to the poeple who live there. Care Homes for Older People Page 5 of 26 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: We carried out an unannounced visit to the home on 5 March 2009 and this lasted eight and a quarter hours. It was done by one inspector. The report will say we when referring to what was done and found at the visit, as it is written on behalf of the Commission for Social Care Inspection. The visit was just one part of the inspection. Before the visit the manager was asked to complete a questionnaire to provide up to date information about the home. We sent out questionnaires to the staff to find out their views about the service. Other information received about the home was also reviewed. During our visit we looked at various records and the premises. We looked at the care records of three of the people who live at the home to see how their needs were being met. We spoke with people who live at Hillside, visitors to the home and others who Care Homes for Older People Page 6 of 26 were there on the day of our visit. We also spoke with the staff on duty. All these people gave their views about the home to help us in our inspection. The fees for the home are 585.00 pounds to 625.00 pounds per week. What the care home does well: What has improved since the last inspection? This is the first inspection of this service since the new owners took over. Care Homes for Older People Page 8 of 26 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 9 of 26 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 10 of 26 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. People receive enough information about the home for them to make an informed decision about moving into Hillside and their needs are assessed before they move in so they know these can be met at the home. Evidence: At Hillside, the information leaflets about the home and what services it provides are known as the statement of care and resident information. They are written in plain English and contain all the information a person who was interested in moving into the home would need to decide if the home was right for them. They were reviewed in November and December 2008 to make sure they were up to date. They tell people about the home, who runs it, who works there, the support that can be provided and how to raise a concern or make a complaint about the home. The leaflets are printed off as they are needed but we recommended that some copies should be kept in the home so they are easily available for people to pick up. We also suggested consideration should be given to producing them in other formats such as large print Care Homes for Older People Page 11 of 26 Evidence: to help people understand the information in them more easily. The manager told us that when somebody is interested in moving into Hillside, she discusses the home and its services with them as well as encouraging them to visit to look around before deciding whether they will move in. We looked at some care files during our visit, to find out how peoples care needs are met once they move into the home. We saw in these files that peoples needs had been assessed by somebody from the home before they moved in, to make sure the persons needs could be met at Hillside. The assessments we saw had been signed by the member of staff who had done the assessment and by the person, or their representative, to show they agreed with it. The manager confirmed that intermediate care was not provided at Hillside. Care Homes for Older People Page 12 of 26 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. People who live at Hillside have their health, personal care and social needs met effectively by the staff in a way that makes sure their privacy and dignity is respected. Evidence: We looked at the care records of three people who live at Hillside, to check the care they receive. They were very well written and each file was divided into sections and included care needs assessment, care plan which was divided into specific areas of need, history of falls, visits from healthcare professionals and accident reports. The care plans had been reviewed regularly to make sure that the care being provided for each person continued to be effective in meeting their needs. When we spoke with people who live at Hillside about their care plans, they could not say whether they had been involved in reviewing their care but they could tell us that staff helped them when they needed it. People told us that The staff are very good and kind, They treat me very well and I like the staff and have fun with them. We recommended that individual risk assessments for moving and handling and falls for each person should be made and where appropriate other assessments for Care Homes for Older People Page 13 of 26 Evidence: continence, mobility or nutrition. This would help to make sure that staff had all the guidance they needed to meet peoples needs safely. The daily records we saw in the files we looked at were good and staff noted any changes to people, activities undertaken as well as details of visitors so that staff and others could see that people were well and active. We recommended that a separate sheet should be used for each person to help maintain confidentiality. The manager designed a new form for staff to use for this purpose and sent us a copy the day after our visit to the home. The manager told us she was in the process of changing the medication system for one she thought would be better for Hillside. At the moment, a monitored dosage blister pack system is used. Medication administration record sheets are completed when staff give medicines to people living at the home to show that the medicine has been given as prescribed. Staff had completed medication awareness training to make sure that they know how to give out the medicines safely without errors. Visits to people living at Hillside from health care professionals were recorded. We could see from these records that GPs, district nurses, opticians, the chiropodist and consultants carry out regular visits to make sure people remain well. We spoke with two healthcare professionals who were visiting the home whilst we were there. They both confirmed that the manager was available to discuss peoples needs with them and that the staff were friendly and helpful to them. The also said that the residents were happy and well cared for at the home. Care Homes for Older People Page 14 of 26 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. People living at Hillside are able to take