Inspection on 10/05/05 for Hillside Resource Centre

This inspection was carried out on 10th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 Resource Centre 23/10/07

Hillside Resource Centre 20/09/06

Hillside Resource Centre 07/11/05

Hillside Resource Centre 23/11/04

Hillside Resource Centre 19/04/04

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

CARE HOME ADULTS 18-65 Hillside Resource Centre Portesbery Road Camberley Surrey GU15 3SZ Lead Inspector Helen Dickens Announced 10 May 2005 9.30 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 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 Resource Centre H58-H09 s34532 Hillside v217753 100505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Hillside Resource Centre Address Portesbery Road Camberley Surrey GU15 3SZ 01276 27720 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Surrey County Council - Adult & Community Care Julie Wadham (application in progress) Care Home 22 Category(ies) of LD Learning Disability (21) registration, with number LD(E) Learning Disability - over 65 (1) of places Hillside Resource Centre H58-H09 s34532 Hillside v217753 100505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Accommodation and services may be provided to named persons aged 65 years and over with prior written agreement of the CSCI. 2. Up to 8 residents accommodated may also have a dual diagnosis of mental health and learning disability. 3. Respite care may be provided to a maximum of 2 persons at any one time. 4. The matters detailed in the attached schedule of requirements must be completed within the stated timetables. Date of last inspection 23 November 2004 Brief Description of the Service: Hillside is owned and managed by Surrey County Council (SCC) Adults and Community Care Services. It is registered for 22 people with learning disabilities. The property is located in a pleasant residential area and is in close proximity to Camberley town centre. The residents live in three self-contained units within the home and all have their own single rooms.The home has fully equipped kitchens, dining rooms, living rooms and adequate numbers of bathrooms and toilets. The home has its own transport. Hillside Resource Centre H58-H09 s34532 Hillside v217753 100505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over 8 and a half hours and was the first inspection to be undertaken in the Commission for Social Care Inspection year April 2005 to March 2006. This inspection was carried out by Helen Dickens, Lead Inspector for the service. Julie Wadham was present and represented the establishment. Andy Erskine, SCC Service Manager for people with learning disabilities, joined us at 3pm. A full tour of the premises took place. Seven residents and five staff were spoken to during the inspection, and the inspector attended the staff handover meeting at 2.30pm. In addition, a pre-inspection questionnaire and ‘comment cards’ were returned to CSCI for inclusion in this report. This was a positive inspection and the inspector would like to thank the residents and staff for their time, assistance and hospitality during the inspection. What the service does well: What has improved since the last inspection? What they could do better: The manager of the home needs to complete the registration process with CSCI. Work is about to get underway to improve care plans, which are currently in a format inaccessible to residents at Hillside. A small number of Hillside Resource Centre H58-H09 s34532 Hillside v217753 100505 Stage 4.doc Version 1.30 Page 6 health and safety requirements also need to be addressed. There was a rumour that Hillside may be closing at some point in the future. The manager gave assurances there were no plans to close Hillside as a facility, but it may relocate to a more user-friendly premises. Given the uncertainty that rumours can cause, the home needs to be proactive in consulting with residents and their relatives whilst any plans to relocate are at an early stage. 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 Resource Centre H58-H09 s34532 Hillside v217753 100505 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Hillside Resource Centre H58-H09 s34532 Hillside v217753 100505 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 Needs assessments examined showed detailed background information on each resident and indications that this was carried through into resident’s care plans; this ensures that resident’s needs and wishes can be properly taken into account. EVIDENCE: Three resident’s files were sampled during the inspection and there was proof that thorough assessments had been carried out both at the time of admission and as an ongoing process. Risk assessments were fed into the care planning process in the home. Evidence of ongoing assessments was seen in the file of one resident with Down’s Syndrome who had had a baseline assessment for dementia. The manager added that all such residents will have this assessment as they have a higher incidence of developing dementia. Therapeutic needs were included in resident’s plans and one service user who needed daily exercises had the initial assessment and ongoing exercise regime clearly documented. There were examples of challenging behaviours being well managed. One resident who found it difficult to cope with the communal laundry rota was found a small space to have her own ‘laundry’ and purchase her own washing machine. Hillside Resource Centre H58-H09 s34532 Hillside v217753 100505 Stage 4.doc Version 1.30 Page 9 Staff at Hillside are commended for being persistent with other agencies and professionals on behalf of residents who need, but are having difficulty accessing, specialist input. Hillside Resource Centre H58-H09 s34532 Hillside v217753 100505 Stage 4.doc Version 1.30 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7,8 and 9 Resident’s individual care plans were detailed and thorough and did reflect their needs and