part in a range of activities so they can stay active and staff help people so they could stay in touch with their family and friends. Evidence: Activities are provided daily at the home. These included card games, bowls, Scrabble, bingo, quizzes, sing-a-longs, reading from the newspaper, reminiscence sessions and a monthly entertainer. Other activities include walks around the local area, visiting library fortnightly and regular visits from the local priest and from other religious denominations as requested. People living at Hillside are offered choices in various ways, such as in the time they get up or go to bed at night, by choosing the clothes they wear, by deciding whether or not to join in activities and by deciding how they wished to be addressed. This enables them to keep some control over what they do each day and to stay as independent as possible. We looked at samples of menus which were on display in the kitchen. These showed the main meal and evening meal. A separate menu for breakfasts was available and this showed in detail peoples usual preferences. We suggested that desserts should Care Homes for Older People Page 15 of 26 Evidence: also be shown on the menu sheets and that a record of alternative meals offered should be kept. This would help to show accurately what diet people were receiving. The cook told us that she knew peoples preferences about portion sizes and that she checked the main meal to make sure it was thoroughly cooked and hot before serving. We also suggested that consideration should be given to developing a four week menu plan so that people living at Hillside would have plenty of variety to help them eat a well balanced diet. Care Homes for Older People Page 16 of 26 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. The homes procedures for complaints and safeguarding adults are effective so that the concerns of the people who live at Hillside are listened to and they are protected from abuse or harm. Evidence: The staff files we looked at during our visit showed that most staff have received training on safeguarding adults, so they know what to do to protect people living at Hillside from harm. The manager confirmed this and showed that she was aware of the policy, procedures and guidance of safeguarding. We saw that there were policies available on safeguarding people, dealing with challenging behaviour and whistle blowing so staff had guidance on how to protect people who live at the home. There have been no referrals under the local safeguarding adults procedures since the new owners took over the home. We looked at the complaints procedure for the home and suggested that timescales should be put in so that people who had raised concerns or made a complaint about the home had clear information about when these would be responded to. Neither the home nor the commission have received any complaints about Hillside. People who live at the home told us they would speak to the staff or the manager if they had any problems. Visitors to the home whilst we were there confirmed they would speak with the manager if they had a problem. Care Homes for Older People Page 17 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well maintained so that people who live at Hillside live in clean, safe and comfortable surroundings. Evidence: During our visit we toured the building. We saw all the shared (communal) areas as well as a number of bedrooms. All the bedrooms are single and a number have ensuite toilet and washing facilities. The standard of decor and furnishings is very good. The home was clean and odour free on the day of our visit. People living at Hillside told us the home was always kept very clean. A visitor who was there when we were told us that there were never any unpleasant odours within the home. People who live at the home had made their rooms more homely using ornaments, pictures, photographs and some furniture they had brought with them when they moved in. Care Homes for Older People Page 18 of 26 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. The recruitment procedures are thorough and staff have done a wide range of training so people who live in the home are protected from poor practices. Evidence: The staff rotas we looked at showed the number of staff on duty over the week. The staffing levels appeared sufficient to meet peoples needs. People living at Hillside told us there were enough staff around to help them and during the visit we saw the staff were attentive to peoples needs. People living in the home said All the staff are very kind and helpful, The staff always treat me well and The staff are great. We looked at three staff files to see what checks had been made when they were recruited. The files are not kept at the home, in order to make sure they are kept confidential. The ones we saw had all the necessary checks in place including Criminal Record Bureau disclosures, two satisfactory references, health checks and completed application forms. These checks are carried out to help make sure that staff are suitable to work with the people who live in the home. We made a recommendation that copies of identity checks carried out at recruitment should be kept in the staff members file. We saw records that showed staff had received mandatory training in moving and handling, first aid, food hygiene, infection control, safeguarding adults and health and Care Homes for Older People Page 19 of 26 Evidence: safety. Specialist training had not been completed at the time of our visit and the manager confirmed that she was looking into courses on subjects that would be of benefit in helping staff to meet the needs of the people living at Hillside as effectively as possible. Progress is being made with National Vocational Qualification (NVQ) training in care at level 2. Seven out of sixteen staff have obtained this award; three people are currently undertaking NVQ level 2 and two people are undertaking NVQ level 3. These qualifications are nationally recognised ones for people working in the field of personal care. We recommend that the home should have at least 50 of the staff with NVQ level 2 or above and the manager confirmed they were working towards this. This helps to ensure that staff are knowledgeable and competent to provide effective care to meet peoples needs. Regular staff meetings are held with the last one being in November 2008. These were held on an informal basis and no minutes were taken. It was suggested that the meetings are minuted so there is a record of the discussions and agreed actions that people who have not been able to attend the meeting can see. Care Homes for Older People Page 20 of 26 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. The procedures within the home are thorough so the health, safety and welfare of the people who live there are protected. Staff are supervised and there are processes in place to make sure the home is run in the best interests of the people who live there. Evidence: The manager of Hillside is a qualified nurse with many years experience in providing care for people. She is currently looking at undertaking an NVQ level 4 course in management. She has worked at the home since the new owners took over on 3 September 2008. She has kept up to date with changes taking place and has updated her knowledge as appropriate. The manager told us that she doesnt keep any money on the premises on behalf of the people who live in the home. The cost of any purchases made by the people living at Hillside or on their behalf is included in a monthly invoice to their next of kin or other representative. Care Homes for Older People Page 21 of 26 Evidence: The quality assurance process for Hillside includes discussions with people who live there, survey forms they complete to say what they think about how it is run and discussion with the staff. Surveys were done two months after the new owners and manager took over the home in November 2008. We suggested that the information from these surveys should be analysed so it can be shared with the people who live at the home and others who may have an interest in it. It was agreed that this was an area that could be developed in the future to include relatives and others such as healthcare professionals who visit the home. This would provide a wide range of feedback for the owners and manager to continue to develop the home so that it continues to run in the best interests of the people who live there. Day to day supervision of the staff team was excellent and the staff confirmed that the new owners and manager were very approachable and supportive to them. Formal supervision had not been undertaken as yet. Annual appraisals had not been undertaken as the owners hadnt known the staff team for a year at the time of our visit but they confirmed that this would be undertaken. We recommended that formal staff supervision should be put into place so staff have a chance to discuss their work with the manager to help them continue to provide good quality care for the people who live at Hillside. We saw that safe working practices were in place in the home. There were policies available to guide staff, including health and safety, control of hazardous chemicals, fire safety, continence promotion, infection control and hygiene and food safety. We saw the fire safety equipment test logbook. This showed that up to date checks had been made on the fire safety systems and staff had received fire awareness training. Safety checks had been completed on the homes gas installation, but the certificate had not been received. The owners were aware the electrical wiring certificate had lapsed and they had arranged for the engineer to complete a full check on 17 March 2009. It was recommended that the owners ensure that certificates for all work are obtained so they can show that the installations and equipment in the home are safe. Care Homes for Older People Page 22 of 26 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 23 of 26 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 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 1 1 Consideration should be given to producing the residents information leaflets in other formats such as large print so they are easier for people to read and understand. Copies of the statement of care and residents information should be available at all times to the people living in the home and to people who are interested in moving into the home. A separate sheet should be used each persons daily notes, to make sure that information about them is kept private and confidential. Individual risk assessments should be completed for each person living at Hillside on moving and handling, falls and, where appropriate, continence, mobility or nutrition. This will provide staff with guidance on how to meet peoples needs safely. Details of the desserts should be added to the menu sheets so that full details of the meals provided can be seen and a record of alternative meals when offered should be recorded so there is an accurate record of what diet people have received. Page 24 of 26 2 1 3 7 4 7 5 15 Care Homes for Older People 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 6 16 The complaints procedure for Hillside should identify timescales so that people who make a complaint or raise a concern will know when these will be investigated and responded to. 50 of the staff team should complete NVQ level 2 in care or above so that a good percentage of staff have a national recognised qualification to show they are knowledgeable and competent to provide effective care to meet the needs of the people living at Hillside. Copies of identity checks carried out at recruitment should be kept on file so that the service has a check on each individual staff member. Further development of specialist training for staff should be considered in line with the current needs of people who live at Hillside so that staff can develop the skills to meet their individual needs effectively. The information from the quality assurance surveys should be analysed so it can be shared with the people who live at the home and others who may have an interest in it. This will help to show that the views of the people who live at the home are being taken seriously and acted upon. Staff should receive an appraisal each year to ensure they have the opportunity to discuss their work with the manager or owners. Formal staff supervision should be put into place so staff have a chance to discuss their work with the manager to help them continue to provide good quality care for the people who live at Hillside Certificates should be obtained of the gas installation and electrical hard wiring when work has been completed to show that these have been tested and are safe. 7 28 8 29 9 30 10 33 11 36 12 36 13 38 Care Homes for Older People Page 25 of 26 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. 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. Care Homes for Older People Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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!