aspirations. However more work needs to be done to make them accessible to the residents themselves. EVIDENCE: The care plans viewed showed that resident’s needs and wishes had been taken into account. Risk assessments were appropriate and regularly reviewed. Protocols for day-to-day routines and behaviours were detailed. Resident’s hobbies, interests, family and community links were also documented. However, more work needs to be done to make these ‘life plans’ accessible to residents; currently no residents hold their own copy. The manager has obtained one year’s funding to do this work starting in June 2005. Residents were encouraged to be independent and to take risks. The inspector saw examples of this in the two ‘independent’ units where residents were choosing and preparing lunch. A number of subtle ways of assisting residents to be independent in the kitchenettes had been devised. For example, the fridges contained designated areas for each resident’s own food, together with their photograph so it was clear to everyone who owned what. Residents were Hillside Resource Centre H58-H09 s34532 Hillside v217753 100505 Stage 4.doc Version 1.30 Page 11 supported to do their own food shopping and banking. There were many examples of resident’s involvement in the life of the home and one good example was the pictorial and word format agenda and minutes of the resident’s meetings which were clearly set out on one wall of the downstairs communal room. Actions, which came out of the meeting, allowed residents to know that their input had been put to positive use. There is currently no resident’s survey/questionnaire and the home may wish to consider this additional means of consulting with them. Hillside Resource Centre H58-H09 s34532 Hillside v217753 100505 Stage 4.doc Version 1.30 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,13 and 16 The home encourages opportunities for personal development and social activity within the context of the local and wider community. This means residents are more likely to experience personal satisfaction and a better quality of life. EVIDENCE: There were numerous examples of residents being encouraged to develop their skills and interests. Some residents had done the local authority food handling and hygiene course, which had been designed specifically for people with learning disabilities. The manager had successfully applied for funding to open a to be café run by Hillside residents in the local adult education centre. This would not only provide resident’s with work experience, but would offer a user-friendly facility for people with learning disabilities – a group who often found it difficult to access the food facilities provided. The café opens in September. In total thirteen residents were attending adult education. Applications were Hillside Resource Centre H58-H09 s34532 Hillside v217753 100505 Stage 4.doc Version 1.30 Page 13 also in progress to get funding for some residents to do NVQs. Other residents worked in the local community. Hillside encourages residents to have their own hobbies and activities and this was evident both in the décor of resident’s rooms and in the stories residents told about their interests. Residents were also encouraged to be part of the local community and they used the local shops, banks, library, and pubs as well as taking part enthusiastically in a local recycling project. In all aspects of their dealings with residents on the day of the inspection, staff demonstrated that they respected resident’s rights and there was a good deal of flexibility and choice for residents in daily routines. This was backed up by the information contained in resident’s care plans. Hillside Resource Centre H58-H09 s34532 Hillside v217753 100505 Stage 4.doc Version 1.30 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 Staff have a good understanding of resident’s support needs and offer help in a way which promotes dignity and independence. EVIDENCE: Speaking individually with staff and being present at the handover meeting, as well as observations during the tour of the home, enabled the inspector to hear about how staff supported residents. Staff appeared knowledgeable about likes and dislikes and offered support in a sensitive manner. The care plans viewed outlined how residents wished to be supported. One resident was seen getting up in the middle of the morning and this was accepted by staff; assistance was given at a time when that resident was ready to receive it. Hillside Resource Centre H58-H09 s34532 Hillside v217753 100505 Stage 4.doc Version 1.30 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 Staff were trained on protection issues and an open complaints procedure was in place. However, the absence of paper copies of policies and procedures in the home generally, and the adult protection policy in particular, was a cause for concern. EVIDENCE: Though staff had not yet had training on the up-dated (February 2005) multiagency procedures for the protection of vulnerable adults, they had received training on this issue previously. However, this procedure, as with all other Surrey County Council policies and procedures, are not kept as paper versions in the office of the home, making it difficult for staff to familiarise themselves with the policy and to have it to hand when needed. Andy Erskine explained that SCC is working towards ‘paperless’ offices and it is better to download the latest version as and when needed. He said that this prevented people keeping out of date versions on shelves. He said he felt that the protection of vulnerable adults policy should perhaps be an exception and agreed to look at this again. A requirement will be made in this regard. There was also a procedure for adults missing from residential care, which sets out the actions to be taken in such circumstances. Resident’s files contained comprehensive up-dated risk assessments on areas likely to cause concern from a protection point of view. The complaints procedure from the SCC intranet was 47 pages long. A userfriendly version, aimed at residents with learning disabilities and communication difficulties has been created by staff and was on display in the home. The complaints file was examined and the one complaint made since the last inspection had been dealt with efficiently. The complaint was Hillside Resource Centre H58-H09 s34532 Hillside v217753 100505 Stage 4.doc Version 1.30 Page 16 substantiated but the shortfalls have now been remedied. A compliments and concerns book is available in the reception area with pull out forms for people to take and complete. Hillside Resource Centre H58-H09 s34532 Hillside v217753 100505 Stage 4.doc Version 1.30 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 30 The home is clean and hygienic and rigorous policies and procedures relating to infection control are in place to protect service users. EVIDENCE: On the day of the inspection the home was clean and free from offensive odours. Bathrooms and toilets inspected were clean and tidy as were the laundry facilities. A recent episode of concern for the home involved a small outbreak of a contagious infection. Staff were commended on the prompt advice sought and action taken to deal with the situation. Those involved were dealt with sensitively and with regard for their privacy and dignity. Hillside Resource Centre H58-H09 s34532 Hillside v217753 100505 Stage 4.doc Version 1.30 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34 Recruitment policies and procedures have continued to improve and one the two outstanding requirements from the last inspection has been met. EVIDENCE: The outstanding requirement to have photographs on staff files has been met as all those sampled now contained a photograph. Not all CRB checks were available to be viewed on the day. A list of those CRBs on file was prepared by the home for the inspector to check and keep on record at CSCI. Recruitment is now done centrally by SCC. The manager needs to apply for another CRB check via CSCI as her previous check was through SCC. Hillside Resource Centre H58-H09 s34532 Hillside v217753 100505 Stage 4.doc Version 1.30 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38,39 40 and 42 The manager is competent and residents and staff benefit from living and working in a well run home. Resident’s views are sought and taken into account in the running of the home. Health and safety of residents are paramount though there are some minor shortfalls which need to be addressed. EVIDENCE: The manager application for registration with CSCI is currently being processed. This is an outstanding requirement from the last inspection. She is currently doing NVQ4 (has completed 3 units) and started the Registered Managers Award in January 2005. Staff commented on the improved management of the home compared with the past which one described as a ‘haphazard management system’. Hillside Resource Centre H58-H09 s34532 Hillside v217753 100505 Stage 4.doc Version 1.30 Page 20 Resident’s views are taken into account in a number of ways as already outlined. In addition, residents are involved in the recruitment of new staff and volunteer to formulate questions for the interview panel. Some policies and procedures, which are of particular significance to residents, such as the complaints procedure and the fire procedure, have been translated into user-friendly formats. The staff rota was in pictorial form, as was the chores rota. Hillside has used outside organisations to empower their residents, for example Advocacy Partners helped set up the Hillside self advocacy group. MENCAP were also used recently to help residents choose holidays. In the main, policies and practices within the home help to safeguard service users. However, there were concerns about the availability of policies within the home as they are only available on the SCC intranet. In addition, monitoring of water temperatures, where the water is accessible to service users, would ensure that temperatures are properly regulated and safe for residents. Hillside Resource Centre H58-H09 s34532 Hillside v217753 100505 Stage 4.doc Version 1.30 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x x Standard No 22 23 ENVIRONMENT Score 2 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x 3 Standard No 11 12 13 14 15 16 17 4 3 3 x x 3 x Standard No 31 32 33 34 35 36 Score x x x 2 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Hillside Resource Centre Score 3 x x x Standard No 37 38 39 40 41 42 43 Score 3 3 3 2 x 2 x H58-H09 s34532 Hillside v217753 100505 Stage 4.doc Version 1.30 Page 22 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 6.7 Regulation 15(2)(a) Requirement Service user plans need to be put into a format accessible to service users. (Time limit to be kept under review as this is an ongoing project). The homes written policies and procedures must be accessible (available) to staff. They should also be signed, dated, monitored and reviewed by the registered manager. Evidence of CRB checks should be available for all staff. The current manager must be registered with CSCI. (Outstanding since 31.12.04) The temperature of water accessible to service users should be recorded and monitored to better promote health and safety. Timescale for action 10.08.05 2. 22,23,40.3, 17(1)(a) 40.4,40.6 17(2) 10.08.05 3. 4. 5. 34.3 37 42.3 19(b) 8(1) CSA Section11 13(4) (a),(b),(c) 10.06.05 10.07.05 17.05.05 6. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Good Practice Recommendations H58-H09 s34532 Hillside v217753 100505 Stage 4.doc Version 1.30 Page 23 Hillside Resource Centre 1. 2. Standard 29.2(viii) 39 Mobility aids currently stored in a stairwell should be moved to a discrete.storage area. Hillside could consider a service user survey to complement other means they employ to consult with residents. 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